Medicine and Health Sciences Commons^™

Impact Of Nurse Manager Peer Mentorship Program On Job Satisfaction And Intention To Stay, Tonya Roth, Diane Whitehead

Journal of Excellence in Nursing and Healthcare Practice

Nurse managers (NMs) play a vital role in patient outcomes by providing a stable work environment for teams. Numerous factors influence a NM’s job satisfaction and intent to remain in a job. The purpose of this project was to develop an evidence-based formal mentorship program for NMs in an effort to impact retention rates. A secondary purpose was to evaluate the impact that a formal mentorship program has on NMs’ job satisfaction and intent to stay. Across two hospitals in the Pacific Northwest, 15 NMs participated in a 6-month mentorship program. The program was guided by both the mentorship enactment …

Impact Of Acculturation On Body Mass Index In Haitians, Nirva Berthold Lafontant

Journal of Excellence in Nursing and Healthcare Practice

Longer term immigrants residing in the United States exhibit physical health decline related to higher body mass index (BMI). Theories on immigrant acculturation have been used to examine health patterns by length of stay in the United States. The purpose of this cross-sectional study, guided by the Schwartz model of acculturation, was to examine the effect of acculturation and length of stay in the United States on BMI in a sample of Haitian immigrants living in a northeast metropolitan area. The research question was developed to examine the effects of acculturation and how long immigrants reside in the United States …

Translation And Validation Of The Hplp-Ii From English To Armenian, Zoya Minasyan, Leslie C. Hussey

Journal of Excellence in Nursing and Healthcare Practice

As the focus of healthcare shifts toward the social determinants of health, more information about health disparities between different ethnic communities is needed. The Health Promoting Lifestyle Profile II (HPLP-II) is an instrument that measures health promotion behavior across various cultural lines. This article describes the translation and validation of the HPLP-II from English to Armenian for the purpose of studying health promotion behavior among the hypertensive and normotensive Armenian American population and addressing health disparities among this community. Translating the HPLP-II required a multistep process to capture cultural linguistic adjustment. First, the researcher, a local bilingual professor, and a …

A Special Message To Students And Graduates About Publishing In A Journal, George Zangaro, Diane Whitehead

Journal of Excellence in Nursing and Healthcare Practice

The Journal of Excellence in Nursing and Healthcare Practice (JENHP) was created to promote innovations, translation, and dissemination of evidence supporting improved outcomes in the nursing practice environment. The journal welcomes manuscripts focusing on topics such as national and international workforce issues, quality improvement projects, evidenced-based practice initiatives, nursing research studies, interprofessional practice, educational issues, improvements in technology, innovative practice problem solutions, and the impact of social change in society. Although we accept submissions from all types of researchers, both new and experienced, one central purpose of this journal is to provide an outlet for research conducted by students. Hence, …

"Evaluation Of Medication Adherence Through The Use Of Home Assisted Telemanagement", Kingsley Ezihe Ngameduru

Walden Dissertations and Doctoral Studies

Medication nonadherence can have serious consequences for patient outcomes. Home-automated telemanagement systems have supported increased levels of adherence among patients. This project explored whether the use of a home telemanagement program (HTM) would improve medication adherence in clinic patients diagnosed with hypertension (HTN). The health belief model, social learning theory, the self-regulation model and the theory of reasoned action guided this project. Providers in a primary care clinic completed the 4-question Morisky, Green, and Levine adherence scale with 50 HTN patients previously enrolled in a HTM. Survey results revealed that after 2 years in the program, patients were still forgetting …

A Phenomenological Study Of Lived Experiences Of Transport Nurses Experiencing Patient Death, Joshua B. Wall

Walden Dissertations and Doctoral Studies

Experiencing a patient death can directly affect the well-being of health care professionals; however, this phenomenon and the effects of patients' deaths are not well understood in the transport setting. Transport nurses work in unique settings with complex patients and significant autonomy in determining the plan of care; therefore, the experiences of other health care professionals may not be applicable in this environment. The purpose of this qualitative study was to explore the lived experiences of transport nurses who have experienced patient death using Husserl's life-world and phenomenological philosophies as a theoretical framework. Semistructured interviews were completed with 8 transport …

Advanced-Beginner Registered Nurses' Perceptions On Growth From Entry Level, Brenda Mason

Walden Dissertations and Doctoral Studies

Many entry-level nurses are not prepared to handle medical emergencies. Although responsible for managing the care of individuals with complex medical conditions, many of these nurses compromise the safety of patients due to a lack of experience and an inability to apply clinical judgment. The purpose of this study was to explore the perceptions of registered nurses about their transition from entry-level to advanced beginner. Bandura's social cognitive theory, along with Colaizzi's descriptive method of data analysis, provided a basis for this phenomenological study. Research questions focused on challenges that entry-level nurses have experienced with problem-solving and complex patient care …

A Quality Improvement Evaluation Of Patient Experience Through The Enhanced Recovery Program, Sarah Orozco

Walden Dissertations and Doctoral Studies

The purpose of this project was to evaluate the effectiveness of adopting clinical care bundles for the enhanced recovery program (ERP) at the project site. The practice-focused questions explored whether care bundles from the enhanced recovery program (ERP) would achieve positive postoperative patient care experiences when compared to the traditional surgical care pathways. The concepts, models, method, and theories used for this project include the Iowa model, the plan-do-study-act model, lean methodology, Donabedian's framework, and Watson's theory of caring. The sources of evidence included the facility site analysis report to evaluate surgical inpatient complications, morbidity, and mortality rates. Over 100 …

Noise Pollution/Reduction Education For Frontline Staff In The Acute Care Setting, Lopa Patel

Walden Dissertations and Doctoral Studies

Noise levels in hospital settings have risen beyond the recommended range of 35-40 decibels, resulting in poor patient healing outcomes and other health conditions ranging from sleep deprivation, anxiety, agitation, delirium, depression, and high heart rate and blood pressure. These negative patient health experiences are evidenced by poor scores for the Hospital Consumer Assessment of Healthcare Providers and Systems, which are indicators of patients' perceptions of care. This project explored whether an educational activity for 48 direct care staff, who include registered nurses and nursing assistants, in a cardiac unit on the impact of noise pollution on patient healing would …

Reducing Door-To-Provider Times By Using Nurse Practitioners In Triage, Megan Lynnell Anderson

Walden Dissertations and Doctoral Studies

Increased patient wait times it the emergency department (ED) have been linked to poor patient outcomes and adverse health care events. The purpose of this quality improvement project was to determine if placing a nurse practitioner (NP) in the triage area would reduce door-to-provider times and improve patient throughput within the ED. The primary question for this quality improvement project was whether the use of NPs in the triage area would improve patient throughput and decrease wait times in the ED. A secondary question identified was if implementing an NP in the triage area would decrease patient length of stay …

Evidenced-Based Staff Education Program For Novice Perioperative Nurses, Marjorie Jasinski

Walden Dissertations and Doctoral Studies

Knowledge of surgical procedures, instruments, and supplies is essential to the perioperative nurse working in the operating room (OR). Nursing school curricula do not specifically educate surgical nurses; therefore, it is difficult to fill open OR positions with experienced perioperative nurses. The purpose of this doctoral project was to develop a perioperative educational program for RNs newly hired in the OR. The practice-focused question asked whether an evidence-based staff education program for the novice perioperative nurse would increase the nurse's knowledge of OR procedures and protocols for patient management. The novice-to-expert framework was used to explore how adult learners acquire …

Acuity-Based Nurse Staffing And The Impact On Patient Outcomes, Sara Kollman

Walden Dissertations and Doctoral Studies

The costs of healthcare in the United States are of national concern. The systematic review of the literature (SRL) explored the practice-focused nursing question regarding the relationship between the use of acuity-based staffing (ABS) models and positive patient outcomes. Analyzing the impact of ABS models on patient quality outcomes and the potential economic value could provide evidence essential for the healthcare executives responsible for fiscally prudent labor management and for creating an evidence-based business case for adequate, patient-centric nurse staffing. The synergy model for patient care and Covell's nursing intellectual capital theory guided the doctoral project. The Preferred Reporting Items …

Doctor Of Nursing Practice Roles In Academia, Jodi Renee Raisor

Walden Dissertations and Doctoral Studies

Over 15,000 master’s and doctoral degree students in the United States were denied admission to nursing schools in 2014 because of insufficient nursing faculty. In 2016, over 64,000 undergraduate and graduate students were unable to gain admission to nursing school due to the effects of faculty shortages. This project explored the role of the Doctor of Nursing Practice (DNP)-prepared nurse in academic settings using a systematic review of the literature to determine the role of DNP-prepared nurses in academia. Souza’s systematic review model and Melnyk’s levels of evidence were used to guide the search, review, and the selection of scholarly …

Tobacco Treatment Education Module For Nurses Working In The Inpatient Psychiatric Setting, Marchell Rene Spielmann

Walden Dissertations and Doctoral Studies

Tobacco use among people with mental illness remain a significant problem in the western United States. At the project site, there is widespread tobacco use among patients with mental illness and lack of training for nurses to address the issue. The purpose of this project was to educate nurses working in the acute psychiatric setting about evidence-based tobacco treatment interventions. The practice-focused question addressed whether a tobacco education program would increase nurses' knowledge, confidence, and skills to provide tobacco treatment interventions to patients with a mental illness. Self-determination theory and the transtheoretical model of change provided the theoretical framework for …

Employee Retention Strategies For Executive Operation Leaders In An Academic Nursing Environment, Polly Castro Ramos

Walden Dissertations and Doctoral Studies

Employee attrition affects organizations in the form of lower productivity, decreased profitability, and reduced sustainability. In 2014, business owners lost over $11 billion in tangible and intangible assets due to the inability to retain employees. Using the social exchange theory as the conceptual framework, the purpose of this multiple case study was to explore effective employee retention strategies used by business leaders in an academic nursing environment. The study encompassed participants from 3 of the United States: Texas, Kentucky, and Florida. Participants were purposefully selected because of their experience in implementing effective employee retention strategies. Data were collected via semistructured …

Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale

Walden Dissertations and Doctoral Studies

Although licensed registered nurses (RNs) comprise a significant percentage of the U.S. health care workforce, there is a lack of qualified nurses to meet patient needs. This shortage is expected to intensify as practicing nurses leave the profession. The problem that prompted this study was that an attrition-reduction program implemented in the nursing program at a U.S. midwestern community college did not show a reduction in the average attrition rate. The academic integration construct of Tinto's theory of student departure was used to examine archival academic performance records of 145 students enrolled in the local program from 2010 to 2012. …

Nurse Practitioner Attitudes, Perceptions And Knowledge About Antimicrobial Stewardship, Evelyn C. Fabian

Walden Dissertations and Doctoral Studies

Resistance to antibiotics has increased dramatically in the United States, with serious associated medical, social, and economic consequences. The purpose of this project was to assess nurse practitioners' attitudes, perceptions, and knowledge about antimicrobial stewardship and knowledge in the management of anaerobic infections as well as resistant gram-negative bacteremia. Data were collected using a web-based survey in a hospital facility. The practice question explored whether nurse practitioners' attitudes, perceptions, and knowledge about antimicrobial stewardship significantly increased after an education program on antimicrobial stewardship. The project was framed by Knowles's adult learning theory. A 16-item survey was administered before and after …

Evaluation Of A Postpartum Hemorrhage Protocol, Lori M. Davies

Walden Dissertations and Doctoral Studies

Postpartum hemorrhage is a leading cause of maternal death, yet many deaths related to hemorrhage might be prevented with early recognition and intervention. The birthing unit of a U.S. community hospital formed an interprofessional task force to plan and implement a postpartum hemorrhage protocol that would provide the obstetric team with the knowledge, skills, and tools needed for early identification and quick action when hemorrhage occurred. Lewin's model of change provided a framework for protocol implementation. The purpose of this doctoral project was to evaluate this quality improvement project. Secondary data internal to the organization were collected and analyzed to …

Physical Activity And Dietary Interventions For Adolescent African Americans In Mississippi, Tanga Deson Hart Robinson

Walden Dissertations and Doctoral Studies

African American (AA) adolescents have higher rates of obesity than many other ethnic groups, which increases their risk for obesity-related diseases. Culturally sensitive obesity preventive interventions have been unsuccessful, resulting in a steady increase of obesity among AA adolescents. AA adolescents in the southern region of the United States are at a higher risk for obesity and physical inactivity; knowledge and understanding of causative factors remains limited. To identify the impact of programs, a systematic review of the literature focused on structured physical activity and/or dietary education interventions in Mississippi. The ecological framework was used to guide this study. The …

Nursing Knowledge On Pressure Injury Prevention In The Intensive Care Unit, Yanick Jacob

Walden Dissertations and Doctoral Studies

Over 60,000 hospital patients die each year from complications associated with hospital-acquired pressure injuries (HAPIs). Pressure-injury rates have increased by 2% within the past decade as life expectancy has also increased due to high cost in Medicare. Evidence shows that the incidence of pressure injuries (PIs) in healthcare facilities is increasing, with high rates of occurrence in intensive care units (ICUs). At the clinical site for which this project was developed, multiple in-services had been provided to staff regarding PIs, but uncertainty persisted about how knowledgeable the nurses were. This project, using the Academic Center for Evidence Star Model of …

Compassion Fatigue In Emergency Department Nurses, Michelle Candice Lawrence

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is defined as a sudden onset of the inability to experience feelings or compassion for others that is triggered by a nurse's inability to separate his/her feelings of stress and anxiety associated with caring for patients who have suffered from a traumatic event. The practice problem addressed in this doctoral project was the lack of knowledge of emergency department nurses (EDNs) related to CF in the work setting, resulting in a negative impact on a nurse's ability to provide quality care to patients. The purpose of the project was to present an educational program on how to …

A Staff Education Module For Depression Screening In Acute Care, Olufumilayo Sayo Onuoha

Walden Dissertations and Doctoral Studies

Depression is one of the most common mental health disorders in the United States. Although it can be treated, it may go unidentified for a long period of time. The World Health Organization (WHO) anticipates that, by 2020, depression will become responsible for more disabilities than a combination of other conditions, excluding heart conditions. The prevalence of depression among the general population is higher in patients who seek emergency healthcare services. The purpose of this project is to develop an evidence-based educational module for nurses to screen for depression in an acute care setting using the PHQ-2 and PHQ-9 depression …

Ambidexterity And Innovation In Chief Nursing Officers In The Healthcare Setting, Jennifer Wasilewski

Walden Dissertations and Doctoral Studies

Leaders in the healthcare setting are challenged with competing responsibilities as they seek to provide high-quality services, ensure the implementation of safety measures, and engage in workforce maintenance. Many researchers have described innovation as a strategic approach to organizational concerns and have noted a failure to implement innovative measures in healthcare. This study was an investigation of the impact of ambidexterity in healthcare leaders on innovation. The purpose of this quantitative study, guided by the ambidexterity theory of leadership for innovation, was to analyze the extent to which ambidextrous leadership characteristics of healthcare executives and chief nursing officers (CNOs) influence …

A Practice Guideline For Triaging Mental Health Patients In The Emergency Setting, Florence Nguh

Walden Dissertations and Doctoral Studies

Today's emergency departments (EDs) are challenged with increasing numbers of patients with behavioral health (BH) issues and associated management problems. Patients presenting in the ED are increasingly in need of BH services due to a lack of available services in the community. The implication is that ED staff are faced with conducting a comprehensive review of their systems and processes for BH care delivery to ensure that the needs of this population are safely met. Specifically, this DNP project addressed the lack of evidence-based screening tools for the ED triage area for patients with BH issues. The purpose was to …

Perceptions Of Caregivers Following Diagnosis Of Primary Benign Brain Tumor, Lisa Ann Richards Homa

Walden Dissertations and Doctoral Studies

A brain tumor diagnosis is traumatic and has a devastating impact upon the caregiver and the family unit. The effects of the tumor growth and treatment often cause significant neurologic injury and dramatically affect the quality of life (QOL) for the patient and their entire family unit. Caregivers are constantly challenged to provide care, yet they feel untrained and underprepared as they struggle to adjust to new roles and responsibilities. The purpose of this study is to gain an understanding of the lived experiences of caregivers of individuals with primary benign brain tumor (PBBT). An interpretive phenomenological analysis approach was …

Implementing Esi Education Project For Nurses In The Triage Process, Narissara L. Tran

Walden Dissertations and Doctoral Studies

Triage nursing assessment supports nursing professionals in delivering safe and effective patient care in emergency departments. This staff education project was driven by an observation of inconsistencies in triage among emergency department (ED) nursing staff. The purpose of the project was to improve the triage assessment knowledge of ED nurses. Specifically, the aim was to determine if educating ED nursing staff about using the Emergency Severity Index (ESI), a 5-level triage algorithm and a previously developed tool, would improve nurse knowledge in the triage process. Following discussion with the ED nursing manager at a hospital, a presentation on the ESI …

Improving Hypertensive Therapy Outcomes Among African Americans, Tanya Sullivan

Walden Dissertations and Doctoral Studies

The effects of nonadherence to prescribed blood pressure medication adversely impacts

African Americans (AA) in comparison to their European American counterparts. The

associated health consequences of uncontrolled hypertension include heart failure, stroke,

and renal dysfunction. And the treatment of the complications negatively impacts quality

of life and contributes to increased health care costs. To address the problem at 1 clinic, a

quality improvement (QI) project was developed by the clinic nursing staff, but the

project had never been evaluated. The project included blood pressure measurements

assessed among AA patients before and after implementation of a 4-item Morisky

Medication-Taking Adherence Scale …

A Clinical Practice Guideline To Improve Education In The Heart Failure Population, Mailey L. Wilks

Walden Dissertations and Doctoral Studies

Managing heart failure patients in the outpatient setting can pose a challenge for nurses and health care staff due to the need to educate patients on self-care skills and management of disease. Several factors, including health literacy and numeracy, need to be considered when developing an education program for heart failure patients to promote self-care management. The purpose of this project was to provide nursing staff with a clinical practice guideline (CPG) that incorporated health and numeracy literacy assessment into an individualized education program. The Johns Hopkins nursing evidence-based practice (EBP) model, the situation-specific theory of heart failure (HF) self-care, …

Policy Knowledge Communication In Nursing, Curtiss John Vavra

Walden Dissertations and Doctoral Studies

Evidence-based practices in nursing improve patient outcomes, decrease healthcare costs, and can be implemented with policies and procedures. However, there is limited literature describing how nurses acquire policy knowledge, the dissemination of which may require a significant investment of resources by a hospital. The purpose of this study was to learn more about how nurses obtain policy knowledge. Rogers's diffusion of innovations theory guided the examination of communication channels and how they relate to the formation of policy knowledge. The research questions were designed to gather information on the relationship of policy communication channels, demographic factors, and the frequency of …

Using A Pediatric Early Warning Score Algorithm For Activating A Rapid Response Team, Ruthann Kosick

Walden Dissertations and Doctoral Studies

The nursing culture of an inpatient pediatric unit was resistant to activating pediatric rapid response team (PRRT) alerts despite guidelines for activation. Nurses routinely assessed patients and assigned a pediatric early warning score (PEWS); however, the level of illness severity was not interpreted consistently among nurses and a PEWS action algorithm did not exist to guide nurses' minimal actions based on the PEWS score. Guided by 3 adult learning theories (Knowles, Kolb, and Bandura) and 1 evaluation model (Kirkpatrick), this staff education project sought to educate pediatric nurses on a PEWS action algorithm and determine whether this project improved nurses' …