Scholarly Work - Nursing
Permanent URI for this collectionhttps://scholarworks.montana.edu/handle/1/8721
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Item Acute kidney injury and workload in a sample of California agricultural workers(2019-11) Moyce, Sally; Armitage, Tracey; Mitchell, Diane; Schenker, MarcBACKGROUND: Kidney damage is associated with an increased workload in high ambient temperatures and may represent a pathway to chronic kidney disease of unknown origin in agricultural workers. We tested the associations of workload and heat with acute kidney dysfunction in California agricultural workers. METHODS: We recruited a convenience sample of 471 agricultural workers from 29 farms in California during two summer harvest seasons. The sustained 3-minute maximum workload was estimated using accelerometer data collected from Actical monitors and individual heat load through elevations in core body temperature. Acute kidney injury (AKI) was defined by a change in serum creatinine of ≥0.3 mg/dL or ≥1.5 times the preshift creatinine over the course of the work shift. Associations between AKI and workload were modeled using logistic regression, controlling for demographic, physiologic, and occupational variables. RESULTS:Of the total, 357 workers (75.8%) had accelerometer readings in the moderate workload category, 93 (19.7%) had readings in the vigorous category. 177 (36%) had elevations of core body temperature ≥1°C; 72 workers (14.9%) demonstrated evidence of AKI after a single day of agricultural work. The workload category was associated with an increased adjusted odds of AKI (1.92; 95% confidence interval, 1.05-3.51). Piece-rate work was also associated with increased adjusted odds of AKI (3.02; 95% CI, 1.44-6.34). CONCLUSIONS: Heavy occupational workload and piece-rate work were associated with acute effects on the renal health of agricultural workers. This indicates that occupations requiring high physical effort put workers at risk for AKI, possibly independent of ambient and core body temperature. Changes to agricultural practices may reduce the risk of renal disorders for these workers.Item Critical incidents in healthcare(2018-08) Mayer, Dale M.; Hamilton, MeganWhile teaching a class for registered nurses (RNs), one of the authors of this article was involved in a discussion of emotionally challenging cases. All participants recalled one or more such cases and were impassioned to share their experiences. These healthcare professionals (HCPs) still were impacted by these cases. Such critical incidents (CIs) first were described by emergency medical services, fire, and law enforcement personnel.Item Psychometric evaluation of the MSU CAM health literacy scale(2019-02) Weinert, Clarann; Shreffler-Grant, Jean; Nicholas, Elizabeth G.Background/Purpose: The rise in the use of alternative health care approaches (CAM) increases the need for adequate health literacy. The MSU Health Literacy Scale was developed to measure CAM health literacy. Psychometric evaluation of the scale is presented in this article. Methods: A test retest design was utilized and data from this instrument evaluation research project were used to explore the validity and several forms of reliability of the MSU Health Literacy Scale. The data analysis was based on the scores of 241 individuals at the T1 data collection and the scores of 188 at the T2 administration of the instrument. Results: There were significant correlations between the MSU CAM Health Literacy Scale and Newest Vital Sign (r = 0.330 p = .000) and with a single question health literacy measure (r = .255 (p = .000). Cronbach\'s alphas were adequate for each administration of the scale (T1 = .774 and T2 = .754). The correlation of scores between the T1 administration and the T2 administration were significant (r = .696 (p = .000). Conclusions: This psychometric evaluation provides confirmation of convergent validity and stable reliability. The scale can be used in future research and clinical endeavors.Item Comparison of the Effects of Hand Reflexology versus Acupressure on Anxiety and Vital Signs in Female Patients with Coronary Artery Diseases(2019-03) Vasokolaei, Zohre R.; Rejeh, Nahid; Heravi-Karimooi, Majideh; Tadrisi, Seyed D.; Saatchi, Kiarash; Poshtchaman, Zahra; Sieloff, Christina; Vaismoradi, MojtabaHospitalization in the cardiac care unit can increase anxiety in patients. This study aimed to compare hand reflexology versus acupressure on anxiety and vital signs in female patients with coronary artery diseases. This double-blinded randomized placebo-controlled trial with a pre- and post-intervention design was conducted on 135 female patients with coronary artery diseases. Female patients hospitalized in a cardiac care unit were randomly divided into three groups of hand reflexology, acupressure and placebo (n = 45 patients in each group) using blocking and a table of random numbers. Data was collected using the Spielberger anxiety inventory. Also, their vital signs were measured before, immediately after and half an hour after the intervention. Data analysis was performed using descriptive and analytical statistics. Before the intervention, there was no statistically significant difference in anxiety levels between the groups (p > 0.05). Also, the effects of hand reflexology and acupressure immediately and half an hour later on the reduction of anxiety and vital signs were equal (p < 0.05). Implementation of hand reflexology and acupressure can have positive effects on anxiety and vital signs in patients with coronary artery diseases. They can reduce patients’ anxiety with an equal effectiveness.Item Strategies for conducting health research with Latinos during times of political incivility(2018-07) Sage, Rayna; Benavides-Vaello, Sandra; Flores, Erin; LaValley, Sydnie; Martyak, PatrickAim The current US political climate towards immigrants introduces new challenges for researchers already struggling to recruit and retain Latino participants in health research. The purpose of this work is to illuminate how current political incivility further deters participation by Latinos in research and present strategies to overcome these challenges. Design/Methods In this discursive piece, we describe how political incivility serves as a proxy for discrimination, discusses the impact of political incivility on health and health outcomes and explores existing knowledge of recruitment and retention strategies in the light of a current, adversely impacted health study with Latinos during the 2016 election season. Results Future work should consider the critical contextual factors (including political incivility) faced by Latinos in the US, while continuing to engage in established research strategies such as increasing trust, developing strong community presence, reducing risks (real and perceived) and being thoughtful in research design and implementation.Item Growing Ranks of Advanced Practice Clinicians - Implications for the Physician Workforce(2018-06) Auerbach, David I.; Straiger, Douglas O.; Buerhaus, Peter I.Nurse practitioners and physician assistants are providing an increasing share of health care services, and education programs have proliferated. These dynamics will have lasting effects on the health care workforce and on relationships among health professionals.Item Nurse practitioners and interdisciplinary teams in pediatric critical care(2018-06) Gigli, Kristin H.; Dietrich, Mary S.; Buerhaus, Peter I.; Minnick, Ann F.OBJECTIVE: To describe the members of pediatric intensive care unit interdisciplinary provider teams and labor inputs, working conditions, and clinical practice of pediatric intensive care unit nurse practitioners. METHODS: A national, quantitative, crosssectional, descriptive postal survey of pediatric intensive care unit medical directors and nurse practitioners was administered to gather information about provider-team members, pediatric intensive care unit nurse practitioner labor inputs, working conditions, and clinical practice. Descriptive statistics, cross-tabulations, and chi2 tests were used. RESULTS: Responses from 97 pediatric intensive care unit medical directors and 59 pediatric intensive care unit nurse practitioners representing 126 institutions were received. Provider-team composition varied between institutions with and without nurse practitioners. Pediatric intensive care units employed an average of 3 full-time nurse practitioners; the average nurse practitioner-to-patient ratio was 1 to 5. The clinical practice reported by medical directors was consistent with practice reported by nurse practitioners. CONCLUSION: Nurse practitioners are integrated into interdisciplinary pediatric intensive care unit teams, but institutional variation in team composition exists. Investigating models of care contributes to the understanding of how models influence positive patient and organizational outcomes and may change future role implementation. ©2018 American Association of Critical-Care Nurses.Item Improving Data for Behavioral Health Workforce Planning: Development of a Minimum Data Set(2018-06) Beck, Angela J.; Singer, Phillip M.; Buche, Jessica; Manderscheid, Ronald W.; Buerhaus, Peter I.The behavioral health workforce, which encompasses a broad range of professions providing prevention, treatment, and rehabilitation services for mental health conditions and substance use disorders, is in the midst of what is considered by many to be a workforce crisis. The workforce shortage can be attributed to both insufficient numbers and maldistribution of workers, leaving some communities with no behavioral health providers. In addition, demand for behavioral health services has increased more rapidly as a result of federal legislation over the past decade supporting mental health and substance use parity and by healthcare reform. In order to address workforce capacity issues that impact access to care, the field must engage in extensive planning; however, these efforts are limited by the lack of timely and useable data on the behavioral health workforce. One method for standardizing data collection efforts is the adoption of a Minimum Data Set. This article describes workforce data limitations, the need for standardizing data collection, and the development of a behavioral health workforce Minimum Data Set intended to address these gaps. The Minimum Data Set includes five categorical data themes to describe worker characteristics: demographics, licensure and certification, education and training, occupation and area of practice, and practice characteristics and settings. Some data sources align with Minimum Data Set themes, although deficiencies in the breadth and quality of data exist. Development of a Minimum Data Set is a foundational step for standardizing the collection of behavioral health workforce data. Key challenges for dissemination and implementation of the Minimum Data Set are also addressed.Item A Story of Emergent Leadership: Lived Experiences of Nurses in a Critical Access Hospital(2017-08) Pare, Judith Maria; Sharp, Dayle Boynton; Petersen, Polly A.Purpose: The purpose of this study was to understand the lived experiences of nurses working in a predominantly rural care setting. In order to meet the needs of an aging population with multiple comorbidities, it is essential for leaders to understand the strategies to recruit and retain highly qualified nurses in CAHs settings. Sample: Nine registered nurses working both full and part time with one to 40 years of experience participated in the interview process that queried their attitudes regarding working in a rural setting. Findings: Five major themes included self-reliance, social responsibility, empathy, isolation, and emergent leadership. Conclusions: The findings from this study support the notion that there is not a universal response to the lived experience of nurses working in CAHs. The unique needs of each nurse should be considered to enhance the practice environment and diminish experiences that result in feelings of isolation. Isolation impacted the five themes; if nurses are not able to maintain current knowledge and skills in a supportive environment, their self-reliance is compromised.Item Effect of aromatherapy massage on anxiety, depression, and physiologic parameters in older patients with the acute coronary syndrome: A randomized clinical trial(2017-12) Bahrami, Tahereh; Rejeh, Nahid; Heravi-Karimooi, Majideh; Vaismoradi, Mojtaba; Davood, Seyed; Sieloff, ChristinaPURPOSE This study aimed to investigate the effect of aromatherapy massage on anxiety, depression, and physiologic parameters in older patients with acute coronary syndrome. METHODS This randomized controlled trial was conducted on 90 older women with acute coronary syndrome. The participants were randomly assigned into the intervention and control groups (n = 45). The intervention group received reflexology with lavender essential oil, but the control group only received routine care. Physiologic parameters, the levels of anxiety and depression in the hospital were evaluated using a checklist and the Hospital\'s Anxiety and Depression Scale, respectively, before and immediately after the intervention. RESULTS Significant differences in the levels of anxiety and depression were reported between the groups after the intervention. The analysis of physiological parameters revealed a statistically significant reduction (P < .05) in systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate. However, no significant difference was observed in the respiratory rate. CONCLUSIONS Aromatherapy massage can be considered by clinical nurses an efficient therapy for alleviating psychological and physiological responses among older women suffering from acute coronary syndrome.
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