Digital Commons Network^™

Lived Experiences Of Nurse Leaders, Catherine J. Mohammed

Dissertations

The National Academy of Medicine (NAM) has called for more leadership, more accountability, and increased education and training of health care leaders. The NAM has demanded that nurses participate in health care policy making, increase their knowledge of research and data collection, advise leaders across the business world, train and educate seamlessly, and practice to the full extent of their licensure. The purpose of this qualitative phenomenological study was to explore the lived experiences of 12 influential nurse leaders from the state of Arizona. Transformational leadership theory provided the framework for the study. Semi-structured interview data were transcribed, coded, and …

Mothers Caring For Technology Dependent Neonates, Valerie Boebel Toly, Julia Blanchette, Carol M. Musil, Arwa Al Hamed

Sigma Foundation for Nursing Research Grant Reports

The purpose of this study was to prospectively examine mothers' psychological well-being and needs for information and support as well as their technology-dependent neonates' healthcare utilization (rehospitalization, emergency room visits) during the 3-month transition from the neonatal transitional care unit to home as a basis for designing interventions to address mothers' and their vulnerable infants' specific needs. Studying the transition from hospital to home affords a unique opportunity to examine factors that affect the psychological well-being of these mothers as they take on the caregiving role and to build evidence for interventions to best support these mothers.

Nursing Documentation Environment In The Hospital Setting, Alice E. Cavin

Theses

Nurses often document in open nurses' stations exposed to frequent interruptions. Much has been written on the need to limit distractions while collecting and administering medications but little has been published on the effects interruptions have on nursing documentation. The purpose of this study was to examine the environment in which nurses chart and to gather their perceptions of the documentation environment. Marilyn Ray's Theory of Bureaucratic Caring was the guiding framework for this study. A review of the literature revealed the effects open work spaces, noise, and interruptions can have on work performance. This study, a focus group discussion, …

Quality Improvement: Improving Type 2 Diabetes Self-Management And A1c Levels In Older Adult Veterans Using An Automated Message System, Danielle Brunson

Dissertations

Background: Diabetes mellitus is prevalent among the US population; particularly type 2 diabetes. As the population ages, the number of adults 65 years of age or older with diabetes is increasing. Diabetes is also common among U.S. veterans. Approximately 25% of U.S. Department of VA patients have diabetes. Evidence demonstrated a prevalence of diabetes among older veterans. Innovative approaches to improve diabetes care and health outcomes for veterans are needed.

Aim: This quality improvement (QI) project examined the use of a unidirectional automated text message system (Annie) to improve self-management behaviors of veterans with Type 2 diabetes, as evidenced by …

Adaptation To Chronic Pain: Religious And Non-Religious Coping In Judeo-Christian Elders, Karen S. Dunn

Dissertations

The purpose of this cross-sectional, correlational study was to examine the relationships between chronic pain, the use of religious and non-religious coping, and the health outcomes of functional ability, depression, and spiritual well being. Specifically, three research questions were addressed: (1) What are the relationships between background contextual factors, pain intensity, and the use of religious and nonreligious coping, (2) What is the relationship between pain intensity and the three health outcomes, and (3) Does the use of religious and nonreligious coping strategies mediate the relationship between pain and the three health outcomes? Structural equation modeling was used to test …

Postpartum Patient Teaching Success: Implications From Nursing And Patient Perspectives, Dawn Day

Dissertations

A recent examination of postpartum patient satisfaction scores in an inner-city hospital revealed decreased satisfaction of discharge teaching practices. Guided by Knowles' model of andragogy and Donabedian's model of structure-process-outcome, the purpose of this study was to gain an understanding of how the structure and process of discharge teaching practices impact successful postpartum teaching. This mixed-method, concurrent study examined the structure, process, and outcome of postpartum patient discharge teaching practices. A convenience sample was used to obtain 138 patient surveys, observations of 15 nurses completing discharge teaching, and 15 face-to-face patient interviews. Data analysis included the use of Spearman's rho, …

Breastfeeding Intention And Initiation Among Rural, Low-Income Native Americans And African American Adolescent Mothers In North Carolina: Testing The Theory Of Planned Behavior, Cynthia H. Herndon

Dissertations

Infant feeding practices can greatly impact a child's life with far reaching implications based upon decisions a mother makes for her newborn. Breastfeeding is the preferred method of infant feeding because of its association with health benefits to both the mother and child. The prevalence of breastfeeding among rural, low income, disadvantaged groups to include Native American (NA) and African American (AA) adolescent mothers is low. NAs and AAs bear a disproportionate burden of illness and health risks compared to other races and ethnic groups in the United States. Breastfeeding is a targeted public health strategy to improve the health …

Responses To Exercise In Elderly Mexican Women, Bertha Cecilia Salazar-Gonzalez

Dissertations

The purpose of this study was to test the effects of an exercise intervention on flexibility, exercise self-efficacy, exercise readiness to change, and perceived flexibility of elderly Mexican women. The theory used Roy's conceptual model. The context of the intervention was explored by examining health status and role load. Attendance and exercise repetitions represented a measure of the intensity of the intervention.

Modifiable Cardiovascular Risk Factors In The Early Adolescent Period, Julia A. Greenawalt

Dissertations

The purpose of this study is to describe patterns and relationships among the modifiable cardiovascular risk factors of smoking behavior, overweight, physical inactivity and poor dietary behaviors within a ninth grade population. Four modifiable cardiovascular risk factors; smoking behavior, overweight, physical inactivity and poor dietary behavior were analyzed from the 2003 Youth Risk Behavior Surveillance System (YRBS) to explore associations in early adolescents, a critical developmental time frame. The specific aims of this study were to: 1) conduct a factor analysis of questions selected from the 2003 YRBS to represent the constructs of smoking behavior, physical inactivity and poor dietary …

Perioperative Experience Of Adolescents, Janean Carter Monahan

Dissertations

Research has shown that preoperative stress is associated with poorer health outcomes in adults and young children, but there is little in the literature about the stress experienced by adolescents. Clinical experience, however, has shown that adolescents behave differently throughout the perioperative experience than either adults or children. For example, common behaviors of adolescent's emerging from anesthesia include combativeness, thrashing, and crying. To promote adolescent health and to provide adolescents with appropriate interventions that will support a positive surgical outcome, research is needed to discover the perceptions and meanings adolescents attribute to the perioperative experience.

The purpose of this hermeneutic …

The Emancipatory Praxis Of Integral Nursing: The Impact Of Human Caring Theory Guided Practice Upon Nursing Qua Nursing In An American Nurses Credentialing Center Magnet® Re-Designated Healthcare System, Lura Wendy Marks

Dissertations

This qualitative study critically examined nurses' perception of nursing qua nursing in an American Nurses Credentialing Center Magnet® re-designated healthcare system in Albany NY. Watson's Theory of Human Caring is used by many Magnet® hospitals, including the site for this study, to inform and guide nursing practice. Watson's Theory supports concepts and practices of integral health, holism, caring, healing, and the education and integration of complementary health care modalities as independent therapeutic nursing interventions. This study aimed to understand the nurse's emancipatory experience, comportment and self-agency as she/he participated in a theory guided practice; and illuminate the nurses' acquisition, understanding …

Advancing The Footprint Of Forensic Nursing Practice, Diana Faugno, Valerie Sievers, Stacey Mitchell

General Webinars

As the specialty of forensic nursing grows and evolves, research, literature, and practice guidelines will support specialty and role expansion. Education on forensic nursing topics and concepts is essential as it forms the basis for certification. The webinar will provide an introduction to the fastest growing nursing specialty today. The past, present, and future of forensic nursing will be discussed, highlighting the continued need for trauma-informed, patient-centered practice.

Hourly Rounding Quality Improvement Initiative, Chelsea Marie Brouillet

DNP and Student Works

Purposeful hourly rounding has been termed the best practice intervention to meet patients' basic needs, decrease the overall occurrence of preventable patient events, proactively prevent problems before they occur. Hourly rounding has been found to increase patient satisfaction and quality of care while reducing call bell lights. This hourly rounding initiative was a standardized structured approach to eliminating preventable inpatient falls and increasing patient satisfaction during an inpatient stay. The project's overall purpose was to increase the Hospital Consumer Assessment of Healthcare Providers and Systems survey scores. Specifically targeting staff hourly rounding percentage, staff responsiveness, and nurse communication domains. Furthermore, …

The Role And Responsibility Of The Nurse In Caring For The Dying Patient, Julia M. Robinson

Theses

The problem undertaken in this study was to learn the specific nursing functions a selected sample of registered nurses performed in an effort to meet the needs of the dying patient and how adequate they felt in performing these functions.

Symptom Cluster Experiences In Patients With Oral Cancer Using Mixed Methods, Asha Mathew Solomon Sathishkumar

Sigma Foundation for Nursing Research Grant Reports

Aims:

1. Identify distinct patient subgroups based on severity of symptoms using hierarchical cluster analysis (HCA) and latent profile analysis (LPA) and assess concordance between the two methods.

2. Examine if selected person-, disease-, and environment characteristics predict subgroup membership.

3. Explicate patients' lived experience of symptom clusters (SCs).

Certified Clinical Nurse Leaders Not Hired Into The Formal Role: Job Title Survey And Systematic Review, Jacqueline Alexander Clavo-Hall

Dissertations

The purpose of this study is to answer the following questions: (1) To what extent do NHA CNLs report engaging in CNL competency-based activities in their current positions? (2) Does NHA CNLs' engagement in CNL competency-based activities vary by job titles? (3) What roles were certified CNLs enacting if they were not hired into officially titled CNL roles?

Ancc Pathway To Excellence® Now Included In The Leapfrog Hospital Survey, Christine Pabico, Rebecca Graystone

Group: American Nurses Credentialing Center (ANCC)

The American Nurses Credentialing Center's (ANCC) Pathway to Excellence® Program (Pathway) and The Leapfrog Group (Leapfrog) are pleased to share that the Pathway program is now included in the Leapfrog Hospital Survey-an annual assessment of hospital safety, quality, and efficiency performance measures. Incorporating Pathway's commitment to workplace excellence in the Leapfrog survey will not only raise the bar for nursing practice in hospitals across the country, but also advance nurses' involvement in critical workforce areas, such as nurse staffing and leadership.

Cna Status As An Admission Criterion For Undergraduate Nursing Students: A Comparative Case Study, Nancy Capponi

Dissertations

Undergraduate nursing programs continue to be unable to meet the current and projected demand for nurses. Faculty and administrators need to choose admission criteria that best predict student success in the program to provide newly graduated nurses to meet societal demands for nurses. The objective for this study was to investigate the perceptions of clinical faculty and undergraduate nursing students regarding effects of the nonacademic admission criterion of status as a Certified Nursing Assistant (CNA) on first-year student preparedness for the clinical setting, self-confidence and anxiety in clinical decision-making (CDM), and student success. A comparative case study design was used …

How The Strong Survive: Health As Expanding Consciousness And The Life Experience Of Black Caribbean Women, Angelleen R. Peters-Lewis

Dissertations

The purpose of this qualitative research study was to answer the research questions: What is the pattern of Health as Expanding Consciousness in Black Caribbean women living in the United States? What is the pattern of Health as Expanding Consciousness across members in a community of Black Caribbean Women?

Margaret Newman's Theory of Health as Expanding Consciousness provided the theoretical framework used to guide the study. Newman's hermeneutic dialectic methodology facilitated understanding of meaningful relationships and significant life events of individuals and across participants. This research method also illuminated the influence of culture on life patterns of individuals and across …

Perinatal Nurses' Therapeutic Attitudes Towards Women Who Use Addictive Substances During Pregnancy, Karen D. Neary

Dissertations

The use of addictive substances during pregnancy continues to rise despite the known deleterious effects of addictive substances on the developing fetus. Neonates exposed to addictive substances in-utero suffer from a variety of negative outcomes that result in the need for specialized care. To improve neonatal outcomes, current research promotes involvement of the mother, who used addictive substances during pregnancy, in her newborn's care. However, women who use addictive substances during pregnancy often feel judged and ridiculed by nurses who care for them, or their newborns, leading these women to be less involved in their newborn's care. The purpose of …

Nurses' Experiences Caring For Patients With Opioid Use Disorder, Pamella M. Campbell

Dissertations

Over the past 2 decades, opioid use in the United States has taken thousands of lives, reached the level of epidemic in 2017, and has been an area of study among scholars. The problem is health care professionals, including nurses, lack training on how to care for people with opioid use disorder (OUD). Nurses are at the frontline of patient care and understanding the nurses' experiences in the care of patients with OUD may help to improve the patients' quality of care. The purpose of this qualitative descriptive study was to develop an understanding of the experiences of nurses with …

Relationships Between Experiential Learning And Effects On Senior Nursing Students' Self-Efficacy And Knowledge: A Non-Experimental Predictive Correlation Multiple Regression Analysis, Shanna Whatley Akers

Dissertations

Preparing nursing students to transition into the professional registered nurse role is the task of nurse educators. These educators must train students to function in multiple nursing specialties post-graduation, to include critical care. As more nursing graduates enter into areas such as intensive care units and emergency rooms, nurse educators must prepare them to work with critically ill patients. Increased exposure to critical care clinical experiences and simulations may be one method to prepare them for these complex, high-acuity patient situations. In order to determine whether or not a relationship exists between increased hours of experience and effects on self-efficacy …

Participant Experiences In Phase I Pediatric Oncology Clinical Trials, Stacey M. Crane

Dissertations

Phase I clinical trials (P1Ts) are the first step in testing new medical therapies in humans, and are essential for developing new and innovative therapies for children with cancer. P1Ts are ethically controversial as they are not intended to directly benefit participants, but are particularly controversial for children with cancer who are only able to participate when there is no known curative therapy for their cancer. Benefits of pediatric oncology P1T participation may include improved quality of life (QOL) and hope. Risks may include fostering unrealistic hope, burdening children with additional medical procedures and toxicities, and limiting the opportunity for …

Research Nurses' Attitudes And Practices Regarding Communication Of Risks And Benefits During The Research Informed Consent Process, Lidia Lika Nusbaum

Dissertations

Many studies show that research participants frequently do not fully comprehend information regarding risks and benefits (R&B) associated with clinical trials even though this is a fundamental component of the research informed consent (IC) process, required by ethical and regulatory guidelines. Research nurses often take an active role in obtaining IC while explaining study details and verifying potential participants' understanding. Although there are published recommended strategies to enhance the IC communication process, particularly for R&B communication, there is a paucity of research focused on research nurses' perspectives about the process. This study addresses this gap in the literature and provides …

Nurse-Led At Home Management Of Patients With Covid-19, Sherry Clement, Barbara Hayes, Erica Sullivan, Kathleen Craig

Covid-19 Webinars

This webinar demonstrates the process by which experienced Registered Nurses adapt and respond to a pandemic emergency, by implementing skills in care coordination, home safety assessments, patient education and caregiver support. Utilizing the transitional care model, Nurses implemented an effective and low-cost telephone-based approach, by assessing, coordinating, and evaluating patient needs, and making appropriate referrals when indicated.

Learning Outcomes:

1. Create an action plan within your facility to deal with an emergent event, utilizing the Coordinated Transitions of Care (C-TraC) model.​

2. Develop an algorithm for nurse implementation when caring for patients' with COVID- 19.

3. Demonstrate knowledge of the …

Barriers And Facilitators To The Completion Of Advance Directives In Healthy, Non-Healthcare Employed Adults Aged 45-65, Michael Lawrence Dion

Theses

The Patient Self-Determination Act passed in 1991 requires staff in health care facilities, such as skilled nursing facilities, hospitals, home health services and primary care offices to ask patients about advanced directives. Despite this, actual completions of advance directives in America remain low. To determine the barriers and facilitators to the completion of advance directives in healthy, non-health care employed individuals aged 45-65. It is believed healthy individuals in this age group both desire the advance directive, and have strong opinions regarding their end of life preferences.

Construction Of Caring: A Study Of Nurses In A Children's Hospital, Christine Dooge Milbrath

Dissertations

The purpose of any health care organization is to provide health care. The very existence of the word care in phrases such as health care, nursing care, patient care, and medical care demonstrate how central the concept of care is within the industry and within society. Because care is so widely recognized and represented in our language, the failure to attend to this important aspect represents a great risk to health care organizations. However, caring is believed to be simple concept, easily understood, when it is, in fact, a complex phenomenon embedded and influenced by multiple contexts and constructions.

Caring …

The Effects Of Career Commitment, Distress, And Persistence On Academic Success Among Undergraduate Baccalaureate Nursing Students, Kimberly D. Kennel

Dissertations

The ability of students, specifically in higher education environments, to persist is a critical determinant of academic success. Student success is especially precarious within programs of nursing, where curricula include clinical, laboratory, and didactic content. Identifying and describing the barriers and facilitators to nursing student persistence provides a blueprint to appropriately use financial and human resources as well as determine the effect student demographic variables has on desiring, attending, or benefiting from persistence interventions. The outcome of this study can guide the deployment of institutional resources to provide persistence-based interventions that are evidence-based. Framed by Tinto's Theory of Student Departure, …

Factors Affecting Nurses' Intention To Leave Their Primary Nursing Position, Scott P. Kaye

Dissertations

The United States is facing an imminent nurse staffing crisis. An aging workforce, an increasing elder population, and new staffing legislation have added to existing difficulties in retaining nurses. Retaining nurses is a priority in emergency departments, one of the few specialty departments that exceed the national average turnover rate, with an average of 95% of the nursing staff leaving their positions every five years.

This dissertation used dual-factor theory, dimensions of nursing surveillance, and intersectionality as theoretical frameworks; employed secondary analysis of the National Sample Survey of Registered Nurses (2018) dataset; and utilized hierarchical regression Modeling to examine the …

Constructing The Process Of Healthcare Decision-Making By Adolescent Athletes Post Sport-Related Concussion, Jeanette Faith Green

Dissertations

Sport-related concussion (SRC) is associated with short- and long-term health consequences. Current recommendations require immediate removal of an athlete suspected of injury, relying symptom self-reporting. Many SRC are unreported resulting in continued play despite symptoms, a risk for subsequent injury. The purpose of this dissertation was to explore influential factors and pivotal decision points within the process of health decision-making (DM) of adolescent athletes post-SRC. Twelve semistructured interviews were conducted with predominantly white high school athletes. Grounded theory methodology was used to examine salient concepts within athletes' DM process. Data were coded and analyzed using dimensional analysis with explanatory model …