Theses and Dissertations at Montana State University (MSU)
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Item Beliefs and use of evidence-based practice by nurses: a needs assessment at a hospital in south central Montana(Montana State University - Bozeman, College of Nursing, 2018) Gipe, Leigh Ellen; Chairperson, Graduate Committee: Stacy StellflugNurses consistent use of evidence-based practice (EBP) will improve healthcare quality, improve patient outcomes, and decrease healthcare costs. Nurses constitute the largest group of healthcare providers and are in direct contact with patients, thus have an opportunity to make the largest impact using EBP. Despite EBP being accepted as the best method of providing care, many nurses may not be fully implementing it in daily clinical practice. The purpose of this project was to investigate nurses' beliefs about the readiness for and organizational culture for evidence-based practice, attitudes and beliefs about evidence-based practice, and nurses' implementation of evidence-based-practice at this organization. This was done by asking the following questions: What are nurses' current individual beliefs and attitudes about EBP at this organization? What are nurses' current levels of self-reported implementation of EBP at this organization? What are nurses' perceptions of organizational and cultural readiness for EBP at this organization? This project used a cross-sectional, descriptive design. A 75-question survey was sent via email in a SurveyMonkey to a convenience sample of 485 nurses. Nurses were asked demographic and professional characteristic questions, three open-end questions about EBP and to respond to three surveys: (1) The Organizational Culture & Readiness for System-Wide Integration of Evidence-Based Practice scale (2) The Evidence-Based Practice Beliefs scale (3) the Evidence-Based Practice Implementation scale. The findings were that nurses had positive attitudes and beliefs about evidence-based practice but reported low levels of implementation behaviors. Nurses report that they need more time, education and training, and resources to increase implementation of evidence-based practice. Interventions recommended to increase EBP implementation include encouraging more nurses to participate in the clinical ladder program, using mentors to assist and encourage use of EBP, and to provide more training and education opportunities for nurses.Item Electric current and magnetic field effects on bacterial biofilms(Montana State University - Bozeman, College of Engineering, 2014) Sandvik, Elizabeth Louise; Chairperson, Graduate Committee: Phillip S. Stewart; Bruce R. McLeod, Albert E. Parker, Philip S. Stewart were co-authors of the article, 'Direct electric current treatment under physiologic saline conditions kills Staphylococcus epidermidis biofilms via electrolytic generation of hypochlorous acid' in the journal 'PLoS ONE' which is contained within this thesis.The ability of bacteria to form and grow as biofilm presents a major challenge in clinical medicine. Through this work, two alternative electromagnetic treatment strategies were investigated to combat bacterial biofilms like those that cause chronic infections on indwelling medical devices. Direct electric current (DC) was applied at current densities of 0.7 to 1.8 mA/cm 2 alone and in conjunction with antibiotic. Unlike most previous studies, chloride ions were included in the treatment solution at a physiologically-relevant concentration. Using this approach, low levels of DC alone were demonstrated to have a dose-responsive, biocidal effect against Staphylococcus epidermidis and Pseudomonas aeruginosa biofilms with no synergistic enhancement of antibiotic activity. Through a series of experiments using chemical measures, cell viability, and global gene expression, electrolytic generation of chlorine, a potent disinfectant, was identified as the predominant mechanism by which DC kills bacteria in biofilm. The second treatment strategy investigated weak, extremely low-frequency magnetic fields (ELF-MFs) as a noninvasive approach, involving an extension of concepts from well-studied ELF-MF effects observed in eukaryotic systems to bacterial biofilm. S. epidermidis biofilms grown in weak, extremely low-frequency magnetic fields (ELF-MFs) at Ca 2+ and K + ion resonance frequencies were assessed using global gene expression to determine if S. epidermidis in biofilm detect and respond to ELF-MFs. Frequency-dependent changes in gene expression were observed with upregulation of genes involved in transposase activity, signal transduction systems, and membrane transport processes indicating possible effects consistent with theories of ELF-MF induced changes in ion transport reported in eukaryotic cells. This is the first transcriptome study to indentify ELF-MF effects in bacteria. While no direct biocidal effect was observed with ELF-MF treatment, alteration of membrane transport processes could potentially modify biofilm susceptibility to certain antibiotics. The ELF-MF responses identified in this work provide a platform for future study.