S. Barnason - Academia.edu (original) (raw)

Papers by S. Barnason

Nursing Clinics of North America, 2000

The clinical exemplar reported in this article demonstrates the usefulness of the Center for Adva... more The clinical exemplar reported in this article demonstrates the usefulness of the Center for Advanced Nursing Practice's Evidence-Based Practice Model in facilitating a structured approach to expanding outcomes management of rapid recovery for coronary artery bypass graft (CABG) patients. The evidence-triggered and evidence-supported components of the model were key in using research and evidence-based practices to analyze the current program of outcomes management used for CABG rapid recovery. The evidence-observed component further validated changes in clinical practice, which became part of the evolving outcomes management program.

Journal of clinical nursing, Jan 7, 2017

Recently, the integrity of reporting nursing research studies has been brought into question, wit... more Recently, the integrity of reporting nursing research studies has been brought into question, with claims that less than half of clinical trials published in leading nursing journals are officially registered (Gray et al 2017). These authors suggest that because of this, the quality of published outcome analysis definitions and trial registrations in nursing journals is often sub- optimal. This article is protected by copyright. All rights reserved.

Journal of nursing management, Jan 23, 2016

To analyse influential policies that inform practice related to pressure injury management in Aus... more To analyse influential policies that inform practice related to pressure injury management in Australia, England, Hong Kong, New Zealand, Scotland and the United States of America. Pressure injuries are associated with significant harm to patients, and carry economic consequences for the health sector. Internationally, preventing and managing pressure injuries is a key nursing activity and quality indicator. Comparative review and synthesis of pressure injury policies that inform practice. The predominant focus of policy is on patient risk assessment, compliance with documentation and pressure relief. Financial penalty for institutions is emerging as a strategy where pressure injuries occur. Comparisons of prevalence rates are hampered by the lack of consensus on data collection and reporting. To date there has been little evaluation of policy implementation and implemented policy strategies, associated guidelines remain founded upon expert opinion and low-level evidence. The pressu...

Applied Nursing Research, 2011

Nursing economic$

Older women have lower levels of physical functioning and higher associated health care costs tha... more Older women have lower levels of physical functioning and higher associated health care costs than men after coronary artery bypass surgery (CABS). Clinical trials have demonstrated that interventions to increase physical activity levels can reduce the risk of recurrent cardiac events, reduce health care expenditures, prolong life, improve functional capacity, and increase quality of life in the elderly cardiac population. It is important for the patients, providers, health care payers, and policymakers to identify a cost-effective recovery intervention that has the potential to increase women's physical activity and functioning during their early recovery from CABS, especially in this time of limited health care resources. This home-based symptom management intervention has the potential to reduce the risk of recurrent cardiac events and health care cost by improving women's physical activity level after surgery. This information is vital to nursing leaders in making resour...

Western Journal of Nursing Research, 2010

This pilot study examined the impact of a hospital transition intervention for older adults (≥ 65... more This pilot study examined the impact of a hospital transition intervention for older adults (≥ 65 years of age) with heart failure (HF) to promote medication use self-management. Forty subjects, hospitalized with either primary or secondary HF, had a mean age of 76.9 ± 6.5 years; 65% were males. The majority of subjects (55%) had NYHA Class III HF. A prospective, repeated measures experimental design was used. Baseline and follow-up data (1- and 3-months after hospitalization) were obtained using the Medication Regimen Complexity Index, Brief Medication Questionnaire, Drug Regiment Unassisted Grading Scale, and Kansas City Cardiomyopathy Questionnaire. Using repeated measures analysis of covariance (ANCOVA), with baseline measures as covariates, the transition intervention group had higher levels of medication adherence ( F(1,35) = 13.4, p < .001), self-efficacy for HF self-care ( F(1,35) = 17.9, p < .001) and had significantly fewer HF related symptoms that impaired health re...

Heart & Lung: The Journal of Acute and Critical Care, 1995

To examine the influence during the early postoperative period of selected nursing interventions ... more To examine the influence during the early postoperative period of selected nursing interventions on mood and anxiety of patients undergoing heart surgery. Prospective, repeated measures, quasiexperimental, random assignment. The cardiovascular intensive care and progressive care units of a midwestern community hospital were used as the setting for this study. Ninety-six patients who underwent elective, heart bypass surgery; the mean age of the subjects was 67 years, with an age range of 37 to 84 years. Most subjects were men (n = 65, 68%). Physiologic measures of anxiety and mood include blood pressure and heart rate. Additional measures included the use of Spielberger's state-trait anxiety inventory (STAI) and patient verbal ratings of both mood and anxiety with use of a numeric rating scale (NRS). Patients were randomly assigned to one of three groups: (1) music therapy, (2) music-video therapy, or (3) scheduled rest group. Subjects in the groups received their assigned 30-minute intervention at two episodes on postoperative days 2 and 3. Subjects had physiologic measures of blood pressure and heart rate measured immediately before the intervention and at 10-minute intervals throughout the intervention. Mood and anxiety were evaluated by having subjects use a NRS (i.e., 0 to 10) to give rating of mood and anxiety immediately before and after each session. Anxiety was further measured with the STAI. A baseline measure of STAI was taken before surgery; patients also completed the "state" anxiety tool before the intervention session on postoperative day 2 and on completion of the session on postoperative day 3. With use of an analysis of covariance (ANCOVA), subjects' mood ratings showed significant improvement in mood among subjects in the "music intervention" group after the second intervention when controlling for the preintervention rating of mood, F(2, 87) = 4.33, p = 0.016. However, no significant differences were reported for anxiety ratings as measured by the NRS and state anxiety instruments. With use of repeated measures analysis of variance (ANOVA), there were no significant interactions between the intervention groups and time for any of the physiologic variables. However, there were significant main effects over time for heart rate and systolic and diastolic blood pressure, which indicated a generalized physiologic relaxation response. Although none of the three interventions was overwhelmingly superior, the overall response by all intervention groups demonstrated a generalized relaxation response. It is also important to note that there was reduced anxiety and improved mood within all three groups.

Heart & Lung: The Journal of Acute and Critical Care, 2006

Heart & Lung: The Journal of Acute and Critical Care, 2009

Background-Older adults with poor functioning preoperatively are at risk for delayed recovery and... more Background-Older adults with poor functioning preoperatively are at risk for delayed recovery and more impaired outcomes following CABS. Purpose-To determine if a 6-week early recovery telehealth intervention, designed to improve self-efficacy and management related to symptoms following CABS, was effective in improving outcomes (physical activity, physiological and psychological functioning) for older adults (> 65 years old) with higher disease burden. Design-A descriptive, repeated measures experimental design was used. Follow-up data was collected at 3-and 6-weeks and 3-months after CABS. Sample-Subjects were drawn from a larger randomized clinical trial (RCT). Parent study subjects who had high disease burden preoperatively [physical component score of <50 on the Medical Outcome Study Short Form 36 (MOS SF-36) and a RISKO score of > 6], were included (N=55); with 23 subjects in the early recovery intervention group and 31 subjects in the usual care group (n=31). Subjects ranged from 65-85 years old (M=71.6 + 5.1). Findings-There was a significant main effect by group [F(1,209)=4.66, p<.05), the intervention group had a least square means of 27.9 kcal/kg/day of energy expenditure compared to the usual care group of 26.6 kcal/kg/day per the RT3® accelerometer. Both groups had significantly improved physical [F(2,171)=3.26, p<.05] and role-physical [F(2,171)=6.64, p<.005] functioning over time. Conclusions-The subgroup of CABS subjects with high disease burden was responsive to an early recovery telehealth intervention. Improving patients' physical activity and functioning can reduce morbidity and mortality associated with poor functioning after cardiac events.

Critical Care Nurse, 2014

Evidence-based nursing care is informed by research findings, clinical expertise, and patients’ v... more Evidence-based nursing care is informed by research findings, clinical expertise, and patients’ values, and its use can improve patients’ outcomes. Use of research evidence in clinical practice is an expected standard of practice for nurses and health care organizations, but numerous barriers exist that create a gap between new knowledge and implementation of that knowledge to improve patient care. To help close that gap, the American Association of Critical-Care Nurses has developed many resources for clinicians, including practice alerts and a hierarchal rating system for levels of evidence. Using the levels of evidence, nurses can determine the strength of research studies, assess the findings, and evaluate the evidence for potential implementation into best practice. Evidence-based nursing care is a lifelong approach to clinical decision making and excellence in practice.

AACN Clinical Issues: Advanced Practice in Acute and Critical Care, 1999

This article reviews the use of distance learning in nursing education and to summarize key quest... more This article reviews the use of distance learning in nursing education and to summarize key questions that must be addressed by programs or students considering advanced practice nursing education using distance technology. An acute care nurse practitioner program using distance learning strategies is provided as an example to illustrate delivery of a clinically based curriculum. Examples of questions to be addressed in evaluating a distance education program include: How much of the course or graduate nursing program is available on-line? What are the specific informational technologies used? How does communication occur between graduate students and faculty? How are clinical requirements of a course managed? Are there any requirements for time to be spent directly on campus? Is it necessary for the student to have a computer and Internet provider? Knowledge of the available technology and components of distance education can enhance the ability of the advanced practice nurse to evaluate better and choose educational program offerings.

Journal of Clinical Nursing, 2011

This review found some evidence that augmenting education programmes for heart failure patients i... more This review found some evidence that augmenting education programmes for heart failure patients improved patient outcomes. The review was not well reported. The range of interventions and outcomes reported, and the short length of most of the included studies mean that these findings cannot be considered to be reliable. Authors' objectives To investigate the efficacy of interventions to improve self-care in patients with heart failure. Searching MEDLINE, PsycINFO, CINAHL and The Cochrane Library were searched for items from 2000 to 2010. A brief search strategy was presented. References were handsearched. Only publications in English were considered. Study selection Any comparative study that used a non-pharmacological intervention that aimed to improve self-care in patients with heart failure was eligible for inclusion. Both control and treatment groups had to receive standard education on heart failure care. Studies had to measure self-care or factors associated with self-care, such as knowledge of self-care for heart failure.

Orthopedic Nursing

This descriptive study examined pain descriptors in a group of patients with arthritis prior to t... more This descriptive study examined pain descriptors in a group of patients with arthritis prior to total knee replacement (TKR), and on postoperative days 1 and 3. The McGill Pain Questionnaire (MPQ), consisting of 78 descriptive words in 20 subclasses of descriptors scaled on intensity dimensions, was administered to each subject prior to and on two occasions after surgery. The findings support results from previous studies indicating that clusters of words are more often selected to express chronic pain, and other patterns are used to describe acute pain during the early postoperative period. Also, subjects experienced considerable pain intensity related to arthritis prior to surgery, and they reported less overall pain intensity following their TKR.

Research and Theory for Nursing Practice, 1996

The purpose of this experimental study was to determine the effects of second and third day posto... more The purpose of this experimental study was to determine the effects of second and third day postoperative music interventions (music, music video) on pain and sleep in 96 postoperative patients having CABG surgery. The Verbal Rating Scale scores obtained before and after each 30-minute session showed that pain decreased over time for all three groups with no difference across groups. The McGill Pain Questionnaire (MPQ) was administered before session 1 and after session 2, and results indicated that Sensory, Affective, and Present Pain Intensity subscales showed no group difference for pain; however, pain decreased from Day 2 to Day 3 for all three groups. For the evaluative component of pain, those in the music group had significantly (F[2,93] = 4.74, p < .05) lower scores on postoperative Day 2 than the rest period control group. Effects of the intervention on sleep as measured by the Richard Sleep Questionnaire indicated that the video group had significantly (F[2, 92] = 3.18,...

The Nursing Clinics of North America, 2000

Organizational endorsement for a dynamic, comprehensive pain management program began in the earl... more Organizational endorsement for a dynamic, comprehensive pain management program began in the early 1990s, and included assessment, education, interventions, and reassessment. Based on study findings and pain management recommendations from national guidelines and authoritative resources, retooling and updating of the pain management program was shaped to include a multidisciplinary team approach, principles of Total Quality Improvement, and outcomes management. Guided by the Center for Advanced Nursing Practice's Evidence-Based Practice Model and the leadership of clinical nurse specialists, organization-wide pain management initiatives have contributed to improved pain management practices. The end-point goal of a comprehensive pain management program that demonstrates positive patient outcomes along the care continuum provides an opportunity for merged health care organizations at two sites. This challenge will be supported by the model and the principles of continuous quality...

Journal of Pain and Symptom Management, 1998

The purposes of this study were to investigate the relationship of postoperative anxiety and pain... more The purposes of this study were to investigate the relationship of postoperative anxiety and pain following coronary artery bypass graft (CABG) surgery, and to determine the effects of level of anxiety, demographic, and other factors on the level of postoperative pain. Pain intensity, sensory pain, and affective pain were measured along with anxiety on postoperative day 2 and day 3 by the McGill Pain Questionnaire Subscales (PPI, PRIS, and PRIA) and State Anxiety Inventory Scale, respectively. A direct relationship of anxiety with pain was found over time with the highest relationship on postoperative day 2 (r = 0.235-0.492, P < 0.001). A significant interaction between time and level of anxiety on affective pain was specific to postoperative day 2 (P < 0.01). Significant differences by level of anxiety and time were reported. Factors of age, gender, marital status, number of previous surgeries, and operation time had no effect on the level of postoperative pain.

Progress in Cardiovascular Nursing, 1995

Shortened hospitalizations following cardiac surgery necessitate re-evaluation of how pertinent i... more Shortened hospitalizations following cardiac surgery necessitate re-evaluation of how pertinent information for self-care management and reduction of coronary artery disease risk factors can be incorporated into an effective inpatient cardiac patient teaching program. This study investigated the effect of three different teaching approaches (i.e., an inpatient teaching program, a postdischarge telephone follow-up program, and a postdischarge group teaching program) among 90 patients who had undergone coronary artery bypass graft surgery. Teaching outcomes were evaluated in this study by use of the Heart Disease Management Questionnaire and Cardiac Surgical Patient Teaching Satisfaction Inventory. Analyses of the data revealed similar patient teaching outcomes regardless of the type of teaching intervention the participant received. Findings supported the effectiveness of the inpatient teaching protocol which focused on "survival skills" for self-care management postdischar...

The Center for Advanced Nursing Practice Evidence-Based Model was the catalyst and driving force ... more The Center for Advanced Nursing Practice Evidence-Based Model was the catalyst and driving force that guided the application of evidence-based practice across boundaries of tertiary health care settings to rural health care settings. The intent of this effort was to enhance knowledge and to streamline practice for the management of patients with chest pain. The model successfully supported practice changes and improved outcome management for this aggregate population.

The Nursing clinics of North America, 2000

The Journal of Cardiovascular Nursing, 2012