Digital Commons Network^™

Implementing An African American Cultural Awareness Program For Skilled Nursing Facility Staff, Adekemi T. Adedipe

Doctor of Nursing Practice (DNP) Projects

Background: Patient care is most effective when patients and providers establish a therapeutic connection in a cultural context. Nurses’ lack of awareness of a cultural context for patient care impairs establishing a therapeutic provider/patient relationship, with care of lesser quality and poorer health outcomes as consequences.

Local Problem: Staff at a Northern Californian skilled nursing facility (SNF) caring for African American patients with mental illness lacked self-awareness of the cultural context of care. Staff did not consider cultural constructs of care in treating patients and developing care plans.

Methods: Educational intervention to increase the cultural competence of a skilled …

Developing And Implementing An Infection Prevention Practice Fellowship Program, Sejal Naik

Doctor of Nursing Practice (DNP) Projects

Developing and Implementing an Infection Prevention Practice Fellowship Program

Abstract

Background: The COVID-19 pandemic placed huge demands on infection prevention programs (Blanchard et al., 2022), seriously taxing a profession already mired with progressively increasing workload and responsibilities (Bryant et al., 2016).

Local Problem: In a rapidly changing environment, infection preventionists (IPs) contend with pandemic surges, emerging infections, and supply chain disruptions. The NCAL Region of an integrated health system experienced IP turnover, and in the absence of a formal training program, newly hired IPs experienced variable to no opportunities to develop their competencies.

Methods: A literature review on infection prevention …

Screening For Uterine Fibroids In Black Women, Winnie N. Kagendo

Doctor of Nursing Practice (DNP) Projects

Background: Uterine fibroids are benign growths in the uterine muscle that affect around 70% of women. Black women have a higher risk, with three times the likelihood of developing fibroids compared to other races.

Problem: The issue of uterine fibroids continues to be poorly addressed in healthcare settings. Black women continue to be particularly adversely impacted by this problem. There is a lack of better screening methods, leading to late detection and limited treatment options for those hoping to maintain fertility.

Methods: A quality improvement project was implemented at a primary care clinic in Loma Linda, California, using the Uterine …

Enhancing Mental Health Assessments For Hysterectomy Patients: Implementing A Depression Screening Tool For Healthcare Clinicians, Dede Mihedji

Doctor of Nursing Practice (DNP) Projects

Background: Hysterectomies are prevalent in the United States ranging from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing preoperative depression could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy. Local Problem: Currently, there is no standard practice for preoperative depression screening in hysterectomy patients. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). Methods: To address the gap, clinicians attended a fifteen-minute Zoom course on the Patient Health Questionnaire 9 (PHQ-9) and its …

A Mixed Methods Study Of Physical Activity In The Intensive Care Unit And Post-Intensive Care Unit Hospital Stay: Patient Characteristics, Symptom Burden, And Experiences Of Postoperative Adults, Christina Bach

Theses & Dissertations

Background: Physical activity (PA) beginning early in the intensive care unit (ICU) can reduce adverse outcomes commonly experienced by individuals after ICU discharge. Patient-centered approaches to PA in the ICU and reliable activity evaluations are essential for understanding PA's impact on patient outcomes.

Objective: This dissertation sought to evaluate patient-related factors associated with PA in the ICU and post-ICU hospital stay.

Methods: The purpose of the dissertation was to conduct: 1) a concept analysis to define ICU survivorship and identify critical care aspects important for patient recovery; 2) an integrative literature review to assess early mobility (EM) interventions with physical, …

Promoting Parent-Child Relationships Through Community-Based Family Wellness Programs To Improve Mental Health In Children, Maria Elena Falcon

Doctor of Nursing Practice (DNP) Projects

Objective: Adverse childhood experiences can affect a child mentally and lead to mental, health, and learning problems later in life. Establishing healthy parent-child relationships through family-oriented programs can promote mental well-being, improve behavior and learning in children and strengthen positive parent-child relationships.

Methods: A systematic electronic search using databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and PsycINFO, contextualized current research on the importance of parent-child relationships and their influence on mental health. The inclusion criteria for the review used were articles in the English language and relevant dates from 2014 to 2021. The key terms used …

Cognitive Test Anxiety, Course Grades, And Course Repetition In Associate Degree Nursing Students, Crystal Elaine Jones

Walden Dissertations and Doctoral Studies

No abstract provided.

Reconceptualizing Complex Post-Traumatic Stress Disorder: An Evolutionary Concept Analysis And Clinical Guide, Jessica Livingston

Doctoral Projects

Conflicting models of how trauma manifests into identifiable symptoms have been a source of controversy and perplexity among practicing mental health clinicians and diagnosticians. Complex post-traumatic stress disorder (CPTSD) is now an internationally recognized diagnosis since its inclusion in the 11^th version of the World Health Organization’s (WHO) International Classification of Diseases (ICD-11) in 2018. The American Psychological Association (APA) does not share this recognition of CPTSD as an individual diagnosis and instead opted to update the diagnostic criteria for PTSD to include DSO and a 4^th category of dissociative features rather than include CPTSD as a separate …

The Development And Evaluation Of Nurse-Created Video Modules To Encourage Healthy Behaviors Among Women With Polycystic Ovarian Syndrome (Pcos), Rebecca Akers

Doctoral Projects

Problem Statement: Women with PCOS have a higher prevalence of overweight and obesity, a problem that is directly linked with many of the symptoms and long-term health problems experienced by these individuals. Research studies indicate that lifestyle modifications, including dietary changes and increased physical activity aimed at promoting weight loss, are often the initial approach to treatment, but many women fail to adopt those health-promoting behaviors, which may be due to insufficient teaching and support provided by healthcare professionals.

Purpose: Utilize Pender’s Health Promotion Model to develop and evaluate a set of educational video modules focused on encouraging women with …

Animal-Assisted Therapy In Mental Illness, Chanae Cypress

MSN Capstone Projects

Mental health disorders are a significant global health concern, with a growing need for alternative therapeutic approaches. Animal-assisted therapy has gained recognition for its potential to improve the emotional and psychological well-being of individuals struggling with these disorders.

This Capstone Benchmark proposed project explores the potential positive impact of animal-assisted therapy (AAT) on patients with mental health disorders during inpatient hospitalization. The project outlines a 4-week intervention program involving 45-60 minutes sessions with dogs, which patients receive 2-3 times per week. For this Capstone Benchmark project, the selected PICOT question is: In patients with mental health disorder (P) how does …

Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis

MSN Capstone Projects

The significance of appropriate nurse staffing in enhancing patient outcomes and mitigating nurse burnout is well-documented. Inadequate nurse staffing can lead to negative consequences, including burnout, decreased nurse retention, and potential safety risks (Shin et al. 2018; Wynendaele et al. 2019) Research has also established a strong connection between nurse-to-patient ratios, well-being, and job dissatisfaction among nursing staff (Andel et al. 2021; Thompson-Munn et al. 2021).

Given this evidence, there is a compelling rationale for aligning nurse staffing ratios with proposed federal standards to address burnout, improve well-being, and enhance patient outcomes. Implementing these changes necessitates careful planning and assessment. …

Feasibility And Acceptability Of A Loving-Kindness Meditation Among Socio-Economically Diverse Older Adults, Carolyn Streb

Undergraduate Research Symposium Posters

In Psychology one of the first theories we learn is Maslow's Need Triangle. Within this theory we learn that love and belonging is one the basic human needs an individual needs to develop. This continues to be relevant later in age. The lack of compassionate love can result in increase feelings of loneliness and subsequent deterioration of mental health therefore making individuals, specifically older adults, more vulnerable to suicidal behavior. Loneliness is a public health epidemic affecting more the 40% of older adults. Theoretical and empirical evidence implies that human beings can cope with adversity when they possess a repertoire …

Evaluation Tools For Undergraduate Nursing Student Performance In Simulated Learning Experiences: A Literature Review, Katie Pettibone

Nursing Masters Papers

Simulated learning experiences (SLEs) are an increasing aspect of clinical experiences in undergraduate nursing programs. Formative student evaluation is a critical component of SLEs as it promotes student growth and demonstrates student learning outcomes. The 2021 International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: Simulation for Student Evaluation of Learning and Performance [INACSL Standards] provide specific guidelines that aim to ensure the best experiences for SLEs participants. With many formative evaluation tools for overall student performance available, it is important that educators utilize evaluation tools that meet the most recent 2021 INACSL Standards.

An integrative …

Online Relational Database For Department Of Nursing: An Evidence-Based Practice Project, Denise L. Rismeyer

Doctoral Dissertations and Projects

Departmental nursing leaders and their support staff manage large amounts of data in their daily work and have reported inefficiencies, manual labor, and dissatisfaction with previous electronic tools. Cognitive overload occurs when the amount of data exceeds the brain’s ability to process it and leads to negative consequences such as errors, burnout, anxiety, and poor productivity. Use of technology aligns with nurse leader competencies for business skills and principles along with utilizing evidence-based data for goal setting and decision-making. An online relational database (ORD) allows multiple users at one time, web-based access, ability to hold a large capacity of data …

Continuity Of Care In The Post-Partum Period, Ashley Quezada

MSN Capstone Projects

Maternal mortality rates in the United States have been a growing concern over the past decade, with rates continuing to climb as recent studies have been published. The total maternal mortality rate in the United States in 2018 was 17.4 and has increased to 32.9 as of 2021, while other developed countries continue to decline (Hoyert, 2023). The maternal mortality rate is the number of deaths per 100,000 live births. More than 50% of pregnancy-related deaths in the United States occur after delivery, in the post-partum period (Melillo, 2020). The purpose of this report is to not only bring light …

Health Care Organizations’ Research Capacity And Culture’S Effect On Nurses’ Evidence-Based Practice Implementation, Tamela Marie Fonseca

Walden Dissertations and Doctoral Studies

No abstract provided.

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Leadership Style And Nursing Retention, Brenae J. Reason

MSN Capstone Projects

Nursing is the heart of healthcare, for decades we have been the drivers of innovation and have contributed to so many advancements in the profession. Even with nursing being a sincere passion amongst many nurses, there is an alarming trend of nurses who are faced with burnout (Brusie, C., n.d.). It has been reported that 1 in 5 nurses left their position in one particular health system (Andreyeva et al., 2023). It is also noted that turnover can be costly for organizations (Zuniga et al., 2019). While there are a multitude of reasons nurses could be leaving their companies, one …

Scaffolded Simulation In Psychiatric Mental Health Nursing Education, Lori Bobo, Stacy Mikel, Yolanda Chandler, Hungwei Tseng

Higher Learning Research Communications

Objectives: The purpose of this study was to investigate the impacts of using scaffolded clinical simulations on nursing students’ confidence in clinical reasoning, clinical judgment, and critical thinking skills. Next, we also attempted to gain insights into students’ perceptions of the benefits of scaffolded clinical simulations.

Method: We used a mixed-methods research design to investigate the impacts of using scaffolded clinical simulations on 133 second-semester baccalaureate nursing students’ confidence in clinical reasoning, clinical judgment, and critical thinking skills.

Results: Findings from this study indicate that students who perceived the benefits of scaffolded simulation activities (i.e., peer observations, debriefings, and self-reflections) …

Predicting Factors Of Health-Related Quality Of Life Among End-Stage Renal Disease Patients Receiving Hemodialysis At A Tertiary Level Hospital In Nepal., Jyoti Gahatraj, Poolsuk Janepanish Visudtibhan, Tiraporn Junda, Nipaporn Butsing

Journal of Health Research

Background: End-stage renal disease (ESRD) puts tremendous burdens upon affected patients and their support persons in Nepal. The health-related quality of life (HRQoL) among Nepalese persons with hemodialysis-dependent ESRD is not well understood. This study aimed to examine HRQoL and its predicting factors among persons undergoing hemodialysis in Nepal.

Methods: A purposive sampling was applied to recruit 106 persons with ESRD receiving hemodialysis at a tertiary hospital in Nepal between October and December 2021. The structured questionnaires included personal information, the World Health Organization Quality of Life instruments (WHOQOL-BREF), the fatigue assessment scale (FAS), the Hamilton depression rating scale (HDRS), …

5th Annual Occupational Therapy Program Research Conference, Kelly L. Taylor Ms, Otr/L, Cbis

Student Scholarship & Creative Works

Occupational Therapy Program RESEARCH CONFERENCE

5TH OT COHORT | CLASS OF 2024

OT Program Student Presentations Graduate Students from the Class of 2024

A Credentialing Protocol Education To Enhance Nurse Float Pool Competency, Dalton J. Skipper

Walden Dissertations and Doctoral Studies

No abstract provided.

Palliative Care Referral Protocol: Best Practice Toolkit For Improving Early Referral Rate For Adult Cancer Patients, Linda Dinh Nguyen

Student Scholarly Projects

Despite the benefits of palliative care being well-documented in studies and early palliative care services being strongly recommended by reputable organizations, such as the American Society of Clinical Oncology, many patients did not receive or received late referrals (Pigni et al., 2022). This mainly occurs because oncologists commonly base their referrals on perceived needs and clinical judgment (Smith et al., 2017). Thus, this program development project aimed to create a toolkit to improve early identification and referral to palliative care for adult patients who would benefit from palliative care services. The PICO question that guides this program is: In ambulatory …

Impact Of Self-Management Education On The Self-Efficacy Of People With Chronic Pain, Tanya Jones

Doctor of Nursing Practice Projects

Self-efficacy is a critical element in the self-management of chronic pain. Despite the traditional approaches to managing chronic pain, such as opioids, traditional methods have proven ineffective and often lead to addiction and misuse, contributing to the overwhelming and devastating opioid crisis. This quality improvement project aimed to reduce the knowledge gap among individuals between the ages of 18 and 75 who have chronic pain by producing data that illustrates that providing individuals with self-management education empowers them to understand and self-manage their pain. The concept of self-management education is grounded in Bandura's Social Cognitive Theory, which highlights the role …

Improving The Mental Health Of Nursing Students By Utilizing A Serenity Room: A Benchmark Study, Megan E. Taylor

MSN Capstone Projects

Research findings consistently show that even though improvements have been made through the years, there is much more work to be done concerning mental health nationwide, especially in nursing. Nurses are the front-line workers in healthcare and face challenging times daily. Mental health-related issues in nursing have increased on a national level since the COVID-19 pandemic (Xiong et al., 2022). A more significant nursing shortage will likely occur without drastic change and support for nurses’ well-being.

The purpose of this paper is to describe a benchmark Capstone project. This benchmark study was conducted with the goal of improving nursing students …

Effect Of Doula Care Education On Cesarean Section Rates: A Benchmark Study, Elena Rubio-Mcdonald

MSN Capstone Projects

A cesarean section (CS) is a vital maternal care intervention when necessary; however, the surgical procedure places childbearing women at direct risk for infection, hemorrhage, thromboembolism, injury to bladder or bowel, post-surgical pain, and complications from anesthesia. The risk of mortality associated with CS is four to five times more likely compared to vaginal delivery. Severe nursing shortages, high patient volumes, and patients with complex pregnancy related health concerns create barriers to the provision of continuous labor support (CLS) by labor and delivery (L&D) nurses. Partnering with certified doulas and implementing the CLS methods they employ may promote spontaneous vaginal …

Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner

MSN Capstone Projects

Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …

Evidence-Based Pain Management With Inclusion Of Music Therapy For Post-Surgical Patients: A Benchmark Study, Ashleigh Rowan

MSN Capstone Projects

Improper pain management in the postsurgical patient can delay proper healing, increase frustration for the patient, and prolong hospital stays (Córcoles-Jiménez et al., 2021). Moderate to severe pain can pose a greater risk for complications such as deep vein thrombosis, pneumonia, and delayed recovery (Kolaczko et al., 2019). Music therapy is an underutilized pain intervention in the PACU environment. Music therapy has been shown to lower pain and anxiety scores in many different clinical settings (Lee et al., 2017). Pain management can radically improve a patient’s outlook and recovery (Luo & Min, 2017). Patients who return to wakefulness and receive …

Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner

MSN Capstone Projects

Although a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.

The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, …

The Effects Of Non-Pharmacological Interventions For Behavior And Psychological Symptoms Of Dementia: A Benchmark Study, Rachel R. Williams

MSN Capstone Projects

The management of behavioral and psychological symptoms of dementia (BPSD) in patients who reside in nursing homes can be challenging. These neuropsychiatric behaviors can include but are not limited to aggression, agitation, delirium, depression, and psychosis (Cloak & Al Khalili, 2022). Patients with BPSD often have difficulty expressing their needs due to the disease process, resulting in further complexity when managing behaviors. There are no psychotropic medications to treat BPSD specifically, but many are often prescribed to treat the symptoms or behaviors exhibited by patients. The use of psychotropics, especially long-term can cause a myriad of adverse effects and should …