Digital Commons Network^™

The Influence Of Nurse Manager Leadership Style Factors On The Perception Of Staff Nurse Structural Empowerment, Work Engagement, And Intent To Stay, Jennifer Moody Manning

Dissertations

Healthcare is facing many challenges which impact all practice settings. Both nurse managers and staff nurses play critical roles in overcoming the challenges faced in healthcare today. Staff nurses are intimately involved in providing care to their patients but not always involved in the decisions impacting care delivery (Health Resources and Services Administration (HRSA), 2010; Institute of Medicine (IOM), 2010). Evidence has shown when staff nurses are not engaged and empowered in their work they are more likely to become dissatisfied in their job resulting in increased turnover and adverse patient outcomes (Hauck, Griffin & Fitzpatrick, 2011; Jenaro, Flores, Orgaz …

Violation Of Personal And Professional Nursing Values: Six Case Studies Of Nurses Who Have Left Nursing, Robert James Muster

Dissertations

Registered Nurses (RNs) comprise the largest group of health care providers in the US. The shortage of RNs is expected to worsen to 29% by 2020. Many nurses depart practice prior to retirement. Previous research has linked professional turnover to various aspects of job satisfaction.

This study sought to understand and describe the decision to leave nursing.

Senior Nursing Students' Knowledge, Attitudes, And Perceived Competency About Older Adults, Deborah Denise Brabham

Dissertations

Nurses entering the workforce may have limited education in gerontological nursing. Therefore, many nurses are unprepared to provide quality care to older adults. An unprepared nursing workforce could negatively influence older adults' health outcomes and care experience.

To determine differences in senior nursing students' knowledge, attitudes, and perceived competency about older adults based on enrollment in a bachelor of science in nursing degree (BSN), associate's degree nursing (ADN), and practical nursing (PN) program that offers geriatric content in curricula.

Giving Up Their Place In The Walls: The Lived Experience Of Community College Nursing Faculty Who Leave The Profession Of Teaching, Cherry A. Karl

Dissertations

Community college nursing faculty members are essential to the continuation and growth of the profession of nursing. Every loss of a nursing faculty member represents an even greater loss to the practice of nursing within the health care system. Previous research has documented the serious and inter-related shortage of both nursing professionals and nursing faculty. This phenomenological study explores the underlying themes leading to the decisions made by nursing educators to leave the practice of teaching, and presents strategies for preserving and strengthening the position of nursing faculty within the community college. The guiding question for this inquiry is: "What …

Coping Strategies, Social Support, And Self-Care Among Young Women With Pelvic Inflammatory Disease, Jessica L. Tillman

Dissertations

Pelvic inflammatory disease (PID), a spectrum of inflammatory disorders of the female upper genital tract, is a serious complication of sexually transmitted infections (STIs) that may lead to chronic pelvic pain, ectopic pregnancy, and tubal infertility. Although PID treatment is critical for the preservation of fertility and health-related quality of life, many young women diagnosed with PID do not fully adhere to treatment recommendations. Interventions focused on clinician practices, patient education, and behavioral modeling have generated limited improvements in outpatient PID treatment adherence among young women, thereby suggesting the influence of other determinants, such as psychosocial factors. Coping and social …

A Quality Improvement Project To Assess Anxiety Of Family Members Who Receive Standard Communication During The Intraoperative Period, Ashlie E. Sinclair

Dissertations

Introduction: The waiting period for surgical patients' family members can be stressful, causing increased frustration and fear. Most patients and families do not regularly experience the surgical environment in the same way that the operating room (OR) staff do, making this area unfamiliar. If there are inconsistent and insufficient information provided to the family, anxiety levels may increase. It is essential that staff attend to family members' needs while the patient is in surgery. The evidence is overwhelming that structured patient status updates to family members and varying waiting room techniques are critical in decreasing their anxiety.

Methods: This quality …

The Experiences Of Cancer Nurses' Existential Care In Response To The Threat Of Patients' Mortality Within The Culture Of Care, Doris Yuet Lan Leung

Dissertations

Patients are living longer with many types of cancer; however, often they face sudden possibilities of dying, not only due to their advancing illness but due to complications of their treatment. Consequently, they can express substantial existential distress. Nurses' close proximity to patients puts them in an ideal place to assess and engage with patients' existential distress; yet this kind of research has been scarce. The purpose of this doctoral thesis was to explore nurses' experiences of being with patients facing the threat of mortality.

Identifying And Addressing Barriers In Type 2 Diabetes: A Three-Step Telemedicine Approach, Stacy Ann Davis

Group: Samford University Moffett & Sanders School of Nursing

The purpose of this project is to help patients diagnosed with type 2 diabetes adapt and manage their diabetes. This will be accomplished through telemedicine support calls offered between scheduled office exams to offer further support and education. Research shows that poor provider-to-patient communication accounts for one reason why patients with diabetes miss their medical appointments (Brewster et al., 2020).

The Meaning Of Informal Bmt Caregiving, Loretta A. Williams

Dissertations

The aims of this qualitative descriptive exploratory study were to (1) describe informal caregiver commitment in informal caregiving; (2) describe caregiver expectations in informal caregiving; (3) describe caregiver role negotiation in informal caregiving, (4) identify other important caregiver energy sources; and (5) refine the conceptual model of Informal Caregiving Dynamics based on the study results.

The Meaning Of Immigrant Women's Experience Of Childbirth For The First Time In A United States Hospital, Carole A. Lorup

Dissertations

The increasing population of immigrants in the United States is largely comprised of immigrant women, whose first contact with the health care system is often to seek maternity care. The literature suggests that immigrant women frequently do not receive the same quality of care and satisfactory experiences from maternity care as their native population counterparts. This study described the experience of maternity care from the perspective of immigrant mothers who gave birth in the United States for the first time. A purposive sample of mothers, who were born outside of the United States, and who have given birth to a …

The Lived Experience Of Latina Women Giving Birth In The United States, Ana-Maria Gallo

Dissertations

As the Latino community continues to grow in the United States, it is essential that cultural considerations be addressed, particularly in health care. Cultural assessment is of the utmost importance when trying to understand the phenomena of childbirth. Childbirth is one of the most significant events in a woman's life. It is complicated when giving birth in a country other than one's own. Therefore, it is crucial to comprehend and appreciate how culture influences the birth experience. Nurses play an essential role in assisting women of diverse cultures to fulfill their expectations regarding traditions, beliefs, and practices regarding childbirth. The …

Perceptions Toward A Restraint-Free Practice: A Case Study, Suzanne Barnum Goetz

Dissertations

The importance of reducing the use of psychiatric-mental health mechanical restraints has been the focus of clinical nursing practice. A hospital with two psychiatric-mental health units has demonstrated a sustained success related to reducing mechanical restraints. In this qualitative case study, nurses were interviewed to understand how the reduction of mechanical restraints on the psychiatric-mental health units impacts the practice culture and the perception of the psychiatric nurses toward a mechanical restraint-free practice. This study provided new knowledge related to evidence from the psychiatric-mental health nursing practice, themes of barriers, and facilitators toward a restraint-free practice. The participants describe the …

Psychological Empowerment And Job Crafting Among Registered Nurses Working In Public Health In Ontario, Canada, Rebecca Ruth Harbridge

Dissertations

In this study, the relationship between psychological empowerment (PE), an intangible sense of feeling powerful from within, and job crafting (JC), proactively adjusting one's job by changing its core job characteristics, was examined among Ontario registered nurses (RNs) working in public health. Past research suggests PE and JC are associated with motivation and engagement. Yet, there are few PE studies and no JC studies in public health. There are also no studies that examine the PE and JC relationship of nurses in any health care setting.

Climate Control: Does Caring Really Matter?, Wendy A. Dubose

Dissertations

In an attempt to address healthcare disparities, nursing programs have been charged with increasing success rates of minority students to increase diversity within the profession. Despite an upsurge in enrollment numbers of minority students in nursing programs, attrition rates are higher for minority students as compared to majority students. Persistence is paramount for minority students to overcome barriers encountered while pursuing an education in nursing. Perceptions of faculty caring behaviors may heighten nursing students' academic self-efficacy.

Newly Graduated Registered Nurses' Perceptions About And Use Of Principles Of Palliative Care In Acute Care Settings: An Interpretive Phenomenology Study, Latrina T. Geyer

Dissertations

The terms serious or life-threatening illness now included in current palliative care literature indicate the broadened scope of palliative care. However, the change in defining terminology has not consistently translated to a broadened understanding or advanced clinical practice for many healthcare professionals in acute care settings. The purpose of this research study was to discover NGRNs' perceptions, meanings, and use of principles of PC for seriously ill patients in acute care settings. The research question for this study was: What are NGRNs' lived experiences of providing PC for seriously ill patients in acute care settings?

Impact Of Water, Hygiene And Sanitation On Medication Adherence Intention Among Hiv Positive Women Enrolled In Option B+ Treatment Regimen In Zambia, Jerry John Yao Nutor

Dissertations

Mother-to-child transmission (MTCT) of HIV is a major problem in sub-Saharan Africa despite increasing availability of free and subsidized antiretroviral treatment (ART); MTCT can be significantly reduced provided pregnant and breastfeeding mothers adhere to prescribed regimens. Access to potable water and adequate sanitation is a major problem in low-resource countries including Zambia, located in sub-Saharan Africa. This study investigated the influence of water hygiene and sanitation (WASH) on ART adherence intention among HIV positive women enrolled in Option B+ regimen, the current World Health Organization recommendation for low resource countries.

Health Related Quality Of Life In Adolescent And Young Adult Retinoblastoma Survivors, Paula Jean Belson

Dissertations

Retinoblastoma (RB) is the most common malignant intraocular tumor occurring in childhood. While survival rates in the United States (U.S.) are high, children are left with the impact of treatment including enucleation, visual impairment or blindness as well as an increased risk of secondary cancer in those with the heritable form. Little is known about the influence of these factors on the health-related quality of life (HRQOL) in RB survivors.

Speaking Up Or Remaining Silent: Understanding The Influences On Nurses When Patients Are At Risk, Jennifer Boice Rainer

Dissertations

Objective: The purpose of this study was to understand speaking up behavior among RNs.

Background: Speaking up is the use of one's voice to share information or alert those in authority of one's concerns about patients, and is primarily influenced by organizational culture, personal culture, and workforce generation. Failure to speak up can lead to moral distress; speaking up can lead to moral courage.

Methods: A cross-sectional electronic survey was distributed to several thousand RNs resulting in 303 surveys providing usable data.

Results: We found that organizational culture was a strong predictor of speaking-up behaviors, and that speaking up partially …

Educational Intervention To Enhance Staff Knowledge And Increase Awareness Regarding Risk Assessment And Personal Protective Equipment Selection To Reduce Blood And Body Fluid Exposures, Teresa Smoot

Dissertations

Accidental occupational blood borne pathogen exposures pose a great occupational risk for healthcare workers, worldwide. After an occupational exposure, there is a potential risk for transmission of blood borne infections such as human immunodeficiency virus (HIV), hepatitis B and hepatitis C, to health care workers. Blood and body fluid exposures reported in an academic healthcare facility in Northeast Florida have been trending upward since 2015. The literature shows accidental blood borne pathogen exposures were greater among healthcare workers with little or no training in exposure prevention.

Weaving Empathy Into Simulation Pedagogy: Nursing Simulation Faculty Barriers And Strategies To Cultivating Empathy In Nursing Simulation Pedagogy, Tamara Holland

Dissertations

The purpose of this interpretive phenomenological study was to develop a deeper understanding of the strategies and barriers to weaving empathy into simulation pedagogy so stakeholders and educators may be able to develop a blueprint for improving simulation pedagogy and improving empathy levels of nursing students. The conceptual framework that guided this research was the National League of Nursing Jeffries simulation theory (Jeffries, 2016). This investigation used an interpretive phenomenological design consistent with principles originally identified by Heidegger (1927/1962) and a modified hermeneutic analysis further developed by Diekelmann, Allen, and Tanner (1989).

The Impact Of Short Papers On Clinical Decision Making Skills Of Nursing Students, Tara R. Hayes

Theses

Clinical decision making and critical thinking are fundamental skills to ensuring the success of undergraduate nursing students. Nursing faculty, and specifically clinical nursing faculty, are responsible for encouraging the development of these types of skills as students work in direct patient care. Traditional methods of clinical evaluation include lengthy case studies, concept mapping, and discussion board participation. While these methods have been in effect for some time, clinical short paper assignments are a fresh, innovative way to challenge students as they refine their critical thinking and clinical decision making abilities. No statistically significant difference was found between the perceived level …

Meaningful Use Of The Ehr-Evaluating The Internal And External Factors Affecting The Timeliness Of Patient Referrals, Beverly J. Schacherbauer

Theses

This project aimed to evaluate specialty referral wait times in a large academic medical center. Internal (organizational) as well as external (patient specific) factors were examined. Additionally, although specific to this QI project, the need to examine the accuracy of EHR data was identified and included. A retrospective review of one month of referral data to five medical specialties was completed (n=752). Logistic regression and multivariable analysis was used to determine whether age, race, insurance, specialty, or days from referral to appointment were associated with delays to timely access. Referrals with significant delays were further reviewed to identify additional factors …

Neuroimaging In Headache Patients: The Sensitivity Of Computerized Tomography (Ct) In Missed Stroke Diagnosis, Elizabeth C. Heetderks-Fong

Dissertations

Stroke is the leading cause of disability in the US, costing $34 billion a year and affecting 800,000 patients. Early detection and treatment is the best way to improve outcomes. Yet, 12.5% of strokes are discharged from the ED within the prior 30 days, with headache the most common diagnosis. Neuroimaging, ideally, would catch an impending stroke, but head CT has variable sensitivity based on onset of symptoms and there are both Federal and provider-led (including Choosing Wisely and the American College of Radiology Appropriateness Criteria (ACR-AC) initiatives to reduce overuse of imaging.

This study examined variation in ED treatment …

An Evidence-Based Evaluation Tool To Assist Healthcare Providers In Their Assessment Of Effective Mhealth Applications For The Management Of Chronic Health Conditions, Sara Belle Donevant

Dissertations

Mobile health (mHealth) apps are considered a viable option to improve chronic disease management. Healthcare providers are now recommending mHealth apps for patient use to assist in managing chronic diseases. However, healthcare providers may have difficulty locating effective, evidence-based mHealth apps for patients as there are currently over 325,000 available health apps (Research2Guidance, 2017). Limited evaluation tools are available to assist healthcare providers in this process. Therefore, our goal was to develop an online mHealth evaluation tool to assist healthcare providers in the selection of evidence-based mHealth apps.

After creating a comprehensive pool of mHealth features, healthcare providers provided feedback …

Self-Management Experiences Of Community-Dwelling Adults With Chronic Obstructive Pulmonary Disease, Wendy S. Bauer

Dissertations

Chronic Obstructive Pulmonary Disease (COPD) is an incurable lung illness causing significant individual and public health burden. Individuals with COPD often experience high symptom burden, unpredictable exacerbations, numerous comorbid conditions, and frequent health care utilization. Self-management can improve health outcomes and reduce health care costs; however, many individuals with COPD struggle with effective self-management. Improving the self-management of individuals with COPD and the delivery of self-management support from health care providers is crucial to reducing the individual and societal costs of the illness.

The purpose of this study was to explore the self-management experiences of community-dwelling adults living with COPD …

Incorporating Virtual Reality In Nurse Education: A Qualitative Study Of Nursing Students' Perspectives, Mohamad M. Saab, Josephine Hegarty, David Murphy, Margaret Landers

Individual Open Access Articles

Background: Recent challenges to nurse education have resulted in an increased use of virtual reality which serves as an immersive and effective medium for skill and knowledge acquisition. Virtual reality technology is being included in nurse curricula at undergraduate level. This technology remains a relatively new experience for many nursing students with limited evidence regarding students' perspectives regarding virtual reality.

Objective: To explore nursing students' perspectives of incorporating virtual reality in nurse education.

Design: Qualitative descriptive study using thematic analysis.

Setting: Public university in Ireland.

Participants: Undergraduate nursing students were recruited using purposive and snowball sampling.

Methods: Students (n = …

Meaningful Recognition: An Imperative For Nurse Manager Well-Being, Bonnie Barnes, Mark Barnes, Christine Pabico

Group: American Nurses Credentialing Center (ANCC)

The DAISY® Award for Extraordinary Nurses was created in 1999 out of grief for the loss of Patrick Barnes to recognize nurses for their compassionate care. The program now honors exceptional nurses from around the world. This is something we never imagined when we stood at Patrick's bedside while a nurse whose name we don't recall, but whose touch we'll never forget, turned off his ventilator and he died of complications of the autoimmune disease idiopathic thrombocytopenic purpura on November 6, 1999. His passing concluded the worst 8 weeks of our lives spent with him in two hospitals whose physicians …

Adult Postoperative Open-Heart Patients: Anemia And 30-Day Hospital Readmission, Lindsey J. Ryan

Dissertations

In 2013 alone, more than 4% (3.9 million) of patients discharged from a hospital were readmitted. Anemia following a surgical procedure is associated with early hospital readmission.

The following specific aims were addressed:

• Aim 1. To develop an operational definition of the term condition-based maintenance as applied to health care and discuss the applicability and effectiveness of condition-based maintenance within health care.
• Aim 2. To identify the number of adult patients undergoing elective open-heart surgery with preoperative anemia.
• Aim 3. To examine the relationship between preoperative anemia, sociodemographics, and 30-day hospital readmission rates among postoperative open-heart adult patients.
• Aim 4. …

The Evaluation Of Graduate Nurses' Performance Gaps In Blood Administration, Vanessa M. Schott

Dissertations

New nurse graduates are expected to help relieve the current and pending massive nursing shortage anticipated in the nursing field (Goode, Reid Ponte, & Sullivan Havens, 2016). However, there is a discrepancy between evaluations of new graduate readiness and the expectation to provide competent complex care. Ninety percent of undergraduate nursing education leaders feel new graduate nurses are prepared to practice, yet 90% of hospital nurse administrators disagree. When graduate nurses participating in nurse residency programs perform self-assessments on procedural readiness, emergency management and blood product administration/transfusion are frequently in the top three skills/procedures they feel uncomfortable performing independently. Yet …

Moving Interprofessional Simulation Online: A Lactation Telehealth Virtual Simulation Pilot, Suzanne Hetzel Campbell, Thayanthini Tharmaratnam, Nicole Bernardes, Marianne Brophy, Melanie Willson

General Submissions: Presentations (Oral and Poster)

The pandemic hit the world by surprise, and a continued need for health care professionals meant university programs scrambled for innovative educational options. We will describe the transition to develop and implement a virtual telehealth simulation for interprofessional health care student team.