Medicine and Health Sciences Commons^™

Evidence-Based Practice Project Proposal: Reducing Chfrr Through The Get Well Networks Chf Prevention Education Materials, Susan Kay Richmond

Walden Dissertations and Doctoral Studies

In the United States, congestive heart failure (CHF) impacts 6.5 million adults and costs about $39 billion year with a projected incidence increasing by 25% by 2030. CHF can be addressed by advancing patient self-care knowledge through interactive patient education. For this project, the Health Beliefs Model guided a strategy to stimulate behavior modification based on perceived benefits of self-care. The purpose of this quality improvement project was to implement an interactive patient education video system, called the Get Well Network, to encourage patient self-care to reduce CHF readmission rates at a veteran's administration hospital. Four evidence-based CHF video order …

The Relationship Between Pre-Licensure Employment And Student Nurse Self-Efficacy, Khristina Lee Grimm

2017 Program & Posters

Lack of self-efficacy in nursing practice contributes to high levels of stress as new nurses enter the workforce, which causes turnover during their first year of practice. Little is known about how the type and amount of pre-licensure employment affects the selfefficacy in nursing practice of the student nurse.

Recovery-Oriented Care In A Psychiatric Health Setting, Renita Denise Hargrow

Walden Dissertations and Doctoral Studies

Psychiatric recovery-oriented care is aimed at improving patients' quality of care while increasing the efficiency of health care providers. Despite the benefits of recovery-oriented care, this approach is often lacking in health care settings. The purpose of this project was to implement a recovery-oriented training on psychoeducational groups on a 26-bed psychiatric unit. The Iowa model of evidence-based practice and adult learning theory provided the framework for the project. The objectives were to (a) assess training needs, (b) evaluate barriers for recovery-oriented psychiatric nursing, (c) develop strategies to address barriers, (d) train staff in psychoeducational approaches, and (e) evaluate the …

Improving Breastfeeding Knowledge Of Staff Nurses, Patience Sirri Mbonifor

Walden Dissertations and Doctoral Studies

The World Health Organization advocates that newborn babies require exclusive breastfeeding until 6 months of age to attain a desired level of growth. Despite this recommendation, exclusive breastfeeding rates continue to be at low levels globally. The purpose of this DNP project was to examine best practices for increasing the breastfeeding knowledge of health care workers, and to understand how breastfeeding is promoted in different healthcare systems. The Critical Appraisal Checklist and the Cochrane Handbook for Systematic Reviews framed this systematic literature review. Additionally, Melnyk's levels of evidence was used to evaluate each article. Articles for inclusion were limited to …

Evaluating The Impact Of A Smoking Cessation Program., Gideon Eke

Walden Dissertations and Doctoral Studies

Forty-six million individuals in the United States used tobacco products. People who use

tobacco products attempt numerous strategies before giving up smoking habit altogether. The goal of this project was to evaluate the impact of a tobacco cessation program by evaluating pre-and post-cessation program data, and hospital records of participants attending the hospital smoking cessation program over a 6-month period to ascertain the degree of reduction in tobacco use and hospitalization from smoking-related diseases. The population sample comprised of both men and women between the ages of 18 years and above. The project question addressed whether the smoking cessation program …

The Impact Of Engagement Strategies On The Reduction Of Patient Falls, Rosemary Martin

Walden Dissertations and Doctoral Studies

Despite the availability of many fall prevention measures, many patients fall in U.S. hospitals each year. Experts view patient fall rates as the measure that can be most affected by a nurse-led, evidence-based intervention. The purpose of this quality improvement project was to implement and evaluate the impact of patient engagement strategies on patient compliance to fall prevention education and the reduction of falls. The quality improvement framework used for this project was the Iowa Model. Interventions for this project included patient engagement strategies including the teach-back (TB) method and video-based fall prevention education paired with the project site's existing …

Polycystic Ovary Syndrome Treatment, Moneka Angilene Patterson

Walden Dissertations and Doctoral Studies

Polycystic ovary syndrome (PCOS) is an endocrine system disorder that affects women of reproductive age. If not treated properly, PCOS can lead to infertility. Lack of proper treatment of PCOS may also result in medical complications such as diabetes or heart disease. The rural clinic where this project took place did not have a mandatory guideline for treatment of PCOS; therefore, no standardized method of diagnosis or treatment of PCOS existed. The purpose of this project, guided by the IOWA evidence-based practice model, was to educate providers on the evidence-based guideline for diagnosis and treatment of PCOS outlined by the …

The Transition Phase Influence On Nursing Career Satisfaction And Retention, Amanda Lee Machesky

Walden Dissertations and Doctoral Studies

Qualified registered nurses are needed to provide bedside care to patients, yet there is a known registered nurse shortage in the United States, which has a global impact on the healthcare industry. Contributing to the nursing shortage is turnover, which is partly due to the inadequacies of preparation for role transition of newly qualified registered nurses. The purpose of this quantitative descriptive study was to determine if there was a relationship between retention and nursing career satisfaction of registered nurses who experience a transition to practice program and those who did not. Duchscher's transition shock theory served as the theoretical …

Educational Module Toolkit To Assist Adult Patients With Type Ii Diabetes Mellitus, Dometrives Armstrong

Walden Dissertations and Doctoral Studies

Diabetes is a challenging chronic disease for adult patients to manage effectively. Poor adherence to prescribed medications treatment is one of the main reasons for poor blood sugar control. Despite healthcare providers' efforts to emphasize the importance of taking medications, adult patients with Type II diabetes frequently present with complications related to persistent failure to adhere to prescribed medication regimen. These patients should thoroughly understand why adhering to a strict medication regimen to maintain control of their blood sugar is so important. The purpose of this project, guided by Orem's self-care deficit nursing theory, was to develop an educational module …

Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá

Walden Dissertations and Doctoral Studies

There is an identified problem with patients receiving suboptimal pain management at a hospice agency in the northwestern United States. At this agency, undertreatment of pain is prevalent. Evidence indicates that this may be a result of a lack of guidelines, education, and knowledge of appropriate prescribing. Known barriers to the correct prescription and administration of potent opioids in the hospice setting include prevailing beliefs, knowledge, skills, and attitudes, all of which can impact care negatively. Contextually, hospice principles mandate patient comfort and caregiver involvement in continuous quality improvement, which includes adequate and informed pain management. Moreover, hospice metrics demand …

The Influence Of Leadership On Nursing Professionalism, Lorelle Anne Wuerz

Walden Dissertations and Doctoral Studies

Leadership style has been studied from various perspectives including transformational leadership and the components of leadership competencies needed to exhibit transformational styles. However, there was a gap in the literature on the influence of leadership style on nursing professional behaviors and overall professionalism. The purpose of this descriptive, phenomenological study was to understand and explore the beliefs, attitudes, and perceptions of staff nurses on leadership style and its influence on professional nursing behaviors working in an inpatient care unit at a tertiary care center. The theory of transformational leadership was the conceptual framework for the study. A phenomenological approach was …

Development Of A Program Evaluation For A Preceptor Preparation Program, Olivia Hagos

Walden Dissertations and Doctoral Studies

A significant nursing shortage exists in the United States, which is compounded by high turnover rates. Skilled nurse preceptors are needed to train and assimilate nurses, which would improve retention of nurse preceptors, facilitate transition of nurses to the practice environment, and increase the number of preceptors within the organization. A preceptor preparation program in a 300-bed hospital was developed to promote nurse preceptor success while enhancing learning outcomes and creating a supportive work environment. The organization's leaders are interested in the successes of the program and its long-term role in retaining nurse preceptors who completed the preceptor preparation program. …

Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and …

An Evidence-Based Mentorship Program For Experienced Nurses, Roma Allen

Walden Dissertations and Doctoral Studies

Turnover of experienced nurses is a component of the nursing shortage, which has created a lack of expert nurses administering bedside care. The project site is a Chicago suburban hospital with an average first year turnover of experienced nurses at 35%. This rate is above the 27% first year turnover reported by the Metropolitan Chicago Healthcare Council. This project focused on development and evaluation of an evidence-based mentorship program supported by theory that can contribute to an increase in experienced nurse retention. A detailed literature review references causative factors of turnover, such as an increasing workload, a multigenerational and aging …

Development Of An Evidence-Based Protocol For The Management Of Acute Vertebral Fragility Fractures, Shannon De Ann Carey

Walden Dissertations and Doctoral Studies

Vertebral fragility fractures are common, affecting approximately 50% of all postmenopausal women and 33% of men over the age of 50, and are the most common type of fracture seen in osteoporosis. The management of vertebral fragility fractures in the acute care setting is lacking in standardization, in the use of evidence-based practice, and in addressing the underlying cause of osteoporosis. The purpose of this project was to develop an evidence-based protocol to standardize the care of the vertebral fragility fracture in the acute care setting. This protocol included patient education, fall risk assessment, screening for osteoporosis, and follow up …

Understanding Self-Management Decision Making In Heart Failure, Constance Louise Schumacher

Walden Dissertations and Doctoral Studies

Heart failure patients are responsible for managing fluctuations in symptoms between exacerbations by employing treatment adherence, active monitoring, and management strategies based on expert guidelines. Despite education, delayed help seeking persists among those in the need of acute medical intervention, as evidenced by high hospital admission and readmission rates. The purpose of this qualitative grounded theory study was to explore the decision making processes undertaken by heart failure, community-dwelling individuals as they experience symptom changes. Eighteen face-to-face interviews were conducted with participants who had heart failure and received self-management education from a home care agency in Southern Ontario, Canada. Data …

Studying The Prevalence Of Depression Among Diabetic Patients In Primary Care, Lanita Rochelle Hood

Walden Dissertations and Doctoral Studies

Abstract

The prevalence of diabetes in the United States in 2015 was 30.3 million people; which is the equivalent of 9.4% of the population. It is a major contributor to morbidity and mortality. Depression is often underdiagnosed in these patients, which contributes to poor self-management and poor health outcomes. In a large primary-care practice on the East Coast, there is no guideline for depression screening in the diabetic population. Focusing on this specific primary care setting, the research question addressed the underdiagnoses of depression in diabetic patients. The project evaluated the prevalence of depression among patients diagnosed with diabetes by …

Leadership Development For The Formal Nurse Leader, Lori Neu

Walden Dissertations and Doctoral Studies

Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …

Translating Evidence Of Skin-To-Skin And Rooming-In To Practice, Francisca Njoku

Walden Dissertations and Doctoral Studies

The old practice of separating the mother-baby-dyad was without measurable benefits to mothers or their infants. Evidence has shown that skin-to-skin care (SSC) prevents hypothermia and hypoglycemia, decreases crying during painful procedures in newborns, and reduces maternal anxiety, stress, and postpartum depression. Rooming-in care (RIC) has been linked to an increase in the rate of breastfeeding and mother-infant interaction, as well as a decrease in the infant morbidity rate. This project assessed the effect of an educational intervention to increase rates of SSC and RIC in an obstetric unit, in addition to measuring nurses' attitudes and barriers in relation to …

Quality Improvement Initiative About Patient Engagement With Clinicians In A Community Hospital, Cheryl Simpson

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a global health problem and efforts are needed to improve the care of individuals affected by the disease. A recent strategy for improving care within the healthcare system is patient engagement. Nurses and other health care clinicians can apply patient engagement into their clinical practice to improve the care they provide to their patients. Therefore, the purpose of this project was to increase the knowledge and awareness of patient engagement among clinicians who work with CKD patients. This quality improvement project used Lewin's force field analysis to analyze driving and restraining forces to help develop …

Servant Leadership And Its Effect On Employee Job Satisfaction And Turnover Intent, Dennis M. Mitterer

Walden Dissertations and Doctoral Studies

Experts expect a shortage of more than 900,000 nurses by 2022, according to the United States Bureau of Labor Statistics Employment Projections. Turnover in nursing contributes significantly to the shortage and often results from poor leadership of nurse managers. The purpose of this quantitative study was to investigate how servant leadership behaviors affected the psychological state and behavioral response of staff nurses as reflected by job satisfaction and turnover intention. Specifically, the research question addressed whether servant leadership positively contributes to the psychological states and the behaviors of staff nurses leading to greater job satisfaction. The study design was correlational, …

Nurses' Reflection, Compassion Fatigue, And Work Burnout - A Correlational Analysis, Sarah Urban

Walden Dissertations and Doctoral Studies

Compassion fatigue and work-related burnout are harmful reactions to patient situations and work environments that negatively affect nurses' well-being and ability to provide safe, effective patient care. However, research is needed to understand how reflection as a self-care response to patient situations is related to nurses' development of work burnout, compassion fatigue, and secondary traumatic stress, a type of compassion fatigue. The purpose of this correlational, cross-sectional quantitative study was to determine the relationship between hospital-based acute care nurses' levels of reflection and their levels of compassion fatigue, secondary traumatic stress, and work burnout. The study was based on Hentz …

Nurse Practitioners' Guide On Consumption Of Hundred Percent Fruit Juice By Children, Monisola Adeyemo

Walden Dissertations and Doctoral Studies

Childhood obesity has reached an epidemic level in the United States, growing exponentially and posing a great risk to the current and future health of the American people. The trend of increasing incidence of overweight and obesity in children has been occurring for decades; there is a need for multimodal preventative solutions to control the rate of growth. Sufficient evidence has shown a correlation between the feeding of 100% fruit juice to infants as dietary supplements and childhood obesity. Therefore, the purpose of this project was development of a guideline for 100% fruit juice feeding in children that is adaptable …

Development Of A Graduate Nurse Residency Program In Women's Services, Dinez Diamond Esmail

Walden Dissertations and Doctoral Studies

Graduate nurses' transition from school to the work place is challenging and often leads to burnout. There was no graduate nurse residency program in women's services at the practicum facility. As a result, this facility had been unable to recruit or hire graduate nurses in the women's services unit. The purpose of this project was to develop a nurse residency program in women's services to address the lack of formal orientation for new graduate nurses at this facility. A graduate nurse residency program will provide further training for nurses to care for a more complicated population of pregnant women. Theoretical …

Developing An Educational Module On Compassion Fatigue, Francisca Chinyere Hennes

Walden Dissertations and Doctoral Studies

Compassion fatigue is viewed as a disconcerting issue facing healthcare professionals in the clinical care milieu, and nurses are identified as the most susceptible population among healthcare professionals. The purpose of this project was to create positive social change by helping oncology nurses find ways to enhance self-care and self-awareness, thereby reducing the risk of compassion fatigue and burnout among healthcare professionals. This project investigated an educational module on compassion fatigue that focused on (a) identifying the occurrence rates of compassion fatigue among oncology nurses, (b) evaluating the demographic features that were associated with the most frequent rates of compassion …

Senior Students' Experiences, Perspectives, And Attitudes Of Technological Competencies In Nursing Education, Patricia C. Bennett

Walden Dissertations and Doctoral Studies

Technological standards appear to be needed in undergraduate nursing education, as existing research has yet to establish technological standards for undergraduate nursing students. The purpose of this qualitative study was to examine the lived experiences of senior nursing students with respect to their perceptions regarding exposure to and abilities gained in the areas of information management, information literacy, and computer literacy. The framework of the study was based on Bandura's theory of self-efficacy and the Dreyfus model of skills acquisition. Using a phenomenological approach, in-depth face-to-face interviews were used with a purposive sample to collect data about the technological competencies …

Influence Of Leadership Styles On Expatriate Nurses' Professional Integration In The Uae, Emmah Ncube

Walden Dissertations and Doctoral Studies

Transnational nurse migration has evoked a growing interest in the phenomenon of professional integration of expatriate nurses into their host societies. Despite research connecting employee and organizational outcomes such as job satisfaction and organizational citizenship behavior to the quality of leadership styles, there remains a lack of research linking professional integration of expatriate nurses to nurse leadership styles in the United Arab Emirates (UAE). The purpose of this grounded theory study was to develop a theory that would explain how nurse leadership styles and behaviors impacted the professional integration of expatriate nurses into the multicultural work environment of the UAE. …

A Clinical Practice Guideline To Reduce Behavioral Outbursts In Veterans With Posttraumatic Stress Disorder, Mary Adejumoke Badru

Walden Dissertations and Doctoral Studies

In a Department of Veterans Affairs hospital on the East Coast of the United States, behavioral outbursts result in 2 out of 10 veterans dismissed from a posttraumatic stress disorder (PTSD) unit prior to completing the 6-week program. The purpose of this evidence-based quality improvement project was to create a clinical practice guideline (CPG) based on social cognitive theory (SCT) to provide new strategies for managing veterans with PTSD and to improve the confidence of the nurses in managing outbursts. The Star Model guided the project development with the Delphi method to achieve participant consensus, the AGREE II to assess …

Impact Of Nursing Certification On Patient Perception, Satisfaction, And Outcomes, Rodney Baccus

Walden Dissertations and Doctoral Studies

Increased responsibilities for patient care within the nursing profession leads one to examine the correlation between nursing care and patient satisfaction. Current evidence indicates that higher levels of nursing education are associated with better patient outcomes. The literature further demonstrates that increased expertise and certification within a nursing specialty leads to increased nursing empowerment, improved intrinsic value and better collaborative relationships. However, the relationship between certification status and patient satisfaction remain unclear. This systematic review sought to understand the relationship between nursing certification and patient satisfaction. Guided by Rogers' diffusion of innovation theory this project examined the peer-reviewed literature using …

Enhancing Nurses' Assessment Of Pain Management In Dementia Patients, Norma Jean Boone

Walden Dissertations and Doctoral Studies

Chronic pain contributes to morbidity, mortality, and disability in millions of people. Prevalence rates for pain are as high as 83% among the 5.2 million older adults living with a diagnosis of dementia. The purpose of the quality improvement project was to assess nurses' knowledge of pain assessment and management in a 45-bed Veterans Health Administration long-term care facility serving older adults with dementia. Knowles' adult learning theory served as the theoretical framework and the knowledge to action model supported the translation of evidence into practice. A convenience sample of 27 licensed and unlicensed nursing staff answered the 16-question, 5-point …