Digital Commons Network^™

Clinical Factors That Influence Nurse Responsiveness In Activating Rapid Response Services, James Tormey

Dissertations

This study advances the understanding of essential clinical knowledge skillsets that nurses need to identify and respond to early signs of patient deterioration. The identification of critical thinking and assessment skills that nurses require may support professional practice through improved nursing education curriculum or additions of necessary critical care skillsets. The purpose of this study, which was framed by Benner's novice-to-expert model, was to identify and measure critical thinking skills that influence a nurse's ability to detect deterioration in patients and call the rapid response system (RRS). The research questions addressed the relationship between a nurse's clinical or reasoning skill …

Investigation Of A Checklist To Reduce Medication Errors Among Pre-Licensure Baccalaureate Nursing Students, Mary Agoglia

Dissertations

This experimental pilot study was aimed at the development of a quality standard to facilitate medication administration error detection, prevention, and reporting among pre-licensure baccalaureate nursing students. Based on both the literature review and peer review, sequential steps of the medication administration process were identified, bundled, and anchored in the mnemonic, C-MATCH-REASON, to form a new inquiry-based paper checklist that pairs clinical reasoning with rule adherence. The Checklist (independent variable), for nursing student utilization, was accompanied by an error tracking instrument (Observation Form) for nursing faculty (raters) to measure medication errors committed, recovered, and reported. Reason's (1990) error theory was …

Retention, Structural Empowerment, And Dialysis Nursing: Integrating Kanter's Theory And The Refined Nurse Worklife Model, Richard C. Scepura

Dissertations

During this two-phase project, factors that dialysis nurses experience contributing to stress, retention, and the intentions of staying were examined. The theoretical frameworks of Kanter's Theory of Structural Empowerment (KTSE) and The Refined Nurse Worklife Model (NWLM) were utilized in the creation of a learning module regarding structural empowerment. In phase one this was reviewed by an expert dialysis nurse focus group from seven different states with experience in dialysis from seven to forty years. During phase one, the expert panel gave high-frequency domain input including access to support, resources, and the need for strong leadership. The module was adjusted …

2020 Ancc Pathway Award® Winner, Sarah Ball, Kristine Diggins, Nairobi Martindale, Angela Patterson, Anne M. Pohnert, Jacinta Thomas, Tammy Todd, Melissa Bates

Group: American Nurses Credentialing Center (ANCC)

Each year since 2011, the American Nurses Credentialing Center (ANCC) has partnered with Cerner to bestow the ANCC Pathway Award® on a Pathway to Excellence®-designated organization to elevate the practice environment using innovative technologies. Cerner has generously doubled the award prize from $25,000 to $50,000 in 2020. MinuteClinic, the retail medical clinic of CVS Health, is the first national retail clinic to be recognized with this award. They stood out from other submissions with their proposal "Virtual Collaboration (VC) for Nurses." Being a national organization means that the benefits of their proposed program can impact millions of people across the …

Hipaa Applied To Jigsaw: A Collaborative Communication Improvement Project, Margaret P. Smallwood

Dissertations

Purpose: To translate the Jigsaw Method of Cooperative Learning into a strategy to improve collaboration in healthcare education through formal online discussions. The Jigsaw Method concept will be utilized to identify any enhancements in collaborative communication among healthcare professionals.

Significance: Communication failures lead to increased healthcare costs, patient care errors, and greater inefficiency in healthcare delivery. This project can improve collaborative communication that can help to eliminate these failures.

Design: The design is a mixed method, using quantitative and qualitative strategies for data collection and analysis.

Method: Online discussions were reformatted into constructive segments using the Jigsaw Technique and implemented …

Using Education To Improve Medication Adherence In Hypertension, Chinyere Oghide

Dissertations

Antihypertensive medication non-adherence is a common problem in healthcare. Currently, the project site has no program to increase medication adherence (MA) in their hypertensive patients. Therefore, the purpose of this quantitative, quasi-experimental quality improvement project was to determine if the implementation of the Million Hearts program impacted the adherence to antihypertensive medication among adult patients, with known hypertension (HTN) in a primary care clinic setting in New York, over a four week period. Orem's self-care theory and Ajzen's theory of planned behavior were the project's theoretical foundation. Data on MA was measured using the Hill-Bone Medication Adherence Scale HB-MAS scale …

Identification Of Primary Care Nurse Practitioner Clinical Procedural Skills Used In Practice: Examination Of Frequency Of Use, Importance Of Skill, And Training For Skill, David R. Want

Dissertations

With primary care NPs functioning in varied settings and roles requiring additional CPS knowledge and skills, NPs have expressed lack of preparedness regarding CPS. Although some evidence identified those CPS considered important to and frequently performed by NPs, the literature provides insufficient evidence to identify the CPS performed most frequently and rated as most important by primary care NPs in practice, and existing curricular standards lack clarity regarding which CPS to include in program curricula. This project aimed to conduct a practice analysis of the most frequently performed and most important CPS to primary care NPs in one region of …

Evaluating The Effectiveness Of Training Used For The Implementation Of A Peer Support Program To Support Second Victims, Karen Adamouski-Marion

Dissertations

In many health care organizations, the needed support for second victims, or care of the caregiver, is lacking or unavailable. This was true of the Inova health system organization at the conception of this project. This paper describes the process of establishing the need for a peer support program and evaluating the effectiveness of the selected peer support training program to meet the needs of the peer supporters, the team members they serve, and the organization. Unfortunately, unanticipated and tragic events will happen to excellent health care team members; the results are often anxiety, depression, guilt, and fear. The effects …

Development And Evaluation Of A Nurse Practitioner-Directed Medication Adherence Program For Adults With Hypertension In An Academic Medical Center, Adrienne E. Thorne

Dissertations

Hypertension affects one in three American adults and is the leading modifiable risk factor of atherosclerotic cardiovascular disease deaths (Arnett et al., 2019). Medication adherence to antihypertensive medications plays an important role in controlling hypertension. Adherence is affected by multiple factors such as medication side effects, multiple medication regimens, and being asymptomatic, as well as social and economic factors, patient-related factors, therapy-related factors, comorbid conditions, and health care system factors (Egan, 2019). Frequent interactions between patients and providers and medication refill reminders have shown to improve medication adherence in cardiac patients (Lambert-Kerzner et al., 2015), thus this project focused on …

Keeping Heart Failure Patients In The "Loop": Creating A Sustainable Program, Rachel E. Phelps

Group: Samford University Moffett & Sanders School of Nursing

The purpose of this project is to increase engagement of the GetWell Loop (GWL) allowing HF patients to have confidence that their decision making is correct for their overall health. Through increasing engagement in the GWL, patients learn and practice self-care measures which play a vital role in controlling their health.

Development Of Culturally Tailored Prenatal Nutritional Counseling For Hispanic Women, Manola Mccain

Group: Samford University Moffett & Sanders School of Nursing

In Nashville, TN in 2018, the average for Hispanic pregnancies with GDM was approximately 6% (CDC, n.d.). Appropriate diet and physical activity are well documented methods for prevention, and also for managing GDM and its sequela (CDC, 2019). In Nashville, 58% of Hispanic mothers are unmarried, 49% have a high school education or less, and the ages ranged from 17 to 43 with the majority of women being 26 years old at time of delivery (CDC, n.d.). Out of the 1,641 births in Hispanic women between 2016-2018, half of them were enrolled in the Women, Infants, and Children (WIC) Program …

Tapped: Teaching Advanced Practice Providers About Erectile Dysfunction, Monique Cornett, Felicia Wadley

Group: Samford University Moffett & Sanders School of Nursing

This project aims to implement an effective screening and treatment tool to offer APPs a more integrated approach to treat ED in men with diabetes to improve patient health outcomes.

Improving Nurse-Patient Communication To Impact Patient Satisfaction, Wendy Winston-Brister

Group: Samford University Moffett & Sanders School of Nursing

Poor communication among nurses and patients has been confirmed by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Often, patients feel left out of decisions and information related to their health and hospitalization. Many benefits are seen in healthcare organizations with high patient satisfaction and HCAHPS scores. The results of high patient satisfaction scores are increased employee retention, increased patient retention, increased quality of care, and higher reimbursement payments from the Centers for Medicare and Medicaid Services (CMS). Due to the importance of patient-centered care, the focus on patient satisfaction has increased. A doctor of nurse practice …

Standardized Management Of Early Pregnancy Loss In A Midwifery Clinic, Hannah Diaz

Group: Samford University Moffett & Sanders School of Nursing

Early pregnancy loss (EPL), also known as miscarriage or spontaneous abortion (SAB), during the first trimester occurs in as many as 25% of all known pregnancies and can lead to significant emotional and clinical morbidities (Al Wattar et al., 2019). It is diagnosed when a non-viable intrauterine pregnancy is identified at less than 13 weeks gestational age (Shorter et al., 2018). While this diagnosis can be tragic for patients, it can also be very complicated and stressful for providers to manage. Management of EPL involves the consideration of a multitude of factors. Providers must discuss implications and management options with …

Identifying Health Priorities For A Vulnerable Underserved Population In Uganda, Africa Using Community Base Participatory Research And The Photovoice Approach, Cheryl Wallin

Dissertations

The purpose of this descriptive phenomenological study was to give voice to an underserved and vulnerable population in Uganda, Africa to advocate for health priorities. Nineteen members of the village of Namagera, identified as a leper colony, were selected by community members and volunteered to participate in every element of this study. Descriptive phenomenology was the guiding philosophy and community-based participatory research methods and photovoice provided the lens for social action. Leininger's theory of culture care diversity and universality (Leininger & McFarland, 2006) anchored the study in cultural caring and the community nursing practice model (Parker et al., 2020) kept …

Symptom Experience And Correlation With Fecal Microbiota In Colorectal Cancer Survivors, Claire Jungyoun Han

Sigma Foundation for Nursing Research Grant Reports

The purpose of this descriptive study with a cross-sectional study design is to explore the differences in symptom experience and features of fecal microbiota among three groups (CRC survivors before cancer treatments, CRC survivors post-cancer treatments, and healthy controls [HCs]) and to explore if there are specific microbiota profiles (primary focus = immune- and inflammation- related microbiota) associated with symptoms in CRC survivors.

Do Novice Nurses Utilize Reflection For Clinical Reasoning?, Jennifer Slate

Theses

This study aimed to answer the following questions.

1. If novice nurses, less than 18 months experience, utilize reflection without prompting in their practice?
2. If so, does using reflection foster clinical reasoning in novice nurses?

The use of reflection in novice nurses would foster their ability for clinical reasoning resulting in increased professional competence and self-confidence.

Experiences, Attitudes, And Perceptions Of Female Adjunct Clinical Instructors Teaching Male Pre-Licensure Nursing Students, Amanda E. Shilo

Dissertations

The global shortage of nurses is a problem that has serious consequences. Recruitment of men into nursing has been seen as one possible solution to both diversify the profession, and fill the shortfall, but there are multiple barriers for males in nursing. These barriers are reported as they first contemplate a career in nursing, during nursing education, and as they transition into the profession. This results in decreased retention and success, with males leaving nursing in higher numbers than their female peers. Clinical instructors are described as an essential source of encouragement and support for nursing students, yet are also …

An Evaluation Of The Healthfulness Of The Hospital Food Environment, Cynthia E. Horton Dias

Dissertations

Though nurses may have knowledge about the health promoting benefits of a healthy diet, many do not consume enough fruits or vegetables. For hospital shift nurses to achieve healthy eating while at work, environmental barriers were reportedly the most challenging to overcome. To better understand the hospital food environment from the nurses' perspective, two mechanisms for workplace food acquisition were studied: 1.) hospital consumer food environment, which includes cafeterias, vending machines, and gift shops; and 2.) free food at work.

Improving Patient Satisfaction At An Inpatient Rehabilitation Facility, Ahmed Hariri

Dissertations

Patients hospitalized in Inpatient Rehabilitation facilities (IFRs) have complex needs that impact their satisfaction with care. The project site sought to improve patient satisfaction at discharge. The purpose of this quantitative quasi-experimental quality project was to determine if the implementation of the Studer Group's Hourly Rounding® tool would impact patient satisfaction at discharge among adult patients in an IRF in rural California over four weeks. The theoretical foundations of the project utilized Roy's model of adaptation and Lewin's planned change theory. The total sample size was N=50, n=25 in the comparative and n=25 in the implementation group. Discharge scores were …

Promoting Prep Uptake In Primary Care Practice For The Prevention Of Hiv Transmissions, Sokonie S. Reed

Dissertations

The nation is charged with the great task of eradicating human immunodeficiency virus (HIV) by year 2030. PrEP is an acronym for pre-exposure prophylaxis. Multiple clinical trials have recognized it as a safe and highly effective regimen that includes taking a daily dose of an antiretroviral medication to prevent HIV transmissions. The regimen is backed by prominent healthcare organizations like the Centers for Disease Control and Prevention (CDC) that have developed guidelines for PrEP implementation. Yet, there is a nationwide problem of low provider uptake of PrEP. Investigators in the literature on PrEP implementation concur that PrEP, as a preventative …

Provider-Focused Lgbtqia+ Education: A Quality Improvement Effort, Amir W. Raad

Dissertations

The purpose of this quality improvement doctoral project was to implement an educational session at Southwest Behavioral & Health Services (SB&H) in rural Kingman, Arizona. The provider education focused on promoting transformational change in mental health provider awareness through education on health disparities, health related risk factors, interpersonal communication, and cultural sensitivity specific to the lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual/allies population (LGBTQIA+).

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine M. Floyd

Dissertations

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt and Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design used …

Improving Tobacco Cessation Processes For Behavioral Health Professionals In Primary Care, Iesha R. Floyd

Dissertations

The purpose of this quality improvement project was to develop evidence-based tobacco cessation recommendations through a pre-program evaluation of current tobacco cessation processes at a Federally Qualified Health Center in Casa Grande, Arizona. The primary investigator explored tobacco screening and counseling practices within the behavioral health department. The project took place alongside two similar projects focused on the pharmacy and primary care departments. Together the three projects functioned together to develop evidence-based recommendations, for implementation by future Doctor of Nursing Practice student cohorts.

Comparison Of Pre-Licensure Bsn Student Outcomes Between Team-Based And Traditional Learning Methods, Tressa J. Pedroff

Dissertations

The increased complexity of healthcare systems requires nurses to have a different skillset, largely not provided in today's nursing curricula. Team-based learning is one possible teaching strategy believed to increase nurses' critical thinking and teamwork self-efficacy. Currently, there is insufficient objective data available that demonstrates improved academic performance and perceptions of teamwork skills in pre-licensure Bachelor of Science in Nursing students.

The purpose of this study is to compare the effects of team-based learning and traditional lecture-format teaching strategies among pre-licensure Bachelor of Science in Nursing students in a Foundations of Nursing Practice course.

Identifying Factors Influencing Pediatric Professionals' Self-Reported Collaborative Practice Behaviors, Susan Kilroy

Dissertations

The aim of this study was to: (1) determine the impact of interprofessional American Heart Association (AHA) resuscitation courses on health care professionals' self- reported collaborative practice behaviors (CPBs); (2) identify differences between the three professions of nursing, medicine, and respiratory therapy on self-reported CPBs; and, (3) describe which specific CPBs were most strongly associated with health care professionals' perceptions of interprofessional teams and enhanced patient care in clinical practice.

Emotional Intelligence Education And Civility In Nursing Education: A Basic Qualitative Study, Vicki A. Ireland

Dissertations

Incivility in nursing is a multidimensional problem that requires a new, innovative approach to managing complicated interpersonal behaviors. Emotional intelligence has emerged as an essential skill for the nursing profession, as these competencies have been associated with enhanced interpersonal interactions and may be effective in cultivating a civil academic and clinical environment. As little was known about how nursing faculty integrated such essential concepts in their curriculum and teaching, the purpose of this study was to gain an understanding of how undergraduate nursing faculty incorporated formal and informal emotional intelligence strategies to foster civility in baccalaureate nursing education. Additionally, faculty …

Fostering The Non-Academic Trait Of Grit To Increase Nursing Student Success, Marianne Biangone

Dissertations

In nursing education, there are few challenges as elusive as determining why attrition occurs. Attrition has been attributed to factors such as academic underperformance, adverse life events, and financial issues. It is imperative to identify additional tools for students to increase the opportunity for program success despite his or her challenges. Grit is passion and perseverance for long-term goals. Grit has had a positive impact on academic achievement, and the need is present for research on the ability to foster the development of the characteristics that make up grit in undergraduate nursing students. The purpose of this study is to …

Improving Post-Operative Infection Rates Using My Five Moments For Hand Hygiene, Reginald Mark R. Dimailig

Dissertations

Adequate hand hygiene is known to diminish surgical site infections (SSIs) and prevent healthcare-associated infections (HAIs) in the post-operative settings. An increase in SSIs due to poor hand hygiene compliance was observed at the chosen project site. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of the World Health Organization's (WHO) Five Moments of Hand Hygiene, would improve hand hygiene compliance and reduce post-operative infection rates among orthopedic patients in a same-day surgery unit. The project took place in a medical center located in the Northeast United States. The health belief model (HBM) …

The Effects Of Post-Operative Pain Management When Comparing The Enhanced Recovery After Surgery (Eras) To The Traditional Approach Amongst Patients Undergoing General Surgery, Tia D. Agboruche

DNP and Student Works

Chronic pain patients are vulnerable to developing addictions due to the long duration of high dose prescription narcotics. Consequently, optimal treatment approaches need to be identified for patients who are at high risk for addiction and for patients who have to undergo surgery but have a history of opioid abuse. Question: In the adult patients receiving general surgery, how does the ERAS approach, in comparison to the traditional approach, affect pain management during the postoperative period? Purpose: Enhanced Recovery After Surgery (ERAS) as a multimodal approach has recently emerged as the best evidence-based practice in minimizing postoperative complications including pain …