Digital Commons Network^™

A Salutogenic Framework To Understand Disparity In Breast Cancer Screening Behavior In African American Women, Regina Conway-Phillips

Dissertations

African American women (AAW) have a higher breast cancer mortality rate and a lower survival rate than any other racial or ethnic group. Research has demonstrated that limited access to care reduces mammography screening for AAW. Despite barriers, some AAW do access mammography and engage in breast cancer screening behaviors. The salutogenic theory of health focuses on factors that support well-being and increase positive health behaviors. Given this perspective, salutogenesis offers a novel framework to understand personal factors that allow some AAW to surmount barriers and to engage in health behaviors. Sense of coherence (SOC) is central to salutogenesis. Individuals …

Strategies To Decrease Drug Diversion Among Anesthesia Providers, Cat Mueller

Group: Samford University Moffett & Sanders School of Nursing

Substance Use Disorder (SUD) is a complicated and detrimental disease that disproportionately affects certified registered nurse anesthetists (CRNAs). Long work hours, lack of sleep, inadequate work-life balance, maladaptive coping skills, and burnout are factors associated with SUD. Personal factors include personality type, family or personal history of addiction, inadequate support system, underlying psychological disorders or history of trauma. There is a higher incidence of death from overdose with anesthesia providers than any other subspecialty. Drug diversion is a consequence of SUD and is defined as the redirection of medication from its intended destination for personal use, sale, or distribution. Consequences …

Gatekeeping Access To Emergency Departments: A Survey Of Hmo Policies, Regina Conway-Phillips

Theses

The purpose of this study is: (1) to determine if the practice of "gatekeeping" to control access to emergency departments by clients is a prevalent practice in nationwide Health Maintenance Organizations (HMOs}; (2) to determine if a consistent HMO-wide definition of "life-threatening" emergency medical condition exists; (3) to delineate emergency triage systems used by HMOs; (4) to determine what medical directors perceive is the impact of gatekeeping access to emergency department (ED} services on the timeliness of HMO members receiving ED services; and (5) to see if differences exists in for-profit and non-profit HMO gatekeeping policies.

Emotional Intelligence And Empathy Of Nursing Students In An Immersive Capstone Clinical Course, Michelle L. Finch

Dissertations

Today's baccalaureate nursing students need to be prepared to care for patients in an ever-changing, high acuity environment. Many programs offer a capstone immersive clinical experience. However, the benefits of this experience have not been fully explored, and the effect on patient care is unknown.

The purpose of the study was to determine if there was a change in levels of Emotional Intelligence (EI) and empathy in senior students who completed a capstone immersive clinical experience in the final semester of a baccalaureate nursing program.

Building A Culture Of Health Through A Laundromat-Based Health Educational Intervention Focused On Women's Fertility, Pregnancy, And Health-Seeking Behaviors, Roxanne Mirabal-Beltran

Sigma Foundation for Nursing Research Grant Reports

This grant funded Building a Culture of Health through a Laundromat-Based Health Educational Intervention Focused on Women's Fertility, Pregnancy, and Health-Seeking Behaviors, a study to assess the efficacy of a reproductive health educational intervention (EI) in Washington, District of Columbia (WDC) laundromats. Laundromats provide services to community members who predominantly identify as biological females (women) of lower socio-economic backgrounds. Patrons generally have time to engage and interest in a short EI while waiting for laundry and visit their local laundromats regularly.

Sepsis Early Recognition And Response: Education And Simulation To Increase Knowledge And Confidence In Associate Degree Nursing Students, Susan G. Bryant

Dissertations

Sepsis kills more than 250,000 people every year in the United States. Immediate treatment is crucial for best patient outcomes but sepsis can be challenging to identify. Nurses may miss signs of sepsis and delay life-saving treatment. The purpose of this quality improvement project was to determine whether an instructional presentation on introduction to sepsis followed by a high fidelity sepsis simulation scenario would improve knowledge and confidence in early recognition of and response to signs of sepsis for final semester associate degree nursing (ADN) students. Tanner's Clinical Judgment Model was used as the theoretical framework for this project. The …

Impact Of Authentic Leadership On Team Psychological Safety As Mediated By Relationship Quality, Mechelle J. Plasse

Dissertations

Leadership is a dynamic process with a far-reaching impact. Leadership is the process of guiding a group of individuals towards the achievement of a common goal. Healthcare leaderships looks to guide staff towards the common goal of positive patient outcomes. The literature has demonstrated that staff outcomes related to the health of their work environment can impact patient outcomes. A contributor to the health of the work environment is the relational tone of the unit; this tone is partly shaped by the skill and philosophy of the leader. Relational dynamics can influence several processes, including psychological safety which is a …

An Analysis Of Cultural Values, Religiosity And Family Member's Caregiving On The Positive Appraisal Of Caring For The Elderly, Fayron R. Epps

Dissertations

The stress and burden experienced by the family caregiver during the caregiving experience has been widely researched and established among the literature. Limited research exists on the impact of cultural values, religiosity and family caregiving on the caregiver's positive appraisal of caring for a dependent elderly family member. Therefore, the purpose of this study was to examine the influence of cultural values and religiosity on the positive appraisal of caregiving among African American, Hispanic and Caucasian caregivers for dependent elderly family members. A predictive correlational study design was employed to examine the relationship amongst variables for 69 African-American, Hispanic and …

Leading Change: Generating Cultural Responsiveness And Competence In Nursing, Kerstin G. Hudgins

Dissertations

Culturally responsive teachings prepare students to support social justice, diversity, equity, and inclusion (DEI) in and beyond the classroom. Rising reports of culturally insensitive care and the reported challenges that nurses experience when caring for culturally diverse patients warrant the advancement of the intercultural readiness of nursing students. The study investigated the cultural content taught, encompassing LGBTQ+ health education, at the School of Nursing at a historically black college and university (HBCU) in the Southeastern United States. The participant selection involved purposeful sampling of various stakeholders engaged in interviews and focus groups, including faculty, nursing students, and nurse managers with …

Self-Management By Adolescents And Young Adults Following A Stem Cell Transplant, Caroline F. Morrison

Dissertations

A grounded theory study was conducted to better understand the process AYA use to manage their care following a SCT. Specific aims included: 1) to explore self-management facilitators, barriers, processes and behaviors within individual, family, community and healthcare system domains using the pediatric self-management framework to develop initial interview guides; 2) to describe how AYA manage their care regimen post HSCT; and 3) to describe rates of oral medication adherence for AYA post HSCT and how they relate to patterns of self-management.

Living As A Dying Child: A Gadamerian Analysis Of The Poetry Of Mattie J. T. Stepanek, Corinne A. Settecase-Wu

Dissertations

Yearly, approximately 500,000 children live with life-limiting conditions in the United States; 50,000 die. Yet, details regarding children's days of living as dying are unknown. The aim of this qualitative hermeneutic study is to gain understanding of the phenomenon of living as a dying child. A Gadamerian-inspired approach was implemented to underpin the study, and to analyze poetic text to address the research question: What is it to be living as a dying child? The text sample included 499 poems written by Mattie J. T. Stepanek, a dying child. The Settecase-Wu Conceptual Guide was developed and implemented to ensure …

Quasi-Experimental Study With The Undergraduate Nursing Program Using Simulation Learning To Reduce Medication Errors, Georgette R. Lohrman

Dissertations

Medication errors in the nursing practice are not only costly but may harm or kill a patient. The problem addressed in this study is the relationship that exists between the lack of medication administration skills taught to students in an undergraduate nursing program. The purpose of this quantitative quasi-experimental study with a two-group pretest-posttest design was to examine if the addition of medication-simulated learning was associated with improved medication administration knowledge compared to a traditional Pharmacology classroom setting.

Influencing Pre-Nursing Student Well-Being Through A Five-Week Online Intervention. A Pilot Study, Regina W. Urban, Leslie A. Jennings

Sigma Foundation for Nursing Research Grant Reports

The purpose of this study was to test a well-being intervention utilized in an Introduction to Nursing Course with pre-nursing students as they prepare for admission to an accelerated online BSN program. Well-being in this study consisted of time management and study techniques, wellness and self-care strategies, and mental health characteristics, including depression, anxiety, stress, resilience, and self-compassion.

Temporal Sequence And Relationships Between Sleep Disorders, Mental Disorders And Traumatic Brain Injury In Deployed Military Members, Pamela Herbig Wall

Dissertations

U.S. military members are often forward deployed to austere environments where they are exposed to environmental, mental, and physiological stressors that can negatively affect their wellbeing and readiness for service. These service members are at high risk for developing sleep disorders, mental disorders, and traumatic brain injury (TBI) that may produce functional disability and further erode mission readiness. While there is ample evidence on distinct relationships between these three clusters of disorders, relatively few studies examine all three in a military and/or veteran population. Health care providers in the United States Military need information about these complex interactions in order …

Tranexamic Acid For Postpartum Hemorrhage, Anna Hudson

Group: Samford University Moffett & Sanders School of Nursing

Postpartum hemorrhage is the leading cause of maternal mortalities worldwide. Its incidence is far to common and for that reason improvement is needed. Literature is now supporting the use of tranexamic acid for parturients undergoing both cesearan sections and vaginal deliveries unless otherwise contraindicated. It should be considered on a case by case basis as an adjunctive therapy to standard oxytocin as a dual therapy to augment hemastasis.

Compassion Fatigue Among Family Caregivers Of Individuals With End-State Heart Failure, Lisa A. Cross

Dissertations

The purpose of this study was to examine the relation between family caregiver demographic characteristics and compassion fatigue for caregivers who were caring for family members with end-stage heart failure. Specifically, the study examined the relation of compassion satisfaction, social desirability, and the relationship between the family caregiver and nursing provider on compassion fatigue. The research was conducted during the COVID-19 pandemic and examined the family caregiver perception of the effect of COVID-19 on caregiving routines.

Nursing Faculty Experiences With Interactive Learning In The Associate Degree Nursing Classroom, Katheryn M. Csonka

Dissertations

The purpose of this basic qualitative study was to explore associate degree nurse faculty perceptions and experiences with the use of interactive learning in their classroom. Interactive learning is an approach to teaching and learning that promotes student learning with an active process. The implementation and continued use of interactive learning can be difficult for nurse educators who may be influenced by their previous perceptions and experience with use. There is a plethora of knowledge on the benefits of interactive learning with students, yet there is a gap in literature specific to nursing faculty experiences in the nursing classroom..

Developing Clinical Judgment Through The Implementation Of Information And Communication Technology, Such As The Electronic Health Record (Ehr), Sherri Carter

Dissertations

Graduate nurses are expected to enter a technology-rich workforce with an understanding of the electronic health record (EHR) and how it is used to guide patient care. Limited access to EHRs in clinical settings may result in students entering professional practice with limited ability to understand the full potential of the EHR. Over a seven-week term, students enrolled in the Patient-Centered Care I course, during the 2018 Spring I term, participated in high-fidelity simulation and seminar activities that included an educational electronic healthcare record (EEHR). These activities were integrated into the course to guide students when making clinical decisions regarding …

Impact Of High-Fidelity Simulation On Confidence Level Of Nursing Students In The Care Of Covid-19 Patients, Faith A. Paine

Dissertations

The COVID-19 pandemic impacted the education of nursing students across the world. Nursing students were unable to care for patients with COVID-19 at the beginning and potentially throughout nursing school depending on the facility and nursing school restrictions. It was not known how the participation in a high-fidelity simulation will impact the confidence level of nursing students in the care of patients with COVID-19. A mixed methods phenomenological qualitative and survey design was utilized to determine the confidence level of nursing students after participation in a high-fidelity simulation of a patient diagnosed with COVID-19.

Needs Assessment And Mentor Program Development For A Midwestern University, Mindy Thompson

DNP and Student Works

An estimated 1.13 million new registered nurses are needed to fill new jobs and replace retiring nurses from 2012-2022. However, the nurse faculty shortage is a primary barrier to expanding the nursing workforce over the next decade (AACN, 2005; AACN, 2015). Nurses moving from the clinical setting to the academic setting need preparation, professional growth, and the development of a social network to make the transition a lasting one (Schoening, 2013). Not only do mentoring relationships improve the work environment, but there is also an indication that it improves organizational commitment by achieving a sense of accomplishment, autonomy in their …

Effect Of The Virtual Simulation Paired Prebriefing-Debriefing Strategy On Nursing Students' Self-Efficacy Perceptions And Virtual Simulation Performance In The Care Of Patients Experiencing A Myocardial Infarction, Laura M. Penalo

Dissertations

Through the use of virtual simulations (VS) in nursing education, nursing students are exposed to a variety of clinical scenarios that may potentially improve their learning of competencies, increase their self-efficacy, and enhance their future clinical performance. Despite limited quantitative research incorporating evidence-based strategies such as prebriefing and debriefing as part of the VS experience, this educational technology continues to gain popularity. In 2020, the use of VS in the nursing curriculum exponentially increased when the global COVID-19 pandemic impacted traditional in-person clinicals, laboratory, and human patient simulation (HPS) experiences. Associate Degree Nursing (ADN) programs have benefited from the use …

Experiences Of Food Insecure College Students During The Covid-19 Pandemic, Amy E. Kendrick

Dissertations

The aims of this qualitative descriptive study were to describe the experiences and needs of food insecure college students during the COVID-19 pandemic and to obtain foundational information about food insecurity during a public health crisis to provide guidance for the development of future interventions.

Persistence Factors Described By Nursing Students Of African Descent: A Narrative Inquiry, Claudette R. Spencer

Dissertations

High attrition rates among nursing students of African descent have resulted in a nursing workforce that lacks diversity. Research has largely focused on the obstacles facing students who dropped out of their nursing programs, including financial constraints, academic issues, and personal challenges. Few studies have considered the students who persisted. The purpose of this qualitative dissertation study was to examine the factors that contributed to the persistence of students of African descent enrolled in nursing programs in community colleges as described in the stories and reflections of recently graduated alumni. Data was obtained with the use of two research questions …

Strategies For The Improvement Of Healthcare Through Simulation, Roger C. Lankheet

Dissertations

Medical errors continue to plague the healthcare industry. The annual rates of morbidity are approximately 2.69 million (AHRQ, 2019), while mortality rates exceed 400,000 per annum (Makary & Daniel, 2016). There may be no panacea to combat these egregious rates. However, simulation of patient care events may better prepare healthcare professionals to prevent medical errors as it has been proven to be an effective learning strategy (Kirkham, 2018), enhancing skills while gaining experiential knowledge, without risk to actual patients.

The purpose of this qualitative study was to gain a better understanding of factors that impede or foster the frequent utilization …

Examining The Effects Of A Rater Training Program On Interrater Reliability With The Lasater Clinical Judgment Rubric, Deborah A. Halliday

Dissertations

There is high demand for competent graduate nurses as they begin working in healthcare. However, the transition from classroom to professional practice can be difficult. Students and newly licensed entry-level practitioners must develop and possess suitable clinical judgments in order to demonstrate clinical competency in the delivery of safe patient care. Currently, there is a call for nursing education to provide increased rigor in performance evaluation of students' clinical judgment prior to graduation.

The primary purpose of this study was to determine if rater training had an effect on interrater reliability among raters with the Lasater Clinical Judgment Rubric (LCJR) …

Clinical Faculty Strategies To Decrease Nursing Students' Anxiety During Clinical Practice: A Qualitative Study, Elijah Z. Yarpah

Dissertations

Stress in the clinical learning environment is a psychological and physiological element that affects nursing students' learning outcomes and health. In clinical settings, nursing students encounter stressors that are critical to their academic success as well as their future professional performance. Nursing educators struggle to assist students in developing strategies to manage clinical stress. A review of relevant literature did not identify coping strategies clinical educators and nursing staff can promote to help learners deal with stressors. Therefore, to provide robust ideas to help nursing students manage stress in the clinical learning environment, this study was designed to answer one …

Reconstruction Of The Professional Identity: The Mature Ad Nurse After Bsn Completion, Constance G. Demmery

Dissertations

In 2011, the Institute of Medicine (IOM) announced a key initiative to increase the number of registered nurses (RN) at the bedside prepared at the baccalaureate of science in nursing (BSN) level. For decades, the RN entry level into the profession has been debated, often lying dormant during nursing shortages. The profile of today's RN is age 50, has many years of clinical experience, and holds an associate degree in nursing (ADN). Many ADN-prepared nurses are returning to academia to earn their BSN. However, there is little research on how the mature, experienced ADN integrates years of clinical experience with …

Exploring The Relationship Between Job Satisfaction And Intent To Remain Within An Organization Among Millenial Nursing Faculty, Kristie E. Davis-Collins

Dissertations

The nursing faculty shortage continues to grow with time with impending detrimental effects. Several factors influence the nursing faculty shortage, including inadequate compensation to clinical areas, low pool of potential nurse educators in graduate programs, and a faculty wave of retirements. Based on this information, it is vital for nursing institutions to improve job satisfaction and the intent to remain among millennial nursing faculty. The purpose of this study is to evaluate the relationship between job satisfaction and intent to remain within an organization among millennial nursing faculty. A cross-sectional, correlational research design was used to test the hypotheses of …

Impact Of Standardized Skin-To-Skin Protocol In The Operating Room On Breastfeeding Rates, Simone M. James

Dissertations

Skin-to-skin contact (SSC) is an evidence-based practice with many benefits for mothers and their newborns. The separation of mothers from their babies after cesarean birth delays SSC, which can adversely affect the initiation and the success of breastfeeding. The purpose of this quantitative, quasi-experimental project was to determine if or to what degree the implementation of Hung and Berg's evidence-based protocol for skin-to-skin in the operating room (OR) would increase exclusive breastfeeding rates at discharge for adult women status post a cesarean delivery in a rural Arizona hospital over four-weeks. The Iowa model and Lewin's planned change theory were utilized …

Utilization Of Modular Build Concept And Community-Led Design Of Facilities To Increase Rural Healthcare Access: Comparative Construction Projects And Evaluation Of Health Disparities In South Africa And Montana, Usa, Modjadji M. Choshi, Elizabeth A. Johnson

Global Advocacy

The purpose of this project is to utilize a community-led design of a culturally sensitive modular build concept to increase rural healthcare access in Limpopo Province, South Africa (SA) and Montana, United States of America (USA).