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Implementation Of An Amiodarone Infusion Nurse Practice Guideline To Reduce The Incidence Of Phlebitis: A Quality Improvement Project, Kristen N. Cottrill

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Patients have an increased risk of developing phlebitis when amiodarone is delivered through a peripheral intravenous catheter. In a 32-bed cardiac surgery step-down unit, patients experienced phlebitis at a rate of 28.57% despite following manufacturer recommendations. Individual interventions targeted at amiodarone-related phlebitis have presented mixed results, however, when an amiodarone infusion practice guideline was established, the rate and severity of phlebitis consistently decreased across studies. Purpose: This project aimed to implement an evidence-based amiodarone infusion guideline to reduce phlebitis development or severity in cardiac-surgery step-down patients without a central venous catheter who received a peripheral intravenous infusion of amiodarone. …

A Quality Improvement Evaluation On A Nurse Residency Program, Mary Christine Richards

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this DNP project was to explore new graduate nurse (NGN) residency program retention data in a large healthcare system to assess if participant retention met or exceeded identified retention benchmarks. The second project question explored NGNs’ reasons for leaving the organization after the first year of experience. The Plan Do Study Act model framed this quality improvement evaluation project. The total number of NGN residency participants for the system in 2020 was 586 and 680 in 2021.Year one retention in 2020 was 539 (92%). Year one retention in 2021 was 625 (92%). Year two retention data were …

Staff Education On Hepatitis C Screening Guidelines, Duy Le Trinh

Walden Dissertations and Doctoral Studies

Hepatitis C virus (HCV) is found worldwide, but the burden is much higher in correctional settings compared to general populations. In a detention centered located in Washington, the nurses at booking do not know who are at risk for Hepatitis C. This Doctor of Nursing (DNP) project attempted to answer the question of if educating nursing staff at the detention facility in Washington increase their knowledge of the importance of screening inmates for hepatitis C.The purpose of this project was to educate nursing staff about the risk factors for HCV so that proper screening can be done. Knowles’s adult learning …

Novice Nurses’ Perceptions And Expectations Of What Constitutes Nursing Practice, Mcfrances Catherine George

Walden Dissertations and Doctoral Studies

AbstractAfter completing preceptorship programs, novice nurses work independently to provide patient care at the bedside. Novice nurses may leave bedside nursing with a minimum of 1 year of experience, resulting in vacant bedside nurse positions. These vacant positions are a problem because this could lead to low patient satisfaction, higher patient mortality rates, and failure to rescue in emergent cases. The purpose of this study was to explore the perceptions and expectations of nursing practice related to performance, demands, and requirements from novice nurses. Afaf Meleis's 1960 transition theory guided the understanding of novice nurses' perceptions and expectations of nursing …

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …

Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky

Walden Dissertations and Doctoral Studies

Emotional intelligence (EI) is defined as the capacity to recognize and manage emotions and feelings to guide behaviors which is an ability that is crucial for nurse mangers to possess. Understanding the key factors for predicting emotional intelligence in nurse managers may influence hiring practices and the appointment of managers who will influence job satisfaction, employee engagement, retention, and turnover. The purpose of this quantitative predictive correlational study, guided by King’s theory of goal attainment and Mayer and Salovey’s four-branch ability model of EI, was to determine whether age, years of experience as a nurse, and years of experience as …

Staff Education On Perinatal Depression, Kirenia Santiuste

Walden Dissertations and Doctoral Studies

Perinatal depression (PND) is a global mood disorder affecting women transitioning into parenthood and is closely related to extensive psychosocial and financial consequences for the family. Ten to twenty percent of new mothers in the US are affected by PND in the year after giving birth. The problem identified for this Doctor of Nursing Practice project was the need for staff education on knowledge of and screening for PND in the obstetrical clinic for which the project was developed in a southeastern state of the US. Using the analysis, design, development, implementation, and evaluation model, the purpose of this Doctor …

Relationship Between Incentive Program Costs, Incentive Payments, And Profitability, Claire Claire Turner

Walden Dissertations and Doctoral Studies

The lack of profitability among primary care businesses can have harmful impacts on business operations. Primary care businesses owners must remain profitable to remain in business and provide quality health care to patients. Grounded in Freeman’s stakeholder theory, the purpose of this quantitative correlational study was to examine the relationship between incentive program costs, incentive payments, and profitability. Data were collected from 73 primary care physician business owners in the Inland Empire region of southern California. The multiple linear regression analysis results indicated the model was able to significantly predict profitability, F(2,70) = 1343.6, p <.001, R2 = .975. Incentive payments (t = 51.837, p < .001,  = .928) was the only statistically significant predictor. Key recommendations include educating primary care physicians on the potential financial benefits of full participation in the commercial line of business pay-for-performance incentive programs and creating a campaign to bring in patients for wellness visits. The implications for positive social change include the potential for an additional revenue stream for primary care physician business owners, which could support more clinics, increasing patient access. Patients having better access to healthcare could positively affect the health and wellness of individuals in local communities.

Retention Strategies For The Current Nursing Workforce, Jennifer Higgins

Walden Dissertations and Doctoral Studies

Retaining a robust nursing workforce is essential to care delivery. As the generation gap in the nursing field widens, retention strategies that align with the current nursing workforce must be considered. Rapid turnover is a looming concern as baby boomers retire and millennials become the leading generation in the nursing workforce. Nurse leaders must identify and deploy strategies that will provide a meaningful work environment to retain nurses in this majority group. The purpose of this project was to address the gap in practice of rising turnover, low nurse engagement, and reliance on premium labor to deliver care. The sources …

Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson

Walden Dissertations and Doctoral Studies

This project was an evaluation of a quality improvement (QI) initiative conducted in a large medical enterprise to address the problem of poor performance of their hospitals in accreditation surveys. The desired outcome was to evaluate whether an innovative plan of correction process was impactful in reducing the negative outcomes of regulatory and accreditation surveys. The practice-focused question guiding this project addressed the effect of the pre-accreditation evaluation and a plan of correction process in this QI initiative on reducing requirements for improvement (RFI) and condition-level deficiencies (CLD) cited in a recent The Joint Commission survey review. This project was …

Dcn Dissertation Proposal: The Impact Of A Pediatric Interdisciplinary Outpatient Feeding Clinic On Preterm Infant Weight Gain And Caregiver Compliance With Feeding Recommendations, Doretta Leung

Dean's Leadership Council Library Research Prize

Early nutrition intervention along with interdisciplinary care is important for premature infants because malnutrition often leads to poor growth in this population.1,2 Poor growth in preterm infants results in subsequent neurocognitive development as there is an association between deficient postnatal growth and poor neurologic outcome up to age 19.1,2 It is important to focus on an infant’s nutrition, feeding, and any gastroenterology concerns after hospital discharge to prevent poor growth. Most importantly, it is essential to have an interdisciplinary care monitoring infant care and outcomes in an outpatient setting; however, this service is lacking in Northeast Florida. The newly developed …

The Efficacy Of Barcoded Medication Administration In The Emergency Department, Aleksandr Vasserman

Walden Dissertations and Doctoral Studies

The practice problem addressed in this Doctor of Nursing Practice project was safe medication administration in the emergency department (ED). Paper-based delivery of medication administration is prone to errors and multiple points of failure affecting patients’ safety. The gap in nursing practice was the lack of analysis regarding the efficacy of the barcoded medication administration (BCMA) process in the ED. The practice-focused question for this project addressed whether the implementation of BCMA in the ED effectively reduced medication administration errors as compared to the previously used paper-based, non-BCMA process. The aim of this doctoral project was to review the efficacy …

Effect Of Compassion Fatigue And Burn Out Education In The Nurse, Pamela Spendiff

Walden Dissertations and Doctoral Studies

Evolving changes in healthcare have caused increased levels of pressure on registered nurses (RNs) which increases compassion fatigue (CF), secondary traumatic stress (STS) and burnout (BO) and negatively affect compassion satisfaction (CS) which may affect a nurse’s abilities and skills to provide quality care for patients and cause the RN to leave the profession. The mindfulness technique is one method which may help reduce CF, STS and BO in RNs. The purpose of this quasi-experimental study, guided by the compassion satisfaction and compassion fatigue model (CS-CF), was to determine what effect a mindfulness-based intervention (MBI) has on CF, BO and …

Meaningful Work And Remote Employee Engagement During The Covid-19 Pandemic, Monique Foster

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic accelerated the remote working trend, causing workplace leaders to be challenged and remote employees to feel meaninglessness and lose interest in their work. The subjective nature of meaningful work and enforced remote work is a relatively recent socioeconomic phenomenon, creating a gap in the literature regarding how middle managers foster meaningful work for employees in a remote work environment. The purpose of this qualitative narrative inquiry study was to understand how middle managers fostered meaningful work for employees in a remote work environment during the COVID-19 pandemic. Data were collected from semistructured interviews with 10 middle managers …

Local Public Health System Comprehensiveness And Opioid Overdose Mortality, 2012-2018, Stephanie Courtney

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Deaths due to opioid overdose are a significant public health burden in the United States. Studies suggest that local public health systems that perform a high number of essential activities where local health departments contribute to the delivery of the activities and promote increased partnership may positively influence population health outcomes such as overdose mortality. Studies have shown that comprehensive public health systems are associated with improved health outcomes, but this association has not been addressed in the context of opioid overdose deaths. Study Aim: The purpose of this study is to evaluate the associations between local public health …

Implementation Of Physical Activity In Kentucky Public Schools: From Theory To Policy, Nancy Kearns

Theses and Dissertations--Rehabilitation Sciences

Physical activity in schools improves academic performance and fitness measures in children. However, state policy supporting implementation of physical activity remains poor. Identifying specific barriers to implementing physical activity minutes in Kentucky public schools is pivotal in preserving the cognitive and physical health of our children. This is of particular interest as physical activity minutes remain low despite the positive effects of exercise on cognition. The purpose of this dissertation is to provide policymakers and school administrators a method of identifying current policies, attitudes and infrastructure that inhibit the implementation of physical activity minutes in public schools. Thus, the findings, …

Promoting A Culture Of Self-Care: Application Of A Caring Science Framework To Prevent Nursing Faculty Burnout, Angela M. Braswell

DNP Scholarly Projects

BACKGROUND: Threats to nurses’ well-being from chronic workplace stress often leads to burnout. Lack of self-care contributes to nursing faculty burnout due to the inability to maintain well-being. Emerging evidence points to theory guided self-caring practices as effective coping strategies to manage the negative effects of workplace environments on well-being.

METHODS: This quality improvement project aimed to provide nursing faculty and staff in the academic workplace with opportunities to cultivate and enhance self-care practices to promote overall health and well-being following principles of Caring Science and Jean Watson’s 10 Caritas Processes^®. A multifaceted set of interventions were provided: …

Implementation Of A Standardized Medication Reconciliation Protocol In A Psychiatric Stabilization Setting, Sara Robinson

DNP Scholarly Projects

BACKGROUND: Medication errors are a prevalent patient safety concern across healthcare settings. High-quality medication reconciliation is an intervention and expected standard of care that can help to prevent adverse drug events. This quality improvement project focused on implementing a standardized medication reconciliation protocol on a short-stay psychiatric unit.

INTERVENTION: An evidence-based toolkit supported by the Agency for Healthcare Research and Quality (AHRQ), Medications at Transitions and Clinical Handoffs (MATCH) was selected as the framework for developing and implementing this protocol.

Congruent with the evidence-based toolkit recommendations, baseline data collection and needs assessment provided context for tailoring the intervention to the …

Staff Education Program On Postpartum Depression Screening, Pamela Barstow

Walden Dissertations and Doctoral Studies

AbstractPostpartum depression (PPD) in the US is a serious health concern that negatively impacts an average of 11.5% of women, with 13.36% of women in Virginia in 2018 reporting PPD symptoms. Mothers experiencing PPD may have trouble bonding with their infants, which may negatively impact childhood growth and development. However, fewer than one-half of pediatricians screen mothers of infants for PPD. Literature supports staff education on PPD to promote the wellbeing of postpartum mothers and their infants. Using the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this Doctor of Nursing Practice project was to …

Exploring Implementation Strategies Of Iot Technology In Organizations: Technology, Organization, And Environment, Khanhhung Hoang Pham

Walden Dissertations and Doctoral Studies

AbstractAfter organizations successfully adopt the internet of things (IoT) technology, many corporate information technology (IT) leaders face challenges during the implementation phase. Corporate IT leaders' potential failures in implementing IoT devices may impede organizations from integrating IoT solutions and promoting business benefits. Grounded in technology-organization-environment (TOE) theory, the purpose of this qualitative, pragmatic inquiry study was to explore strategies that corporate IT leaders use to implement IoT technology in their organizations. The participants were six corporate healthcare IT leaders who successfully used implementation strategies for implementing IoT solutions for their organizations. Data were collected using semistructured interviews and industry security …

Organizational Barriers To Effective University Student Mental Health Services, Felicia Evans-Edwards

Walden Dissertations and Doctoral Studies

This study was focused on organizational barriers to effective university student mental health services access in the department of student resources (DSR) at a for-profit university in the northeastern United States. Once such barriers are addressed, faculty may be more successful in reaching out to students needing mental health services who are not self-identifying as needing these services. The Baldrige excellence framework guided this descriptive case study to examine the organizational barriers that prevent university leadership from creating clear policies and procedures for faculty to refer students to mental health services. Data sources included interviews with the behavioral health leader …

Comparison Between Hospital Ownerships In The Prevention Of Surgical Site Infections, Kameha Johnson

Walden Dissertations and Doctoral Studies

AbstractMillions of Americans seek health care for surgical interventions throughout the United States. Despite the 2010 Affordable Health Reform Act, hospital-acquired infections (HAIs) are still rising. Specifically, surgical site infections (SSIs) are a national problem in both non-profit and for-profit hospitals. SSIs are the third most commonly reported HAIs and account for 14%-16% of HAIs among U.S. patients. The purpose of this quantitative study was to determine an association between the independent variable of the type of hospital ownership (i.e., non-profit and for-profit), and SSI rates, health care utilization cost (i.e., readmission rates and LOS), and patient outcome measures (i.e., …

The Efficacy Of Barcoded Medication Administration In The Emergency Department, Aleksandr Vasserman

Walden Dissertations and Doctoral Studies

The practice problem addressed in this Doctor of Nursing Practice project was safe medication administration in the emergency department (ED). Paper-based delivery of medication administration is prone to errors and multiple points of failure affecting patients’ safety. The gap in nursing practice was the lack of analysis regarding the efficacy of the barcoded medication administration (BCMA) process in the ED. The practice-focused question for this project addressed whether the implementation of BCMA in the ED effectively reduced medication administration errors as compared to the previously used paper-based, non-BCMA process. The aim of this doctoral project was to review the efficacy …

Strategies For Achieving Sustainability Of Home Healthcare Agencies, Robert J. Gagnon

Walden Dissertations and Doctoral Studies

AbstractSome organizational leaders of home healthcare agencies (HHA) experience financial pressures to sustain within the changing regulatory landscape. Organization healthcare leaders who develop sustainability strategies remain competitive and employ the community. Grounded in the balanced scorecard framework, the purpose of this descriptive, qualitative multiple case study was to identify strategies home healthcare agency (HHA) leaders used to maintain sustainability. The participants were five organizational leaders of three HHA and two home health industry consultants in the Northeast United States who implemented sustainability. Data collected came from semistructured interviews, archival records, and organizational documentation. Three themes emerged from the thematic analysis: …

Development Of A Capacity Building Program To Promote Trauma-Informed Services, Juan Miguel Medina

Walden Dissertations and Doctoral Studies

Wichita County, Texas experienced decreased academic performances of elementary level children in 24 out of 45 communities. Higher numbers of traumatic experiences increase a child's risk of not meeting developmental benchmarks. The purpose of this capstone project is to support the development of a trauma-informed capacity-building program. Ungar's resiliency theory was used to understand the factors related to building resilience in children to prevent trauma. Using action research, the researcher explored how developing program content may improve an agency's system readiness to deliver effective trauma-informed care. Data were collected from a focus group with local social workers. Content analysis was …

Challenges For Hospital Leadership In Obtaining Urology And Otolaryngology Community Preceptors, Donna Orsatti

Walden Dissertations and Doctoral Studies

Healthcare organizations are becoming more complex and medical education is constantly evolving in response to healthcare needs. These changes have an impact on community preceptors that supervise and train medical residents. Physicians willing to engage in community-based precepting are decreasing, thereby making it difficult for students to complete medical specializations. The purpose of this qualitative study was to understand the challenges healthcare leaders face when attempting to secure practicums or residencies in urology and otolaryngology. This case study used the Baldrige Excellence Framework as a lens to understand the organization’s functioning within the educational healthcare sector. In-depth, semi-structured interviews were …

Educating Nurse Leaders On The Application Of Watson’S Caring Science, Diane Lm Updyke

Walden Dissertations and Doctoral Studies

Nurse leaders’ creation of a culture of caring for their nursing staff has been shown to improve nurses’ job satisfaction and retention, and ultimately patient outcomes. At the project site, there was a perceived gap in nursing leadership practice in integrating a culture of caring into leadership and management practices. Although staff and leadership identified similar caring behaviors, staff members did not perceive nursing leadership as caring, which affected the former’s job satisfaction. The purpose of this education project was to provide site leaders with information on specific caring behaviors and how to model these behaviors with staff using Watson’s …

Military Emergency And Critical Care Nurses’ Lived Experiences Of Resilience, Carla Ann Wiese

Walden Dissertations and Doctoral Studies

Resilience has been studied across a myriad of populations. Many resilience studies have focused on military service members, including military healthcare personnel, specifically nurses. Although many quantitative resilience studies have been conducted, there have been few qualitative studies in this area. Qualitative studies have focused solely on spiritual resilience, although mixed methods studies have identified other resilience characteristics. The aim of this descriptive phenomenological study was to identify resilience characteristics through rich description within the situational and philosophical patterns of resilience and gain a better understanding of how emergency and critical care military nurses honed resilience in the face of …

Improving Medical-Surgical Nursing Knowledge Of Congestive Heart Failure, Sylvia Rene Cunningham

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing practice project was to address the nursing gap in knowledge about congestive heart failure (CHF) management. Lack of staff knowledge on this topic inhibits their ability to educate patients. Poor patient understanding can lead to frequent readmissions and poor patient outcomes. The project aim was to determine if educating medical-surgical nurses about CHF management increased their knowledge of topic. The ADDIE model was used to design staff education. Lewin’s change theory guided the project. Nine registered nurses attended a power point presentation. A pre-education questionnaire was distributed, and participants created unique identifiers. The …

Behavioral Predictive Analytics Towards Personalization For Self-Management – A Use Case On Linking Health-Related Social Needs, Bon Sy, Michael Wassil, Helene Connelly, Alisha Hassan

Publications and Research

The objective of this research is to investigate the feasibility of applying behavioral predictive analytics to optimize patient engagement in diabetes self-management, and to gain insights on the potential of infusing a chatbot with NLP technology for discovering health-related social needs. In the U.S., less than 25% of patients actively engage in self-health management even though self-health management has been reported to associate with improved health outcomes and reduced healthcare costs. The proposed behavioral predictive analytics relies on manifold clustering to identify subpopulations segmented by behavior readiness characteristics that exhibit non-linear properties. For each subpopulation, an individualized auto-regression model and …