Digital Commons Network^™

Chemotherapy-Induced Peripheral Neuropathy Education And Assessment, Kim Schmidt

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating side effect of most chemotherapeutic agents used to treat cancer. To ensure the best possible care and outcomes for patients, nurses should be at the forefront of CIPN education and patient assessments. The purpose of this project was to evaluate an educational intervention for oncology nurses on CIPN and CIPN patient assessment by assessing the knowledge and confidence level of nurses in assessing CIPN before and after an educational session. The methodology for this project was a quasi-experimental one-group pretest multiple posttest design with a convenience sample of nurses employed by the Cancer …

Investigation Of Reasons Children Are Unvaccinated, Tracy L. Clawson

Walden Dissertations and Doctoral Studies

Many communicable diseases can be prevented with the use of immunizations. The issue this study addressed was the use of vaccinations and the rise of continued preventable communicable disease. Researchers have recommended that children be vaccinated, a recommendation that is bolstered by the readily available supply of vaccinations worldwide. However, even with vaccine promotions, availability, and education, children continue to be unvaccinated and outbreaks have continued to occur. For this study, data will be collected from the Iowa Registry of Immunization Records and a local community health center pediatric clinic. Examples of data that will be collected are vaccine records, …

Racism Vs. Social Capital: A Case Study Of Two Majority Black Communities, Bruce W. Strouble

Walden Dissertations and Doctoral Studies

Several researchers have identified social capital as a means to improve the social sustainability of communities. While there have been many studies investigating the benefits of social capital in homogeneous White communities, few have examined it in Black homogeneous communities. Also, there has been limited research on the influence of racism on social capital in African American communities. In this dissertation a comparative case study was used within a critical race theory framework. The purpose was to explore the role of racial oppression in shaping social capital in majority African American communities. Data were collected from 2 majority Black communities …

An Outcome Evaluation Of An Evidenced-Based Leadership Framework On Nursing Retention In A Tertiary Medical Center, Robbie Gail Robbie

Walden Dissertations and Doctoral Studies

An evidence-based leadership (EBL) framework is an intervention designed to facilitate organizational changes such as the reduction of nursing turnover and the improvement of nursing job enjoyment. This project provides an overview of the effect of nursing turnover on an organization, presents the components of the EBL framework, and provides an evaluation of the influence of EBL on nursing turnover and job enjoyment. The EBL framework provided a method for reducing variance in leadership skill and behavior by outlining specific methods necessary to reduce inconsistency. The project objective was to determine if the implementation of an EBL framework for 820 …

Conducting A Needs Assessment At Outpatient Medical Clinic, Fidelia Ijeuru Ukah

Walden Dissertations and Doctoral Studies

Colorectal cancer is one of the most common cancers in the United States and confronting its challenges has remained a problem to the United States health sector, especially among outpatient clinics. Guided by health belief model, the purpose of this needs assessment was to identify patients age 50 and older in outpatient clinic located in a large metropolitan city in Texas who should receive information on the need for colorectal cancer screening based on their risk for developing colorectal cancer as outlined by American Cancer Society. A sample of 70 charts of patients age 50-75 years was randomly selected and …

The Effect Of A Culture Of Safety On Patient Throughput, Laurie Lee Dawn Dillon

Walden Dissertations and Doctoral Studies

There is a national movement to create improvements in patient safety and outcomes due to evolutionary changes in the healthcare. Many health care organizations are using the framework of a culture of safety in order to create a reliable and stable work environment that emphasizes safety and improves patient outcomes. Patient throughput, defined as the active management of the supply of patient beds (rooms for occupation) to the demand of patients to beds and the length of time it takes for this action to occur, has been identified as one of the areas in need of improvement. This study considered …

An Educational Program For Nurses On Therapeutic Misconception In The Oncology Setting, Debra Magnanelli

Walden Dissertations and Doctoral Studies

A key component of informed consent to participate in research is the understanding that research is not the same as treatment and that scientific goals have priority over therapeutic ones. However, studies have found many research participants do not understand these important differences between research and treatment, a phenomenon termed therapeutic misconception (TM). The problem addressed in this project was research nurses' lack of education regarding the existence and concepts of TM, and their struggles to assess and address research participants' TM of clinical trials. Matutina's conceptual model of TM was used to guide this project. The purpose of this …

Practices Of Tracheal Suctioning Technique Among Health Care Professionals: Literature Review, Rozina Khimani, Fauziya Ali Dr., Salma Rattani, Mohammad Sohail Awan

Department of Surgery Docs

The current study aims to assess tracheal suctioning practices among health care practitioners; nurses, critical care technicians and physiotherapist. Employing literature review as the methodology, multiple databases were searched focusing on three phases of tracheal suctioning (a) the pre suctioning phase, (b) the suctioning phase, (c) the post suctioning phase and complications related to tracheal suctioning. It was concluded that to provide quality care it is important that the evidence based practice guidelines should be followed.

Engagement Of Undergraduate Nursing Students In Virtual Learning Environment In Karachi Pakistan, Zohra Kurji, James Mwenda, Amina Aijaz

School of Nursing & Midwifery, East Africa

Aga Khan University (AKU) is implementing blended learning (BL) in their existing programs. This study reports the use of BL mode in one of the courses entitled Advanced Concepts of Community Health nursing (ACCHN), offered for undergraduate nursing students, for the first time in Karachi Pakistan. A qualitative exploratory design was adopted.The year II students of Post-RN BScN programme who were studying the course were invited to participate in the study. Data was collected by using focus group discussions (FGDs.). Students found ACCHN course flexible because of the use of blended modalities. They felt that their learning was enhanced by …

Barriers To Receiving The Influenza Vaccine In Adults 65 Years And Older, Melissa Madalone

Walden Dissertations and Doctoral Studies

Vaccination is regarded by many as the most effective means of reducing influenza infection and disease; however, many people in the United States are hospitalized from flu-related illness each year. Adults 65 years and older account for more than half of these hospitalizations and almost all flu-related deaths. This project aimed to identify barriers to receiving the influenza vaccine among the adult population (> 65 years of age) in a community setting. The goal was to develop a teaching tool that would assist practitioners towards improving influenza vaccination rates among this population. The Health Belief Model was the theoretical framework …

Nursing Staff Participation In Chart Audits Increases Documentation Compliance, Susan Elaine Nelson

Walden Dissertations and Doctoral Studies

Clinical documentation is an essential quality element that is often not adequately completed. Current data demonstrate that 32% of home health claims do not meet the requirements for federal reimbursement. Rogers's diffusion of innovation was used as a conceptual framework to guide this quality improvement project which determined whether home health nurses with education and chart audit experience demonstrate increased documentation compliance relative to nurses with education only. After completing a 1-hour education program on documentation, a convenience sample of home health nurses (n = 8) was divided between a chart-audit group (n = 4) and a no-chart-audit group (n …

Success Experiences Of Hispanic Nursing Students Who Persisted And Graduated After Academic Failure, Barbara Ninan

Walden Dissertations and Doctoral Studies

Twenty percent of Hispanic nursing students at a west coast university are being dismissed from the nursing program due to repeated failures in nursing courses. The purpose of this study was to gain a better understanding of Hispanic nursing students' experiences of successfully completing a nursing program, earning a baccalaureate of science degree, and passing the state licensing examination for registered nurses despite having failed a nursing course and having been placed on academic probation. Guided by Tinto's theory of academic integration, a descriptive phenomenological design was used to explore Hispanic nursing graduates' success experiences. Purposive sampling was used to …

Evaluation Of Empowerment Levels Of The Cleveland Clinic Nurse, Cynthia J. Willis

Walden Dissertations and Doctoral Studies

Nurses' perceptions of their work environment and empowerment in relationship to patient satisfaction are well explored in the literature. Empowerment has been linked to improved job satisfaction and improving the elements of empowerment cam improve overall patient satisfaction. This project examined 2 nursing units, 1 with lower patient satisfaction scores (Unit A) and 1 with higher patient satisfaction scores (Unit B), in order to compare their structural empowerment scores as measured by the Conditions of Work Effectiveness Questionnaire II (CWEQ-II). A total of 29 nurses who worked full-time, part-time, or per diem on 1 of the 2 units were recruited …

Building Resilience And Coping Effectiveness (Brace): A Program For Military Families, Linda Pauline Zarrett

Walden Dissertations and Doctoral Studies

Building Resiliency and Coping Effectiveness (BRACE): A Program for Military Families

by

Linda Zarrett

MSN, University of Cincinnati, 2012

BSN, Minnesota State University, Moorhead, 1985

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Veterans returning from combat report significant family strain and Post Traumatic Stress Symptoms (PTSS) yet have limited access to care resources. Family members, including children, report very similar symptoms to those of veterans and have yet fewer health care resources. The purpose of this project was to apply principles from existing research on post-traumatic stress …

A Policy Guide To Decrease The Use Of Continuous Passive Motion Machines, Rosa M. Cooper

Walden Dissertations and Doctoral Studies

A Policy Guide to Decrease the Use of Continuous Passive Motion Machines

by

Rosa M. Cooper

MSN, Walden University, 2009

BSN, Immaculata University, 2007

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

This project was conducted at a post-acute rehabilitation hospital that served post-acute orthopedic, stroke, brain injury, cardiac, and skilled nursing patients. On the orthopedic unit, there were 5 practicing physicians, 3 of whom consistently used continuous passive motion (CPM) therapy on total knee arthroplasty (TKA) and 2 of whom did not. As a result of discussions …

Leveraging The Power Of Shared Governance, Cynthia S. Cohen

Walden Dissertations and Doctoral Studies

Shared governance (SG) creates an evidence-based framework to support decision making in healthcare organizations by encouraging nursing staff ownership of nursing practice issues. This project assessed the current state of shared governance at a community hospital through: (a) deployment of Hess's Index of Professional Nursing Governance (IPNG) and the National Database of Nursing Quality Indicators (NDNQI) nursing satisfaction surveys which were open to nurses working in areas included in the SG framework at the project site, and (b) retrospective review of Unit Practice Council (UPC) and Nursing Senate (NS) minutes and agendas. Kotter's theory of change and the logic model …

Planning For A Community Supported Farmers Market In A Rural Usda Food Desert, Carrie Lynn Engelbright

Walden Dissertations and Doctoral Studies

A community initiative to develop and sustain a farmer's market can address insufficient access to fresh and affordable fruits and vegetables for individuals working and residing in a United States Department of Agriculture (USDA) designated food desert. This project addressed a particular USDA food desert in South Wood County, Wisconsin. The purpose of this project was to develop and plan for implementation and evaluation of a community-supported farmers market in South Wood County, with the goal to increase access to fruits and vegetables. Project objectives included development of a sustainable community infrastructure to support the market, development of policies and …

Development Of An Evidence-Based Influenza Vaccination Program For Nurses, Marlene Reid

Walden Dissertations and Doctoral Studies

The purpose of this educational influenza vaccination project was to increase nurses' influenza vaccination rates. Nationally, 41% of nurses were vaccinated, which is far below the Healthy People 2020 goal of an influenza vaccination rate of 90%. Literature suggests that the low nurses' vaccination rate is responsible for inpatient healthcare associated influenza, mortality, and influenza-like illness. Healthcare facilities will not be reimbursed for treatment of healthcare associated infection. Despite recommendations from the Centers for Disease Control and Prevention for nurses to become vaccinated, only 20% of the 800 nurses at a healthcare facility in Baltimore were vaccinated for the past …

Needs Assessment For A Nurse Practitioner-Led Transitional Care Program, Maria Victoria Trinidad Salcedo

Walden Dissertations and Doctoral Studies

The rising cost of health care and changes in healthcare delivery have prompted a need to improve continuity from the hospital to home. This scholarly project was initiated to assess the impact on patient outcomes related to initiation of a nurse practitioner-led transitional care program (TCP). Using the Diffusion of Innovations and Health Belief Models, the purpose of this study was to identify the impact of a TCP on improving the health of patients with congestive heart failure (CHF), diabetes mellitus Type II (DM II), and chronic obstructive pulmonary disorder (COPD). The impact of the TCP was evaluated by a …

A Guide For Delivering Evidence - Based Discharge Intructions For Emergency Department Patients, Andre Walker

Walden Dissertations and Doctoral Studies

Discharge instructions provided to patients discharged from the emergency department (ED) are often provided in a way that is neither clear nor concise. Patients are often discharged home without a clear understanding of their diagnosis, medications, reasons to return to the ED, follow-up instructions, or how to manage their care at home during their illness. Therefore, a guideline needed to be developed in order to help the ED staff provide clear and concise discharge instructions to patients discharged from the ED. The Ace Star Model of Knowledge Transformation was the foundation for the development of the evidence-based guideline. A formative …

Systematic Review Of Retention Of Direct-Care Workers In Long-Term Care Facilities, Regina Evonne Goins

Walden Dissertations and Doctoral Studies

Turnover among direct-care workers in long-term care (LTC) facilities is high, and has a significant impact on residents, leaders, and owners of LTC facilities. The overall turnover costs are also substantial and constitute a significant financial burden in LTC facilities. This systematic review of the literature examined, retention strategies for direct-care workers in the LTC workforce. The information may be used to develop and provide practice recommendations that will help improve retention rates among direct-care workers in LTC facilities. The project design involved a systematic examination of English-only studies from 2001-2004, retrieved from 3 major databases: CINAHL with Medline simultaneous, …

A Clinical Pathway Education Program For Pediatric Nurses, Lisa M. Scheiber-Case

Walden Dissertations and Doctoral Studies

Clinical pathways have been studied to promote best practices in nursing and enhance patient satisfaction. For 10 years a pediatric orthopedic surgical team at a Midwest hospital has not had a clinical pathway to treat or standardize care for adolescents following posterior spinal fusion surgery. Pain scores and patients' length of stay were collected using a retrospective chart review. This information was used to revise preoperative education materials and develop a visual poster. The purpose of this project was to identify and develop a way to educate the pediatric nursing staff on the use of the developed educational materials, poster, …

The Effectiveness Of Combining Simulation And Role Playing In Nursing Education, Shari Lynn Redden

Walden Dissertations and Doctoral Studies

The profession of nursing is affected by a nursing and nursing faculty shortage that is impacting the ability to produce adequate numbers of nurse graduates to address the healthcare needs of the future. Nursing schools are increasingly using simulation and/or role-playing to supplement the decreased number of nurse faculty and clinical sites in order to be able to continue to enroll nursing school applicants. The purpose of this phenomenological study was to examine the experiences of nursing students with role-playing and simulation and the extent to which role-playing with simulation is perceived by students as beneficial for learning within the …

Role Ambiguity, Role Strain, Job Dissatisfaction, And Difficulty Transitioning Into Academia Among Nursing Faculty, Paula Stallard Whitehead

Walden Dissertations and Doctoral Studies

Registered nurses with experience in the clinical area entering academia go through a transition that may lead to difficulties such as role ambiguity and role strain when beginning a new job. The purpose of this study was to understand the experiences leading to role ambiguity, role strain, difficulty with role transition, and job dissatisfaction among the faculty at colleges of nursing in the mountain region of Western North Carolina. Guided by Kahn's organizational role theory and Schlossberg's transition theory, research questions investigated the nursing faculty experience of role ambiguity, role strain, difficulty transitioning into academia, and job dissatisfaction. A qualitative …

Attitudes And Beliefs Of Registered Retired And Registry Nurses Regarding Holistic Spiritual Care, Beverly S. Ward

Walden Dissertations and Doctoral Studies

The purpose of holistic spiritual care is to assess and provide for the spiritual needs of patients. Current literature indicates that holistic spiritual care is important to the healthcare of patients. Researchers suggest that nurses who practice holistic spiritual care are more aware of the attributes of caring, respect, and emotional support. This project study addressed a problem at the research site reported by local community nurses and holistic spiritual care experts of nurses not practicing holistic spiritual care. Mezirow's transformational learning theory was used as the theoretical foundation for this qualitative study, which was designed to examine the attitudes …

Decreasing Attrition Of Novice And Newly Hired Professional Nurses Through Preceptorship, Brenda Gould-Johnson

Walden Dissertations and Doctoral Studies

Approval

Walden University

College of Health Sciences

This is to certify that the doctoral study by

Brenda Gould-Johnson

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Eric Anderson, Committee Chairperson, Health Services Faculty

Dr. Patti Urso, Committee Member, Health Services Faculty

Dr. Jonas Nguh, University Reviewer, Health Services Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2015

Walden University

College of Health Sciences

This is to certify that the doctoral study by

Brenda Gould-Johnson

has been found to be …

Reducing The Surgical Patient's Family Member's Anxiety Using An Electronic Patient Tracking Board, Pamela M. Barberi

Walden Dissertations and Doctoral Studies

Family members of surgical patients experience anxiety due to lack of consistent communication during the surgical process. Attending to the needs of the surgical patient's family members is an important factor easily forgotten in a busy clinical arena. The purpose of this project was to decrease the surgical patient's family member's anxiety by providing family members with timely and consistent information regarding the patient's progress through surgery. The theoretical foundation used was general systems theory showing that a change in one part of a system leads to change in the whole system with the use of improved communication and feedback. …

Educating Medical-Surgical/Staff Nurses To Improve Nursing Knowledge Of Patient Education, Focusing On Health Literacy, Justin Thomas Loew

Walden Dissertations and Doctoral Studies

A primary problem faced by a majority of medical-surgical nurses is a lack of knowledge and skills necessary to improve health literacy among patients. This inadequacy among medical-surgical nurses is often linked to insufficient training on how to identify and interact with patients with lower health literacy. Improvement of patient health literacy can be realized through proper training, education, and a better application of communication strategies. The aim of this project was to improve current medical-surgical nurses' practice guidelines via the use of educational programs. The project developed pilot protocols and policies in order to improve its practical applications. The …

Developing And Validating A Type 2 Diabetic Patient Drug Telephone Reminder Program, Perpetua E. Okoh

Walden Dissertations and Doctoral Studies

Research has shown that telephone drug reminder scripts can be an effective way to increase drug adherence and decrease health care costs for persons with Type 2 diabetes. The purpose of this project was to develop and validate a telephone drug reminder script for Type 2 diabetes patients based on evidence-based practice. Following a review of the literature, a telephone drug reminder script was developed for Type 2 diabetic patients to educate and improve drug adherence. Five local experts with at least 10 years' experience in diabetes treatment, education, and or research were asked to participate in the validation of …

How Nursing Educators Address The Differing Learning Styles Of Students, Kimmie Sue Gore

Walden Dissertations and Doctoral Studies

Educational research has shown that student learning styles, and educators' consideration of learning styles, significantly influence the academic success of adult learners. This project study was designed to identify the perceptions and attitudes of nursing faculty concerning student learning styles and consideration of student learning styles in their praxis. The study was guided by Malcolm Knowles' theory of andragogy, and investigated nursing educators' knowledge about learning styles and course delivery with regards to students with different learning styles. It used a descriptive multiple case study approach and collected data among nursing educators using the Principles of Adult Learning Survey (PALS) …