The Role Of Advanced Practice Nurses In Advanced Care Planning For Cancer Patients, Sincere Mcmillan

Walden Dissertations and Doctoral Studies

In the United States, more than 75% of people will spend their last months of life in a health care facility. A key role for clinicians is to discuss care goals with the patients as part of a process called advanced care planning (ACP). As part of the oncology care team, advanced practice nurses (APNs) could help to increase the frequency of ACP discussions. The purpose of this project was to assess the knowledge and practice experiences of APNs regarding ACP at a National Cancer Institute designated cancer care hospital. Carper's patterns of knowing was the theoretical framework of this …

Reducing Central Line-Associated Bloodstream Infections, Alexis Genarrian Whitfield

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infection (CLABSI) at the local healthcare setting exceeded the benchmark of 0 CLABSI. The Infection Prevention and Control (IPC) department determined that a role as CLABSI nurse champion would address the problem; however, no comprehensive education on CLABSI prevention and maintenance was available at the site. The purpose of this project was to develop a CLABSI prevention and maintenance education module using Knowles's adult learning theory and the chain of infection model. The practice-focused question asked whether a CLABSI educational module would provide the necessary information to educate nurse champions on CLABSI prevention and maintenance. The education …

Improving Nurse Well-Being Through A Mindfulness-Based Education Strategy, Sandra Dearholt

Walden Dissertations and Doctoral Studies

Abstract

An estimated 33% to 54% of hospital nurses exhibit signs of emotional stress and

decreased well-being, which is associated with a negative impact on nurses’ health, job

performance, patient care outcomes, and healthcare cost. This project sought to improve

nurse well-being by providing nurses with education on mindfulness-based practices.

The practice question addressed whether implementing a mindfulness-based education

strategy for nurses improved nurse well-being. Three models informed this project: the

health promotion model, the andragogical model, and Kirkpatrick’s 4 levels of training

evaluation. Sources of evidence included the Maslach Burnout Inventory (MBI) and a

knowledge assessment administered to 10 …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Hospital-Acquired Pressure Ulcer Prevention, Druscilla Willis Jones

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure ulcers (HAPUs) represent a significant challenge in the care provided for hospitalized patients. HAPUs impact morbidity, mortality, and quality of life. At the local practice site, the incidence of HAPUs increased in the perioperative setting. The practice-focused question for this project asked if an education program for staff nurses working in a perioperative care setting with high HAPU incidence can advance nurse knowledge regarding prevention, early assessment, symptoms, and treatment of HAPUs. The purpose of this educational project was to develop a pretest and posttest designed education program on HAPU prevention and care for perioperative nurses. The Iowa …

Staff Education On Metabolic Syndrome In Patients Taking Antipsychotic Medications, Juliana Ifeoma Omile

Walden Dissertations and Doctoral Studies

Second-generation antipsychotics (SGAs) are prescribed for treatment of psychosis. A major side effect of SGAs is an increased risk of metabolic syndrome (MetS) with symptoms of hypertension, hyperlipidemia, hyperglycemia, and truncal obesity. A clinic in the northeastern United States was not screening patients for MetS when being treated with SGAs. The purpose of this project was to educate staff on MetS risk factors, signs, symptoms, and patient management with a goal to improve their knowledge of MetS. Lewin's change theory provided a conceptual framework for the project. The project question explored the development and evaluation of an educational module on …

A Survey Of Providers And Patients Assessing The Need For And Use Of Prevention Practitioners To Combat Obesity In The Primary Care Setting, Amanda R. Lyons

DNP Projects

Purpose: The overall aim of this project was to gather information from two groups of stakeholders, providers and patients, on the feasibility of implementing prevention practitioners in the primary care system to address overweight and obesity.

Methods: This study utilized a quantitative descriptive design through the use of electronic surveys. Provider surveys were explained and presented during a monthly provider meeting. Patient flyers were posted in exam rooms and surveys were accessible through a provided link and QR code.

Results: Providers (N=10) agreed that they saw a need for the use of a prevention practitioner (Mean=4.44, SD=.88) as well as …

Utilizing Telecommunication To Provide Patient Centered Care For Adults Newly Diagnosed With Gi Cancer: A Quality Improvement Project, Laurie Miller

DNP Scholarly Projects

INTRODUCTION: A confirmed diagnosis of GI Cancer causes anxiety and stress as patients become overwhelmed with questions, worries and fears. At diagnosis, patients are not yet formally connected to the support services available to those actively receiving chemotherapy, creating a “gap period”. To help reduce anxiety, as well as, foster therapeutic relationships and improve overall patient experiences, a structured telephone communication by the gastrointestinal cancer oncology nurse practitioner (GI NP) was proposed.

AVAILABLE KNOWLEDGE: Reduction of anxiety has been shown to enhance the quality of life, increase compliance with a prescribed treatment plan and foster the ability to sign informed …

Quality Improvement Initiative To Improve Patient Attendance In Diabetes Self-Management Education Classes, Charon Denise Randel

Walden Dissertations and Doctoral Studies

Diabetes self-management education (DSME) is a key resource in the battle against diabetes and its secondary effects. This quality improvement project was conducted to address the decreased attendance rates of DSME classes in a community health center in the southern United States. The practice question for this project explored process-related strategies to increase patient attendance in DSME classes. Based on review of patient reports of reasons for nonattendance and an evaluation of peer reviewed literature on improving attendance in DSME, the following strategies were implemented: (a) alternative solutions such as providing patients with the dates for a year of initial …

Development Of A Standardized Oral Care Staff Education Program, Katrina Detoye

Walden Dissertations and Doctoral Studies

Hospital-acquired infections such as nonventilated hospital-acquired pneumonia (NV-HAP) are significant patient safety concerns. The lack of oral care in the nonventilated acute care patient population is a major contributor to NV-HAP. Nursing staff are on the frontline in the provision of oral care to hospitalized patients, but a lack of knowledge regarding the relationship between oral care and NV-HAP was identified as a gap in practice at the project site. The purpose of the project was to develop a staff education program on oral care of the nonventilated patient population. The practice-focused question addressed whether an evidence-based education for nurses …

Strategies For Patient Engagement In A Self-Management Program For Adults With Diabetes, Carolinee Jokotola Ogungbayi

Walden Dissertations and Doctoral Studies

Patients' lack of adherence to diabetes self-management education and support (DSMES) recommendations is a challenge for healthcare. One approach to addressing patient noncompliance with DSMES is through education of staff on current guidelines. In an outpatient facility in South Texas, staff training on current DSMES guidelines was recommended as one of the solutions to the problem of Type 2 diabetes mellitus (T2DM) complications observed among clinic patients. An educational module was created to increase staff knowledge on T2DM and to assist staff members in teaching patients to self-manage T2DM. The module was built on the self-management and health promotion models, …

Fostering Self-Care And Nurse Resilience, Cheryl Jean Mcnamara

Walden Dissertations and Doctoral Studies

Role expectations and stressful work environments place nurses at high risk for burnout. Nurses at an urban hospital were experiencing unhealthy work environments and not engaging in self-care to promote health and wellbeing. The purpose of this project was to evaluate the effectiveness of an existing quality improvement (QI) initiative developed to encourage nurses to engage in self-care. Pender'€™s health promotion model supported the premise that despite barriers, nurses will engage in self-care. A survey elicited responses from 1,248 participating registered nurses on the extent of their engagement with self-care and perceived effect on their health, health knowledge, stress level, …

Frailty In Patients Undergoing Left Ventricular Assist Device Implantation, Candice Falls

Theses and Dissertations--Nursing

Heart failure is a progressive condition that affects over 5.7 million Americans and costs associated with heart failure account for 2-3 % of the national health care budget. The high rates of morbidity and mortality along with increased costs from readmissions associated with advanced heart failure have led to the exploration of advanced treatments such as left ventricular assist devices (LVADs). LVADS have demonstrated morbidity and mortality benefit but cost remains extensive with costs per quality-adjusted years > $400,000. With this in mind, it is important to identify those who are most likely to benefit from an LVAD to avoid unfavorable …

The Impact Of Maternal Nutrition During Pregnancy On Inflammation And Birth Outcomes, Lori Ogden

Theses and Dissertations--Nursing

More than 85% of American adults do not consume recommended amounts of fruits or vegetables. Preterm birth and hypertensive disorders of pregnancy are common adverse conditions affecting pregnancy and are leading causes of maternal and fetal morbidity and mortality. Preterm birth affects nearly 10% of all births in the United States and is on the rise, as are hypertensive disorders, which have increased by 25% over the last two decades. Pregnancy is a state of controlled inflammation, and dysregulation has been linked to preterm birth and other adverse gestational outcomes. A healthy diet is recommended in pregnancy, but little is …

Addresing Challenges In Caring For Morbidly Obese By Learning About Bariatric Care, John Abayomi Makanjuola

Walden Dissertations and Doctoral Studies

Obesity is a public health issue linked to high morbidity and mortality among critically ill patients. There are approximately 15.5 million morbidly obese adults in the United States. The purpose of the project was to develop and implement an educational program using evidence-based protocols for bariatric care to educate nurses and caregivers regarding best practices when attending to obese patients. The practice-focused question examined whether learning about evidence-based bariatric care would improve the knowledge of nurses and caregivers caring for morbidly obese patients in an acute care setting. The theoretical foundation was Bandura'€™s self-efficacy theory. A questionnaire using a Likert …

Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern

Walden Dissertations and Doctoral Studies

No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided …

Guest Editorial: National Consortium For Building Healthy Academic Communities (Bhac) 2019 National Summit: An Experience To Remember, Christine S. Gipson, Teresa Donegan

Nursing Faculty Publications and Presentations

National Consortium for Building Healthy Academic Communities (BHAC) 2019 National Summit: An Experience to Remember.

Creating A Culture Of Wellness: A Call To Action For Higher Education, Igniting Change In Academic Institutions, Megan Amaya, Teresa Donegan, Debbie Conner, Julie Edwards, Christine S. Gipson

Nursing Faculty Publications and Presentations

Background: Due to the continued rise of chronic conditions and unhealthy lifestyle choices, more innovative and evidence-based practices are needed for students, faculty and staff to improve population health outcomes and enhance overall well-being.

Aim: The purpose of this paper is to inform academic health promotion professionals of key strategies to consider in order to create cultures of wellness on their college campuses.

Methods: A review of the existing literature was conducted.

Results: The most current evidence-based practices to create a culture of wellness are discussed.

Conclusions: Institutions of higher education have an opportunity to create campus cultures that foster …

Improving The Care Of Infants With Neonatal Abstinence Syndrome By Implementing Rooming In, Tammi M. Clutter

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Opioid use and drug abuse has led to an increase in fetal exposure to illicit drugs in the United States, putting these infants at risk for developing neonatal abstinence syndrome (NAS). Parental involvement in the care of these infants during their hospitalization has become an essential part of the treatment process

Purpose: The purpose of this project is to implement rooming in for infants with in utero exposure to opioids as a quality improvement practice change.

Methods: A literature search relating to improving the care of infants with NAS was conducted. Educational handouts were provided to staff regarding the …

Study To Assess The Prevalence Of Breakfast Skipping And Its Associated Factors Among Nursing Students In Selected College, Mangaluru, Derina Benny Ms, Anu Varghese Ms, Ashly Susan Baby Ms, Aishwarya Roy Ms

Manipal Journal of Nursing and Health Sciences

Introduction: Nowadays breakfast skipping is a tradition in the adolescent group. Breakfast actually means breaking the fast over the night. One of the most important meals which is required for a normal growth is breakfast. If we fail to have breakfast it can lead to the poor concentration, obesity, high blood pressure, irritability, fatigue, etc. Objectives: The objective of the study was to identify the prevalence among nursing students in relation to their breakfast skipping pattern and find out the factors associated with it. Methods: The approach used was a descriptive survey design. The sample comprised of 349 students. The …

Management In Paediatric Burns: A Case Report, Sangeetha Priyadarshini Ms, Pramod Kumar Dr, Elsa Sanatombi Devi Dr, Anice George Dr

Manipal Journal of Nursing and Health Sciences

Burns are common childhood injuries among children, mainly caused by scald, fire or abuse. The authors presented the case of a one-year child who presented with second degree thermal burns due to fall of hot liquid on the child. Most of the burn injuries, which occur in the early ages of life, are mostly due to the negligence or lack of supervision of the child during the growing period. So, proper management of burn injury and adequate education of parents should be considered as an important aspect in prevention of burns in children. Further, the classification of burns injury helps …

Activities Of Daily Living, Peter F. Edemekong, Deb Bomgaars, Sukesh Sukumaran, Shoshana B. Levy

Faculty Work Comprehensive List

The activities of daily living (ADLs) is a term used to collectively describe fundamental skills that are required to independently care for oneself such as eating, bathing, and mobility. The term activities of daily living was first coined by Sidney Katz in 1950. ADL is used as an indicator of a person’s functional status. The inability to perform ADLs results in the dependence of other individuals and/or mechanical devices. The inability to accomplish essential activities of daily living may lead to unsafe conditions and poor quality of life. Measurement of an individual’s ADL is important as these are predictors of …

An Instructional Module For Nurses To Teach Patients With Gestational Diabetes Mellitus, Josephine Onyekachi Ollawa

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus (GDM) is a carbohydrate metabolism issue during pregnancy that is dangerous for mother and the baby. GDM occurs in 1 out of 3 diabetic women in 16.2% of live births. GDM knowledge and treatment practices among nurses were found inadequate when nurses’ effectiveness in treating a disease they have a shallow knowledge about (GDM) was investigated in the local medical facility. A GDM instructional module was applied and its effectiveness in promoting nurse’s use of GDM education as a treatment strategy tested. The total concept for knowledge and care, empowerment and the social cognitive theories grounded this …

Depression Screening For Bariatric Surgical Patients, Cova Teresa Stidham

Walden Dissertations and Doctoral Studies

Obesity in the United States has increased to epidemic numbers over the last decade. Practitioners need to reverse the trend. To address the problem of depression in obesity, a practice guideline from a bariatric clinic for under-served populations was proposed to an expert panel. The Spell Out on First Use (PHQ-9) screening is a valid and reliable self-screening tool to assist the practitioner in determining the level of depression if any. The PHQ-9 has nine questions. No formal screening existed at the bariatric clinic, and the practice guideline (with algorithm and revised workflow) was proposed for use at the clinic. …

Depression Screening In Poststroke, Shannah Lowe

Walden Dissertations and Doctoral Studies

Depression, a sequela of stroke, is underrecognized and underreported. The American Heart/Stroke Association estimated 1/3 of patients develop depression after a stroke. Depression after a stroke has negative influence on stroke recovery through decreased participation in rehabilitation, and increased morbidity and mortality. The American Heart/Stroke Association recommended that depression screening be conducted on stroke patient; however, there is a lack of guidance regarding the optimal time and tools for depression screening. The practice problem identified was the absence of depression screening in poststroke patients at the project site. The project question focused on identifying evidence-based approaches for depression screening in …

A Psychoeducational Support Group For Family Caregivers Of Elders With Major Neurocognitive Disorder/ Dementia, Brooke D. Katz

Doctor of Nursing Practice Projects

Background: Dementia is a major public health problem impacting an estimated 65.7 million people worldwide by 2030. It primarily occurs in the elderly population (over age 65) and also affects family caregivers, who often experience significant stress and burden. A psychoeducational support group may be an easy and cost-effective solution to caregiver stress and financial burden.

Objective: To determine whether or not there is an effect on self-reported stress and burden on family caregivers of elders with dementia (EWD) of a voluntary psychoeducational support group in the setting of Assisted Living, Memory Support, and Skilled Nursing led by a psychiatric …

Standardized Clinical Guideline For Assessment, Documentation, And Treatment Of Statins, Esther Onyirimba

Walden Dissertations and Doctoral Studies

The purpose of this project was to develop a practice guideline for screening patients at risk for cardiovascular disease, educate the staff at the site about the guideline, and implement the guideline at a primary care clinic. The intention was to identify and treat patients at risk for cardiovascular disease to prevent occurrence of heart disease. Cardiovascular disease includes hypertension, coronary heart disease, heart failure, and stroke. Coronary heart disease is one of the leading causes of death in the Western world. The local practice problem and focus of this project was underprescribed statin therapy for patients at risk for …

Instrumental Role Modeling And The Sensitive Topic Of Obesity: A Grounded Theory, Tulie Blot Gay

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role is more prominent now than ever before in primary healthcare, positioning them as providers who defend initiatives and ongoing health agendas. Obesity is among those agendas. The concept of instrumental role modeling was explained as a combination of understanding and physical presence that gives meaning and quality to inspire change. It implied that health professionals are not merely insightful clinicians but suggested their expertise is complimented by demonstrations of wellness in knowledge and practice. This topic of weight was perceived as sensitive but must be addressed. In this grounded theory study, the perspectives of NPs …

Evaluating State Anxiety Levels In Nursing Students, Rachel Stevens, Rachel Nussbaum, Tyler Blake

Williams Honors College, Honors Research Projects

Anxiety, dependent upon the frequency and severity, can be a serious problem that reduces physical, cognitive, and clinical performance. Nursing students have been found to experience especially high levels of state and trait anxiety which, according to Dorothea Orem’s self-care deficit theory, causes a deficit in health promotion and the health of oneself. There is little evidence available about how progression through a baccalaureate nursing program in the United States impacts anxiety. This research investigates anxiety in baccalaureate nursing students and how progression through the program influences self-reported anxiety levels. A descriptive cross-sectional study was performed on a convenience sample …

Long-Term Effects Of Breastfeeding Compared With Alternative Food Sources: A Systematic Review, Charlotte Bates

Williams Honors College, Honors Research Projects

The topic of the long-term impact of breast milk and alternative foods on the health status of children continues to be a focus of discussion and research. The aim of this systematic review was to describe and appraise evidence about the effects of breast feeding on health outcomes in children four years and older. Seventeen studies about on infant feeding were identified using Google Scholar and scholarly databases through The University of Akron. Google Scholar, CINAHL, and MEDLINE PLUS methods of searching were utilized, incorporating keywords, i.e., “breastfeeding” AND “cognitive development;” “obesity,”, “intelligence,”, and “immune system.” Based on appraisal of …