Digital Commons Network^™

Improving Patient Safety With The Stanley And Brown Suicide Safety Template, Amber Larson

DNP and Student Works

Background: The effect of safety planning for patients discharged from the emergency department (ED) with suicidal risk is not yet determined but using safety plans to mitigate suicidal behavior is regarded as best practice.

Importance: ED patients do not consistently follow up with recommended outpatient mental health treatment. However, brief ED interventions, including individualized suicide safety plans, can reduce suicide risk and improve patient safety after ED discharge.

Aims: The project aimed to improve the safety of positively identified suicidal risk patients in the ED of a regional medical center in the Upper Midwest with brief ED interventions to reduce …

Native Hawaiian Caregivers' Cultural Perspectives Of Pediatric Asthma Management, Donna-Marie Palakiko

Dissertations

Asthma remains the leading cause of chronic respiratory illness among Native Hawaiian children 0 to 17 years in Hawai'i. The National Asthma Education and Prevention Program (NAEPP) established asthma management guidelines which includes medical assessment and monitoring, education in partnership with the caregiver, control of environmental triggers, and medication adherence (National Asthma Education Prevention Program [NAEPP], 2007).
However, these guidelines do not consider the worldview, health beliefs, and cultural practices of caregiver, child, and family.

The purpose of this study was to describe how Native Hawaiian caregivers manage pediatric asthma, to understand which strategies are considered cultural practices, and to …

Improving End Of Life Care: Symptom Assessment And Education For Informal Hospice Caregivers (A Quality Improvement Project), Erika Buchholz

DNP and Student Works

In the setting of COVID-19, more individuals experience the dying process in their home rather than at hospice facilities. Currently, there are limited resources to help informal caregivers identify signs and symptoms of death and dying. The Edmonton Symptom Assessment System (ESAS) is a standardized assessment tool that can be offered in the hospice setting. This quality improvement (QI) project aims to increase utilization of the ESAS tool among caregivers with loved ones enrolled in hospice.

Improving Provider Confidence And Knowledge Of Sexual Assault Treatment Through Education And Guideline Implementation, Tera Sabatino

DNP and Student Works

Sexual assault is a pervasive public health concern that disproportionately affects women and can have long-term effects in every aspect of a woman's life (Nathan & Ferrara, 2020). While acute treatment of sexual assault has been standardized, follow up care for victims has not. This project was created to improve OB-GYN provider confidence and competence when treating sexual assault victims in the clinic. Education as well as treatment guidelines and tips were used as an option to fill this care gap. Objectives of the project included improving knowledge of sexual assault and treatment through education as well as improving standardized …

Reducing Medical Device Related Pressure Ulcers: A Quality Improvement Project, Jonathan Allen

DNP and Student Works

The purpose of this quality improvement project was to improve medical device-related pressure ulcers (MDRPU) incidence rates on a 23-bed orthopedic unit within a large midwestern hospital located in a metropolitan area. Medical devices have an essential role in providing effective therapeutic care by restoring mobility and reducing pain for orthopedic patients. However, MDRPUs can cause pressure injuries if not closely monitored by nurses.

Differences In Preferred Teaching Strategies: A Quantitative Study Of Nursing Student Perspectives, Kaela L. Appleman

Dissertations

The preparation of nursing students to meet the demands of the nursing profession remains the goal of academic institutions worldwide. The most productive methods of preparation, including specific teaching strategies to attain that goal, have long been debated. This quantitative, nonexperimental study included an investigation of the most preferred teaching strategies among baccalaureate degree nursing (BSN) students in an effort to support the development of best practice recommendations for meeting the andragogical needs of adult learners and aid in the preparation of effective nurses who practice safely. The results of the study showed that BSN students most prefer hands-on, simulation-based …

Improving New Faculty Onboarding Through Implementation Of A Faculty Mentoring Program, Melissa M. Skelly

DNP and Student Works

In the United States there is a shortage of experienced nursing faculty, and clinicians often transition to educator roles without any formal training; this often leads to significant stress and a period known as disorientation. Mentoring is one way to bridge the gap. This project focused on development and implementation of a mentoring program in an agency's department of graduate nursing. Project objectives included implementing a mentoring program to provide career development for new faculty and to cultivate mentor development to enhance the mentoring experience.

The Effect Of Classroom And Clinical Learning Approaches On Academic Achievement In Associate Degree Nursing Students, Jo Anne Carrick

Dissertations

While many students compete aggressively to enter into nursing schools, those who succeed have no guarantee they will be successful in their nursing studies, graduating, and passing the National Council Licensing Exam for Registered Nurses (NCLEX-RN®). This study's objective was to gain a better understanding of how nursing students approach learning and to determine what characterizes the successful student. The study's design was based on the theoretical framework of the students' approach to learning, which ultimately impacts on the students' learning outcome.

This study followed a non-experimental causal-comparative study design using the Revised Approach to Studying Inventory - Short Version …

Team Dynamics And Learning Behavior In Hospitals: A Study Of Error Reporting By Nurses, Lindsay Thompson Munn

Dissertations

Error reporting is the primary way that hospitals identify errors and near misses, and it is essential for organizational learning and improvement to occur. However, it is widely recognized that errors in hospitals are significantly underreported. As a result, there are numerous lost opportunities for health care organizations to learn from errors and improve the care delivered to patients.

The purpose of this study was to use the model of work-team learning as the theoretical foundation to examine the error reporting behaviors of nurses. The study examined the team factors of safety climate, leader inclusiveness, and psychological safety and their …

A Quality Improvement Project On Improving Cultural Humility Through Clinical Virtual Reality, Alissa Boekhout

DNP and Student Works

The purpose of the quality improvement project is to implement a clinical simulation training on cultural humility for newly hired staff so as to increase nursing confidence in how to respond to these events. Cultural humility training was completed via virtual reality with thirty newly hired nurses at the project agency. The training consisted of a real life event in the life of Sumaya, who plays herself in the virtual reality. In this act, she is the victim of cultural abuse by a patient that was witnessed by two other healthcare workers who did not stand up for her. Participants …

Family Care Of Persons With A Brain Tumor, Paula R. Sherwood

Dissertations

Research has demonstrated that caregivers of persons with cancer and persons with dementia are at risk for negative consequences from providing care, such as increased mortality, depressive symptoms, and anxiety. However, there have been minimal efforts to describe the impact of providing care for persons with both oncological and neurological sequelae. The purpose of this study was to determine the effects of the care recipient's functional, cognitive, and neuropsychiatric status on the caregiver's level of burden and depressive symptoms for caregivers of persons with a primary malignant brain tumor, and to determine whether caregiver mastery and perceived adequacy of information …

Implementing In-Person And Online Educational Materials In A Quality Improvement Project To Improve Nursing Confidence And Competence In Providing Spiritual Care, Jordan Anderson

DNP and Student Works

Hospitals are held accountable for their accommodation of patient rights including cultural, personal, religious, and spiritual values. At the studied hospital, there is not a formal training curriculum for nurses on spiritual care. The objective of this quality improvement project is to implement an educational curriculum to improve nursing confidence and competence in providing spiritual care.

Promoting Safe Sleep Education For At Risk Mothers, Breanna James

Dissertations

Sudden infant death syndrome (SIDS) is an unexplained scary phenomenon that has plagued parents for years until research determined there was a link between the infants sleeping position and sudden death. Local community leaders in health and advocacy review fetal and infant deaths on an annual basis to identify ways that infant mortality may be prevented. Barriers related to social determinants of health and lack of knowledge specific to safe sleep were identified root causes. Evidence-based recommendations for safe sleep set forth by the American Academy of Pediatrics have demonstrated effectiveness in reducing mortality. The purpose of the quality improvement …

Improving Clinical Alarm Fatigue And Alarm Management Competency Among Critical Care Nurses By Implementing A Unit Based Alarm Management Bundle, Stephanie Bosma

Dissertations

Clinical alarms are designed to signal an unsatisfactory patient physiological state, alert staff to malfunctioning medical equipment or systems, and warn the operator of potential hazards to the patient. While alarms interrupt the patients healing process, alarms also induce a crippling fatigue among nurses, known as alarm fatigue. The concept of alarm fatigue and clinical alarm management competency remains a common problem among nurses who work in the acute care setting. In the Surgical Intensive Care Unit (SICU) at a teaching hospital in Northeast Florida, alarm fatigue, consistent alarm management skills, and competency surrounding the use of the Philips physiologic …

Nursing Faculty Shortages: Perspectives From Deans And Directors Of Bsn Programs, Diane Porretta Fox

Dissertations

This study examined the shortage of nurse faculty in one Midwestern state. The purpose of the study was to identify facilitators and barriers to recruiting and retaining nurse faculty. Case studies were conducted, with the primary data source being semi-structured interviews with deans and directors of six nursing programs that offer the Bachelor of Science in Nursing (BSN) degree. The interviews and a review of institutional artifacts informed the study.

A Multidisciplinary Mentoring Approach To Improve The Equity Of Nursing Education For The English Language Learner In An Undergraduate Nursing Program: A Mixed-Method Quality Improvement Project, Laurie Bisila

DNP and Student Works

This quality improvement (QI) project is a multidisciplinary approach to mentoring, matching a doctorate of nurse practice (DNP) student in their final year and a second-semester post-baccalaureate (PBN) nursing English language learner (ELL) student who is enrolled in an accelerated nursing program in a small Midwest private college. This QI project seeks to answer two questions. First, will a DNP mentor who is trained in the principles of cultural Competemility improve the sense of belongingness for the ELL undergraduate nursing student through six weekly mentoring sessions using the 12 domains in Purnell's model as a guideline? Secondly, does training on …

Emergency Department Bedside Handoff Report For Increased Communication And Patient Experience: A Quality Improvement Health Program, Mickey Muller

DNP and Student Works

A BHR process was implemented in a suburban ED on the 7:00 AM, 3:00 PM, and 11:00 PM shift changes to improve communication and patient experience. Nurse perceptions of care quality were explored using a survey with a four-point Likert scale, and nurse compliance with the program was evaluated with a self-auditing tool.

Factors Associated With Household Contacts' Tuberculosis Testing And Evaluation, Elvy G. Barroso

Dissertations

Contact investigation (CI) is one of the core elements of tuberculosis (TB) control. It is intended to achieve early identification of contacts who may have been exposed to a patient with infectious active TB and contacts who may benefit from treatment for latent tuberculosis infection (LTBI). LTBI is an infection in which the Mycobacterium tuberculosis organisms cause no signs and symptoms but the infection can be reactivated and develop into full-blown active TB disease. Failure to be identified as a contact is the primary reason for disease development in more than half of TB patients, thus a complete and timely …

Exploring Psychological And Situational Factors That Influence Female College Students' Participation In Oral Sex, Margaret Bergeron

Dissertations

Although sexually transmitted infections (STI) are not officially reported via the route of transmission, the CDC (2016) reports that individuals who provide fellatio have the highest risk of oral transmission of a STI. Therefore, females who engage in fellatio are at risk for acquiring a STI. The majority of research studies on young adult heterosexual female sexual activities primarily focus on vaginal sex and the associated risks of pregnancy and sexually transmitted infections. Limited research exists on the oral sex behaviors of female college students and their understanding of the risk for contracting an STI through fellatio. The purpose of …

The Lived Experience Of Being A Caregiver For A Family Member Dependent Upon Hemodialysis, Christine Kearney Turner

Dissertations

An identified gap in the literature exists regarding studies using an inductive approach that allow caregivers to describe the lived experience of caring for family members dependent upon hemodialysis for managing end stage kidney disease. This study used a purposive sample of six caregiver participants, male and female, with an average age of 36 using a descriptive, phenomenological approach designed to share experiences of providing care to a family member dependent on hemodialysis. The representative sample was recruited from a mid-sized hospital in the mid-Atlantic region of the United States. The investigator conducted face-to-face, semistructured interviews with participants. Using the …

Advanced Nursing Education: Critical Factors That Influence Diploma And Associate Degree Nurses To Advance, Rose L. Mcghie-Anderson

Dissertations

Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of the nurse as educator, manager, nurse leader, and researcher who will effect policy changes and assume leadership roles as revolutionary thinkers in addition to implementing paradigmatic shifts.

This grounded theory study sought to unearth the critical factors that motivate nurses to advance academically. The study aimed to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance their nursing education.

Clinical Nursing Faculty Perceptions Of Undergraduate Baccalaureate Nursing Student Stress In The Clinical Environment, Catherine A. Stubin

Dissertations

High stress levels are experienced by student nurses throughout their professional education, with the chaotic ever-changing clinical environment being a predominant source of stress. Clinical nursing faculty have a critical role to recognize the stress their students experience in the clinical environment and understand its significance.

A qualitative descriptive design was used to provide a rich description of clinical nursing faculty perceptions of undergraduate baccalaureate nursing student clinical stress. A purposive sample of 14 clinical nursing faculty with at least 4 semesters of clinical nursing faculty experience from accredited, generic baccalaureate nursing programs in the Northeast region of the United …

The Effect Of Using The Adaptive Crawler™ On The Development Of Infants With Spina Bifida, Age 6-12 Months, Margaret E. Williams

Dissertations

During the timeframe of crawling, age 6--12 months, infants typically interact independently with their environment and their parents in order to perform certain developmental tasks. However, many infants with spina bifida are unable to crawl, as would typically developing infants. The inability to crawl may place these infants at a distinct disadvantage during this developmental timeframe. As a result of the developmental disadvantage, the parent-infant relationship may be negatively affected. For this study, the Adaptive Crawler™ assistive technology infant mobility device was designed, and a prototype created, to promote independent mobility and exploration of their environment by infants with spina …

The Voiceover Art Of Nursing, Shania Dubbert

General Webinars

There are so many different avenues and career paths a nurse can take along their nursing journey. Have you ever heard of medical narration or voiceover? In this webinar, Shania speaks about her journey of blending the art and science of nursing by combining her passions of medicine with her past acting background to create her own medical voiceover business.

Emotional Responses And Mother-Infant Interactions Of Mothers With Early-Preterm, Late-Preterm, And Full-Term Infants In Malawi, Kaboni Whitney Gondwe

Dissertations

Malawi has the highest preterm birth rate in the world and preterm birth contribute to more than one-third of the neonatal deaths annually. Malawi is also faced with limited resources, both human and material. The lack of incubators led to the adoption of Kangaroo Mother Care (KMC) as routine care for preterm infants. Families also provide support, physical and emotional during this entire period. Evidence from developed countries has shown that preterm birth contributes to maternal emotional distress (depressive, anxiety, and posttraumatic stress symptoms and maternal worry about child's health) and fewer maternal and infant interactive behaviors. The majority of …

Transitional Care Interventions As Implemented By Faith Community Nurses, Deborah J. Ziebarth

Dissertations

Hospitals are seeking innovative and efficient methods of decreasing avoidable readmissions. Despite the volume of nursing literature exploring the use of advanced practices nurses in providing transitional care, only one study mentions the use of a faith community nurse. The faith community nurse operates in the community and has the skills to provide transitional care. The purpose of this study was to describe transitional care as implemented by faith community nurses using a standardized nursing language: the Nursing Intervention Classification (NIC). A mixed method descriptive design was selected to facilitate a thorough exploration of the interventions implemented by faith community …

Conceptualization Of Factors That Have Meaning For Newly Licensed Registered Nurses Completing Nurse Residency Programs In Acute Care Settings, Beverly Dianne Rowland

Dissertations

Nurse residency programs (NRPs) have been identified as a means to promote transitioning of new nurses into the professional nursing role. Questions have arisen related to which elements within those programs are most meaningful to the development of new nurses. As the nursing shortage drives the need for quick transition and development of nurses to meet workforce needs, nursing must identify what is meaningful to nurses in their transition to practice. The purpose of this multi-site study was to explicate meaning from the experiences of newly licensed registered nurses (NLRNs) who have just completed NRPs. The research question was ";What …

The Relationship Between Nursing Unit Culture And The Use Of Evidence-Based Practice Among Nurses In Hospitals, Jin Jun

Dissertations

Evidence-based practice (EBP) has been the gold standard for clinical practice. However, the use of EBP by healthcare providers, including nurses, has remained at suboptimal rates. Though researchers have examined various factors that influence nurses' use of EBP, studies of more complex organizational factors are limited. Nursing unit culture, which encompasses unique shared values, beliefs, and assumptions, may be one of the driving forces in determining nurses' behavior, leading to variation in the use of EBP. The purpose of this study was to examine the association between nursing unit culture and the use of EBP among nurses in hospitals under …

Perceived Learning Needs Of High School Teachers Regarding Suicide Prevention, Miranda L. Bevilacqua

Dissertations

Suicide is the second leading cause of death among youth in Canada. Though school-aged youth are surrounded by teachers, mentors, and school mental health nurses (SMHN), little is known about what teachers want to know regarding suicide and whether the teachers have the knowledge to recognize youth at risk. The purpose of this generic exploratory qualitative study, guided by the health belief model, was to explore the perceived learning needs of high school teachers in northwestern Ontario (NWO) regarding suicide prevention. The data collection process involved semistructured virtual interviews with 14 high school teachers in NWO recruited via social media. …

Predictors Of Early Rehospitalization Among African American And Caucasian Women Hospitalized With Heart Failure, Carolyn B. Sue-Ling

Dissertations

Heart Failure remains a complex clinical syndrome that affects all races and backgrounds. Periodically individuals with a heart failure diagnosis will require hospitalization during the course of the disease progression. Consequently, early and repeated rehospitalizations for acute exacerbations presents additional social and economic difficulties. Prior research demonstrated that elderly African-American and Caucasian women account for a large proportion of the population at risk for future heart failure hospitalizations along with readmissions within 60 days of discharge. Unfortunately, the literature remains unpredictable or largely non-existent regarding the unique associations between risk predictors for heart failure and early (31 to 60-day) heart …