Digital Commons Network^™

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 …

Quality Remediation Programs Lead To Successful Learning, Katherine T. Ralph

Dissertations

The mission of nursing programs is to prepare as many students as possible to pass the first-time attempt on the National Council Licensure Examination- RN (NCLEX-RN®). If a school's first-time pass rate drops below 80%, the school is at risk of being closed by the State Board of Nursing. Furthermore, a student's ability to work as a registered nurse (RN) depends on passing the NCLEX-RN®, and the overall impact on our nation's health due to the current nursing shortage.

The purpose of this study was to examine the policies and strategies used in nursing programs to increase NCLEX-RN® first-time attempt …

The Lived Experience Of Traumatic Amputation For Haitian Adults, Margarett Alexandre

Dissertations

Amputation of a limb is a traumatic and disabling condition that impacts the lives of people worldwide. Trauma remains the leading cause of major limb amputation, second only to Diabetes Mellitus and dysvascular complications (Ziegler-Graham, MacKenzie, Ephraim, Travison, & Bookmeyer, 2008). Little is known about the experience of traumatic amputation for Haitian Adults, therefore this study was to understand the lived experience of traumatic amputation in Haiti. The purpose of this descriptive phenomenological study was to investigate the lived experience of traumatic amputations as talked about by adults who suffered an amputation because of the 2010 earthquake in Haiti.

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 …

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.

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, …

"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 …

Firearm Injuries In Maryland, 2005-2014: Trends, Recidivism, And Costs, Paul A. Thurman

Dissertations

Violent injuries related to firearms are common in the U.S., whether accidental or intentional. Restrictions on use of Federal dollars for research on injury prevention involving firearms has limited our knowledge of how firearm injury impacts the health care system. The objectives of this study are to characterize firearm injuries (FI) in Maryland, quantify recidivism, and to describe hospital treatment and their associated costs for Maryland.

ED and inpatient hospital records utilizing E codes consistent with FI were linked across visits to create unique cases from 2005-2014. Recidivism was defined as any subsequent ED visit or hospitalization for FI. The …

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 …

Celiac Disease: Examination Of Executive Function And Social Phobia Among Female College-Aged Students, Jacqueline M. Arnone

Dissertations

This study compares traditional age female college students (18-25) diagnosed with celiac disease (CD) to age matched controls on measurements of executive function (EF) and social phobia (SP). Although previous research in this area has been mixed, a preponderance of the evidence from these studies suggests that CD impacts cognitive functioning as a whole; executive functioning in particular. However, most of the literature in this area focuses on age groups outside of the normal traditional college age range. No research to date has examined executive functioning or social phobia among 18-25-year-old female college students with CD. Bronfenbrenner's Bio-Ecological Systems Theory …

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.

Preparing Nursing Students To Respond To Disasters: Faculty Perspectives, Melissa Jayne Freshwater

Dissertations

This mixed methods study explored emergency preparedness and disaster response in the concept-based learning curriculum adopted by the Alabama Community College System (ACCS) in 2016. The concept-based curriculum employs active learning in lieu of the traditional lecture-style teaching methods.

This study addressed the problem that educators may be unfamiliar with this content and are unsure how to present this material to students. The purpose of this study was to gain insight on teaching methodologies, to better prepare nursing students on this content.

Kolb's 1984 Experiential Learning Theory was the framework that parallels closely with this curriculum. Kolb emphasizes four stages …

Nurses Caring For Birth Tourism Families In Neonatal Intensive Care Units: A Phenomenological Inquiry, Tamara Lacroix

Dissertations

Birth tourism families plan their birthing experience that includes purchasing a maternity care package, traveling internationally to a preferred destination, and the delivery of a healthy newborn in an expected short hospital stay. However, some families admit a premature or ill infant into a South Florida neonatal intensive care unit. When admitted into this setting, neonatal nurses are unique in providing quality nursing care to birth tourism infants and their parents as a family unit. There remains a gap in nursing research in understanding neonatal nurses' lived experience caring for birth tourism families in the neonatal intensive care unit.

The …

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.

Elderly Partners' Lived Experience Of Bladder And/Or Colorectal Cancer Diagnosis Living With A Ostomy, Dinah R. Herrick

Dissertations

Bladder and colorectal cancer (CRC) are two of the most aggressive types of cancer with treatment creating physical and psychosocial comorbidities that affect the quality of life of patients affected by the disease. Numerous studies have been conducted about the experiences and needs of people who have had a bladder and/or CRC diagnosis, surgical intervention, and an ostomy, but studies about the experiences of the elderly partners are negligible. Specifically, the older adult (65-84 years old) group was found to be essentially unstudied with only 10 (0.51%) known 75- to 84-year old participants included in relevant studies that involved 1,750 …

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 …

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.

Nurse Family Member Perceptions Of Patient Death And Nursing Care After Withdrawal Of Life-Sustaining Treatment, Deena M. Drake

Dissertations

This pilot study explored nurse family member perceptions of nursing care and patient quality of death and dying during and after withdrawal of life-sustaining treatment within Intensive Care Units (ICU).

The Effects Of Nursing Program Simulation Experience Level And Type Of Advanced Organizer On Clinical Judgment Performance, Satisfaction, Self-Confidence, And Perceived Cognitive Load Of Pre-Licensure Nursing Students In Simulation Based Learning, Tina D. Barbour-Taylor

Dissertations

Nursing education programs face many challenges with training students to become professional nurses who will practice safely in an evolving and complex healthcare system. Nurse educators are obliged to prepare students to meet these challenges, with clinical experience being a key aspect of training. However, limited availability of clinical sites restricts adequate training. Simulation based learning (SBL) activities that mimic real world environments are now transforming the clinical experience, however, research is limited and additional research is needed.

The Feasibility Of Using A Theory-Based, Online Delivery Microlearning System To Educate Nurse Practitioners About Clinical Skin Examination For Melanoma, Delaney Baker Stratton

Dissertations

The purpose was to explore the feasibility of delivering and developing an evidence-based intervention to educate PCNPs about comprehensive CSE for MM. Aim 1 was to develop three evidence-based, brief skin cancer videos with content on comprehensive CSE skills (risk assessment, head-to-toe skin examination, skin lesion assessment) that are suitable for online, theory-based delivery to PNCPs in various formats. Aim 2 was to determine enrollment and retention rates, intervention adherence, and acceptability and usability of the intervention following completion of the one-week intervention. The exploratory aim was to explore preliminary associations among information, motivation and behavior skills for CSE behavior …

You’Ve Got Mail: A Sequential Mixed Methods Linguistic Investigation Of Faculty And Advisor Email, Kevin A. Manley

Dissertations

Email is one of the most prolific forms of communication in the world. As colleges and universities move more student experiences online, faculty members and advisors need to understand how to best communicate with students. In an attempt to understand how faculty and advisors write, and, more importantly, how students read, I developed this two-phase mixed methods investigation. In Phase I, I collected nine writing samples from 19 faculty and advisor participants and dissected the samples with Pennebaker Conglomerate’s 2015 Linguistic Inquiry and Word Count (LIWC) program. In a transition phase, I leveraged Phase I data to create an instrument …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice X. Woods

Dissertations

Objective: The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method: A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician's orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

Associate And Baccalaureate Degree Nursing Students' Knowledge Of The Attitudes Toward Medication Errors And Reporting Medication Errors: Implications For Curriculum Development, Tabatha D. Teal

Dissertations

This paper evaluates senior nursing students' knowledge and attitudes of medication errors and reporting errors. This study was conducted to evaluate a need for improvements to nursing education on these two concepts. This mixed method study was conducted using a modified version of the Medication Administration Error Reporting Survey by Wakefield, Uden-Holman, and Wakefield (2005) and focus group sessions at four nursing programs in the Southern United States. Medication errors continue to be a threat to patient safety and underreporting exists due to the stigma surrounding admitting a mistake. Evaluating nursing students' knowledge and attitudes on these concepts is a …

A Quality Improvement Project: Evaluation Of Teach-Back Training On Medication Adherence In Hypertensive Older Veterans, Chelsea Hall-Mcarthur

Dissertations

Hypertension remains one of the most common yet uncontrolled chronic diseases among older adults. Medication adherence is a vital part in managing uncontrolled hypertension. The purpose of this QI project was to evaluate the effectiveness of using the teach-back method on improving anti-hypertension medication adherence of hypertensive older adult patients age 65 to 75 with at least two uncontrolled blood pressure readings during their most recent clinic visit in the past 6 months. Medication adherence was assessed using the Hill-Bone Medication Adherence Scale (HB-MAS) before and after the intervention. Health literacy scores were also recorded prior to the intervention using …

Primary Care Access And Use Among Homeless Persons, Kirsten A. Dickins

Dissertations

On a single night in the United States, more than 550,000 persons are homeless, a number that has increased in recent years. Homeless persons are disproportionately afflicted by acute and chronic communicable and non-communicable diseases, mental health disorders, and substance use disorders. These health disparities contribute to premature mortality: a marked life expectancy gap, as the average lifespan of a homeless person is 42 to 52 years, compared to 78 years among the general population. Further contributing to this gap is historic barriers to healthcare system access and use, such as lack of health insurance and resulted fragmented care receipt. …

A Quantitative Content Analysis On K-12 Public Education In The News Media: An Analysis Of Word Sentiment And Tone In Different Media From 2015 To 2020, Thomas Butler

Dissertations

The researcher used quantitative content analysis techniques and explored how the media used language, sentiment, and tone, when reporting on United States K-12 public education (USPE) in four different media types and over a five-year period. The researcher used positive and negative word frequencies on stories in four different news media: New York Times (print & online), Huffington Post (online), ABC/NBC broadcast (TV), and Time/ Newsweek magazine (magazine); across a five-year period. The researcher converted positive and negative word frequencies in each news story to an overall tone rating scale from 1 to 5 indicating an overall positive or negative …

Factors Influencing The Recruitment And Hiring Of Early Career Nurse Faculty, Katie Sladky

Dissertations

The nursing faculty and subsequent nursing shortages have plagued the profession for decades with little progress made in altering the trajectory of the problem (AACN, 2005; IOM, 2010; NLN, 2017). Primary influences on the faculty shortage include later entry into faculty roles, the aging of faculty, and early retirements, and a logical solution is to recruit nurses to faculty roles earlier in their careers. The purpose of this study was to examine factors relating to recruitment strategies and hiring practices used by administrators of undergraduate, prelicensure nursing programs for early career nursing faculty. This study contributes new knowledge about administrators' …

Music Listening: An Evidence-Based Approach To Help Manage Postoperative Pain, Tammie Ferguson

Dissertations

The current standard of practice to manage postoperative pain includes the use of opioids. The purpose of this evidence-based project was to evaluate the effectiveness of music listening as an adjuvant to traditional pain management strategies to relieve postoperative pain and to assess the dosage of opioids used to help manage postoperative pain. Kolcaba's Comfort Theory was used to guide this evidence-based project.

Nursing Staff Approaches To Providing Oral Hygiene In Stroke Survivors With Dysphagia: A Grounded Theory Study, Willard Brewer

Dissertations

The purpose of this qualitative grounded theory study was to explore how the nursing staff approaches oral hygiene in stroke survivors with dysphagia during the rehabilitation phase of recovery and what guides their decisions. Oral hygiene is a proven effective task known to prevent systemic health disparities (i.e. aspiration pneumonia, diabetes, gastrointestinal disparities, and even stroke). However, there are no current evidenced-based guidelines that provide instruction on how to execute oral hygiene to stroke survivors with dysphagia. Little is known about how nurses make decisions to implement oral hygiene in stroke survivors with dysphagia.