Digital Commons Network^™

Transformational Leadership Training For Leaders, Kristie M. Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …

Building Resilience In Graduate Nurses Through Online Virtual Simulation, Robert Grant Harmon

Electronic Theses and Dissertations

Resilience has become a popular topic in nursing research. Nurses experience enormous stress throughout their training process that extends into their first employment as they transition into practice. Simulation training is a standard for training nurses and for continuing professional education within academia. Most simulation training for nurses is focused on building critical thinking skills. While critical thinking is an essential quality equipping nurses to meet professional demands, resilience is a crucial quality to overcome the stress of both training and practice. Resilience is believed to play an essential role in the retention of new graduate nurses and preventing burnout …

Exploring Clinical Judgment In An Accelerated Undergraduate Nursing Curriculum, Marlie Lawrence Farrar

Electronic Theses and Dissertations

Nurses play a pivotal role in the healthcare world. They play a role in many settings, caring for patients with chronic issues to patients in life threatening situations. These settings call for nurses to be able to analyze patient situations and correctly intervene. This skill is clinical judgment. However, Kavanagh and Swzeda (2018) have shown that new graduate nurses do not demonstrate this skill, potentially causing patient harm. Findings such as this one have led to a reformation of the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The revamped exam called the Next Generation NCLEX (NGN) will focus on …

Addressing Stress In Graduate Nurse Practitioner Nursing Students, Shandria K. Sawyer

Electronic Theses and Dissertations

This project was developed to address the issue of high stress levels among graduate nursing students, which is a common phenomenon that increases the risks of mental health disorders, professional burnout, and poor-quality patient care among students and professional nurses after earning their degrees. This project sought to utilize a simple educational intervention delivered online to impart coping skills to graduate nursing students to assist them in reducing their stress levels. The intervention was a brief, single-session, self-guided educational module featuring informational and participative elements related to stress causes, the impacts of stress, and stress reduction techniques. In total, 11 …

Technological Change And The Practice Of Healthcare Communication: Implications For Patient-Centered Care, From A Communication Ethics Perspective, Emmalee Torisk

Electronic Theses and Dissertations

Written in a historical moment marked in many ways by the COVID-19 pandemic and the changes it has wrought, including the increased availability and use of telehealth services, this project attempts to consider the implications of the continued integration of technology into health care, centering on the following essential question: How do technological changes affect the contemporary practice of healthcare communication, particularly that which occurs between the patient—the consumer of health care—and their provider? This dissertation thus considers the ways in which such linkages of technology and health care seem to fit into a larger shift within health care …

Ontario’S Registered Nurses Knowledge, Comfort, And Self-Efficacy Surrounding Patient Health Literacy (Hl) Assessments: An Observational Mixed Method, Cross-Sectional Study, Sheena A. Gagnier

Electronic Theses and Dissertations

Health literacy (HL) is the ability to access and act on health-related information, as well as the ability to navigate through healthcare systems in order to maintain a healthy lifestyle. Health literacy assessments (HLA) are a direct measure of an individual’s ability to understand health related information using valid and reliable health literacy assessment tools. Objective: to explore the current state of HLA frequency use within the nursing profession in Ontario, as well as nurse’s perception of knowledge, skills, self-efficacy, and environmental influences surrounding their HLA practices. Methods: convergent mixed-method cross-sectional study utilizing an exploratory descriptive design. Results: Seventy-one Registered …

A Program Evaluation Of A Rural Nursing Academic Partnership, Meagan A. Spencer

Electronic Theses and Dissertations

As the American Association of Colleges of Nursing and Commission on Collegiate Nursing Education continue to promote the implementation and creation of literature on academic partnerships, a Christian university, sought to evaluate its academic partnership with a for-profit hospital for the first time in regard to student perspectives. The purpose of this mixed-methods program evaluation was to describe the student perceptions of the academic partnership in trusting, collaborating, and engaging nursing students and recruiting and retaining nursing graduates to rural hospitals and health care facilities. Measurable impacts included both qualitative and quantitative coding of the levels of trust, collaboration, and …

Moral Distress And Moral Residue Among Nurses Working In The Surgical Intensive Care Unit: A Descriptive Qualitative Approach., Adam Tyler Booth

Electronic Theses and Dissertations

Introduction: Approximately one in five Americans will die in the intensive care unit (ICU). Nurses spend more time with chronically ill and end-of-life patients than any other healthcare professional, and may perceive some actions in the ICU as immoral. Moral distress is defined as knowing the right course of action to take but being hindered by institutional constraints. Development of the Moral Distress Scale-Revised revealed that 31% of ICU nurses left a prior position or considered leaving their current nursing job because of moral distress. The purpose of this descriptive qualitative study is to explore surgical ICU (SICU) nurses’ perceptions …

The Relationship Of Self-Efficacy And Clinical Reasoning Of Undergraduate Nursing Students, Amy G. Holder

Electronic Theses and Dissertations

Aim. This investigation aimed to discover if a there is a correlation between a student’s clinical reasoning self-efficacy and a student’s actual clinical reasoning ability. Also, this research sought to discover the connection between an undergraduate nurse’s self-efficacy of clinical reasoning and the locus of control of that student. Finally, this investigation sought to discover if perceived self-efficacy of clinical reasoning changed over time.

Background. The ability to successfully navigate the process of clinical reasoning is critical to providing safe, effective care for patients. For nurses, this process begins to develop in nursing school. Unfortunately, evidence suggests that newly graduated …

Examining Instructional Methods In End-Of-Life Nursing Education: Lecture Vs. Simulation, Jonathan M. Benson

Electronic Theses and Dissertations

Undergraduate nursing programs have historically glossed over end-of-life care, if their curricula addressed it at all. This lack of instruction can leave practicing nurses feeling poorly prepared to deliver this specialized care. Feeling incompetent and lacking confidence may lead to poorer attitudes regarding this nursing specialty. Thus, effective continuing education activities are paramount in equipping nurses to provide this care and improve attitudes towards caring for terminally ill patients and their families. The purpose of this study was to examine how registered nurse attitudes towards end-of-life care are impacted using a simulation-based learning experience compared to a traditional face-to-face lecture …

Follow-Up Nurse Telephone Calls For Heart Failure Patients: A Case Study, Danielle M. Schievelbein

Electronic Theses and Dissertations

Follow-up care is essential when trying to avoid readmissions for patients who have recently been discharged from a healthcare facility. As evidenced by the literature, multiple strategies have been implemented to help manage the care of heart failure patients; however, readmissions continue to be higher than desired, which implies the current strategies utilized should be reviewed and revised. It is important to evaluate the effectiveness of methods when providing follow-up care that prevents readmissions and is also beneficial and convenient for the patient. The qualitative case study explored a heart failure follow-up protocol completed by a registered nurse using the …

Local Anesthesia Before Intravenous Cannula Insertion: Recommendations For Registered Nurses In Practice, Vera Campbell-Jones

Electronic Theses and Dissertations

Abstract

Administering local anesthetics, such as intradermal, should become standard practice for RNs in pretreatments for pain control prior to intravenous insertion. Peripheral venous cannulation has provoked the most fear and anxiety in adult patients about everyday practice in hospitals. Adult patients often state that this procedure causes considerable discomfort. Local anesthesia for cannulation is usually not offered to adult patients who are on general medical units. Evidence has indicated inconsistency in the use of pain management strategies during these procedures. The researcher’s goal in this project was to educate RNs about the intradermal pretreatment procedure, provide education on the …

Contemporary Nursing In Rural Appalachia: A Hermeneutic Study, Evelyn Brewer

Electronic Theses and Dissertations

Nurses make up a significant source of direct care for individuals, families, and communities. The problematic distribution of nurses and the potential to lose practicing nurses emphasizes the importance of retention and support of nursing professionals, especially in rural locations. One of the best ways to discover what is important to nurses is to ask and listen to the replies.

The focus for this dissertation is the lived experience of registered nurses in a six-county area in three adjoining states in rural South Central Appalachia. The purpose of this study is to interpret and understand the lived experience of contemporary …

Understanding Emotional Intelligence And Its Relationship To Clinical Reasoning In Nursing Students: A Mixed Methods Study, Heidi M. Meyer

Electronic Theses and Dissertations

Purpose. The purpose of this study was to explore emotional intelligence (EI) and its relationship to clinical reasoning in senior bachelor of science in nursing (BSN) students to gain a better understanding of how emotions are used in clinical learning experiences. This study was guided by the Four Branch Ability Model of EI.
Background. The current complex healthcare environment requires nursing students to be prepared to effectively reason in emotionally charged situations. The concept of EI and its beneficial effects in nursing are becoming more evident in the literature. However, it is still not well understood what the …

Fostering Compassionate Care For Persons With Alzheimer's Disease In Nursing Facilities., Sam Gilbert Cotton

Electronic Theses and Dissertations

The aim of this dissertation study was to examine the impact of the implementation of a new Compassionate Care (CC) curriculum on the quality of care provided by Certified Nursing Assistants (CNAs) to residents with Alzheimer’s disease (AD). More specifically, this dissertation used Kirkpatrick’s model of evaluation to assess the reactions, learning, and behavior change of the CNAs exposed to the curriculum, and ultimately the impact of the curriculum on the stress levels of residents with AD. To accomplish this, we had two studies that aligned with the Kirkpatrick model of evaluation. For Study #1, the evaluation of the compassionate …

Student Nurses’ Perception Of Sleep Quality, Nicole Wall

Electronic Theses and Dissertations

Sleep health is an underrepresented topic in the literature. Poor quality of sleep can lead to sleep deprivation, which has serious health and social consequences. The first year of university encompasses new demands and challenges to learning. Nursing students and nurses who suffer from poor sleep quality are at risk of providing unsafe patient care. The purpose of this pilot study was to explore the perceived level of sleep quality of first year nursing students. This was a descriptive, cross-sectional study that was guided by Rosenstock’s Health Belief Model. The participants completed an online survey that included the Pittsburgh Sleep …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

Exploration Of Fatigue In Fourth-Year Nursing Students, Kelly Riccardi

Electronic Theses and Dissertations

The purpose of this study was to explore fatigue in fourth-year nursing students enrolled at a university in southwestern Ontario. A sample of 134 participants completed a demographic questionnaire and the Occupational Fatigue Exhaustion Recovery (OFER) scale midway through their final semester of school. The study examined the perceptions of fatigue, along with the predicting factors of chronic fatigue, acute fatigue and intershift recovery. Participants experienced moderate-high levels of acute and chronic fatigue, and low-moderate levels of intershift recovery. More than half of participants agreed that work drains their energy everyday, that they never have enough time between shifts to …

The Perceptions Of Success Of Latino Nursing School Graduates In The Appalachian Region Of The United States, Barbara M. Rauscher

Electronic Theses and Dissertations

This qualitative narrative descriptive study focused on nine successful Latino nursing school graduates. Five participants were interviewed twice and four participants were interviewed once for a total of fourteen interviews. Participants and their families immigrated from Brazil, Costa Rica, Cuba, and Mexico. Participants attended school in North Carolina, South Carolina, and Tennessee.

Interviews revealed themes of Familism, Empowerment, and Perseverance. Familism was an overriding theme throughout each of the interviews. Participants described family as being their greatest support. They discussed sacrifices made by their families which assisted them in being successful. In addition, they also shared their willingness to make …

Registered Nurses’ Perceptions Of Organizational Power And Its Relationship To Perception Of Physician-Perpetrated Verbal Abuse, Stress, And Coping, Michael Neiswonger

Electronic Theses and Dissertations

The study was conducted to determine the relationships among organizational power, Registered Nurses (RN) perceptions of physician-perpetrated verbal abuse, and stress/coping behavior by exploring the following research questions: 1) What relationships exist between RNs’ perceptions of physician-perpetrated verbal abuse, perceived stress, and coping? 2) What is the relationship between RNs’ perceptions of physician-perpetrated verbal abuse and perceptions of power within an organization? 3) What are the relationships between RNs’ perceptions of stress and coping, and perceptions of power within an organization? 4) What relationships can be noted between RNs’ perceptions of physician-perpetrated verbal abuse, perceived stress and coping, organizational power …

A Randomized Controlled Trial Assessing The Impact Of An Innovative Approach To Educating New To Practice Nurses, Evelyn Lengetti

Electronic Theses and Dissertations

Background/Purpose

Catheter associated Urinary Tract Infections (CaUTI) are preventable, and hospitals receive no additional reimbursement for these infections. The purpose of this study was to evaluate the effect of mastery learning compared to traditional learning on new nurses’ skill acquisition and self-regulation practices for indwelling urinary catheter insertion.

Theoretical Framework

Mastery Learning posits that all learners have the potential to achieve mastery when given the time to learn along with deliberate practice and repetition. Traditional Learning, a more rote instructional approach, emphasizes memorization with a single summative assessment. Self-regulation signifies actions practiced by the learner to gain new knowledge which …

The Effect Of Education On Elder Abuse, Kathleen M. Evanina

Electronic Theses and Dissertations

This study was designed examine the effect of education on prevention of abuse in a long term care center. Participants in this study included direct care worker staff at a nursing home and nursing home residents.

The Impact Of Structured Debriefing, Following Simulation, On Bsn Student Development Of Clinical Reasoning And Clinical Judgment Skills, Robin Weaver

Electronic Theses and Dissertations

The necessity of appropriate clinical reasoning and clinical judgment skills is recognized as essential for the development of a competent practitioner. In response to the Institute of Medicine (IOM) report which called for a re-evaluation of the educational processes used to prepare practitioners, nursing educators have embraced the use of simulation technology as an innovative approach to enhance student learning. Simulation has been recognized as a vehicle to support student development of knowledge, skills, and attitudes necessary to become a competent practitioner. Recognized in the literature as the most essential element of simulation, debriefing practices vary throughout nursing education. Recently …

The Struggle For Balance: Culture Care Worldview Of Mexican Americans About Diabetes Mellitus, Jesus Antonio Hernandez

Electronic Theses and Dissertations

The purpose of this study was to describe, explain, and interpret perspectives, perceptions, meanings, symbols, and lifeways to explicate the culture care worldview about Diabetes Mellitus (DM) for Mexican American participants. Leininger's Culture Care Diversity and Universality Theory served as an organizing framework Interviews were conducted with thirty Mexican American key participants without DM. Four phases of analysis of ethnonursing method revealed thirteen categories, five patterns and three themes. The categories were: Health; faith and religion; natural living; tranquility and stress; strong emotions; susto; immigration; life in US; family advice and support; cultural beliefs; treatments of diabetes; care; and communication. …

The Lived Experience Of Parenting A Child Adopted From An Institution In Eastern Europe, Kimberly A Curry-Lourenco

Electronic Theses and Dissertations

This study sought to explore the lived experience of parenting a child adopted from an institution in Eastern Europe. A hermeneutic, phenomenologic method following the Utrecht School was used. The setting for this study was a southern state on the east coast of the United States. The sample consisted of 11 participants, nine mothers and two fathers, self- identified as adoptive parents to children from institutions in Eastern Europe. Semi-structured interviews, with thematic analysis of transcriptions were conducted. Five major themes were identified: choosing-being chosen, weaving the fabric, the importance of doing, remaining mindful, and looking-in, looking out. Conclusions were …

The Role Of Forensic Nurses In Communities Experiencing Environmental Contamination, Wendy Robinson

Electronic Theses and Dissertations

Purpose

The purpose of this study was to provide an understanding of the self-perceived physiological and psychosocial needs of persons living in communities which have been exposed to environmental contamination, and to provide an understanding of how forensic nurses can be utilized in these communities.

Background

This study was conducted to provide an opportunity for forensic nurses to advance their profession by finding ways that they can move beyond their traditional roles. Dixon and Dixon's Integrative Environmental Health Model was the theoretical framework.

Research Design

This cross-sectional triangulated study used quantitative and qualitative methods. The Community Environmental Health and Rights …

Nurse Educators' Perceptions About The Culture Of Nursing And Their Role In Bringing Students Into That Culture: A Focused Ethnography, Susan Maria Strouse

Electronic Theses and Dissertations

Purpose: The purpose of this study was to discover nurse educators' perceptions about the culture of nursing and how they bring students into that culture.

Background: Although the extant literature addresses the process of socialization to the profession, literature exploring socialization as enculturation is scant. Nurse educators' perspectives on the culture of nursing needed further exploration, as their voice on this topic is relatively silent and they provide the first formal enculturation to the profession. Viewing nursing as a professional culture may more effectively enable faculty to clarify and explicate for students the values, behaviors, symbols, and beliefs inherent in …

Development And Evaluation Of An Instrument To Measure Mother-Infant Togetherness After Childbirth, Carol Lawrence

Electronic Theses and Dissertations

No existing measure to date captures mother-infant togetherness. A valid measure of togetherness is essential to engage in evidence-based practice, evaluate obstetric delivery models and nursing interventions, and measure the level of togetherness which promotes optimal maternal-infant outcomes. When together and in close proximity, a women and her infant have access to one another to allow for mutual caregiving or caregiving on cue. A new measure entitled the Mother-Infant Togetherness Scale (MITS) was developed based on a review of the literature and conceptual framework of Mother-Newborn Mutual Caregiving. The MITS is a 35- item instrument composed of four subscales that …

Exploring Health And Social Exclusion Within Hidden Homeless, Josephine Watson

Electronic Theses and Dissertations

Homelessness and poverty are extreme forms of social exclusion which extend beyond the lack of physical or material needs. Using Brunner and Marmot's social determinants of health model (1999, 2004), this secondary analysis explored the everyday living conditions of a hidden homeless population. The purpose of this study was to explore and expand the understanding of the physical, psychological and social health impacts associated with material and social deprivation. The study aimed to expand the concept of social exclusion within the social determinants of health perspective. Health professionals who understand health behaviours as coping mechanisms for poor quality social environments …

Assisted Living Facilities In Louisville Kentucky : A Case Study To Examine Aging In Place., James Luther Wilson

Electronic Theses and Dissertations

As the older adult population in the United States continues its accelerated growth, there is a growing concern about the long-term care options for these elders. While nursing homes are no longer desirable and costly for federal and state governments, viable alternatives are being sought to meet this need. The development and rapid expansion of the numbers of assisted living communities have grown as older adults, family caregivers and government bureaucrats are looking for lower cost options. How beneficial are assisted living communities for the older adults that live in them? Most older adults seek to avoid multiple moves to …