Digital Commons Network^™

Lived Experiences Of Or Nurses Working Off Peak Hours, Tashma E. Watson

Dissertations

Nursing plays a vital role in the care and safety of patients. Compared to other health care disciplines, nursing spends the greatest amount of time at the bedside. As health care continues to evolve, nursing will be an active participant in effecting the delivery of patient care. However, there is a paucity of research focused specifically on experiences of nurses caring for patients in the OR. Recent research explores the phenomenon of the "weekend effect." This phenomenon suggests variations in patient outcomes on weekends and nights (off-peak hours) compared to weekdays. The purpose of this hermeneutic phenomenological study was to …

Fluctuating Cohesion: A Grounded Theory Study Of Nursing Students Engaged In A Hybrid Debriefing Format, Carol L. Senette

Dissertations

Debriefing is a key component of simulation that promotes development of students' reflective processes. Instructor-led debriefing (ILD) is considered the gold standard; however, research conducted over the past decade demonstrates the negative effects of anxiety on student reflection during ILD. Nursing students' experiences with ILDs have been substantially investigated; yet scant research explores students' perceptions and experiences of more learner-centered debriefing formats that deemphasize the instructor role.

Impact Of Comfort Management On Narcotic Use In The Cardiopulmonary Surgical Icu, Caroline Janga Doe

Dissertations

Patients may experience acute pain after cardiopulmonary surgery. Narcotic pain relievers may reduce pain, yet many patients still complained of discomfort at the project site despite the medications provided to reduce it. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of Kolcaba's comfort verbal and comfort daisies scale assessments combined with the use of non-pharmacologic comfort measures would reduce the narcotic dose and increase the patients' comfort levels among post-cardiopulmonary surgical intensive care patients in an acute care hospital in urban New York over four weeks. Kolcaba's comfort theory guided the project. Narcotic …

Mentorship Program To Improve Nursing Knowledge On Prevention Of Hospital-Acquired Pressure Injuries, Terri Lo

Dissertations

In the United States, hospital acquired pressure injuries (HAPIs) is one persistent patient safety problems with an increasing incidence rate resulting in patient harm and patient deaths. Pressure injuries can lead to problems for the patient and family related to wound care and quality of life. Prevention of HAPIs is an essential aspect of nursing practice. Education and mentorship about HAPI prevention can help facilitate translation of evidence-based research findings to clinical nursing practice to improve patient care outcomes.

A Correctional Study Of Nursing Instructor Use Of Best Practice With Multiple Choice Questions, Diane Droutman

Dissertations

Multiple choice questions are used as evaluations in nursing schools. Nursing instructors and nursing book publishers develop exam questions. The specific problem addressed by the study was how best practice in multiple choice test items, item analysis, and revision of choice test items used by nursing instructors. Using a survey method, this correlational design research looked at the relationship of faculty use of best practice in test item construction, analysis, and revision of multiple choice test item in nursing programs in the United States. Even though a relationship was noted, the statistical effect level was minimal. There was no correlation …

Safe Opioid Prescribing Through Proper Screening, Joelle M. Carson

Dissertations

It is known in today's healthcare that opioid abuse is on the rise in the United States. The project site noted aberrant behaviors and the seeking of narcotics from certain clients in the occupational health clinic. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of Webster's Opioid Risk Tool (ORT) would impact the number of opioid prescriptions written for acute pain among patients seen an occupational health clinic in central Indiana over four-weeks. The theoretical frameworks utilized in the project included Skinner's behaviorist theory, Bandura's social cognitive theory, and Orem's self-care deficit theory. …

Use Of An Affective Teaching Intervention To Impact Connections Between Academic And Professional Integrity, Deborah Morrill

Dissertations

Dishonesty and misconduct of nursing students during their education is a continuing concern, especially as it relates to expected professional behaviors. This quasi experimental pre-and post-interventional study explored the impact of an affective learning module on developing beliefs and perceptions of ethicality of academic and professional misconduct of students in a BSN program. A modified version of McCrink's (2008) tool, entitled "Nursing Student Experiences and Perceptions of Academic and Professional Conduct Survey" measured these constructs. The affective learning module, based on Rest's theory of moral development, and Krathwohl's affective taxonomy, actively engaged students in ethical decision-making with connections to professional …

Registered Nurses' Perceptions Of Obesity, Elizabeth Pettifor

Dissertations

Obesity has become an epidemic in the United States (U.S.) population. Obesity is a risk factor for many health problems that ultimately lead to death or disability. Nurses in the U.S have a higher-than-average rate of overweight and obesity. The purpose of this exploratory, qualitative case study was to identify and recommend areas for change in the hospital environment to assist bedside nurses in the U.S to have a healthier lifestyle. Social media was used to conduct a purposeful sampling technique and recruit 10 registered nurses working full time at the bedside in the U.S who struggle with obesity. Semi …

Educating Nurses To Engage In Health Policy And Advocacy, Donna J. Barry

Dissertations

Few nurses engage in developing health policy from the local to global level. For a scholarly practice project, American Association of Colleges of Nursing (AACN) accredited nursing schools in New England were surveyed to measure what recommended AACN Essentials content on health policy is taught in their baccalaureate and master's programs. The online, quantitative-descriptive survey captured whether content is taught in stand-alone courses and if those courses are required. Barriers to teaching health policy at both levels and barriers to nurses engaging in health policy and advocacy were also solicited. A majority of responding programs include most AACN content in …

The Mother's Lived Experience Of Breastfeeding In The First 4 Weeks Postpartum: A Heideggerian Hermeneutic Phenomenological Analysis, Stacy Rosales

Dissertations

The purpose of this study was to more fully understand, in their own words, the experiences of mothers who began breastfeeding their infant after birth and may or may not have been breasting at four weeks postpartum. A single research question guided this study: What are the lived experiences of breastfeeding mothers during the first four weeks postpartum? Eight mothers who delivered in the past four to six weeks were interviewed. Data were analyzed using a Heideggerian hermeneutic phenomenological approach. This method was chosen because it allowed the researcher to conduct interviews and explore the lived experience of breastfeeding mothers …

Pre-Anesthesia Assessment In Children With Down Syndrome: A Head To Toe Guide, Laurel Kinsey

Dissertations

The purpose of this project was to provide and assess an educational intervention for a multidisciplinary interprofessional collaborative sedation team at a children's hospital in Anchorage, Alaska.

The Effects Of Race, Ethnicity, Education, Marital Status, And Family Size On Hysterectomy Rates, Zula Price

Dissertations

Decreasing disparities in hysterectomy rates have been a goal of the United States Department of Health and Human Services as a method of improving women's health. In the United States, hysterectomy rates remain high, particularly among Black women in contrast to other racial and ethnic groups (Qi et al., 2013). This study, using a descriptive research framework, utilized a sample of 1,921 women across the United States who participated in the 2012 National Health and Nutrition Examination Survey (NHANES).

Data were analyzed from the responses of subjects who reported having a hysterectomy in the 2012 NHANES, which is designed to …

Educating College Students About Human Papillomavirus, Pamela Bryant

Dissertations

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in the US affecting almost 60% of college women ages 20 to 24 years. At one west coast community college, two thirds of males and half of females were unaware of HPV vaccine recommendation through age 26 years.

This aim of this project is to determine if an evidence-based online educational video about HPV and HPV vaccine would increase knowledge of HPV and intent to receive the vaccine among community college students enrolled in urban and suburban community colleges in Southern California. Measured outcomes of interest included HPV knowledge …

A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad

Dissertations

Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff's minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging …

Social Media Use For The Early Career Nurse, Craig Davidson, Charlotte Jakab-Hall

Early Career Nurses Series

This webinar aims to help fellow early-career nurses understand how they can best utilize social media in an authentic yet professional manner. When used correctly, it has endless benefits to develop your career and networks.

Learning Outcomes;

1. This webinar aims to help fellow early-career nurses understand how they can best utilize social media in an authentic yet professional manner. When used correctly, it has endless benefits to develop your career and networks.
2. This webinar aims to help fellow early-career nurses understand how they can best utilize social media in an authentic yet professional manner. When used correctly, it has endless …

Holistic Blood Pressure Management Plan In Primary Care, Marilyn L. King

Dissertations

The purpose of this Doctor of Nursing (DNP) quality improvement (QI) project was to demonstrate the usefulness of implementing a bilingual educational module for patients with hypertension on improving knowledge, self-efficacy, and self-management at Kids Kare Pediatrics and Family Kare Clinic.

A Screening Tool To Identify Patients At High Risk For Perioperative Neuropathy, Carla M. Ibbotson

Dissertations

This project aimed to evaluate anesthesia provider attitudes surrounding the clinical topic of perioperative peripheral nerve injury. Additionally, the project sought to introduce anesthesia providers to a novel risk assessment device that may help identify patients at high risk for perioperative peripheral nerve injury while assessing its potential utility in anesthesia practice.

Factors That Affect Adequate Analgesia In African Americans With Cancer Pain, Navdeep Singh

Dissertations

Receiving adequate analgesia has been shown to be problematic for African Americans with cancer pain. The vast majority of studies only simply highlights the existing disparities between African Americans and Caucasians in pain management. There is a lack of research focusing on the etiology of these disparities, specifically on what causes prescriptions for inadequate analgesics, especially for African Americans. The purpose of this study was to characterize the adequacy of analgesia received by African Americans with cancer pain and to elucidate what patient characteristics contributed to receiving adequate analgesia.

Nurse Residency Program Use In Alabama Hospitals: Exploring The Decision-Making Strategies Of Hospital Administrators, Miranda M. Smith

Dissertations

Current literature supports the creation and implementation of nurse residency programs to support new graduate nurses as they transition into nursing practice. Additionally, nurse residency programs have been shown to increase nurse satisfaction and retention (Crimlisk et al., 2017; Olson-Sitki et al., 2012). Currently, there are only three nurse residency programs in the state of Alabama. The lack of this important post-licensure resource poses a problem for new graduate nurses who are seeking additional assistance and guidance during the transition to professional practice.

This qualitative study examined the decision-making process of hospital leaders in the implementation of the nurse residency …

The Shocking Truth Regarding Job-Related Problems Prior To Nurse Suicide, Cadie Ayers, Marie Manthey, Amanda Choflet, Judy Davidson

General Webinars

We have known for several years that nurses are at higher risk of suicide than the general population and that nurses have more job-related problems recorded prior to death by suicide. What we have now learned about those job-related problems is troublesome at best with implications for clinicians, educators, risk managers, hospital executives, and all leaders in healthcare. This panel will describe the issues and implications for education, advocacy and policy change necessary to right the wrongs leading to death by suicide amongst nurses.

Reducing Hospital-Acquired Pressure Injuries Through The Implementation Of The Leaf Patient Monitoring System, Meghan Kelley

Dissertations

A top priority for all hospitals is patient safety. A major component of patient safety classified under this category is prevention of hospital-acquired pressure injuries (HAPIs), which are considered "never-events" by the Joint Commission and align with the World Health Organization as preventable harm. Due to current policies on a particular unit not proving to be effective at reducing HAPIs, the implementation of the FDA-cleared Leaf Patient Monitoring System was proposed. This technology uses a sensor adhered directly to the patient to reduce the trending HAPI rates on the a progressive care unit while assisting nursing in adhering to the …

Diabetic Education To Reduce Readmission Of Patients With Diabetes, Nicoleta F. Buiciuc

Dissertations

Hospital readmissions by patients with diabetes rise due to known risk factors such as lack of a healthy diet, physical activity, aging and obesity (Sonmez, Kambo, Avtanski, Lutsky, & Poretsky, 2017). Diabetes education and management is key to improving self-care behaviors and reducing hospital readmissions within 30 days (Drinic et al. 2017 & Sullivan & Alexander, 2019). Diabetes self-management involves education on healthy diet, exercise, self-monitoring of blood glucose, avoidance of risk factors and complications (Chai et al., 2018). Hospitalization provides an ideal time to identify barriers to improving a diabetes home regimen and promote DSME (Inpatient Diabetes Management, 2016). …

Depression Screening And Management In A Free Primary Care Clinic, Ashley Gagne

Dissertations

Introduction. Depression diagnoses in the United States continue to rise within the primary care setting. At a free primary care clinic in the Southeastern United States, the PHQ-9 screening tool was being used to screen patients for depression, but providers were not regularly addressing positive screenings. Aims. This quality improvement project aimed to evaluate health care staffs' awareness, attitudes and confidence towards depression screening and management and implement best practices in primary care identification and follow up for depression.

Methods. Health care staff at a primary care clinic responded to Revised Depression Attitudes Questionnaire (RDAQ) pre-and post-surveys to measure their …

Nursing And Midwifery Links [June 2021 Issue], Secretariat At Johns Hopkins University School Of Nursing Global Network Of Who Collaborating Centers For Nursing And Midwifery

Nursing and Midwifery Links (LINKS)

In this June edition, all regions of the Collaborating Centers are represented with insight into the global health experience as Nurses, Midwives, Students, and Educators over the past six months. Progressive programs for better supporting the dedicated Nurse are explored. Our international colleagues are celebrated and honored; as well as mourned. In honor of those who lost their lives during the Covid Pandemic, and those who continue to forge on in the face of loss, we offer a heartfelt representation of solidarity in the form of voices from Collaborating Centers across the globe, from our community to yours.

Interdisciplinary Rounding And Its Effect On Communication And Quality, Elizabeth Dasher, Ashlee Loewen

DNP and Student Works

Communication is vital in healthcare. Ineffective communication has been often cited as one of the root causes of patient harm. Interdisciplinary rounding (IDR); a structured framework for communication between multiple disciplines, the patient, and family, has been shown to increase communication and thus improve quality outcomes. The current communication and provider practices of individual assessments, as opposed to a team approach, contributed to poor communication and suboptimal quality outcomes within the project unit. This quality improvement project utilized interdisciplinary rounding as an intervention to improve communication and quality outcomes.

An Evaluation Of Timing Of Discharge Instruction And The Impact On Patient Satisfaction, Donald L. Tanner

Dissertations

Ambulatory surgical patients face unique challenges with discharge instruction comprehension and retention. The volume of information provided to patients, frequently combined with sedatives and narcotics, leads to failure to retain this crucial information needed for home care. At one healthcare facility, this failure to retain was reflected in the Outpatient Ambulatory Surgery- Consumer Assessment of Healthcare Providers and Systems (OAS-CAHPS) survey scores which were below the facility goal of 75th percentile nationally. This project implemented a preoperative teaching intervention to provide written and verbal discharge instructions in the preoperative area prior to the administration of anesthetic agents to improve patient …

Family Management Of Severe Obesity In Adolescents, Karyn J. Roberts, Agatha M. Gallo, Crystal L. Patil, Catherine Vincent, Helen J. Binns, Mary Dawn Koenig

Sigma Foundation for Nursing Research Grant Reports

Severe obesity, defined as a body mass index (BMI) >120th percent of the 95th BMI percentile for age and sex, is the fastest growing subcategory of obesity among children and adolescents. The aims of this study were to explore how parents and adolescents understand severe obesity and incorporate management into their daily lives and evaluate the applicability of the Family Management Styles Framework (FMSF) to severe obesity in adolescents.

Team-Based Fall Prevention Program Derived From Teamstepps 2.0 Methodology: Quality Improvement, Deanna Hasan

DNP and Student Works

A team-based fall prevention program is vital in establishing teamwork and patient safety standards. The Doctor of Nursing (DNP) Capstone project focused on the lack of a team-based fall prevention program within a Telemetry unit. The project's purpose was to identify and create a change in team perception of teamwork and patient safety to promote the staff's perception of teamwork and reduce the fall rates with injuries in the healthcare settings. The project's aim in relation to the PICOT question is to establish a team-based fall prevention program derived from the TeamSTEPPS 2.0 methodology and Lewin's Change Theory to produce …

The Impact Of Length Of Experience On Clinical Nursing Instructor's Perceptions Of Effective Teaching Behaviors In Undergraduate Nursing Programs, Carolyn Molina

DNP and Student Works

Effective clinical teaching is vital for student learning, and it is essential that clinical nursing instructors exhibit effective clinical teaching behaviors in the clinical learning environment. To provide students with the opportunity to successfully acquire and understand nursing professional roles and values, effective clinical nursing behaviors of the clinical instructor must be investigated. The effectiveness of the clinical instructor has been examined through various perspectives. However, the majority of studies have focused on effective clinical teaching behaviors as perceived by the student. The purpose of this quantitative correlational descriptive pilot study is to identify effective clinical teaching behaviors of clinical …

Resistiveness In Dementia: Nurse Communication In Acute Care, Clarissa Shaw

Sigma Foundation for Nursing Research Grant Reports

Persons living with dementia (PLWD) are twice as likely to be hospitalized compared to cognitively intact older adults and while hospitalized PWD often exhibit behavioral symptoms of dementia such as aggression. Challenging behaviors that disrupt nursing care are termed resistiveness to care (RTC) and leave patients at risk for neglect and nurses at risk for strain. Effective communication by nursing staff is critically important in preventing RTC. The purpose of this cross-sectional study was to identify and characterize elderspeak communication by hospital nursing staff to PLWD and determine the association between elderspeak communication and RTC by PLWD. Nursing staff were …