Digital Commons Network^™

Effectiveness Of Fall Prevention Multimedia Program On Patient Awareness, Self-Efficacy, And Engagement, Perlita C. Cerilo

Dissertations

Hospitalized adults are at high risk of falls during their acute episode of care making fall prevention programs a critical element of care. Patient self-efficacy and engagement in fall-prevention activities are important aspects of fall-prevention programs. Education may play an important role in increasing self-efficacy and the likelihood of engagement; however, a gap in evidence explores the effect of patient education on self-efficacy and engagement among hospitalized older adults in preventing falls. This quasi-experimental study examined the effect of a multimedia program on hospitalized adults' levels of fall risk awareness, self-efficacy, and engagement in fall prevention. Sixty hospitalized adults in …

Exploring Multilevel Factors Influencing Quality Of Life In Young Adult Cancer Survivors: A Mixed Methods Study, Lauren V. Ghazal

Dissertations

The purpose of this dissertation was to explore the relationship of WRGs and QOL in YA hematologic cancer survivors with a focus on factors influencing QOL at the individual level, and work-related factors at the microsystem and mesosystem levels. Specific aims of this study were to: 1) describe the relationships between patient-reported individual characteristics (distress, anxiety and depressive symptoms, cognitive function, CRF, and financial health), work-related characteristics in the microsystem (job control, workplace support, psychological job demands, physical job demands, and job security) and QOL; 2) Explore symptom experiences, WRGs, work ability, self-identity, and perceived psychosocial needs; and 3) Examine …

The Health Impacts Of Nursing Shift Work, Amanda M. Shandor

Theses

This descriptive pilot study was intended to evaluate negative outcomes of shift work stress in nursing. Objective analysis of waist-hip-circumference ratios (WHR) and subjective survey reports were utilized to assess whether differences existed in expressed stress, stress related health disorders, and stress associated behaviors among day shift, night shift, and rotating shift registered nurses (RNs). Statistical analysis of the WHRs indicates that no statistical difference exists in the results from this study across the three nursing shifts.

Understanding Families'/Surrogate Decision Makers' Experience Of Decision Making For Critically Ill Patients In Saudi Arabia, Omaimah A. Qadhi

Dissertations

Critical illness not only affects patients, but also may negatively impact the families and people who are responsible to make decisions for those patients. Making decision can be challenging for people when it is for someone else who is critically ill. This study explores the decision-making experience for family or a surrogate decision maker for critically ill patients in Saudi Arabia. This project also tested the presence or absence of regret after making serious decisions about a medical treatment for another individual. Goal Attainment Theory was used to guide this study. The concepts of the Interpersonal Interacting Systems were used …

Health Service Cost And Use Associated With Advance Directive Documentation Among Patients With Copd, Brandon Duck

Theses

Little available research has focused on the question of whether advanced-careplanning has the potential to impact health-care related spending especially in patients with chronic and incurable conditions such as Chronic Obstructive Pulmonary Disease (COPD). The purpose of this secondary data analysis was to investigate the prevalence of Advance Directives (ADs) documented in the electronic health records, compare healthcare spending between individuals with versus those without ADs on file, and examine socio-demographic variables as potential predictors of having documented ADs on file for patients with COPD in a large tertiary academic medical center in 2012 and 2013. This retrospective cohort study …

Faculty Descriptions Of Teaching Strategies For Professionalism In Nursing Students, Diane L. Smith Levine

Dissertations

The purpose of this qualitative single case study was to explore how nursing faculty described strategies for teaching professionalism, across the curriculum, to pre-licensure Bachelor of Science in Nursing (BSN) students at one college in the Midwest. It was not known how nursing faculty described developed strategies. This study was supported by two core theoretical foundations: Miller's Wheel of Professionalism in Nursing model (Miller, 1988) and Benner's Novice to Expert Nurse concept (Benner, 2001). Research study questions included: RQ1: How do pre-licensure nursing faculty, in one program in the Midwestern United States describe teaching professionalism to BSN students across the …

The Missing Concept To Improve The Nursing Process: A Quality Management System, Pilar Parker

Theses

Quality in the healthcare industry has been gaining much importance in the last two decades. Every health professional is carefully trained to provide high quality service. Historically, healthcare providers have done their best in providing honorable service to the public. However, according to the Agency for Healthcare Research & Quality, the healthcare industry reports hospital stays of $375.9 billion in aggregate costs (2010). As a result, the healthcare crisis has demanded improvement in the quality of the healthcare industry. Because nurses are the largest group of healthcare providers in hospitals, they have become a major target for improving healthcare in …

Frameworks For Patient Safety In The Nursing Curriculum, Theresa M. Chenot

Dissertations

Patient safety (i.e., the degree to which patients are free from accidental injury) has received a great deal of media coverage during the past few years. Professional and regulatory agencies have indicated that patient safety education should be provided to healthcare workers to improve health outcomes. The primary purpose of this exploratory study was to gain a better understanding of the current status of patient safety awareness among pre-licensure nursing students. To this end, six research questions guided the study:

1. Will interpretable item constructs be identified when responses to the Healthcare Professional Patient Safety Assessment Curriculum Survey (HPPSACS) are …

Effects Of Clinical Nurse Educator Professional Role Development: An Evidence-Based Quality Improvement Project, Connie Dagg

General Submissions: Presentations (Oral and Poster)

Centralization of Clinical Nurse Educators (CNEs) from the Med-Surg and Critical Care units of a Midwestern health care system created role confusion and poor role outcomes. This evidence-based quality improvement (EBPQI) project focused on the implementation of best practice education strategies integrating the Association of Nursing Professional Development (ANPD, 2016) Transition to Practice Fellowship© and their Practice Model© for six CNEs. The purpose was to discern the effect of such strategies on CNE self-assessed competency and three nurse sensitive quality outcomes. Evaluation of the EBPQI project included paired self-assessments via a pre- and post-intervention survey. Additional project outcomes included fall …

Enhancing Post Surgical Discharge Education At A Dermatology Clinic: A Quality Improvement Project, Kayla Olds

DNP and Student Works

This qualitative project's aim was to reduce patient concerns by implementing enhanced discharge educational materials with visual aids and improve staff engagement during patient education.

Implementing A Restorative Yoga Therapy To Reduce Anxiety And Improve Quality Of Life Among Patients With Breast Cancer, Alyssa Kurjan

Dissertations

Maintaining psychological health is an important component of a patient's well-being throughout breast cancer treatment. Anxiety and quality of life are two common indicators of psychological health. Restorative yoga therapy enhances psychological health by reducing anxiety and improving quality of life among patients with breast cancer. Restorative yoga is a gentle subtype of yoga that incorporates stretching, breathing, and meditation exercises aimed to calm the body. The purpose of this project is to determine if participation in restorative yoga therapy decreases anxiety and increases quality of life among patients with breast cancer undergoing therapy or who have previously completed therapy. …

Competency And Work Environments Among Military And Civilian Perioperative Registered Nurses: A Predictive Model, James X. Stobinski

Dissertations

This study examined the self-assessed competency levels, work environments, sub-specialty training and selected demographic characteristics of two groups—civilian and military (United States Navy) perioperative nurses. The Nurse Competence Scale (NCS) was used to assess competency levels, and the Practice Environment Scale-Nursing Work Index (PES-NWI) was used to assess the nursing work environment. Demographic characteristics, including years of experience, educational level and type of sub-specialty training, were gathered, and comparisons were made between the groups.

A cross-sectional non-equivalent comparison group design was used. The research was conducted by mailed survey packets. All active duty Navy perioperative nurses (228) were surveyed, as …

Evaluating Psychiatric Nursing Competencies Applied To Emergency Settings: A Pilot Role Delineation Study, Joanna J. Mello

Theses

Aims: 1) To examine emergency department (ED) nurses' reports of a) frequency b) importance and c) self-efficacy related to the application of recommended psychiatric nursing competencies in three domains (i.e., assessment, tasks, knowledge).

2) To test the extent to which frequency and importance independently predict ED nurses' self-efficacy related to the application of the competencies in their daily work.

Preparing New Nurses To Improve The Systems In Which They Work: A Matter Of Degree Or Skillset?, Franco Herrera

Theses

The multitude of players, rules, and economic factors involved in organizing and delivering healthcare in the US today requires a highly skilled workforce, who can go above and beyond excellence at the practitioner level by acting as change agents to continuously improve the systems in which they work. Early acquisition of quality and safety competencies, along with leadership and inter-professional collaboration, systems thinking, and health economics are essential for preparing new nurses for the demands of their future jobs. Using these competency domains as a framework for evaluation, the purpose of this descriptive study was to examine program coordinators' assessments …

Developing "A Personal Knowing" - A Grounded Theory Study, Mark Davies

Dissertations

The past 30 years have seen rapid expansion in nursing roles, and the provision of education that supports them. However, the nature of the knowledge that characterises advanced practice, and the pedagogical strategies that are utilised in catalysing its development have yet to be extensively evaluated. Whilst a number of frameworks which purport to conceptualise this knowledge do exist, such structures remain somewhat provisional. Likewise, the pedagogical approaches employed in the development of knowledge for advanced practice are derived as much from teacher preference, organisational expedience, and external policy drivers as educational efficacy. The study presented within this thesis addresses …

Assessing The Influences On Rural Women's Reproductive Life Plans: A Cross-Sectional Descriptive Study, Lori M. Jagoda

Theses

Rural women's unique personal, social, cultural, and economic characteristics influence their health care decision-making processes. To assess the influences on rural women and their Reproductive Life Plans, a cross-sectional descriptive study, based on the Health Promotion Model (HPM), was used.

Racial Disparity In Health Insurance Acquisition In The State Of California, Florence Jill Polina

Theses

Racial disparity continues to be a struggle in America. The main purpose of this project was to determine whether there is a relationship between race and the acquisition of health insurance in adult residents of California who are younger than 65 years old. Through secondary data gathering, analysis of an existing racial disparity in health care insurance acquisition was accomplished. The results of the project indicate that a relationship exists between race and health insurance acquisition, thereby promoting an opportunity to determine hindering factors and discuss recommendations that can help to alleviate them.

A Guideline Recommendation Implementing Inferior Vena Cava Ultrasound To Guide Hemodynamic Resuscitation Of Septic Adults During Air Medical Transport, Marin E. Peterson

DNP and Student Works

Sepsis is present in one out of every three hospital deaths (CDC, 2020). Primary and time-sensitive interventions for sepsis include intravenous fluid and vasopressor administration for hemodynamic resuscitation, but inappropriate administration can lead to complications and poorer patient outcomes (Schmidt & Mandel, 2020). In the early stages of care, air medical transport clinicians frequently transport septic patients from small, rural hospitals to hospitals with higher levels of care. These clinicians could utilize inferior vena cava (IVC) ultrasound to guide optimal hemodynamic resuscitation. Therefore, an IVC ultrasound guideline was created for sepsis management during air medial transport to improve patient outcomes.

Associate Degree Nurses Caring Behaviors During High-Fidelity Simulation: A Basic Qualitative Study, Crystal Bowman

General Submissions: Presentations (Oral and Poster)

Despite validation of the importance of caring behaviors in nursing, questions remain about how to teach these behaviors Teaching and evaluating caring behaviors with nursing education programs are challenging due to the subjective nature of the experience. Caring as a factor that influences patients and organizational outcomes is underestimated. There is a lack of scientific analysis to support how caring nursing behaviors are taught and then transferred to the bedside of a patient. The use of simulation as a teaching methodology has historically been focused on the technical and procedural aspects of nursing education but has begun to shift to …

Acculturation, Self-Efficacy And Breastfeeding Behaviors In A Sample Of Hispanic Women, Ivonne F. Hernandez

Dissertations

Breastfeeding confers immunological, physiological and psychological benefits for the infant and mother as well as social and economic benefits to the nation. The United States Department of Health and Human Services (HHS), Healthy People 2020 has established national objectives for the initiation and duration of breastfeeding at 82% initiation, 61% at six months and 34% at one year. In addition, they have set goals for exclusive breastfeeding at 3 months to be 46% and 25% at 6 months of infant's age. Currently breastfeeding initiation is at the highest recorded level of 76.9%, yet significant disparities exist (CDC, 2012). The purpose …

Breastfeeding Education In University Nursing Programs, Penny R. Marzalik

Dissertations

Past goals, future goals, and current statistics regarding breastfeeding rates in the United States support the need for university programs to address the topic of breastfeeding education. Currently, exclusive breastfeeding rates are 46.3% initiation and 17.2% continuation at 6 months of age, well below the goals of 75% initiation and 50% continuation. Nurses are the largest group of health care professionals, and research has shown that their care influences women's breastfeeding experience. The literature informs us that although nurses most often have positive attitudes towards breastfeeding, they lack knowledge about breastfeeding support.

The purpose of this study was to describe …

Improving Patient Care Through Effective Nurse Delegation To Assistive Personnel, Toni Hamilton

DNP and Student Works

A pre/post survey design was employed to assess the knowledge and willingness of medical surgical-telemetry nurses to delegate tasks to AP working within a new caregiver model after receiving an educational intervention. Patient falls and HAPI rates were collected pre/post intervention and compared for statistical differences.

Exploring The Effects Of A Nurse Mentorship Program On Career Satisfaction And Retention, Jennifer Smith

DNP and Student Works

Global statistics have shown there is a major nursing shortage. It is imperative to stabilize the nursing workforce as the healthcare continuum continues to grow. Nurse career satisfaction is related to nurses' overall intent to stay. Newly licensed registered nurses are leaving healthcare settings at disturbing rates. With the increased need and the current shortages, the nursing profession is unequipped to meet the needs of the growing population. The purpose of this project is to increase nurse career satisfaction and intent to stay with the organization through the implementation of a nurse mentorship program for newly licensed registered nurses with …

Implementation Of Remote Patient Monitoring To Improve Medication Adherence And Efficacy In Patients With Asthma And Chronic Obstructive Pulmonary Disease: A Quality Improvement Project, Barbara A. Werner

Dissertations

Asthma and chronic obstructive pulmonary disease (COPD) are long-term respiratory diseases that can adversely affect an individual's quality of life and inflict financial strain on the patient, family, and healthcare system (Kocks et al., 2018). Adherence to prescribed inhaler medication is an integral component of effective disease management. Remote patient monitoring may serve as an effective means to proactively measure adherence with inhaled medications to improve respiratory health outcomes and decrease avoidable healthcare utilization (George & Bender, 2019). An inobtrusive device attaches to the metered dose inhaler to passively monitor the use and electronically transmit the information to a digital …

Improving The Mental Health Of Immigrant And Refugee Children In Canada, Nazish Nazish, Olga Petrovskaya, Bukola Oladunni Salami

International Nursing Research Congress (INRC)

The mental health of immigrant and refugee children is a combined product of personal, social, cultural, and economic, pre-, and post-migratory factors. Cultural diversity, institutional receptivity, and social support mediate well-being of immigrant and refugee children in Canada. This presentation will provide a review of recent research and offer recommendations. Purpose: Globally, millions of children migrate across borders. It is predicted that by 2036, the number of immigrant children in Canada will increase. The purpose of this presentation is to report findings of a review of existing recent research on factors affecting immigrant and refugee children's mental health in Canada. …

A Qualitative Descriptive Study Of The Experiences Of Nurse Educators In Developing And Implementing Concurrent Enrollment Adn-Bsn Programs, Janice E. Hawkins

Dissertations

Nursing leaders have called for more bachelor-of-science-in-nursing-(BSN)-prepared nurses to meet workforce demands. There is limited capacity in BSN programs to meet the projected demand. Currently, associate degree in nursing (ADN) programs produce the majority of registered nurses. To increase the number of BSN graduates, nurse educators recommend innovative educational models for seamless progression from the ADN to the BSN. Concurrent enrollment ADN-BSN programs offer one potential model to produce more BSN graduates. The purpose of this study was to describe the process of developing and implementing concurrent enrollment ADN-BSN programs. The research question was as follows: What is the experience …

Improving The Management Of Tardive Dyskinesia On An Inpatient Mental Health Unit, Jennifer Krebsbach

DNP and Student Works

The purpose of this quality improvement project was to implement a practice change on the adult mental health unit at a rural hospital in the Upper Midwest to improve the accuracy and increase the rate of completion of the abnormal involuntary movement scale (AIMS). Results showed that post-intervention confidence levels improved among the RNs. The overall rate of completion of the AIMS increased by 50% for AIMS screening upon admission and 67% for total AIMS screening requirements among applicable patients. It can be concluded that revising the behavioral health AIMS flowsheet and expectations for documentation improved the rate of AIMS …

Advanced Practice Provider Privileging Tool Within A Transition To Practice Program: A Quality Improvement Project, Emily Jelen

DNP and Student Works

Evaluate the use of a privileging tool in a formal program designed to support advanced practice providers in transitioning from academia to clinical practice.

Decreasing Compassion Fatigue And Burnout In Nursing Through Mindfulness: A Quality Improvement Project, Andrea Redmann

DNP and Student Works

Health care professionals are at risk for developing compassion fatigue and burnout, which creates a decrease in productivity, increases the risk for medication and medical errors, and decreases the overall morale. The World Health Organization recognizes burnout to be an occupational phenomenon that results from exposure to chronic workplace stress and is a significant concern for employee and patient outcomes. The aim of this quality improvement project is to utilize mindfulness through guided imagery to reduce burnout and compassion fatigue.

Barcode Medication Administration In The Emergency Department To Mitigate Medication Errors, Holly E. Gauthier-Wetzel

Dissertations

Electronic health record systems (EHRs) have been adopted in healthcare facilities to unify the workflow process of healthcare professionals. Studies have demonstrated the addition of barcode medication administration (BCMA) software technology within the EHR has decreased medication errors within hospitals and long-term care facilities. However, limited research has been conducted to establish whether using BCMA in outpatient areas has had an influence on medication error rates. Literature reveals that many facilities have not adopted BCMA in outpatient areas. The purpose of this study was to investigate whether medication errors were mitigated after BCMA was implemented in the emergency department (ED). …