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Delirium Epidemiology, Systems And Nursing Practice In Palliative Care Inpatient Settings: A Descriptive Mixed Methods Project (The Depac Project), Annmarie Hosie

Theses

Background: Delirium is a distressing and serious acute neurocognitive disorder frequently experienced by hospitalised patients yet under-recognised by nurses.

Aim: To identify the actions required to improve the capabilities of specialist inpatient palliative care nurses to recognise and assess delirium.

Design: A two-phase sequential transformative mixed methods project, involving five studies and underpinned by a knowledge translation conceptual framework – collectively termed the DePAC project.

Methods: A mixed methods design was used to examine delirium in palliative care inpatient settings from epidemiological, systems and nursing practice perspectives. Participants were nurses, physicians, allied health professionals, managers and patients of Australian palliative …

Effectiveness Of Dance Movement Therapy On Attention Deficit Hyperactivity Disorder Children Aged Between 6-12 Years, Shilpa J Ms, Asha P. Shetty Dr

Manipal Journal of Nursing and Health Sciences

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common behaviour disorders of childhood. Mental health and school practitioners are increasingly faced with the challenge of assessing children and adolescents who might have ADHD. The purpose of the study was to assess the effectiveness of dance movement therapy (DMT) among ADHD children. Methods: Data collection was done using demographic proforma; SNAP IV rating scale and an opinionnaire. Results: Analysis revealed post-test teacher and parent mean scores were significantly lower than the pre-test teacher and parent mean scores i.e. the t-value for teacher is t(29)=16.81 and for parent is …

Effectiveness Of Yoganidra On Quality Of Sleep Among Cancer Patients, Divya N. Anand Ms, Linu Sara George Dr, Anil Raj Mr

Manipal Journal of Nursing and Health Sciences

Introduction: Cancer is one of the major health problems that occur in people of all races and cultures. There is a dearth of literature on implementing non-pharmacological measures to improve quality of sleep among cancer patients. Objectives: This study assessed quality of sleep among cancer patients and the effectiveness of Yoganidra intervention on quality of sleep in terms of improvement using Pittsburgh Sleep Quality Index (PSQI). Methods: A survey was used in Phase I (n=25) to assess the quality of sleep using PSQI. In phase II, an evaluative approach was used through one group pre-test post-test design (n=19).The participants with …

Noise In Neonatal Intensive Care Unit: Effects On Hospitalized Preterm Infants, Sonia R B D'Souza Dr, Leslie E. Lewis Dr, Vijay Kumar Dr, Asha Kamath Dr

Manipal Journal of Nursing and Health Sciences

For continued existence and survival, preterm infants depend on the Neonatal Intensive Care Unit (NICU). The NICU is a sophisticated and technology-driven environment, and preterm infants experience enormous stress in an NICU environment. Even though NICU is actually required by preterm infants for their continued existence, it may end up being an inappropriate milieu. The presence of overwhelming stimuli, most potent being the continuous presence of noise, may have various effects on preterm infants. Regardless of the recommendations by various committees, investigators have found that noise levels in the NICUs have exceeded the recommendations. The objective of this review was …

Living After Confronting Death; Story Telling During The Recovery Trajectory Of Intensive Care Unit Survivors: An Interpretive Biographical Approach, Beverley Anne Ewens

Theses: Doctorates and Masters

Aim: To create new meaning of the experiences of intensive care survivors during early recovery and the meaning of “self” during this time. To add to the understanding of how support should be focussed for survivors during recovery.

Background: Survival from a critical event/illness and intensive care unit experience is increasing, as is associated physical and psychological complications. Complications are due to the severity of illness, the intensive care experience itself and the nature of the treatments which promote survival. If complications remain untreated increased health care service uptake and reduced quality of life can ensue. Despite the …

Coping With Traumatic Events In The Emergency Department, Amy L. Quinn, Tricia Davis

Graduate Research Projects

No abstract provided.

Factors Contributing To Loss Of Nursing Intellectual Capital, Vera Ligia Grover

Walden Dissertations and Doctoral Studies

In a Level II trauma center, experienced nurses are retiring from nursing positions, which is causing an unstable workforce. According to the literature, there are not enough experienced nurses to mentor the new nurses. Evidence suggests that experienced nurses are associated with improved patient outcomes and that experienced nurse mentors can improve the work environment for less experienced nurses. Focusing on Watson's theoretical framework of caring and Covell's theoretical framework of intellectual capital, this phenomenological study explored the lived experiences of a small group of nurses. Five nurses with 15 years of experience and who had served as mentors were …

Improving Attitudes And Perceptions About Teamwork Among Health Care Professionals With A Teamstepps Approach, Tetsuya Umebayashi

Walden Dissertations and Doctoral Studies

Effective communication among health care professionals is essential for the provision of quality patient-centered care; however, effective communication practices are not guided by evidence-based models in many health care organizations. The Joint Commission has estimated that most sentinel events are induced by miscommunication among health care professionals. The problem addressed in this project was poor and ineffective teamwork skills and general communication among health care professionals and a lack of formal models to guide effective communication among the healthcare team. The purpose of the project was to adapt TeamSTEPPS to an institutional context in order to improve health care team …

A Staff Development Program: Diabetes And Tb Education And Screening, Relyndo Manalo Salcedo

Walden Dissertations and Doctoral Studies

There is a growing body of evidence on the positive association between diabetes and tuberculosis (TB), especially in populations with low socioeconomic status. According to the CDC and the WHO, diabetes is increasingly seen as a global epidemic, one that poses a threat to global TB control. The goal of this DNP project was to develop a program to educate clinical staff on the importance of early identification of diabetic and TB patients. The logic model was chosen as the framework for this project because it allows the planner to rationally observe each stage of a project's development. The program …

A Proposal For The Development And Validation Of A Diabetic Self-Management Education (Dsme) Program, Melissa Sue Garrison

Walden Dissertations and Doctoral Studies

The World Health Organization has estimated that by 2030, approximately 350 million people will be diagnosed with Type 2 diabetes mellitus (T2DM). Currently, 18.8 million people are diagnosed with T2DM. An additional 7 million people have high blood sugar but have yet to have an official diagnosis of diabetes. The literature supports early identification and prevention are key to reducing the severity of T2DM its complications. The Health Belief Model, the Chronic Care Model and Orem's Theory of Self-Care guided the current proposal, whose purpose was to develop and validate a new T2DM DSME module. A validation of the DSME …

Reducing Emergency Department Length Of Stay By System Change, Brian Dale Haybarker

Walden Dissertations and Doctoral Studies

Emergency departments (ED) are exceeding the Centers for Medicare and Medicaid Services and The Joint Commission's recommended 4-hour door-to-admission and 2-hour door-to-discharge for patients. The purpose of this project was to look for factors that decrease door-to-admission and door-to-discharge times and offer recommendations to the Patient Flow Committee (PFC) at the health care facility that may reduce overcrowding, diversion, and patient boarding. The 7-step Iowa model of evidence-based practice (EBP) was used to concentrate on problem-focused triggers that initiate the need for change. The project focused on decreasing door-to-admission and door-to discharge times: by opening an observation unit run by …

Barriers To The Influenza Vaccination In Veterans, Zina Floyd

Walden Dissertations and Doctoral Studies

Influenza is the eighth leading cause of death in the United States, accounting for 56,000 deaths annually and leading to an average of more than 200,000 hospitalizations every year. Adults 65 years of age and older account for 50% to 60% of influenza-related hospital admissions and an estimated 90% of influenza-associated deaths occur in people age 65 and older. During the 2011 to 2012 influenza season, approximately 50 % of veterans between 45 and 70 years of age refused the influenza vaccine within the metro-area outpatient Veteran Administration (VA) facility in Atlanta, Georgia. The aim of this project was to …

Assessing Spirituality Among Hospice Patients: A Phenomenological Study Of Hospice Nurses, Isabel Esther Kaufman

Walden Dissertations and Doctoral Studies

The shift in health care and nursing philosophy and practice from a holistic approach to a highly technological, cure-oriented approach has been attributed to effective pharmaceuticals made to prolong life. Recently medical professionals have shifted their focus to a combination of spiritual healing and medicine. Hospice care in particular have taken a key interest in integrating spirituality within their health care. The problem is that due to the complications in defining spirituality and appropriate training and education of spirituality within nursing curriculum, assessing patients' spiritual distress may be difficult for many hospice nurses which may be at a loss when …

Fall Prevention Quality Initiative: Implementation Of A Unit Safety Champion (Usc), Susan Lynn Rednak

Walden Dissertations and Doctoral Studies

The literature supports that a Unit Safety Champion (USC) may reduce falls among hospitalized patients. The purpose of this project was to determine if the implementation of a USC would assist in reducing falls on an acute unit in an urban hospital environment. The frequency of patient falls on the unit was collected from the hospital's quality department 3 months before and 3 months after the implementation of the USC. The average number of falls for 3 months before implementation was 5.0 per month (SD = 2.65) and involved a total of 15 individual patients. The average number of falls …

Evidence-Based Mentorship Program: Overview, Review Of Evidence, And Approach, Elizabeth Villanueva

Walden Dissertations and Doctoral Studies

Nurses comprise the largest segment of the healthcare workforce. Adequate numbers of

nurses help to ensure sufficient and safe nursing care in all settings. The current nursing shortage poses a barrier to optimum nursing care, and the nature of recruitment and retention of nurses has generated research interest because of its association with the labor shortage. The purpose of the project was to develop a nurse mentorship program for possible adoption by a northern state correctional facility. Goals are to aid recruitment and improve retention of nurses in the facility. This quality improvement project was informed by Jean Watson's theory …

Provider-Initiated Condom Education, Hiv, And Stds Among Older African American Women, Natasha Hall

Walden Dissertations and Doctoral Studies

Older African American (AA) women are at increased risk for HIV and STDs. The purpose of this quantitative study was to examine the influence of provider-initiated condom use education on condom use among unmarried, heterosexually active AA women aged 50 and over using the constructs of self-efficacy and attitudes of the health belief theoretical model. The relationships between provider education on condom use, condom use self-efficacy, condom use attitudes, and actual condom use were tested individually, and provider education on actual condom use was tested after controlling for condom use self-efficacy and attitudes among 95 study participants recruited primarily from …

The Effects Of The Night Shift On Nursing Staff Of An Inpatient Hospice Facility, Carolyn Dopson Horton

Walden Dissertations and Doctoral Studies

The night shift environment in an inpatient hospice facility is unique in care and relegates challenging situations for the nursing staff. Using the Parse methodology, the purpose of this project was to explore the challenges faced by inpatient hospice facility night shift nursing staff in providing a continuum of care for dying patients and their families. Nine night shift hospice nurses participated in 45-60 minute interviews. The interviews were conducted in a hospice quiet room or a designated place of comfort for the participant, which allowed for dialogical engagement. The interviews were unstructured with open-ended questions about lived experiences. The …

Visual Arts And Chronic Pain: Thematic Analysis To The Artistic Statements Of Visual Artists, Susan Beth Janicke

Walden Dissertations and Doctoral Studies

The relief of pain is an essential element of nursing practice. Nursing has begun to successfully use art to assess and reduce pain among hospitalized children, surgical patients, and oncology patients. Structured art projects have been used to provide distraction from pain and patient drawings have allowed nurses to assess pain. This project employed grounded theory and thematic analysis to uncover significant concepts in the artists' statements. The Roy adaptation model and Saunders' total pain theory provided the project theoretical framework. The artistic statements and the art of chronic pain patients were examined using thematic analysis to identify recurrent themes. …

Can Nurse-Facilitated Support Groups Foster Self-Awareness?, Althea Lenore Phillips

Walden Dissertations and Doctoral Studies

Students with learning disabilities (LDs) represent 9% of students attending college, and college administrators must comply with a large number of federal requirements outlining the provision of educational services for students with LDs, including offering support groups. Nurse-facilitated support groups, held within the university setting, could provide effective social support, increasing likelihood of college success among students with LDs. The purpose of this project was to develop a plan for implementing nurse-facilitated support groups for students with LDs within the student health services (SHS) department at a university designed to improve their coping skills on personal, social, and academic levels. …

Relationship Between Stress Burden And Perceived Support Among Elderly Male Spousal Caregivers, Stephanie Fitzsimmons Sexton

Walden Dissertations and Doctoral Studies

As older couples age, often one partner becomes more competent and able to care for the other, in which case they are able to remain in their homes. In one township in the northeastern United States, the caregiving role had a significant effect on the lives of elderly men who care for their wives. The purpose of this quantitative project study was to determine the relationship between perceived stress burden and perceived level of social support services and between perceived stress burden and use of support services by elderly male spousal caregivers residing in active adult communities. Watson's theory of …

Nursing Faculty Perceptions Of And Responses To Student Incivility, Lori Linn Theodore

Walden Dissertations and Doctoral Studies

Student incivility has become a problem in nursing schools around the country. Researchers have noted that uncivil behavior that goes unaddressed may compromise the educational environment. Nursing faculty have differing standards about uncivil behavior; thus, students experience inconsistencies in approaches to incivility. The purpose of this mixed-methods explanatory study was to explore nursing faculty experiences with, understandings of, and responses to student incivility. The conceptual framework was Clark's continuum of incivility and the conceptual model for fostering civility in nursing education. Descriptive analysis of the level and frequency of uncivil behaviors of nursing faculty members (17 full-time and 15 part-time), …

The Role Of Nursing Practice In Promoting Sleep During Brain Injury Rehabilitation, Jill Massengale

Walden Dissertations and Doctoral Studies

During hospitalization, sleep can be interrupted or even elusive. It has been established that quality sleep is essential in neural repair. Previous research has indicated that many nurses are unaware of the impact of sleep disturbance on brain injury recovery and do not understand how to promote sleep in the neurorehabilitation setting. The purpose of this project was to determine whether educational intervention would influence nurses' knowledge and attitudes toward sleep. Benner's (2001) novice to expert theory provided a framework for the project. With the collaboration of a neuropsychologist, this study produced a sleep knowledge and attitudes instrument. Pulmonary sleep …

Impact And Prevention Of Psychiatric Polypharmacy In The Elderly, Rose Cordelia E Onyekwe

Walden Dissertations and Doctoral Studies

Adequate medication management is a focus of effective care that is often overlooked in caring for adults with comorbid psychiatric and physical conditions, especially in patients who are treated by multiple care providers and have a variety of health issues at the same time. The purpose of this project was to develop evidence-based policies and practice guidelines to reduce polypharmacy in elderly patients in a rural outpatient psychiatric clinic. Bandura's self-efficacy theory was used to inform the project for its value in assessing motivation, capacity for self-regulation, and perceptions of individual ability. An interdisciplinary team of stakeholders explored best practices …

Student Perceptions Of Effective Learning Strategies For National Council Licensure Examination Preparation, Lori Jean Johnson

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine efficacious instructional strategies that the New England Community College (NECC) nursing program could implement in the curricula to improve National Council Licensure Examination Registered Nurse (NCLEX-RN) first-time pass rates. Effective strategies from students and nursing program faculty had used were investigated. Such strategies support student nurses in their efforts to succeed on the first administration of the exit examination. The rationale for this study and resulting project was that they could improve NCLEX-RN first-time pass rates and positively impact the local hiring of qualified nurses. Guided by Knowles's adult learning theory, key …

Care Transition Gaps: Risk Identification And Intervention, Michael Howard Jongsma

Walden Dissertations and Doctoral Studies

Hospital readmissions related to chronic heart failure (CHF) are costly, widespread, and often avoidable. Patient education that includes diagnosis, causes, medications, diet, exercise, and exacerbation warning signs has been shown to reduce the number of CHF readmissions. The purpose of this study was to use risk stratification to identify CHF patients at high risk for 30-day readmission. Once a high-risk CHF patient was identified, nursing interventions would be triggered to reduce readmissions and close the gaps in the continuum of care following acute care admission. Transitions of care theory was used as the framework for this project. The methodology had …

Recent Graduates' Perspective On The Efficacy Of Nursing Simulation Laboratory Experiences, Holli Sowerby

Walden Dissertations and Doctoral Studies

It has become progressively difficult to find suitable clinical placement for nursing students. To help meet this need, local schools of nursing are turning to high-fidelity simulation manikins to substitute for clinical experience. There is a lack of research that explores recently graduated nurses' perceptions about the efficacy of simulation experiences. Guided by the constructivist theory, this qualitative case study identified how recent RN graduates viewed simulation experiences and whether associate's-degree RN program graduates and bachelor's-program RN graduates viewed simulation differently. Nine recent graduates participated in individual face-to-face interviews. The data were coded and grouped into 5 major themes in …

Critical Care Nurses' Perceptions Of Their Knowledge And Self-Efficacy About Providing End-Of-Life Care, Mary Kathryn Gaffney

Walden Dissertations and Doctoral Studies

Most nurses receive limited formal education regarding end-of-life (EOL) care, which affects their ability to meet dying patients' needs. Guided by Bandura's social learning theory, this explanatory correlational study examined the relationships between critical care nurses' personal and professional characteristics and their perceived knowledge and self-efficacy when providing EOL care at an academic medical center. Convenience sampling was used to recruit participants from the eligible adult, pediatric, and neonatal critical care nurses for this study. The 67 participants completed the End-of-Life Professional Caregiver Survey (EPCS) to assess EOL care knowledge and self-confidence. Total EPCS scores revealed only moderate levels of …

Communication Skills Of Novice Psychiatric Nurses With Aggressive Psychiatric Patients, Rose Moss

Walden Dissertations and Doctoral Studies

Communication Skills of Novice Psychiatric Nurses with Aggressive Psychiatric Patients

by

Rose L. Moss

MS, University of Hartford, 1996

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

March 2015

The transition from novice nurse to a competent psychiatric staff nurse is often associated with major communication challenges, primarily when caring for aggressive patients. Guided by Peplau's theory, this quantitative study assessed the communication skills of novice psychiatric nurses (N = 25) who worked 24 months or less in the state psychiatric hospital with aggressive psychiatric patients. Additionally, certain demographic data …

The Effect Of Evaluating A Quality Improvement Initiative On Reducing Hospital Transfers Of Nursing Home Residents, Denise Eileen Jarboe

Walden Dissertations and Doctoral Studies

The Effect of a Quality Improvement Initiative on Reducing Hospital Transfers of Nursing Home Residents

by

Denise Eileen Jarboe

MSN, Walden University, 2010

BS, University of Maryland, 1981

Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2015

Nursing homes (NH) in the 21st century provide skilled healthcare services for resident populations who are older, frailer, and often suffering from multiple incurable chronic medical conditions. Nurses practicing in this setting must be keen observers and effective communicators with the ability to recognize and report subtle changes in health status …

The Impact Of Scheduled Meal Breaks On Icu Nurses, Ericka L. Privitt

Doctor of Nursing Practice (DNP) Practice Innovation Projects

The goal of this practice improvement project was to evaluate the impact of scheduling meal breaks for intensive care unit nurses at a Midwestern hospital. A literature review identified stress a main source for burnout and the nursing shortage. Recommendations for the creation of a healthy work environment were found and a program to schedule meal breaks was implemented over a nine week period. The Meal Break Impact Survey was utilized to gather pre and post-survey data. The following data was collected on the Meal Break Impact Survey: (a) demographics; (b) questions in Likert scale response on availability, access, beliefs, …