Education Commons^™

The Contributing Factors To Student Nurse Medication Administration Errors And Near Misses In The Clinical Setting As Identified By Clinical Instructors, Kristen M. Selig

Theses and Dissertations

The report, To Err is Human, by the Institutes of Medicine (IOM, 2000) brought attention to medication safety in the United States healthcare system. While advances have been made in patient safety, including electronic medication dispensing systems, electronic medication administration records, and scanning systems, it is estimated that 7,000 to 9,000 people die each year due to medication errors (Tariq et al., 2019). The medication administration process involves steps from prescribing to administration. However, nurses administering the medications are the final check point. James Reasons’ Swiss Cheese Model of Accident Causation illustrates the role that systems play in medical errors. …

Improving Care Experience Of Total Joint Home Recovery Patients Through Nursing Education, Earvin Ledi

Master's Projects and Capstones

Problem: At a Northern California hospital (NCH), there is a current effort to ensure the perioperative patients are satisfied with their care. These patients receive the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey after surgery. The scores regarding discharge process and patient knowledge over the last five quarters have fluctuated between the 10th percentile and the 36th percentile. NCH relies on patient satisfaction scores to better serve their members.

Context: NCH understands the higher the scores, the more members they will retain and the higher the overall income. Based on the low OAS …

A Strategic Plan To Thread Genomics Competencies Into Undergraduate Curriculum, Holly Mathis

Dissertations

Problem: Genomics in undergraduate nursing education has experienced slow adoption in the United States. Various approaches have been proposed but do not address barriers to successful implementation.

Methods: A strategic plan was developed to increase the amount of genetics and genomic content in the curriculum of an undergraduate nursing program. A gap analysis was performed on the curriculum revealing a paucity of content. A SWOT analysis informed the strategic plan, which included a faculty education program using the ANA/ISONG’s Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines and Outcome Indicators (2^nd ed.) (2009) as a foundation.

Results: Faculty …

Fall Prevention Assessment In The Intermediate Care Patient Population, Dawn Rose

Doctor of Nursing Practice Final Manuscripts

Fall Prevention Assessment in the Intermediate Care Patient Population

Falls cause greater than 600,000 deaths per year and are the most common injury in people over 65 years of age. Fall prevention in the acute care setting has been identified as key goal in the most recent JCAHO review process. Falls on an intermediary care unit lead to an increased rate of morbidity, delayed discharge, and excess cost expenditure.

Even with appropriate evidence-based tools in place, Hospital A’s intermediate care unit, recorded an increased rate of falls; the highest rate in its health care system. An investigation identified factors contributing …

Increasing Knowledge And Self-Efficacy In Nurses Orienting To Cardiovascular Surgery Using A New Periop 202 Program, David Reinhart

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

The operating room theater can be intimidating for new nurses, thus leading to a shortage of nurses who are comfortable working in this environment. Evidence supports that 50% of perioperative nurses in 2017 were between the age of 50 and 59. Additionally, no formal didactic courses are being offered in undergraduate programs and the challenging environment related directly to the future shortage of perioperative nurses. This negatively impacts the number of trained perioperative cardiovascular nurses. The project proposed a new didactic educational Perioperative (Periop) 202 program that aimed to increase nurses’ self-efficacy to function on the cardiovascular operating room (CVOR) …

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

The Lived Experiences Of Clinical Nursing Faculty With Student Performance Anxiety, Heather Lapoint

Walden Dissertations and Doctoral Studies

The nursing shortage in the United States has led to a call for nursing education reform. Current clinical educational methods precipitate nursing student performance anxiety (PA). PA can inhibit the clinical judgment, reasoning, critical thinking, and the adaptability required for advancing healthcare initiatives and reducing the nursing shortage. PA has not been defined nor addressed in undergraduate nursing education. The purpose of this descriptive phenomenological study was to explore the lived experiences of associate degree (AD) nursing program faculty in addressing student PA as it occurs in the clinical setting. Specifically, how faculty define PA and recognize, address, and assess …

The Impact Of Faculty Bullying On Associate Degree Nursing Students, Angela M. Vitale

Walden Dissertations and Doctoral Studies

Bullying is prevalent in the profession of nursing, impacting the quality of health care and health care costs. The foundation of bullying, in the profession of nursing, may be attributed to bullying behaviors in nursing academia among nursing faculty and nursing students. Using Bandura’s social learning theory, the purpose of this study was to determine the relationship between bullying behaviors of nursing faculty and bullying behaviors of nursing students in associate degree nursing programs. Seventy-one randomly selected registered nurses who graduated from associate degree nursing programs in the past 5 years completed an online Incivility in Nursing Education-Revised survey. Spearman’s …

Hospital Nurses’ Perceptions Of Computer-Assisted Instruction For Professional Development, Katherine Irizarry

Walden Dissertations and Doctoral Studies

Computer-assisted instruction (CAI) is increasingly being used for professional development. However, at one hospital in the northeast region of the United States, it was observed that nurses were not completing their CAI professional development modules and were failing to meet continuous education requirements. This qualitative case study explored professional nurses’ perspectives regarding the usefulness of CAI as a mode of professional development. The conceptual frameworks used to guide this study were Davis’ theory of technology acceptance, and Knowles’s theory of andragogy. The research question explored how professional nurses perceived the usefulness of CAI to assimilate new learning. The participants in …

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 …

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 …

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 …

Evidence-Based Practice Self-Study Education Program For Staff Nurses On Genomics, Nancy L. Norman-Marzella

Walden Dissertations and Doctoral Studies

Nurses routinely obtain genomic data when collecting family health histories. However, they report low confidence in their knowledge and understanding of genomics and the genetically engineered medications prescribed for their patients. The purpose of this project was the development and implementation of an evidence-based online education program about genetics and genomics to increase the nurses' understanding and ability to provide competent care for their patients receiving treatments based on the science of genomics. Knowles's principles of adult learning theory guided the development and delivery of the online education project to 12 medical-surgical registered nurses employed in a hospital in the …

Development Of An Interactive Game For Education Regarding Sexually Transmitted Infections, Sherri Arrington

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) prevalence rates are increasing in the United States and globally. Education has been found to be an important strategy for increasing STI testing and treatment rates among sexually active young adults. The goal of this project was to develop an interactive educational game suitable for young adults to decrease the social and economic burden of STIs. The health belief model informed the project. A moderated usability evaluation was conducted using the concurrent think-aloud technique. The participants (N = 5) were a purposive sample of professionals who played the interactive game and then completed Schnall, Cho, and …

Direct Care Staffs’ Experiences And Perceptions Of Person-Centered Care Training, Jennifer Miranda Strollo

Walden Dissertations and Doctoral Studies

Many long-term care (LTC) facilities within the United States have replaced the institutional model of care with one that accepts person-centered care (PCC) as the guiding standard of practice. Quality training ensures that direct care staff have the skills and the knowledge in the delivery of quality PCC. However, many nurses and nursing assistants have expressed the desire for further training in PCC practices to effectively deliver quality care. The purpose of this study was to explore the types and length of training and education provided based on the perceptions and experiences of direct care staff related to their implementation …

Effect Of Multiple Entry Levels Into Nursing Practice And Professionalism, Ogechi Abalihi

Walden Dissertations and Doctoral Studies

Entry into professional nursing practice in the United States occurs at varied education levels including a diploma, an associate degree, and a baccalaureate degree. These multiple entry levels into practice create a situation where academic preparedness for nursing practice varies, which may influence the professional behavior of nurses and, consequently, patient care and outcomes. The purpose of this quantitative comparative study, guided by Miller's wheel of professionalism in nursing, was to determine if there is a difference in the professional behaviors of associate degree prepared registered nurses (RNs) compared to the professional behaviors of baccalaureate degree prepared RNs. The Behavior …

Development Of Nursing Education For An Observation Unit, Donna Mckinney

Walden Dissertations and Doctoral Studies

As healthcare continues to face scrutiny related to the cost and quality of patient care, organizations are challenged with providing the right care to patients in the right setting. Some healthcare organizations are implementing observation units to provide appropriate care to a specific subset of patients. The purpose of this project was to develop education for nursing staff who will work on the dedicated observation unit and are unfamiliar with the care requirements. Benner's novice-to-expert theory was used as the framework for the project. This theorist posits that nurses transitioning to a new area require new knowledge and skills to …

Evidence-Based Care In Urgent Care Centers, Kelly Wagner

Walden Dissertations and Doctoral Studies

Concussions are brain injuries--also called mild traumatic brain injuries--that affect the function of the brain temporarily or permanently. The purpose of this doctoral project was to develop an education module for staff at an urgent care center to address the lack of knowledge and low level of comfort regarding the care for patients with a head trauma. This project introduced and educated the clinical staff on an evidence-based protocol for the treatment and management of a patient with a concussion. The Rosswurm and Larrabee model for evidence-based change was used as a foundation for refining the practice question, gathering evidence, …

Stroke Clinical Order Pathway Education (Scope) For Apns, Varsha Singh

Seton Hall University DNP Final Projects

More than 795,000 American adults have a stroke annually. About 610,000 are first or new strokes. Almost 140,000 Americans of all ages die of a stroke every year (Centers for Disease Control and Prevention [CDC], 2017). Stroke requires emergent treatment and an exact clinical order pathway to ensure better patient outcomes and compliance with the standards of care defined by regulatory bodies such as the Joint Commission (TJC) and the Centers for Medicare and Medicaid Services (CMS). While stroke management teams often include an Advanced Practice Nurse (APN), there is a lack of a standardized protocol across New Jersey (NJ) …

Adapting Safemedicate (Medication Dosage Calculation Skills Software) For Use In Brazil, Samia Valeria Ozorio Dutra

USF Tampa Graduate Theses and Dissertations

Medication related errors are a significant cause of morbidity and mortality. In Brazil, most errors are related to prescribing, preparing, and administering medications. One way to deal with this barrier to safe care is through assessment and education of medication calculation dosage skills. Considering the Brazilian reality, this dissertation is a context and language adaptation of an evidence-based intervention called safeMedicate, a program that reinforces learning synthesis in crucial elements of medication dosage problem solving and provides the foundation for development in remaining levels of the hierarchy of learning. A guideline for medication calculation skills development or improvement based on …

Educating Oncology Nurses On The Benefits Of Patient Exercise, Roberta Anderson

Walden Dissertations and Doctoral Studies

Exercise benefits patients with cancer during and after treatments. A formalized educational program is lacking at the project's site for oncology nurses on the benefits of exercise for their patients during and after treatment. The purpose of the project was to address the identified gap in practice at the project's site by providing education to oncology nurses on the benefits of exercise for their patients during and after treatment. The ARCS model of motivational design was used as a theoretical foundation to develop and guide the educational program presented to the oncology nurses. The question addressed in the project was: …

Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing

Walden Dissertations and Doctoral Studies

Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …

Improving Health Literacy Assessments In Pediatrics, Kristina Michelle Wright

Walden Dissertations and Doctoral Studies

Low health literacy (LHL)--when patients do not understand their treatment or medications--has been linked to poor healthcare outcomes. Nurses need to know how to assess health literacy (HL) and teach pediatric patients and their families to help ensure that patients and family members can understand and follow health education messages. Evidence-based HL tools were obtained from a literature search and used to create a nursing staff education program on pediatric patient HL assessment and education. The project answered the practice-focused question that asked whether a staff education program on HL assessment and management would improve nursing knowledge of HL for …

Exploring Incivility Among Nursing And Health Science Students: A Descriptive Study, Diane Louise Smith

Student Theses, Dissertations and Capstones

Incivility has infiltrated our institutions of higher learning as well as the world of nursing. All too familiar in nursing is the phrase “eating their young,” which aptly describes how nurses treat other nurses, even though they should be nurturing and caring professionals.

The investigator explored nursing and health science students’ perceptions of student and faculty uncivil behaviors within the academic environment, seeking the levels and frequency of the problem. Bandura’s social learning theory presents a sound theoretical framework for this dissertation. The research methodology consisted of a quantitative descriptive approach. The Incivility in Higher Education-Revised (IHE-R) Survey was used …

High School Seniors' Educational Experience Lnfluencing The Decision To Pursue A Career In Nursing, Ryan L. Rowe

Dissertations

Many high school students interested in nursing as an occupation choose to engage in a Career and Technical Education (CTE) program and subsequently progress through the exploration stage of Super’s Career Development Theory in a succinct, deliberate, and intentional manner. While CTE continues to serve as an educational option for many high school students interested in nursing, its value as a means for students to crystallize, specify, and implement the choice to pursue the high-wage, high-skill, and high-demand career of nursing is not understood to the extent possible. CTE is regularly overlooked as a viable educational option by high school …

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 …

Just-In-Time Education For Intensive Care Nurses, Rosemary D. Soriano

Nursing Masters

Background: Continuing education is fundamentally necessary to ensure ongoing competency of nurses in the Intensive Care Unit (ICU). There are many effective methods of continuing education, but there is a gap in continuing education for ICU nurses for high-risk low-frequency therapies (HRLFT).

Objectives: The purpose of this project was to determine if the implementation of Just-in-Time Education (JITE) for HRLFT in the Pediatric Intensive Care Unit (PICU) improved nurses’ feelings of competence, comfort, and safety when utilizing these interventions.

Methods: JITE checklists for nurses were developed for HRLFT in the PICU. The checklists were reviewed by the staff …

Fall Prevention In An Acute Care Hospital: The Challenges Encountered By Patients, Staff And Administrators, Barbara J. Watson

Electronic Thesis and Dissertation Repository

Abstract

Falls are frequent and often serious events that take place in hospitals. Healthcare providers find it challenging to minimize fall risk factors. In fact, just being in a hospital is a risk factor in itself! The aim of this thesis was to investigate the reasons behind patient falls, identify gaps in prevention strategies and suggest additional recommendations to improve patient safety. A mixed method approach was used to interpret the data and uncover the reasons for falls.

The first study was a secondary data analysis where 7,721 patient falls were examined. The data were taken from the hospital’s central …

Development Of A Delirium Educational Program For Hospital Medicine Providers, Lindsay Erin Stone

Nursing Masters

Hospital medicine providers were surveyed to evaluate baseline delirium attitudes and behaviors. An educational program was then shared, and a follow up survey was given to determine if their delirium attitudes and practices were impacted by the educational intervention. Follow up survey results indicated that providers perceived more of a change in their attitudes than practices, and overall found the education to be useful and felt more confident in treating delirium as a result.