Digital Commons Network^™

Fostering Ambulation For A Preschool Child With Rett Syndrome: A Case Report, Catherine Schaefer-Campion, Norah L. Johnson

College of Nursing Faculty Research and Publications

Children with Rett Syndrome (RS) have neuromotor impairments that impact their mobility. Poor hand function among children with RS limits the selection of an assistive device for ambulation. Purpose: The purpose of this case report is to describe the process of selecting an assistive device for a child with RS to promote ambulation. Method: This single subject case reports on a 5-year-old girl with RS at a suburban mid-western early childhood special education setting. Results: The child in this case was able to walk the farthest distances with a metal toy shopping cart and then with an anterior facing four-wheeled …

Family Caregivers’ Knowledge Of Delirium And Preferred Modalities For Receipt Of Information, Margaret J. Bull, Lesley Boaz, Jennifer M. Sjostedt

College of Nursing Faculty Research and Publications

Delirium is a life-threatening, frequently reversible condition that is often a sign of an underlying health problem. In-hospital mortality alone for older adults with delirium ranges from 25% to 33%. Early recognition of delirium is critical because prolonged duration poses a greater risk of poor functional outcomes for older adults. Family caregivers, who are familiar with the older adult’s usual behaviors, are most likely to recognize delirium symptoms but might dismiss them as due to aging. It is important to learn what family caregivers know about delirium to ascertain their need for education. The aims of this study were to …

Strategies For A Successful Phd Program: Words Of Wisdom From The Wjnr Editorial Board, Vicki S. Conn, Julie Zerwic, Susan M. Rawl, Jean F. Wyman, Janet L. Larson, Cindy M. Anderson, Nancy L. Fahrenwald, Lazelle E. Benefield, Marlene Z. Cohen, Carol E. Smith, Robert V. Topp, Natalie E. Markis

College of Nursing Faculty Research and Publications

Nursing doctoral programs prepare students for research-focused careers within academic settings. The purpose of this Editorial Board Special Article is to provide PhD students and advisors with suggestions for making the most of their doctoral experience. Editorial Board members provide their individual insights on the skills and attributes students must acquire during the course of their doctoral education in order to succeed. The authors provide practical tips and advice on how to excel in a PhD program, including how to select an advisor and a dissertation committee, the importance of attending conferences to increase visibility and develop a network of …

A Comparison Of Quality Of Care In Critical Access Hospitals And Other Rural Hospitals, Marianne Baernholdt, Jessica Keim-Malpass, Ivora D. Hinton, Guofen Yan, Marilyn Meyer Bratt

College of Nursing Faculty Research and Publications

Purpose:

The United States has about 2100 rural hospitals. Approximately 1300 are Critical Access Hospitals (CAHs) with 25 beds or less. CAHs receive cost-based reimbursement through the federal Flex program with the goal to improve quality and access to health care. Reports on quality of care (QOC) and factors that influence quality in CAHs are mixed. This study compared QOC and factors that influence QOC in CAHs and other rural hospitals.

Sample: 385 staff nurses in 6 CAHs and 9 other rural hospitals in North Carolina and Virginia.

Method:

Descriptive cross-sectional design using nurse surveys aggregated to the hospital level, …

Decreasing Central Line Complications With A Dedicated Team Approach, Donna Degennaro

Walden Dissertations and Doctoral Studies

Central-line catheters save lives, but they can also bring about complications, such as hospital-acquired infections. The Institute of Healthcare Improvement has collected data indicating that using proper insertion techniques and maintenance care, known as "the bundle," can prevent bloodstream infections associated with central lines. Progress has been made toward that end: The bundle has been used in intensive care units in a variety of hospitals and reportable central-line infections have decreased by 38%. However, because infections continue to occur inside and outside intensive care units, more needs to be done to protect all patients from these deadly infections. The purpose …

Understanding Causes Of Attrition Of 1st- And 2nd-Year Nursing Students, Catherine Mary Griswold

Walden Dissertations and Doctoral Studies

Attrition of nursing students has a negative impact on students, university nursing programs, and the heath care community. At a local university, the nursing program and its stakeholders aspire to increase retention of nursing students in order to mitigate the nursing shortage projected over the next decade. The purpose of this study was to examine issues related to high attrition of 1st- and 2nd-year nursing students at a university located in the mid-Atlantic area of the United States. Tinto's model of retention was used as the foundation to explore variables affecting 1st- and 2nd-year nursing students who remained in (n …

Developing A Lifestyle Modification Toolkit To Prevent And Manage Hypertension Among African American Women, Julia Ugochi Ugorji

Walden Dissertations and Doctoral Studies

Hypertension is a global public health issue affecting many people in the United States. African American women remain the highest in percentage by race and ethnicity for developing hypertension with poor risk awareness. Hypertension has costly implications for the health care system. Through lifestyle modifications in the form of a nutrition plan called Dietary Approach to Stop Hypertension and increased physical activity, hypertension could be prevented. Among African Americans, the incidence of hypertension increases in their late thirties. The purpose of the project was to develop a toolkit of resources for African American women between the ages of 20 to …

Diminishing Incontinence In Long-Term Care Using Electronic Health Records, Catherine Rodgers

Walden Dissertations and Doctoral Studies

Urinary incontinence affects up to 70% of residents living in a long-term care facility and can affect their quality of life. Specifically, urinary incontinence has a direct impact on older adults in regards to self-esteem, pressure ulcer development, falls, urinary tract infections, and psychosocial wellbeing. The goal of this quality improvement pilot project was to determine if an electronic health record (EHR) assessment tool could help older adults remain continent longer and assist in maintaining an independent lifestyle. Orem's self-care deficit theory and social cognitive theory were used to determine how the electronic health record incontinence template could be used …

A Developmental Disabilities Program: A Proposed Education Program For Direct Support Professionals, Yurlene Sales Dela Cruz

Walden Dissertations and Doctoral Studies

Nurses can play integral role in collaborating with community leaders and identifying health promotion strategies, such as physical activity and nutrition classes, for people with developmental disabilities (DD). This study identified a role that nurses can establish among Direct Support Professionals (DSPs) who serve important functions in the daily supervision and care of clients with DD. The data reviews from the archival results from Association of Individual Development Health Matters Assessment Reports in August 2012 and September 2013 indicated DSPs' need for further training in their roles as health instructors. The Health Matters Assessment Report in 2012 indicated low scores …

Employing Provider Mentoring/Coaching To Improve Preventive Quality Ordering, Julie Knox-Woodward

Walden Dissertations and Doctoral Studies

Preventive quality ordering is a provider intervention aimed at disease prevention through the ordering of industry-recommended health maintenance tests. This pilot study evaluated the effectiveness of provider mentoring/coaching to improve preventive quality ordering using the 2014 Agency for Healthcare Research and Quality best practice preventive clinical services guidelines. Literature indicates provider inconsistency in preventive and quality ordering as the primary cause of disparate health outcomes. Guided by theories of modeling and role-modeling, as well as the theory of cognitive continuum, this pilot study offered provider mentoring/coaching to encourage timely preventative quality ordering. Routinely monitored historic provider practice patterns in a …

Implementation Of A Nurse-Initiated Topical Anesthesia Protocol, Jennifer Anderson

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Although topical anesthetics are a safe, effective, and non-invasive alternative to infiltrated anesthesia for laceration repair, their availability to providers continues to limit their use. This practice innovation project developed a protocol for the nurse-initiated anesthesia for patients over one year of age presenting to a critical access hospital emergency department with lacerations. Pre and post implementation chart reviews were utilized to determine the effectiveness of the implementation of this protocol. This project has potential to impact patient pain levels, anxiety, restraint use, total treatment time, and patient satisfaction scores.

Implementing A Screening Pathway For Identifying Patients At Risk For Obstructive Sleep Apnea In Primary Care, Emily Fett

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Obstructive sleep apnea (OSA) is emerging as a significant health problem largely underrecognized by health care providers in the primary care setting (Pagel, 2008). The intent of this practice innovation project was to change and reduce the variation in practice for OSA screening that did not follow what is known about best practices. In this study, a preexperimental one-group pretest-posttest design was carried out to evaluate the outcomes associated with implementing an evidence-based screening pathway into practice for OSA based on the recommendations set forth in a clinical practice guideline recently published by the American Academy of Sleep Medicine (Epstein …

De Concentv Amisso Qvaerendo: An Investigation Into The Relative Benefits Of Three Different Types Of Ambient Music On The Observed Agitated Behaviour And Quality Of Life Of Dementia Sufferers In Residential Aged Care Facilities, Peter Wilkinson

Theses: Doctorates and Masters

There is an increasing body of research evidence to support the use of music as a therapeutic modality in reducing the agitated behaviour frequently associated with late-stage dementia. Although much of this evidence suggests that music interventions are most effective when they are “individualized”, this type of intervention is often difficult to implement in large, busy, aged care facilities where residents may be located together in communal areas during the day. The challenge therefore is to try and identify a particular musical genre which, when played as “ambient” or “background” music, demonstrates a consistent capacity to reduce agitated behaviour in …

Interprofessional Curriculum On Environmental And Social Determinants Of Health In Rural Kenya: Aga Khan University East Africa University Of California San Francisco Integrated Primary Health Care Program, M. R. Mahoney, K. Baltzell, Esther Nderitu, R. Dhanani, S. Macfarlane

School of Nursing & Midwifery, East Africa

The Aga Khan University East Africa (AKU)-University of California San Francisco (UCSF) Integrated Primary Health Care Program (IPHC) is a public–private partnership with community and government to strengthen the primary health care (PHC) system in Kenya. IPHC provides opportunities for health professions students to work and learn together in the rural and underserved district of Kaloleni.

Active Ageing In Pakistan: Challenges And Opportunities, Samina Vertejee, Noureen Nasruddin Karamali

Department of Surgery Docs

Abstract

The increasing number of ageing population is a signpost for re-directing the resources to ensure quality of life for elderly thus promoting active ageing. However, the challenges to achieve the goal outweigh the opportunities due to scarcity of resources. Several factors including, brain drain, poverty, lack of knowledge of elderly to protect their rights in association with poor state laws determines the poor quality of life for elderly in Pakistan. Although, the apparent scenario is quite unpleasant yet there are several opportunities such as improved crude birth and death rates, increased awareness about gerontology as a specialty care area …

African American Race And Culture And Patients' Perceptions Of Diabetes Health Education, Linda Marie Keenan

Walden Dissertations and Doctoral Studies

African Americans diagnosed with diabetes are less likely to self-manage diabetes-specific modifiable risk factors. As a result, utilization of healthcare services occurs at a greater rate than other racial groups, and thereby incurs higher than expected healthcare costs. This ethnographic study explored the elements of diabetes educational material African Americans in a large city in the southern part of the United States found most useful to facilitate self-management of their disease. Bandura's self-efficacy theory provided the theoretical framework. Research questions addressed the preferred educational content, layout of material, and methods for educational delivery and caregiver support. A purposive sample of …

Consequences For Nursing Graduates Of Failing The National Council Licensure Examination (Nclex), Julius Atemafac

Walden Dissertations and Doctoral Studies

Little information is available regarding the consequences of new nursing graduates who fail the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The purpose of this study was to understand how these graduates could successfully pass this examination in subsequent attempts. Guided by Fisher's personal change model, the key research questions addressed the consequences of failing the NCLEX-RN exam and the actions the new graduate took after failing it. A phenomenological design was employed with a purposive sample of 17 new nursing graduates in the metropolitan area who had failed the NCLEX-RN. An inductive approach using a constant comparison, content …

Preoperative Education Needs In Ear, Nose, & Throat Clinic: A Patient Perspective, Jonathan Edmun Ramos

Walden Dissertations and Doctoral Studies

A medical center specializing in ear, nose, and throat (ENT) services noted an increase in the number of postoperative ENT complications compared to the national average. The purpose of this mixed-methods project study was to examine ENT patients' preoperative patient education (PPE) needs regarding postoperative care. Grounded in Knowles's model of learning, core adult learning principles were applied as guidelines in facilitating patients' PPE learning. Data were collected from 58 ENT patients who were selected using a convenience sampling method and who responded to a PPE survey using a 5-point Likert scale and open-ended questions. Quantitative data were analyzed using …

Enhancing Nurses' Perceptions Of Patient Safety Culture Through The Just Culture Model, Aida Solomon

Walden Dissertations and Doctoral Studies

An organizational culture of safety affects employees' attitudes, beliefs, perceptions, and values related to safe practice as well as their behaviors and level of engagement. The purpose of this project was to determine the influence of introducing the just culture model through staff engagement in an interactive workshop. A convenience sample of acute care staff were recruited for this 1-sample pretest and posttest project design. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture instrument was used to measure safety culture perceptions on 7 dimensions pre and post intervention. For the theoretical framework, Ajzen's theory of …

Advanced Nurses' Perspectives On The Drug Addiction Treatment Act, 13 Years Later, Dorothy L. Were

Walden Dissertations and Doctoral Studies

The United States experiences opioid addiction at epidemic levels. In 2012, the National Institute of Drug Abuse reported that 23.1 million Americans were in need of addiction treatment services, although only 2.5 million were enrolled in treatment. Following an amendment to the Drug Addiction Treatment Act of 2000 (Public Law 106-310), advanced practice nurses were qualified as providers who could bridge the healthcare gap in treatment access. The purpose of this project was to determine the interest of advanced practice nurses in (a) prescribing buprenorphine and (b) establishing guidelines that would allow them to do so. This quantitative project used …

Integration Of Technology Into A Nursing Curriculum Using A Mixed Method Approach, Susan Ramnarine-Singh

Walden Dissertations and Doctoral Studies

In 2011, the Institute of Medicine and 2010 Affordable Care Act addressed the need to use technology in nursing programs. The purpose of this study was to understand faculty perceptions of technology use and integration into the nursing curriculum at a college located in Texas. Lewin’s change theory acted as the theoretical framework to explore organizational dynamics involved in effective strategies. The guiding research questions explored faculty perceptions of technology use, types of technology used, and correlation to teaching experience using a convergent mixed-method approach. Thirty faculty members completed the Teacher’s Intention to Use Technology survey and 15 faculty members …

Best Practices In The Management Of Pediatric Obesity In Primary Care Clinics, Lori Moseley

Theses and Dissertations

Obesity prevalence among children and adolescents has nearly tripled since 1980. Children and adolescents are at risk for developing the comorbidities seen in obese and overweight adults such as hypertension, type 2 diabetes, and sleep apnea. Traditional treatment for obese and overweight children involved counseling children and their families. Current recommendations include a comprehensive staged approach to weight management that includes prevention plus structured weight management, comprehensive multidisciplinary intervention and tertiary care intervention. Unfortunately structured weight management programs have not been widely available, leaving the primary provider with limited options.

The purpose of this project was to analyze the literature …

Experiences And Perceptions Of Novice Associate Degree Nursing Faculty Assuming A Classroom Instructors Role, Mary N. Fontenelle

LSU New Orleans Theses and Dissertations

The purpose of this research was to explore the classroom experiences and perceptions of novice faculty in the classroom setting of an Associate Degree of Nursing programs, located in community colleges. The transition from expert practitioner to novice teacher can be a difficult experience for new classroom nursing instructors. Novice nursing faculty often has very limited educational preparation or background in classroom instruction skills. Nursing research, typically conducted at university level, has minimal applicability for the community college nursing programs. Community colleges educate sixty percent of the graduate Registered Nurses in the United States and have scant research into their …

The Relationships Between Licensed Vocational Nurses' Care, Documentation, And Perceptions Of Dementia-Compromised Behaviors In The Nursing Home, Jennifer J. Yeager

Nursing Theses and Dissertations

Behavioral and psychological symptoms of dementia increase as Alzheimer's disease and related dementias progress; these symptoms occur in as many as 80% of persons with dementia living in nursing homes. Behavioral and psychological symptoms of dementia, also known as dementia-compromised behaviors, are a source of stress for nursing home staff, family members, and other residents and adversely affect the quality of life and safety of residents. Ethnonursing, a qualitative research method, was used to examine the relationship between licensed vocational nurses' responses to dementia-compromised behaviors, documentation, and perceptions of dementia care. Data analysis resulted in three overarching themes related to …

Improving An Outpatient Diabetes Program Telephone Follow-Up Process: Evaluating Its Impact On Glycosylated Hemoglobin Levels, Joan B. Niemczewski

Graduate Theses, Dissertations, and Capstones

Telephone follow-up for diabetes self-management is used to facilitate ongoing support for individuals striving to maintain a healthy lifestyle. With the use of telephone follow-up after Diabetes Self-Management Education (DSME), key concepts can be emphasized and goal reinforcement can occur. When successfully managed, improved glycemic control occurs, as evidenced by reductions in glycosylated hemoglobin (A1C) levels. A review of the literature surrounding this topic and description of a capstone scholarly project utilizing findings from the literature to create an evidence-based telephone follow-up pilot study are included. Findings from this study did not reveal statistically significant reductions in A1C levels with …

Assessing Quality Outcomes In A Behavioral Oncology Program: Capstone Project, Elizabeth M. Archer-Nanda

Graduate Theses, Dissertations, and Capstones

The landscape of cancer care has changed dramatically over the past several decades. An illness that was once often fatal, now represents both an acute life threatening illness and a chronic condition. While there have been tremendous advancements in the treatment of the physiological aspects of cancer, management of related psychosocial and emotional issues have not seen this same progress. Limited information exists related to both the evaluation and outcome metrics associated with the screening and management of psychiatric sequelae after referral to specialized psychiatric services in cancer patient populations. This capstone project focused on (a) implementation of consistent use …

Efficacy Of Motivational Interviewing And Centering To Increase Physical Activity And Dietary Adherence In African Americans With Pre-Hypertension And Hypertension, Chioma U. Okereke

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract Title: Efficacy of Motivational Interviewing and Centering to Increase Physical Activity and Dietary Adherence in African Americans with Pre-hypertension and Hypertension.

Objectives: The purpose of this study was to evaluate the knowledge and self-care behaviors of African Americans necessary to prevent the development of hypertension or to improve the control of all ready existing hypertension. Motivational interviewing was used to identify and address barriers to lifestyle modifications. The feasibility of using a Centering Care Model to deliver interactive educational sessions to empower individuals to take an active role in their health care was evaluated.

Significance of the Problem: African …

Surveys Of Women With Hpv And Their Healthcare Experiences., Danielle Defayette

Undergraduate Honors Theses

Genital human papillomavirus infection is the most common sexually transmitted virus in the United States, with almost 20 million Americans currently infected and an additional 6.2 million becoming newly infected each year. Women rely strongly on their health care providers to educate and comfort them regarding this distressing diagnosis. This study will use an online, self-completion questionnaire to obtain women’s opinions regarding their health care providers’ performances concerning the initial consultation after learning of their HPV diagnosis. Findings from this study provided insight as to how women prefer receiving information from their health care providers concerning their diagnosis of HPV. …

Effects Of Wii Fit™ Plus Cardiovascular Exercises On Cognitive Function In Older Adults: Feasibility Study., Ifeanyichukwu Chinedozi

Undergraduate Honors Theses

Cognitive decline increasingly plague older adults. Although various studies have correlated aerobic exercises with decreased incidence of the development and progression of cognitive deterioration in older adults, there is no evidence as to whether or not the Wii Fit Plus Rhythm Kung-Fu, Hula-Hoop and the Wii Just Dance can improve the cognitive function of older adults as measured by the Standardized Mini Mental State Examination (SMMSE) instrument. A descriptive study design was used to explore the feasibility of implementing an aerobic exercise program for older adults in an assisted living facility using these Wii games, and evaluating whether or not …

Hand Hygiene Perceptions Of Student Nurses., Brittany Berger

Undergraduate Honors Theses

Compliance with hand hygiene is widely recognized as the most important factor in preventing transmission of infection to patients in healthcare settings (Haas and Larson, 2007). Hand hygiene dramatically decreases the potential pathogens on hands and is considered the first measure for decreasing the risk of transmitting organisms to patients, healthcare professionals, and family members. Noncompliance with hand hygiene practices has been shown to increase healthcare-associated infections, costing hospitals $35.7-$45 billion each year (Centers for Disease Control and Prevention [CDC], 2012). Education about hand hygiene starts in school and should transfer into the real world of nursing. The purpose of …