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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 …

Schools On The Frontlines Of Governance: How The Convergence Of Criminal Justice And Education Shapes Adolescent Perceptions And Behavior, Jennifer O'Neill

Dissertations

Theories of legal socialization posit that individuals’ interactions with both nonlegal (e.g., teachers) and legal (e.g., police officers) authorities impact our broader orientation towards governance our compliance with rules and laws. Examining the process of legal socialization in adolescents is critical for understanding individuals’ relationships with major institutions of social control, and further, predicting delinquency. Extant literature tends to consider legal socialization in the school and in interactions with the police as distinct processes related to offending, neglecting the potential influence of school contextual factors; and yet, because the incorporation of carceral features (e.g., exclusionary discipline, restrictive security, and enhanced …

The Lived Experience Of Becoming A Professional Nurse For Associate Degree Nursing Graduates: A Phenomenological Study, Jean L. Hershey

Dissertations

This qualitative study used a hermeneutic phenomenological design to investigate the lived experience of becoming a professional nurse for associate degree nursing graduates. The study looked specifically at the process of acquiring a professional identity for associate degree nursing graduates. The theoretical frameworks of structural functionalism and reference group theory provided the lens which guided the study. Structural functionalism is a sociological perspective describing how groups reproduce themselves by creating members whose behaviors and values correspond to the established group norms. A reference group is the social group which an individual uses to define attitudes, beliefs, and values which the …

Exploring The Experiences Of African American Nurses: An Emancipatory Inquiry, Laurie Pierce

Dissertations

This inquiry provided a critical and in-depth analysis of African American nurses' situations within the context of the work environment. Through this examination, multiple oppressions were illuminated. Participants identified both personal experiences of oppression and oppression related to administrative and interdisciplinary hierarchies. Additionally, the participants provided their insights on the concept of empowerment. Definitions of empowerment included being a voice for self and others and empowering others is empowering to self. Thus, the concept of relational empowerment was explicated. Furthermore, the participants envisioned an ideal environment where administration is supportive of nurses, nurses have time to care for the patients, …

The Female Overactive Bladder In Our Beverage-Centered Society: An Evolutionary Perspective, Sarah Becker Hortsch

Dissertations

Over recent decades, chronic disease has trended upwards, associated with the mismatch between our modern nutritional environment and our paleolithic genome. The beverage industry has exploded in sync with chronic conditions, including bladder symptomatology. This dissertation uses the logic and paradigm of evolutionary medicine to examine the modern beverage culture as a cause of the current high overactive bladder prevalence rates (17-31%, age dependent). A natural experiment exemplar concludes the dissertation with proof of concept that societal-wide influences to hyper-hydrate by drinking beyond thirst influences non-pathological changes to bladder state. The study is a secondary analysis with main outcome measure …

Senior Nursing Students' Perception Of Faculty Caring And The Caring Milieu In Two Associate Degree Nursing Programs, Martha A. Desmond

Dissertations

Caring, according to Jean Watson (1979), is the "core" and "essence" of nursing. The link between wisdom (knowledge) and caring can be achieved for the faculty member, according to Berkowitz (2011), if more attention is paid to the learning environment, role modeling, interactional practices, and professional development of the teaching staff. To do so, it will be critical for faculty to model caring as the core value and precept of nursing (Li et al., 2013) as well as create a caring environment (milieu) for students to replicate when they become professional nurses.

A gap was identified in the literature review …

Relationship Between Nurses' Perception Of Empowerment, Job Satisfaction, And Intent To Stay, Ma Leilani Hall

Dissertations

Retention of perioperative nurses who work in the operating room is critical to an organization's effectiveness and financial wellness. Factors that retain perioperative nurses are empowerment and job satisfaction. The purposes of this quantitative study, guided by Kanter's theory of structural empowerment, were to determine (a) the level of empowerment and job satisfaction among perioperative nurses and their intent to stay in the organization and (b) if age, gender, education, perioperative experience, and national nursing certification predict empowerment among perioperative nurses. Fifty-five perioperative nurses responded to the Conditions for Work Effectiveness Questionnaire- II, Nursing Workplace Satisfaction Questionnaire, and Intent to …

First-Generation Undergraduate Nursing Students' Perceptions Of Faculty Advising, Robin R. Kappler

Dissertations

The purpose of this qualitative phenomenological study was to explore the perceptions of first-generation undergraduate baccalaureate nursing students regarding their experiences with BSN faculty advisors at two Midwestern colleges. Peplau's Interpersonal Relations Theory was used as the foundation for this study. A phenomenological research methodology was utilized for this study. This included interviews with six self-identified first-generation undergraduate baccalaureate nursing students. These participants shared their individual perceptions of their experiences with faculty advising. Participants perceived relationships, knowledge, and supportive behaviors to be most important in a successful faculty advisor-advisee dyad. Overall, participants reported that their experience with faculty advising was …

Exploring Higher Rates Of Breastfeeding Among Civilian Military Wives: A Mixed Methods Study, Nicole Ann Ringo

Dissertations

As compared to the U.S. general postpartum population, civilian military wives (CMWs) encounter unique challenges that can impede their ability to breastfeed, including geographic replacement and physical and emotional challenges. Yet despite these challenges, CMWs demonstrate higher rates of breastfeeding initiation and duration in the U.S. postpartum population as a whole.

The purpose of this study was to explore factors contributing to the high rate of breastfeeding initiation and duration among CMWs and to determine what might be learned from these factors for intervention design for the broader population of postpartum mothers.

Determining The Needs Of Fathers Of Premature Neonates, Linda Ann Merritt

Dissertations

In order to practice true family-centered care in the NICU setting, a nurse needs to understand the perceptions and concerns of both parents of the neonate. Although research is emerging on fathers' perceptions and experiences, researchers have not examined fathers' needs with respect to sociodemographic factors and gestational age of neonates. The purpose of this study was to determine the needs of NICU fathers and if these needs differed based on sociodemographic factors and gestational age of neonates.

How Do Faculty Foster The Development Of Nursing Student Empathy In The Clinical Learning Environment?, Caroline E. Rae

Dissertations

The purpose of this qualitative case study was to explore how faculty foster the development of nursing student empathy in the clinical learning environment. While much of nursing education focuses on building technical knowledge and skills, the literature supports a growing need to focus on developing an empathetic practice. It is important to support the development of empathic skills to better prepare future nurses to provide high-quality patient-centered care.

Following The Yellow Brick Road: The Lived Journey Of Nurses Becoming Nurse Practitioners, Kathleen Theresa Ogle

Dissertations

In this phenomenological study, I explore the lived experiences of registered nurses who become nurse practitioners. Text for this study comes from narrative sources such as reflective writings, one-on-one conversations, and group conversations with seven new nurse practitioners.

The guiding question for this inquiry is: "What is the lived journey of nurses who become nurse practitioners?" Phenomenological philosophers such as Heidegger, Gadamer, and Casey guide this work. Other authors are drawn upon for grounding the study and to draw out the phenomenon for examination. The six research activities of van Manen (2003) provide the methodological framework for the research.

Effectiveness Of An Educational Intervention At An Academic Medical Center To Reduce Stigma Of Accelerated Pre-Licensure Nursing Students Toward Patients Living With Hiv, James Strickland Miller

Dissertations

Some health care providers may be reluctant to care for patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). The inclusion of educational opportunities for students to advance knowledge of HIV transmission risks, while decreasing stigma, is important, and many health care providers have not participated in these types of activities, which could promote learning and the practice of unbiased care.

Hypoglycemia Management In The Tnpatient Setting: Protocol Education For The Registered Nurse, Sarah Firmin

Dissertations

Hypoglycemia in the hospital setting is associated with increased mortality, morbidity, and an increased length of stay. In the clinical setting for this quality improvement project, there is an emergency standing order for the presentation of hypoglycemia. The purpose of the order is to direct the registered nurse to utilize specific measures when patient presentations are emergent. The literature review for this project provided an overview of quality improvement projects which had a focus on the care of patients with hypoglycemia. This project had the following specific aims: nurse knowledge related to diabetes and the treatment of hypoglycemia will increase, …

Predictors Of Quality Of Life In Thai Adults With Early-Stage Chronic Kidney Disease, Warissara Sorat

Dissertations

The incidence and prevalence of chronic kidney disease (CKD) are increasing worldwide. Persons with CKD constitute a large population with a high prevalence of morbidity and mortality in Thailand. Treatment of CKD generally involves a multidisciplinary team and requires a comprehensive assessment and aggressive treatment plan to improve the health status of persons with CKD to slow the disease progression. This study aimed to examine factors that influence quality of life among Thai adults with early-stage CKD and test the constructs of a complex model identifying individual and family factors, knowledge, depression, and self-efficacy related to self-management behavior and quality …

Impact Of End-Of-Life Education On Nurses' Moral Distress, Jenniffer L. Mullen

Dissertations

Moral distress is a state of concern or anxiety that occurs when there is a correct action to take but an individual's ability to take that action is constrained in some way. Nurses, especially those who work in intensive care units (ICUs), may struggle with moral distress due to feelings of futility when caring for end-of-life patients. The purpose of this 1-group pretest–posttest quasi-experimental study, guided by Lazarus's theory of stress, coping, and adaptation, was to determine whether End-of-Life Nursing Education Consortium (ELNEC) education reduces moral distress in ICU nurses caring for end-of-life patients. A revised Moral Distress Survey (MDS-R …

Reducing Unplanned Hospital Readmissions: A Qualitative Exploratory Multiple-Case Study, Kathleen Janet Weatherspoon

Dissertations

Healthcare quality measurement and care reimbursement have become a central focus for leaders and administrators of healthcare organizations. The provision of high-quality healthcare is contingent on the skills and abilities of leaders and clinical staff who support evidence-based clinical practice through implementation strategies. The problem defined in this qualitative exploratory multiple-case study was concerned with the frequency of unplanned hospital readmissions occurring in the state of Florida specifically, in healthcare facilities located in Broward, Miami-Dade, and Monroe Counties (tri-county area). Healthcare stakeholders working in organizations located in the tri-county area report hospital readmission rates of 23%, that resulted in higher …

Qualitative Exploration Of Perceptions Of Nursing Undergraduates Regarding Family Care At End-Of-Life, Penny A. Alt-Gehrman

Dissertations

Family care at end-of-life is delivered by nurses and includes communication and explanations, providing emotional support for the family, creating an environment in which death occurs with dignity, providing privacy, facilitating visitation, and honoring and meeting cultural and personal family values (Beckstrand et al., 2011; Bloomer et al., 2013; Cronin et al., 2015; Heidari & Norouzadeh, 2014).

There appears to be a gap in the empirical evidence and literature on this topic. Regarding the knowledge and comfort of student nurses, and subsequently nurses, in family care at the end-of-life, there is disparity. To determine what must be taught to nursing …

The Relationships Among Self-Regulation, Cognitive Load, Decision Support, And Decision Making Readiness In Surrogate Decision Makers For The Critically Ill, Grant Alan Pignatiello

Dissertations

Chronic critical illness is expected to impact 600,000 Americans annually by 2020. Often, the chronically critically ill (CCI) experience persistent cognitive impairment. Thus, family members serve as surrogate decision makers (SDMs) to make complex healthcare decisions for their loved one. Decision support interventions have been developed to meet the informational needs of SDMs during this distressing period. However, past decision support interventions have not been effective in meeting the informational needs of SDMs. Current decision support interventions have not evaluated unique behavioral and cognitive factors that may influence an SDM's readiness to engage in decision making. Therefore, this study applied …

A Basic Qualitative Exploration Into The Academic Persistence Of Minority Nursing Students In Minority Nursing Programs, Marta S. Coleman

Dissertations

The academic persistence of minority nursing students has become a healthcare concern due to health disparities in minority groups. Evidence suggests that receiving healthcare from healthcare providers of the same ethnic or cultural background as the population served reduces health disparities, increases positive health outcomes, and decreases overall healthcare costs. Unlike previous studies of minority nursing students' persistence, this study was conducted solely in minority nursing programs. The problem addressed in this basic qualitative study was that a significant number of minority nursing students were not persisting to graduation in minority nursing programs. The purpose of this study was to …

Electronic Health Record Instruction In First-Semester Nursing Students: A Comparative Study, Angela R. Ruckdeschel

Dissertations

The use of health information technology has been shown to have positive effects on patient outcomes and provider efficiency. New nurses make more than half of the 7 million lifethreatening medication errors that occur each year, and electronic health records (EHRs) have been shown to significantly reduce these errors. Nurses now are expected to enter practice with a solid foundation in health information technology and the use of the EHR. Unfortunately, the vast majority of nursing schools do not specifically train their students in effective EHR utilization. Academic EHRs (AEHRs) are software packages with learning features that can be incorporated …

The Impact Of Adverse Childhood Experiences And Forgiveness On Nurses' Capacity For Compassion Satisfaction, Anne D. Troy

Dissertations

The objective of this study was to examine the relationship between Adverse Childhood Experiences (ACEs), forgiveness and compassion satisfaction in nurses. In addition, the study sought to determine the impact of forgiveness, as a moderator on the relationship of adverse childhood experiences and compassion satisfaction. Lastly, this study explored which demographic characteristics serve as predictors of forgiveness and compassion satisfaction in a select population of nurses.

Bedside Counseling For Medical Inpatients Who Misuse Alcohol, Lise Anne Cooper

Dissertations

This dissertation addresses the process and results of a program implemented to motivate patients that are admitted to a medical center with diagnoses of alcohol misuse to seek addiction recovery. The primary research question is: How does bedside addiction counseling reduce the patient's number of readmissions and length of stay? This is a comparative, interventional mixed methods study. This study also examines the methods used to identify the inpatients at the medical center that are admitted with alcohol misuse, and how that identification process initiates treatment.

A Qualitative Descriptive Study Of Novice And Advanced Beginner Nurse's Experiences Caring For Patients And Their Families At The End-Of-Life, Bethany A. Nasser

Dissertations

Nurses are the primary healthcare professionals that spend the most time caring for seriously ill patients. Nurses have a responsibility to care for patients at the end of their lives, to relieve pain, and promote dignity so that patients can experience a peaceful death. As our elderly population grows and chronic health problems increase, there is a need to teach nurses and nursing students End-of-Life Care (EOLC). New nurses must be properly prepared to provide sensitive, quality care to dying patients and their families. Nursing students do not have opportunities during clinical training to care for patients that are dying, …

Measuring Knowledge And Behavior After An Educational Program On Air Pollution As A Health Risk Reduction Strategy, Mary Eileen Guerin Kloster

Dissertations

Potential exposure to indoor and outdoor air pollution must be considered as part of an overall health risk reduction strategy. Toxicants identified in outdoor air pollution, fine particulate matter (PM2.5), and photochemical ozone cause a systemic inflammatory response to the heart and lungs after exposure. Inside the home, health issues from exposure to carbon monoxide (CO), PM2.5, nitrogen dioxide (NO2), and volatile organic compounds (VOC) are intensified when the home is sealed with the windows and doors closed. This explanatory study sought to promote health by teaching participants about strategies to reduce risks related to indoor and outdoor effects of …

"It Was A Season..." Postpartum Depression In American Indian/Alaska Native Women, Jennifer Leigh Heck

Dissertations

Postpartum depression (PPD) is linked to diminished maternal, pediatric, and family health outcomes and is designated as the most common childbirth complication. PPD is found in most populations, and touts international status as a major public health concern. Clinicians define PPD as an episode of major depressive disorder with a "peripartum onset" that occurs within the first year after delivery. Studies suggest that American Indian/Alaska Native (AI/AN) women suffer higher PPD prevalence (14% to 29%) than other United States' women, revealing a racial/ethnic disparity. Health disparities research is a national public health priority and substantiates the need to explore PPD …

Family Dementia Caregivers' Perceptions Of The Virtual Dementia Tour®: A Changed Reality, Candace Currie Harrington

Dissertations

Family dementia caregiving involves many challenges that often lead to stress and frustration. A subjective understanding of the daily struggles associated with dementia is not possible unless one has the disease; therefore, the family dementia caregiver's perception of dementia might be incongruent with their family member's lived experience.

The Virtual Dementia Tour® (VDT) provides a vicarious first-person perspective for six of the most common symptoms of dementia. Although extensive evidence supports the use of the Virtual Dementia Tour® in the healthcare profession and education, no research studies were found investigating the Virtual Dementia Tour® with family dementia caregivers.

American Association Of Diabetes Educators 7 Intervention In Managing Type 2 Diabetes In Older Home Health Patients, Anne N. Ohakosim

Dissertations

Management of chronic disease pathologies requires the patient to have the ability to understand and manage their care. This may be especially challenging in the aging population caring for themselves at home. The home care agency noted the patients had a knowledge deficit regarding T2DM self-management of blood glucose levels. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the implementation of the American Association of Diabetes Educators 7(AADE7) diabetes self-management program improved glucose levels and diabetic management knowledge among adult diabetic home health patients aged 65 and older. The project took place in northwestern Illinois …

Dispositional Mindfulness In Senior-Level Nursing Students: Examining The Relationship To Situation Awareness And Clinical Outcomes, Deborah L. Struth

Dissertations

Experts in the study of ergonomics and human performance factors have described the 'collective mindfulness' of nurses as a critical element to the attainment of highly reliable safety within patient care delivery. Little research exists related to the construct of mindfulness and its impact on safe nursing practice and situation awareness by the nurse.

Best Teaching Practices For Providing Culturally Sensitive And Inclusive Nursing Education: Nurse Educators' Perspectives, Christine L. Sommers

Dissertations

This paper explored problem-based learning and cultural diversity, critical thinking and clinical judgment and cultural diversity, and nurse educators' perceptions of implementing culturally diverse and inclusive nursing education. The results of this exploration are presented in three articles (Chapters 2-4). In Chapter 2, a synthesis of literature regarding strategies for problem-based learning with culturally diverse students was described. Studies in nursing literature have not specifically focused on the needs of culturally diverse students when implementing problem-based learning. Nurse educators need to consider their own culture and their students' culture when implementing problem-based learning. They also need to dialogue together about …