Digital Commons Network^™

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) …

Gender And The Authoritarian Dynamic: An Analysis Of Social Identity In The Partisanship Of White Americans, Bradley Dimariano

Dissertations

This dissertation examines the influence of authoritarianism and gender on the political behavior of white Americans. Authoritarianism and gender are two prominent variables in the formation of political preferences. Authoritarianism is regarded as a dynamic psychological disposition toward order and structure in social relations. Meanwhile, gender reflects external cultural markers attached to sex to indicate appropriate social behavior. Environmental factors like resource disparities and social conventions contribute to the production of gender. Both gender and authoritarianism have become increasingly contentious subjects in the context of contemporary partisanship. Scholars believe that each variable uniquely contributes to polarization, and have studied the …

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.

Thriving In Student Affairs Professionals: An Exploration Of Supporting Constructs, Shawn Brodie, Phillip Campbell, Gretchen Day Fricke, Kawanna Leggett, Norris Manning

Dissertations

Student affairs professionals provide vital services to college students while also facing various challenges that impact their ability to thrive at work. This study examined overall thriving, its constructs and a set of predictors that impact thriving in student affairs professionals. Seligman’s (PERMA) theory of thriving provided the conceptual foundation for this study. Understanding the constructs that support thriving for student affairs professionals will help institutional leaders and professional organizations develop work environments and strategies that promote thriving. A global pandemic occurred during the time of this research, allowing exploration of how COVID-19 impacted thriving. This study also included variables …

Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton

Dissertations

Abstract

Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.

Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …

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. …

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 …

Vocational Education: Cna Students’ Perspectives Of Soft Skills In Training And The Workplace, Kimberly S. Mcclendon-Payton

Dissertations

Purpose: The purpose of this quantitative study was to identify CNAs’ perceptions about the most important soft skills used by CNAs in training and the workplace.

Methodology: This quantitative research study identified CNAs’ perceptions of the most important soft skills they used based on the composite model for soft skills. CNAs were selected based on purposeful sampling. Likert scores were collected from the survey responses.

Findings: Examination of the quantitative data from the 35 CNAs revealed that brainstorming is the most important collaboration soft skill in CNA training and the workplace.

Conclusions: Results based on the findings of this study …

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 …

How Elementary Principals Use The Six Sources Of Influence To Achieve Extraordinary Results, Monette Perez

Dissertations

Purpose: The purpose of this phenomenological study was to identify and explore how elementary principals of organizations who have achieved extraordinary results influence employees through personal motivation, personal ability, social motivation, social ability, structural motivation, and structural ability.

Methodology: This phenomenological study identified and explored 12 Southern California public elementary school principals and how they used the 6 sources of influence with their stakeholders to achieve extraordinary results. An interview protocol aligned with the study’s theoretical framework was developed with a thematic team. The respondents were purposefully chosen from principals who have led their schools to attain National …

Primary Care Screening For Adverse Childhood Experiences (Aces) In The Adult Population, Carrie Plisco

Dissertations

Problem: Exposure to Adverse Childhood Experiences (ACEs) is associated with chronic diseases in adulthood. Several studies found over 60% of adults have had exposure to one or more ACEs. While guidelines for ACEs screening exist, most primary care practices do not perform screening at this time. This results in a lack of referrals for adults with history of ACEs for proper behavioral health (BH) intervention.

Methods: This quality improvement (QI) initiative utilized a descriptive observational design. The Centers for Disease Control and Prevention (CDC) ACEs screening tool was administered to a convenience sample of adult patients aged 18 years and …

Evaluation Of Depression, Anxiety And Stress In Graduate Nursing Students, Rachel Dunston

Dissertations

Mental health issues are growing in the United States. Postgraduate school is widely known to increase the level of psychological difficulties (Dyrbye et al., 2006) experienced by students. There is a need to address mental health care in graduate nursing students. This project was a descriptive observational comparison pre-post-intervention design used to see if online modes of delivery would aid in decreasing mental health issues for nursing graduate students. Participants were provided with access to three podcasts and encouraged to use the Sanvello mobile application provided to all students at this university. The first podcast focused on using the Sanvello …

Impact Of Social Isolation In Hiv-Positive Individuals During A Pandemic, Corina Jane Bakoylis

Dissertations

Problem: The global pandemic of COVID-19 caused concern for immunocompromised individuals. The purpose of this quality improvement initiative was to assess the impact of social isolation on feelings of loneliness, depression, and social isolation experiences in HIV-positive individuals residing in a long-term care facility.

Methods: A mixed-method convergent design with a purposeful sample of HIV-positive adult residents residing in a long-term care facility was utilized. An evaluation of loneliness using the University of California Los Angeles (UCLA) Loneliness Scale (Version 3) and depression using the Patient Health Questionnaire-8 (PHQ-8) were completed. Personal experiences were also assessed with five predetermined open-ended …

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …

Identification Of Veterans Experiencing Symptoms Of Mental Illness For The First Time After Covid-19 Diagnosis, Brittania Phillips

Dissertations

There has been a general increase in psychiatric symptoms since the COVID-19 pandemic began. Literature that has been published since the start of the pandemic has indicated there is an increased risk of depression, insomnia, altered mental status, new-onset psychosis, neurocognitive syndrome, and anxiety. The military veteran population is at higher risk for psychiatric illness than the general population, and should be screened accordingly. This quality improvement project was developed in collaboration with the mental health clinic at urban medical center in the Midwest to identify new symptoms of mental illness after COVID-19 diagnosis utilizing the PDSA model and descriptive …

Implementing A Depression Screening In A Pediatric Acute Care Setting For Adolescents With Type 1 Diabetes, Kelcie Marler

Dissertations

Problem: Depression among adolescents with Diabetes Mellitus type 1 (DM 1) is three times more prevalent than adolescents without chronic disease. Diagnosis of depression has been found to negatively affect the quality-of-care management, quality of life, and results in an increase in hospital admissions with hypoglycemia or hyperglycemia events.

Methods: A depression screening, the patient health questionnaire 9 (PHQ-9), a validated screening tool for use among adolescents was implemented in this quality improvement (QI) project. It was the first cycle of a plan-do-study-act (PDSA) cycle for in a pediatric ICU. Adolescents between the ages of 12 – 18, were …

A Standardized Approach To Awakening And Breathing Trials, Maureen Awuor Abongo

Dissertations

Abstract

Problem: Mechanical ventilation with sedation, are crucial co-therapies for the critically ill. Risks of both, known as Ventilator Associated Events( VAEs), can worsen outcomes. Performing Spontaneous Awakening Trials (SATs), with Spontaneous Breathing Trials(SBTs), is a targeted evidence-based strategy in reducing VAE rates. The Intensive Care Unit (ICU) lacked a coordinated approach to operationalizing SATs with SBTs.

Methods: An observational retrospective study involving a review of VAE and patient data for corresponding months in years before, and after an improvement strategy application, and making comparisons. The multimodal strategy includes filling out checklists outlining criteria for performing a SAT with …

Impact Of Aging Information On The Continuing Education Preferences Of Behavioral Health Clinicians, Nicholas Schmidt

Dissertations

The United States population is aging rapidly and the behavioral health workforce is ill-prepared to meet the concurrent rise in demand for services for older adults. Clinicians specializing in working with older adults make up a very small portion of providers and the majority of service provision falls on general practitioners. The discipline of counseling has emphasized multicultural competencies in training and practice but has not specified standards of competence for work with older adults; little is known about the interests and training preferences of Licensed Professional Counselors (LPCs). This study examined the impact of receiving foundational information about aging …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

Mental Health Effects Of The Covid-19 Pandemic On Older Adults, Elizabeth Kerr

Dissertations

Problem: Significant psychological effects such as anxiety, depression, stress, and loneliness are shown to affect the older adult population, aged 65 years and older. The social isolation and disconnectedness related to the COVID-19 pandemic potentially worsens anxious and depressive feelings, increasing the risk for adverse outcomes in the high-risk older adult population. This project aimed to identify older adults at risk for acute, situational mental health issues associated with the pandemic.

Methods: A descriptive study design was used. Telephone interviews were conducted to explore effects of the COVID-19 pandemic on mental health responses in older adults. A convenience sample …

Youth Sports In A Pandemic Age, Robert Bohnert

Dissertations

Abstract

Problem: Youth sporting events is a public health concern as infected youth with coronavirus disease 2019 may unknowingly spread the virus, as many show little to no symptoms (Zimmerman & Nigel, 2020). This project aimed to identify level of adherence to posted Youth Sports Guidelines, which were designed to mitigate the spread of virus at youth sporting events.

Methods: An observational descriptive design was utilized. Two observers tallied guideline violations by participants and spectators at six high-contact (basketball) and six low-contact (swimming) public high school youth sporting events.

Results: A total of 726 youth sport participants and 139 …

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 …

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 …

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.