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You searched for +publisher:"Case Western Reserve University" +contributor:("Winkelman, Chris"). Showing records 1 – 3 of 3 total matches.

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1. Johnson, Kimberly D. Patients’ Vital Signs and the Length of Time between the Monitoring of Vital Signs during Times of Emergency Department Crowding.

Degree: PhD, Nursing, 2011, Case Western Reserve University School of Graduate Studies

The purpose of this study was to examine patients’ vital signs and what factors influence the length of time between vital sign recordings during various levels of ED crowding. Secondary purposes were to explore the nurse's response when vital signs were abnormal and to investigate the effect of ED crowding on the occurrence of abnormal vital signs. Vital signs are an integral component of the nursing assessment and often used as a decision-making tool. There is limited information about discernment of clues (i.e. vital sign abnormalities) that precede catastrophic outcomes. It is not known if crowding affects vigilance and reporting/communicating in the presence of clues. Current research does not provide information of the effect that ED crowding on the quality of care provided to ED patients by nurses. A conceptual model was developed for this study by merging Asplin’s Model of ED Crowding and Donabedian’s Structure-Process-Outcome Model. A descriptive, retrospective chart review was performed of 202 randomly selected adult ED patients' charts using a strategic sampling plan to capture a variety of ED occupancy scenarios at an urban, teaching hospital. Data was analyzed using multiple regression, correlation and Structural Equation Modeling. The results of this study demonstrated that: (a) as crowding increased, the time between vital signs increased significantly but the clinical importance of this finding needs further investigation, (b) several factors contributed to the length of time between vital sign recordings: length of stay, triage category and patients arriving by private car had the greatest predictive value, (c) reactions to abnormal vital signs were not commonly documented by nursing in the handwritten records used for this project (d) ED crowding did not have an effect on the composite vital signs of patients. Results from this study may contribute to establishing a standard of care related to frequency of vital signs monitoring. Future study should focus on determining if frequency of vital signs surveillance contributes to high quality care. Findings also provide direction for future research linking quality of care to missing vital signs or inadequate monitoring and ED team response to abnormal vital signs. Advisors/Committee Members: Winkelman, Chris (Committee Chair).

Subjects/Keywords: Nursing; emergency department; crowding; vital signs; monitoring

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APA (6th Edition):

Johnson, K. D. (2011). Patients’ Vital Signs and the Length of Time between the Monitoring of Vital Signs during Times of Emergency Department Crowding. (Doctoral Dissertation). Case Western Reserve University School of Graduate Studies. Retrieved from http://rave.ohiolink.edu/etdc/view?acc_num=case1301014586

Chicago Manual of Style (16th Edition):

Johnson, Kimberly D. “Patients’ Vital Signs and the Length of Time between the Monitoring of Vital Signs during Times of Emergency Department Crowding.” 2011. Doctoral Dissertation, Case Western Reserve University School of Graduate Studies. Accessed October 27, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1301014586.

MLA Handbook (7th Edition):

Johnson, Kimberly D. “Patients’ Vital Signs and the Length of Time between the Monitoring of Vital Signs during Times of Emergency Department Crowding.” 2011. Web. 27 Oct 2020.

Vancouver:

Johnson KD. Patients’ Vital Signs and the Length of Time between the Monitoring of Vital Signs during Times of Emergency Department Crowding. [Internet] [Doctoral dissertation]. Case Western Reserve University School of Graduate Studies; 2011. [cited 2020 Oct 27]. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=case1301014586.

Council of Science Editors:

Johnson KD. Patients’ Vital Signs and the Length of Time between the Monitoring of Vital Signs during Times of Emergency Department Crowding. [Doctoral Dissertation]. Case Western Reserve University School of Graduate Studies; 2011. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=case1301014586

2. Petchprapai, Nutthita. Adaptation to Mild Traumatic Brain Injury among Thai Adults.

Degree: PhD, Nursing, 2007, Case Western Reserve University School of Graduate Studies

Mild traumatic brain injury (MTBI) affects more than 28,000 individuals annually in Thailand; however, little information about outcome after MTBI is known. This investigation aimed to explore adaptation, determine factors associated with adaptation, and identify the predictors of adaptation among Thai adults who experienced MTBI in the previous 3-12 months. Roy’s Adaptation Model was the framework for this study. A descriptive-predictive, cross-sectional design was used. A sample of 135 adults was interviewed. Subjects were typically men, middle aged, and about half were married. All of them finished the compulsory level of education and had low income. Subjects had Glasgow Coma Scores 14 at 30 minutes after injury and 15 (full score) after 3 days. Duration of posttraumatic amnesia was six minutes while the duration of loss of consciousness was two minutes. Subjects reported low postconcussion symptoms scores, few stressful life events and few depressive symptoms. Scores of coping, social support and quality of life (QOL) were high. All subjects worked or studied before the injury and almost of them returned to normal lives at the time of interview. However, 18% did experience moderately severe disability and 1.5% suffered severe disabilities. Social support was positively correlated with QOL whereas none of the other stimuli were significantly associated with QOL and the Extended Glasgow Outcome Scale (GOSE). All stimuli, coping and depressive symptoms significantly explained 15.8% of QOL, with social support as the only significant predictor. The same set of stimuli could not successfully explain the GOSE. Although the mediator effects of coping and depressive symptoms in the original conceptual model were not supported, moderator effects with social support were found. Future studies with longitudinal, comparison, or predictive methodology with reduced but relevant variables are suggested. Developing a middle range theory is recommended to continue investigating QOL conceptually equivalent to adaptation. Measures used in this study demonstrated reliability, supporting their use in Thailand. Providing of health education or printed information about outcomes especially problems after MTBI is recommended. Further study of the small but clinically important percentage of subjects who experience ongoing disability after MTBI is needed. Advisors/Committee Members: Winkelman, Chris (Advisor).

Subjects/Keywords: Health Sciences, Nursing; Quality of life; Adaptation; Mild Traumatic Brain Injury; Coping; Social support

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APA (6th Edition):

Petchprapai, N. (2007). Adaptation to Mild Traumatic Brain Injury among Thai Adults. (Doctoral Dissertation). Case Western Reserve University School of Graduate Studies. Retrieved from http://rave.ohiolink.edu/etdc/view?acc_num=case1175874744

Chicago Manual of Style (16th Edition):

Petchprapai, Nutthita. “Adaptation to Mild Traumatic Brain Injury among Thai Adults.” 2007. Doctoral Dissertation, Case Western Reserve University School of Graduate Studies. Accessed October 27, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1175874744.

MLA Handbook (7th Edition):

Petchprapai, Nutthita. “Adaptation to Mild Traumatic Brain Injury among Thai Adults.” 2007. Web. 27 Oct 2020.

Vancouver:

Petchprapai N. Adaptation to Mild Traumatic Brain Injury among Thai Adults. [Internet] [Doctoral dissertation]. Case Western Reserve University School of Graduate Studies; 2007. [cited 2020 Oct 27]. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=case1175874744.

Council of Science Editors:

Petchprapai N. Adaptation to Mild Traumatic Brain Injury among Thai Adults. [Doctoral Dissertation]. Case Western Reserve University School of Graduate Studies; 2007. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=case1175874744

3. Swickard, Scott W. Patient Safety Events During Critical Care Transport.

Degree: PhD, Nursing, 2016, Case Western Reserve University School of Graduate Studies

Purpose StatementThe purpose of this retrospective chart review was to investigate the type and frequency of patient safety events (PSE) during critical care transport (CCT) between hospitals and explore the patient characteristics, nursing competencies, and environmental factors impact on PSE. Research QuestionsResearch questions were:1.What are the types and frequencies of patient safety events that occur when registered nurses (RNs) and advanced practice nurses (APNs) are lead clinicians in ground, rotor and fixed-wing vehicles? 2.What is the impact of the patient characteristics of stability, vulnerability, complexity, predictability, and resiliency on frequency of patient safety events?3.Do the nursing competencies of caring practices and clinical judgment, have a mediating or moderating role on the frequency PSE?4.Do modifiable environmental factors (i.e., time outside of the ICU and mode of transport) influence the frequency of PSE?MethodThis was a descriptive, comparative review of 5 months of records at a quaternary academic medical center. Inclusion criteria were all inter-hospital transports via ground, rotor, and fixed wing transport. Cases with PSE reported were compared to randomly selected non-PSE cases (ratio 1 PSE: 8 non-PSE cases). Logistic regression was used to determine relationships among the variables of interest with the occurrence of PSE.ResultsThe rate of PSE was 2.65% among all qualifying cases. A total of 440 cases were reviewed and entered into the database (48 with PSE: 392 without PSE). Adverse events were the most common type of PSE (1.88%), and new or recurrent hypoxia was the most frequent type of adverse event. The patient characteristic of stability was significant (p=0.083, OR 1.059, 95% CI 0.993-1.113). Secondary analyses supported the association of hypoxia, a component of stability, with PSE. The nursing competency of clinical judgment, as measured by experience in years of transport employment of the lead clinician, was identified as a potential moderator of hypoxia-related PSE. Duration of transport demonstrated the most consistent relationship with PSE in secondary analysis.Conclusion Hypoxia, defined as new or recurrent decrements in peripheral oxygenation, emerged as a new consideration for evaluating patients risk for CCT PSE. Advisors/Committee Members: Winkelman, Chris (Committee Chair).

Subjects/Keywords: Nursing; Patient Safety Events; critical care transport; inter-facility transport

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Swickard, S. W. (2016). Patient Safety Events During Critical Care Transport. (Doctoral Dissertation). Case Western Reserve University School of Graduate Studies. Retrieved from http://rave.ohiolink.edu/etdc/view?acc_num=case1468431671

Chicago Manual of Style (16th Edition):

Swickard, Scott W. “Patient Safety Events During Critical Care Transport.” 2016. Doctoral Dissertation, Case Western Reserve University School of Graduate Studies. Accessed October 27, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1468431671.

MLA Handbook (7th Edition):

Swickard, Scott W. “Patient Safety Events During Critical Care Transport.” 2016. Web. 27 Oct 2020.

Vancouver:

Swickard SW. Patient Safety Events During Critical Care Transport. [Internet] [Doctoral dissertation]. Case Western Reserve University School of Graduate Studies; 2016. [cited 2020 Oct 27]. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=case1468431671.

Council of Science Editors:

Swickard SW. Patient Safety Events During Critical Care Transport. [Doctoral Dissertation]. Case Western Reserve University School of Graduate Studies; 2016. Available from: http://rave.ohiolink.edu/etdc/view?acc_num=case1468431671

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