Medicine and Health Sciences Commons^™

“You Came To Not Normal Land”: Nurses' Experience Of The Environment Of Disaster: A Phenomenological Investigation, Stasia Elizabeth Ruskie

Doctoral Dissertations

Previous research suggests US nurses are unprepared for disaster, and suffer from adverse psychosocial outcomes following their disaster response. Current disaster preparedness focuses on providing hospital-centric trauma and acute care in fully resourced Western conditions, and does not include the environmental realities of the disaster setting. This study utilized an existential phenomenological approach to explore the meaning of the nurse’s experience of the disaster environment. Eleven nurses with broad disaster expertise and training levels participated in this research. The essence of their disaster experiences can be summed up by the central theme of “You came to not normal land.” Four …

Examining The Relationships Between Gratitude And Readiness For Self-Directed Learning In Undergraduate Nursing Students, Kellee Renee Vess

Doctoral Dissertations

The purpose of this study was to explore the relationships between gratitude and readiness for self-directed learning among nursing students enrolled in a four-year baccalaureate nursing program. For this study a sample of 59 nursing students were selected from a four-year baccalaureate nursing program, situated in a private, faith-based college in the Southeast United States. During data collection, participants were asked to complete the Gratitude 6-item questionnaire [GQ-], the 40-item Self-Directed Learning Readiness Scale for Nursing Education [SDLRS-NE], and two demographic questions (i.e., age and class rank). Using both parametric and nonparametric statistics, this study examined eight research questions, and …

Experiences Of Newly Licensed Registered Nurses Who Stay In Their First Jobs, Lisa D. Kirkland

Doctoral Dissertations

Most newly licensed registered nurses go to work in acute care hospitals, which means they enter an increasingly complex healthcare environment where they experience staffing shortages, high nurse-patient ratios, and workplace violence. The purpose of this study is to attempt to understand the experiences of newly licensed registered nurses who have endured the early years of bedside hospital nursing and continue to work in their first nursing job. The existential phenomenological philosophy of Merleau-Ponty serves as the guiding framework for this qualitative research study. Following IRB approval, criterion and snowball sampling were used to recruit newly licensed registered nurses who …

Injection Drug Users’ Perceptions Of Received Nursing Care: A Case Study, Kimberly Dion

Doctoral Dissertations

The primary aim of the exploratory case study was to explore the injection drug users’ experience with received nursing care while hospitalized on a medical unit. Data were gathered using semistructured interviews with nine injection drug users at two needle exchange services. Five men and four women were interviewed for 27–90 minutes. Travelbee’s (1971) interpersonal nursing model served as the theoretic framework for this study. Data were analyzed through the process of coding, pattern matching, and the convergence of emerging themes. For the rival case, the theme of Understanding Addiction emerged. For the comparison cases, the overarching themes of Marginalization …

Developing An Optimal Model For Infant Home Visitation, Isaac Atuahene

Doctoral Dissertations

The United States, Great Britain, Denmark, Canada and many other countries have accepted home visitation (HV) as a promising strategy for interventions for infants after births and for their mothers. Prior HV studies have focused on theoretical foundations, evaluations of programs, cost/benefit analysis and cost estimation by using hospital/payer/insurance data to prove its effectiveness and high cost. As governments and private organizations continue to fund HVs, it is an opportune time to develop and formulate operations research (OR) models of HV coverage, quality and cost so they might be used in program implementation as done for adult home healthcare (HHC) …

Newly Licensed Registered Nurses' Experiences With Clinical Simulation, Carrie Ann Bailey

Doctoral Dissertations

The purpose of this study was to understand how new graduate nurses perceive the value of simulation in making the transition into professional practice. This study will use a descriptive qualitative approach with a sample of first year nurses. Kolb’s Experiential Learning Model serves as this study’s conceptual framework. For the current study, the sample consisted of 10 newly graduated, female nurses with less than one year of experience working in the hospital setting were interviewed. Data analysis included interviews and transcription by the researcher. Finally, participants were asked about themes to increase rigor. Four themes emerged from this research: …

A Cyberbullying Needs Assessment In A Middle School Population: Identifying A Direction For Nurses, Ashley M. Eggleston

Doctoral Dissertations

Cyberbullying is a fairly new phenomenon that most adolescents will experience or be exposed to during their lifetime. It produces devastating outcomes on those who are victims and perpetrators of cyberbullying. There is a limited amount of research regarding the prevention of cyberbullying. The evidence that is available is mostly exploratory in nature. Currently, the literature recommends conducting a needs assessment to validate the problem, raise awareness, and identify potential solutions that are specific to a population and/or setting. Therefore, the purpose of this scholarly project was to administer a cyberbullying needs assessment at a local west Michigan middle school. …

A Process Improvement Toolkit To Guide The Attainment Of Meaningful Use Stage 2 Requirements, Katie M. Alfredson

Doctoral Dissertations

Healthcare is evolving. Reimbursement is transitioning to a model based on quality and patient outcomes. To remain relevant and survive this transition, providers of care must adapt and implement new models of care delivery that account for these changes. This toolkit was created as a deliverable of a Doctor of Nursing Practice dissertation that explored a successful primary care delivery model of a Patient-Centered Medical Home that utilized an interdisciplinary team approach that included nurses. Through this model high quality care was delivered to achieve desired outcomes, specifically, successful attestation for Stage 2 of the Meaningful Use Incentive Program during …

The Evaluation Of Select Lifestyle Behavior Modification Following Participation In A Comprehensive Weight Management Clinic, Jennifer L. Bowling

Doctoral Dissertations

Over the last decades, obesity in the United States has reached epidemic proportion. Obesity rates have nearly doubled since 1960 when 43% of the United States population was overweight or obese and 1% was extremely obese. In 2012, approximately 69% of the US population was overweight or obese while 6.3% were extremely obese. Obesity rates are expected to progressively increase; therefore, interventions and guidelines are imperative in order to reduce the long term health risks of the Nation and to reduce overall health care costs (National Institute of Health [NIH], 2012).

Obesity increases morbidity resulting from associated hypertension, cardiovascular disease, …

An Interdisciplinary Team Approach To The Patient-Centered Medical Home As A Means Of Meeting Meaningful Use Stage 2 Requirements, Katie M. Alfredson

Doctoral Dissertations

In an attempt to address the shortcomings of the current U.S. healthcare system, reimbursement structure is changing from fee-for-service to a value-based model. This requires drastic change in how care is delivered. Therefore, care delivery models and reimbursement incentive programs are evolving to promote advancements in care delivery. This project examined an interdisciplinary team model utilized at a rural, privately owned practice that is a Patient Centered Medical Home (PCMH). This practice has incorporated unique structures and processes to attain Stage 2 Meaningful Use requirements in the first year attesting for this stage became available as a means of addressing …

Exploring Holistic Comfort In Children Who Experience A Clinical Venipuncture Procedure, April Athena Bice

Doctoral Dissertations

Children often experience the uncomfortable effects of invasive procedures as a part of primary health supervision and during times of illness. Inadequate procedural comfort management can lead to numerous lasting harmful effects including distrust of healthcare providers, future intensified pain responses, negative cognitive and emotional experiences, and psychosocial health problems (Czarnecki et al. 2011). Holistic comfort has been well documented in adult literature but little research exists on the understanding of holistic procedural comfort from the child’s perspective. The purpose of this study was to explore perspectives of children age 4 to 7 years and their caregivers regarding procedural holistic …

The Development Of An Evidence-Based Ebola Virus Disease Preparedness Plan For A College Health Center, Julie Cooper

Doctoral Dissertations

Ebola Virus Disease (EVD) represents a new and previously unexplored threat to college campuses across the United States. In the fall of 2014, thousands of international students arrived on college campuses across the nation, but there were few resources for officials in higher education to reference as they sought to manage the threat of an unfamiliar hemorrhagic disease. Preparing for viral outbreaks is an essential task for campus emergency response committees. Colleges and universities are at risk for disease outbreaks because of extensive travel programs and close living quarters. At the same time, colleges must also promote hospitality and avoid …

The Effectiveness Of A Multi-Component Community Program For The Prevention Of Childhood Obesity, Katelyn Bailey

Doctoral Dissertations

Trends in childhood obesity have increased in the past several decades at an alarming rate. According to the CDC, there are 12.5 million children ages 2-19 years affected by the condition. There are many associated comorbidities to childhood obesity and they are negatively affecting our nation’s youth. Research supports childhood obesity prevention programs that are familybased, take place in the community, and include education about nutrition, physical activity, and behavior change. B.Healthy Families is a program designed to address the issue of childhood obesity in a rural county in the Midwest. It was a six week community-based program that involved …

Implementation Of Motivational Interviewing In A Multidisciplinary Hiv Clinic In An Academic Medical Setting, Lucy Ledesma

Doctoral Dissertations

Purpose: People living with HIV (PLWH) struggle with medication adherence. Antiretroviral therapy (ART) requires greater than 95% adherence to prevent HIV drug resistance and treatment failure. Motivational interviewing (MI) is an effective counseling method designed to enhance health behavior change. This project determined the effectiveness of a two-day introductory MI training course on participant MI knowledge, perception of MI effectiveness, perception of client behavior change, and likelihood of MI use in a Midwest outpatient HIV clinic.

Participants: Seven clinical and non-clinical members of the multidisciplinary care team completed the two-day MI training course. Approximately 82% of the participants had never …

Implementation Of A Treatment Plan In A Rural Health Clinic For Patients With A Diagnosis Of Migraine Headache, Darleen C. Hoffert

Doctoral Dissertations

The purpose of this practice dissertation was to improve the quality of care and outcomes for patients in a small, rural health clinic with a diagnosis of migraine headache. The Institute for Clinical Systems Improvement (ICSI) prepared a health care guideline for the diagnosis and treatment of headaches (Beithon et al., 2013). As part of this guideline, aims and measures were provided for the purpose of quality improvement in migraine headache management (Beithon et al., 2013). The guidelines state the purpose of Aim #5 is to, “increase the percentage of patients with migraine headache who have a treatment plan” (Beithon …

Exploration Of Chemotherapy Safe-Handling Practices And Identification Of Knowledge Deficits Among Oncology Nurses In The Ambulatory Care Setting, Cheryl A. Verstrate

Doctoral Dissertations

The purpose of this project was to explore nursing practice perceptions regarding the safe-administration of outpatient chemotherapy and establish whether a knowledge deficit existed in an ambulatory care setting. Although recommendations for chemotherapy administration exist they are not mandatory and data suggests that contamination may still be occurring, due in part to inconsistent nursing compliance. To provide a foundation for instituting safety improvements in the administration of chemotherapy, a mailed survey was distributed to a population of 68 oncology nurses in an outpatient setting to explore the disparity between evidence-based recommendations and actual implementation.

The Chemotherapy Handling Questionnaire previously developed …

Cup Feeding In The Neonatal Icu: The Influence Of Country, Belief, Preference, And Past Behavior, Sameh Ghareeb

Doctoral Dissertations

Background/ Purpose: Cup feeding has been identified as a safe alternative for preterm infants who are not able to fully breastfeed, and it has been recommended by international organizations like World Health Organization, yet the practice is limited worldwide. One potential reason this alternative is underutilized is lack of health care providers’ (HCP) knowledge and negative beliefs regarding cup feeding. Jordan and the United States have different health systems, languages, cultures, and economies. A cross cultural comparison of HCP’s knowledge and beliefs in these two contrasting countries may yield some interesting and valuable findings that may further inform clinicians …

Effects Of A Mental-Health Clinical Simulation Experience Using Standardized Patients And Two Debriefing Styles On Prelicensure Nursing Students' Knowledge, Anxiety, And Therapeutic Communication And Psychiatric Assessment Skills, Debrayh Gaylle

Doctoral Dissertations

The purpose of this quasi-experimental pretest-posttest study was to compare the effects of two debriefing styles (insimulation and postsimulation) on (a) students’ knowledge of psychiatric assessment and therapeutic communication, (b) students’ performance of a psychiatric assessment using therapeutic communication, (c) students’ perceived anxiety related to a clinical rotation in psychiatric mental-health, and (d) students’ perceptions of the efficacy of the insimulation debriefing. The participants (n = 67) were senior, prelicensure nursing students enrolled in a baccalaureate degree program. Students were assigned randomly to either the treatment or the compression group and participated in a series of simulated interviews using student …

The Effect Of Simulation With Debriefing For Meaningful Learning In Courses Of Nursing Theory And Practicum On Student Knowledge And Perception Of Instruction, Kathleen L. Shea

Doctoral Dissertations

Nursing students are expected to apply knowledge from lectures and laboratories to the clinical setting. One major challenge of nursing educators is facilitating the transfer of knowledge to the clinical-practice setting. Simulation-based education provides students with an experiential-learning activity within the context of a simulated clinical environment. Following the simulation activity, the instructor facilitates a debriefing session and guides student discussion and reflection related to the experience. Debriefing promotes understanding of nursing concepts (Benner, Sutphen, Leonard, & Day, 2010).

The purpose of this research is to compare two debriefing methods: traditional method and Debriefing for Meaningful Learning DML (Dreifuerst, 2012). …