A Quality Improvement Project To Implement Shared Medical Appointments For The Management Of Type 2 Diabetes In Latino Patients, Denisse Maldonado

Doctor of Nursing Practice (DNP) Projects

Problem: Santa Rosa Community Health (SRCH) is one of the largest federally qualified health centers in Northern California, providing health care to more than 30,000 patients. More than half of the patients receiving care at the SRCH Lombardi site are Latino patients. Patients self-identify as Latino or other ethnicity on the initial health center registration form. SRCH serves 964 patients with diabetes. Due to limited access to appointments and resources, seeing a healthcare provider regularly can be difficult, posing a barrier to diabetes management. Patients with diabetes would greatly benefit from regular appointments with their primary care provider and resource …

Strengthening The Advanced Practice Clinician Workforce Pipeline Through Preceptor Education And Support, Tarina Levitt-Trujillo

Doctor of Nursing Practice (DNP) Projects

Problem: The Advanced Practice Clinician (APC) workforce pipeline is dependent on clinical training opportunities. Clinician providers are encouraged to precept students but rarely are offered support tools to ensure a successful process. Lack of adequate support can result in a suboptimal outcome for the APC students.

Context: Clinician preceptors in a large healthcare organization looking to build a robust APC pipeline to support future patient populations.

Interventions: Preceptor materials were developed and delivered to clinical preceptors to help them successfully precept advanced practice clinician students during their clinical rotations. This material consisted of 20 microlearning modules to help clinicians …

Coaching Nurse Leaders In Conflict Management And Team Building To Improve Retention, Jeanette Black

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Retention of assistant nurse managers (ANMs) was identified as a concern from interviews with executive leadership and ANMs employed at a large hospital within a Northern California integrated health system. The nurse leader orientation training was reviewed, with gaps identified in conflict management and team building.

Context: The attrition rate of U.S. nurse managers in 2010 was 8.3%, higher than executive nurse leaders, with replacement costs equal to 75% - 125% of a nurse manager’s salary (Loveridge, 2017). Employee turnover and dissatisfaction due to conflict can have detrimental effects on retention, productivity, morale, and quality of patient care. …

The Relationship Between Emotional Intelligence, Perceived Stress And Coping Mechanisms In The Undergraduate Nursing Student, Marissa Rebello

Master of Science in Nursing Final Projects

Purpose:The aim of this study was to evaluate the relationship between emotional intelligence (EI), coping mechanisms and perceived stress in undergraduate nursing students.

Design:A quantitative non-experimental descriptive design was followed.

Method:The data was collected through a convenience sample. The sample was collected during an undergraduate nursing class where the students in the classroom were asked to participate in the study. The students that chose to participate took a survey that included data collection on demographics, EI scores, perceived stress and coping mechanisms. The Perceived Stress Scale (PSS) (Cohen et al., 1983), the Brief COPE (Carver, 1997), and …

Development Of A Text Message Stress Management Intervention And Its Impact On Perceived Stress And Coping Self-Efficacy Among Student Nurses, Kristin Jaye Henderson

Graduate Theses and Dissertations

Purpose: The purpose of the two studies was to develop a text message intervention and examine its effects on lowering perceived stress and increasing coping self-efficacy among nursing students. We also explored stress perceptions and investigated student satisfaction with the text message stress management program. Methods: For the first study, twenty three students participated in the focus groups for intervention development. Sample messages were presented to participants and feedback was requested. The messages were modified based on student feedback. The second study utilized an experimental pre/post design with a convenience sample (N=101) to examine the effects of the text message …

Impact Of A Web-Based Instructional Module Of Alzheimer’S Disease Within Seven Content Knowledge Domains, Joyce Haynie

Dissertations

Abstract

Alzheimer’s Disease (AD) has been classified as the most common form of dementia. Primary health care providers are usually the first clinicians to whom individuals present with symptoms of dementia. By 2050, it is expected that as many as 13.8 million Americans will be living with AD, and millions more will be placed in the challenging role of providing care for these individuals. However, studies continue to show that dementia is often underdiagnosed and under detected. The purpose of the study was to systematically inquire about the impact of AD education on level of knowledge about AD among primary …

Fathers' Experiences With Their Premature Infants Or Unhealthy Neonates, Lisa Cummings

Dissertations

Author: Lisa Cummings PhD RN

Fathers’ Experiences with Their Premature Infants or Unhealthy Neonates

Purpose and Background/Significance: Fifteen million babies worldwide are born prematurely each year, impacting a multitude of fathers. The importance of an early close father-infant relationship has been identified as central for the development of the child. Fathers influence on a child’s emotional and cognitive development and their physical well-being and health. Many times, the Neonatal Intensive Care Unit (NICU) is the initial contact environment between a father and his premature infant. Studies have shown that the NICU can be a stressful environment for parents, producing emotional …

The Nurse As The Facilitator Of Patients' Narration: An Educational Intervention, Petra Stockman

Electronic Theses and Dissertations

More than one million resident patients live and receive care at certified long-term facilities in the United States, many of whom suffer from depressive symptoms and anxiety. Prior research recommended storytelling as a vibrant nursing intervention to assist long-term care residents in overcoming challenges and emotional pain. However, nurses frequently lack knowledge of successful planning and implementation of narrative reminiscence. This scholarly project was designed to increase nursing competence and confidence in using storytelling as a clinical tool to improve mental health in long-term care, using a quasi-experimental, nonrandomized pretest, intervention, and posttest study design. A convenience sample of 10 …

Nurse Educators Fostering Critical Thinking In First-Year Students In An Associate Degree Nursing Program, Pamela Rogers

CUP Ed.D. Dissertations

Nurse educators are required to prepare students with the CT skills to solve complex problems, make sound clinical judgments, and decisions in nursing practice. This study explored the strategies used by nurse educators to foster critical thinking in nursing education for first-year nursing students in a community college. The research questions of this study were aligned with Bloom’s revised taxonomy, based on the work of Anderson et al. (2001) and Krathwohl (2002), who focused on the learner’s cognitive processes that transfer knowledge to a higher level of thinking. The selected method was a qualitative methodology with a phenomenological design. The …

Understanding The Lived Experiences Of Saudi Students Enrolled In Canadian Graduate Nursing Programs, Aisha Namshan Aldawsari

Electronic Thesis and Dissertation Repository

Despite the increased number of students in the field of nursing, there is a great shortage of Saudi nurses in Saudi Arabia (SA). Cultural issues in SA have influenced the development of the nursing profession. For instance, it is not culturally acceptable for female nurses or nursing students to work for long hours and night shifts in a mixed-gender practice environment in SA. Thus, a large proportion of nursing students tend to look for positions other than working in hospital settings upon completion of their undergraduate degree. Pursuing graduate nursing education overseas is also viewed as a viable option. To …

Implementing Foot Care Program In A Rural Clinic, Maliheh Bakhshi

Doctor of Nursing Practice (DNP) Projects

Abstract

The prevalence of type 2 diabetes mellitus and its complications have increased in the United States (U.S.) in recent years. Patients with diabetes have a higher risk of foot ulcers due to diabetic peripheral arterial disease accelerated by the direct damage to the nerve and blood vessels in lower extremities by high blood sugar. Foot amputations, and frequent hospital admissions due to these and other diabetes complications are also increasing. Healthcare providers’ have a unique opportunity to prevent these complications and hospital admissions, and to promote patient wellness and physical well-being through the provision of timely education and direct …

A Rural Telehealth Objective Structured Clinical Examination, Devon Schlottach

Dissertations

Problem Rural healthcare consumers experience increased health disparities, especially when accessing health care. The use of telehealth to improve access has become an essential competency for nurse practitioner (NP) students. This study evaluated NP students’ confidence and competence of rural social determinants of health (rSDOH) before and after a telehealth simulation.

Methods A descriptive, cohort design was used to review NP students’ pre- and post-surveys, written case studies, and a video-recorded telehealth OSCE for a patient living in a rural area.

Results Student self-rated knowledge of rural health care did not improve despite didactic learning and simulation (z = …

The Relationship Between Nursing-Faculty Incivility And New-Graduate-Nurse Self-Confidence During Transition To Practice: A Correlational Study, Martha Kershaw

CUP Ed.D. Dissertations

Decreased self-confidence is seen in nursing students who experience nursing-faculty-to-nursing-student-incivility and in new-graduate-nurses during their transition to practice. Using a quantitative correlational design, I examined the relationship between nursing-faculty-to-nursing-student incivility and new-graduate-nurse self-confidence including the extent to which the relationship exists and whether the relationship existed for some groups more than others, specifically male and female nurses, and nurses who graduated from associate’s degree and Bachelor of Science programs. Through the surveys completed by 212 registered nurses who had been practicing less than three years, the participants reported on their experience with nursing-faculty-to-nursing-student incivility using the Perceived Faculty Incivility Scale …

Beyond The Transcript: A Narrative Analysis Of Students' Experiences With Academic Dismissal In A Baccalaureate Nursing Program, Angela Edwards Capello

LSU Doctoral Dissertations

ABSTRACT

Re-defining different is the first step in addressing inequity in nursing education and the disparities that result in a high incidence of academic dismissal in baccalaureate nursing programs. What are the students' differences that contribute to one student’s ease of progression through a baccalaureate nursing program and those who struggle from the first semester?

This study provides a private look into the experiences of nine baccalaureate nursing students who were academically dismissed from their nursing program. Each story chronological from the time they decided to pursue nursing to their experiences during nursing school and to their lives after dismissal. …

Nurse Anesthesia Program Administrator's Decision-Making In Determining Interventions For A Student Exhibiting Unsatisfactory Clinical Performance, Laura S. Bonanno

University of New Orleans Theses and Dissertations

The purpose of this grounded theory study is to define the process that nurse anesthesia program administrators use to determine if a student nurse anesthetist’s unsatisfactory clinical performance warrants intervention by the program. There is little room for error in anesthesia practice as mishaps typically result in significant injury and death. Students who exhibit unsatisfactory clinical performance may pose an immediate risk to patient safety as well as a future risk if allowed to progress in the program. The lack of guidance in the form of clearly articulated expectations and processes contribute to the emotional strain nurse anesthesia faculty and …

Enhancing Nutrition Education For School Aged Children; A Preventive Health Measure And Quality Improvement Project, Fanny M. Powell

Doctor of Nursing Practice (DNP) Projects

Objective: The purpose of the DNP project was to improve nutritional knowledge of the adolescents at Kings Canyon Unified School District while also improving their perceived ability to choose healthy food. This project was enveloped in a larger community outreach mission utilizing a free school-based clinic for the purposes of providing sports physicals to students and health screening and physicals to the community. Additionally, nurse practitioner students engaged in a cultural immersion experience through clinical rotations in Central Valley.

Methods: Adolescent students who registered for the clinic watched a nine-minute nutrition video, created by the DNP student, while waiting …

Enhancing Health Literacy Using Teach Back Method To Increase Patient Adherence To, Tram Mendoza

Doctor of Nursing Practice (DNP) Projects

Background: Health literacy is a complicated and perplexing topic for those not trained in the medical field. Patients possess pieces of health literacy to some degree, while some have none at all. Limited health literacy can pose a very threatening risk on a patient’s well-being, interfering with their self-care and health maintenance, possibly creating more obstacles for the patient if health instructions and education are not clearly understood. This can lead to increased health expenditures due to treating the effects of poor health maintenance in addition to emergency room visits that may have not been necessary had the patient understood …

The Effects Of A Mobile Fitness Application On Weight Management And Physical Acticity Amongst University Students, Erica Deenihan

Evidence-Based Practice Project Reports

The prevalence of obesity, and obesity related diseases throughout America, specifically in regard to the college student population has steadily climbed over the course of the last forty years, due largely in part to the increase in sedentary lifestyle behaviors, amongst other factors (Swanson, 2016). Physical activity has been widely recognized as a valid means of combatting obesity and weight gain while promoting health related quality of life (Swanson, 2016). Therefore, implementing strategies aimed at increasing physical fitness in attempt to control weight management is imperative to promoting improved health outcomes. The purpose of this evidence-based project was to examine …

Utilizing Simulation To Implement Cognitive Aids In The Operating Room, Kaitlyn Brown

Doctor of Nursing Practice Projects

Background: Operating room crises require prompt, efficient action to avoid detrimental outcomes. Research shows that crisis checklists or other cognitive aids assist anesthesia providers in taking prompt action while improving efficiency by decreasing treatment steps missed during critical events.

Objectives: The purpose of this project was to evaluate the effectiveness of incorporating cardiac arrest and malignant hyperthermia crisis checklists into the operating room using high-fidelity simulation-based education.

Methods: Researchers implemented the Stanford Emergency Manual Cognitive Aids for cardiac arrest and malignant hyperthermia to anesthesia staff at a community hospital in southern Illinois with 18 participants. Implementation consisted of an education …

Heart Failure Knowledge Among Cnas In A Skilled Nursing Facility: A Pilot Project, Amanda Mcdannald

Doctor of Nursing Practice Projects

Heart failure (HF) is one of the leading causes of hospitalization among patients over the age of 65 years. Many are transitioned to skilled nursing facilities (SNF) following hospital discharge. HF-specific SNF staff education was designed for early detection of changes and improved management of this patient population. Computer-based education modules and hands on skill demonstration stations were created to provide basic HF knowledge and specific guideline recommended care measures for the SNF environment. A pretest, post-test, and skill demonstration were implemented and included weight assessment, application of compression stockings, volume status monitoring, and low sodium diet recommendations. Pretest scores …

Learning Science: Physical And Life Sciences In Curricula Across U.S. Schools Of Nursing, Valerie C. Sauda

Electronic Theses and Dissertations

Nursing educators are being challenged to provide curriculum that meets the changing healthcare environment and demand for creative, innovative nurses to assist in transforming healthcare into the future (Benner, Sutphen, Leonard, & Day, 2010; Institute Of Medicine, 2011). The liberal education provided within a baccalaureate of science in nursing (BSN) degree program provides a diversity of courses within the curriculum, including courses in the natural, physical, mathematical, and social sciences (American Association of Colleges of Nursing [AACN], 2008). Although nursing programs have included science courses in curriculum since the early 1900s (Nutting & Dock, 1907), there is lack of nursing …

Simulation Facilitator Competency: Validity And Reliability Of A Self-Assessment Tool, Mary (Molly) Kellgren

Theses and Dissertations

The use of simulation as a teaching and learning strategy continues to grow in nursing education. Standards of Best Practice, certification criteria, and simulation theory support the notion that facilitation of simulation requires a specialized skill set that differs from traditional classroom and clinical teaching. The discipline of nursing has already established valid and reliable tools for teachers within the classroom and clinical environments to complete self- and/or peer evaluation to inform teaching effectiveness. The National League for Nursing/Kellgren Simulation Facilitator (NLN/KSF) tool fills a gap in the literature by providing a valid and reliable tool to self-assess comprehensive facilitator …

Health Literacy Intervention For Low Income Uninsured Population, Laura Larson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Health literacy (HL) requires basic skills in writing, reading, numeracy, and communication all within a health context (Berkman et al., 2011). HL is a critical element for individuals to take an active role in managing their health. The National Assessment of Adult Literacy found only 12% of adults had a “proficient” HL level. Hispanics were found to be at greatest risk for lower HL than all other ethnic groups (Kutner, Greenberg, Jin, & Paulsen, 2006). Low HL can lead to poor health outcomes including: decreased utilization of preventative services, difficulty in managing chronic conditions, and increased disparities in access …

Simulation As Replacement For Traditional Clinical In Pre-Licensure Nursing Education: Outcomes Of Different Ratios Of Replacement Time For Traditional Clinical With Simulation, Tiffany Zyniewicz

Dissertations

The use of simulation in nursing education has grown over the last 30 years. The National Council of State Boards of Nursing National Simulation Study indicated that up to 50% of traditional clinical hours can be replaced with simulation at a 1:1 replacement ratio and produce the same outcomes. A review of the literature indicated that there is no standard replacement ratio for simulation time to traditional clinical time being used in pre-licensure nursing education in the United States. The purpose of this study was to explore the outcomes of utilizing a 1:1 simulation-to-traditional clinical time replacement ratio and a …

Assessing The Long-Term Effects Of A Cultural Immersion Experience On Nursing Practice, Karen H. De La Cruz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cultural immersion has been identified as a preferred method of teaching cultural competence in undergraduate nursing education. Multiple qualitative and quantitative studies have shown that baccalaureate nursing students enjoy international learning experiences and, based on self-efficacy evaluations, feel they have increased cultural competency following immersion experiences. However, there is little evidence to indicate concepts learned during undergraduate cultural competency course work is retained or integrated into nursing practice after leaving the milieu of academia.

To inform future cultural competency educational efforts, I conducted a qualitative phenomenological study to provide a baseline of evidence regarding the impact of a cultural immersion …

The Perception Of Iron-Deficient Anemia In Bolgatanga, Ghana Among Women Of Childbearing Age, Sydney Albrecht

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Objective: To understand the perception of anemia among the women of childbearing age in Bolgatanga, Ghana, and to correlate the reasoning with the high incidence of anemia in the area.

Method: This research was a qualitative study consisting of 67 interviews over the course of the three weeks that were spent in Bolgatanga. 50 of these interviews were women of childbearing age (15-49), 6 were health professionals, and 11 were women older than the age range provided. Interviews were taken from the maternity clinics nearby as well as from women in a rural area that was a 10-minute taxi ride …

Differences In Kaplan Integrated Exam Scores Based On Institutional Factors, Lee Ann Danner

Graduate Theses and Dissertations

Registered Nurses constitute the largest health care occupation in the United States. Current entry-level education for the profession of nursing is either an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) (Altman, 2011). After successful completion of a nursing program, all nursing graduates must apply to take the National Council Licensure Examination (NCLEX-RN). The pass rate for first time United States educated NCLEX-RN exam test takers in 2017 was 87.11% leaving 12.89% unsuccessful (NCSBN, 2018). A nursing programs quality and recruitment are often influenced by a students’ ability to pass the NCLEX-RN on the first attempt. …

A Comparison Of The Curricula Of The Top-Ranked Prelicensure Baccalaureate Nursing Programs In The United States, Silvia Imanda

Graduate Theses and Dissertations

What constitutes an ideal prelicensure nursing curriculum is not well understood. Specifically, what are the strategic curricular sequencing and curricular themes or focus might be included to contribute to producing high quality graduates? The purpose of this qualitative multiple case study investigation was to look at successful programs and identify effective curricular sequencing and curricular themes or focus that might be inferred to have contributed to producing high quality graduates. Seven top-ranked prelicensure baccalaureate nursing programs were selected based on three national college rankings services. Based on data from interviews and publicly accessible documents, seven case studies were compared and …

Implementing A Heart Failure Education Program For Bedside Nurses In The Acute Care Setting, David L. Morrow

UNLV Theses, Dissertations, Professional Papers, and Capstones

Heart failure is a chronic disease in which a weakened heart is no longer able to deliver adequate blood flow to supply the body with needed oxygen and nutrients. Heart failure is the most common reason for hospitalization in the United States for patients age 65 and over, accounting for over 1,000,000 hospital admissions annually. Due to the chronic nature of this debilitating condition and associated symptoms, patients discharged from the hospital with a diagnosis of heart failure are at high risk for readmission. Effective self-care behaviors have been shown to reduce readmissions and improve quality of life for these …

Ohiohealth Grove City Methodist Hospital: Workday Implementation, James Eastep

Masters Theses/Capstone Projects

No abstract provided.