Digital Commons Network^™

Preceptor Effectiveness As A Mediator Of Relationship Between Psychological Empowerment And Newly Registered Nurses' Intent To Stay, Deborah Taffe

Dissertations

The nursing profession is currently experiencing a nursing shortage that is projected to worsen. One in five newly licensed registered nurses (NLRNs) leaves the profession within the second year of practice (National Healthcare Retention and RN Staffing Report, 2018). Work empowerment has been shown to decrease turnover rates among nurses: However, the factors that mediate this concept have not been fully explored.

The purpose of this study was to investigate nurses' perceived preceptor effectiveness as a mediator of the relationship between psychological empowerment during the transition from an academic environment into practice and intent to stay in practice for NLRNs …

A Model To Facilitate Transformative Learning In Learner Nurses At Nursing Education Institutions, Tebogo A. Tsimane

Dissertations

Transformative learning is a learner-centered process of learning that actively engages learners in self-examination and critical reflection on assumptions and results in the development of competence and self-confidence in new roles and relationships that bring about change in specific environments, rather than rote learners who are inherently deficient, lacking change attributes such as clinical reasoning and judgment.

The purpose of the study is to describe and evaluate a model with guidelines to facilitate transformative learning in nursing education institutions. A qualitative, exploratory, descriptive and contextual research design for theory generation was used. The study was conducted in four phases. Phase …

Night Shift Nurses' Perceptions On Fatigue Management Approaches: A Qualitative Case Study, Consuelo Nelson

Dissertations

The purpose of this study is to identify and understand the effects of working night shift to acquire insight into environmental, formative, and institutional constituents that may influence the development and utility of fatigue risk management approaches for nurses in acute care hospitals.

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena W. Jones

Dissertations

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …

Exploration Of Gratitude In Cardiovascular Health: Mediators, Medication Adherence And Psychometrics, Lakeshia A. Cousin

Dissertations

The purpose of this dissertation was to explore the effect of gratitude on cardiovascular health outcomes using mediators, medication adherence, and psychometrics. The specific aims were to (1) establish the state of the science for gratitude and cardiovascular health outcomes via a state-of-the-science literature review, (2) explore mediators affecting gratitude and medication adherence using a structural equation model in patients with cardiovascular disease, and (3) analyze the psychometric properties of the Gratitude Questionnaire-6, a self-report questionnaire designed to assess individual differences to express dispositional gratitude, to provide evidence for the validity and reliability of the instrument in African Americans at …

Bedside Nurses' Perceptions Of Pursuing An Academic Career As Nursing Faculty, Suzanne L. Benfield

Dissertations

There is a nursing faculty shortage at a Mid-Atlantic associate degree nursing program. In response, program administrators have hired adjunct faculty with bachelor of science in nursing degrees (BSNs), hired full-time faculty with master of science in nursing degrees in areas other than education who also are not certified nurse educators, and reduced its minimum requirement for nursing faculty clinical experience. The nursing faculty shortage combined with the resulting gaps in practice are problematic because they may (a) negatively influence the program's ability to produce degreed nurses; (b) increase faculty workload; (c) decrease the quality of student education, which may …

International Students’ Perceived Support And Barriers Adapting To The New Cultural Experience In A Southern California University, Jeanette Ayala

Dissertations

Purpose: The purpose of this phenomenology study was to explore the lived experiences of international students’ perceptions regarding the types of support they received to adapt to a new culture experience and barriers to their successful adaptation to a new cultural experience while enrolled in a southern California university.

Methodology:

Qualitative research was the methodology used for this study because it was the approach best suited to gain a better understanding of the phenomena of international students’ lived experiences. The present study involved a qualitative design with a phenomenological inquiry approach. The technique of using semi-structured interviews is a method …

Relationship Between Aprn State Practice Authority Perceived Autonomy, Professionalism, And Interprofessional Team Function Among A National Sample Of Aprns In The U.S., Patricia R. Gilman

Dissertations

Healthcare that includes high performing interprofessional clinical teams (IPTs) is one recommended strategy to provide optimal quality and cost-effective care delivery. Highly functional IPTs are characterized by effective communication, trust, respect, collaboration, information-sharing, and conflict resolution and are more efficient than individual providers working alone. Internally, IPT members' relationships and understanding of both one's own professional identity and others' role and responsibilities are crucial to team functionality and effectiveness. Externally, factors including regulatory practice environments might influence the effectiveness and performance of both individual team members and the team overall. Inconsistencies between states' practice authority (SPA) for advanced practice nurses …

The Impact Of Technology Centered Instruction And Implementation Measures On Student Performance, Daniel Kania

Dissertations

This study was conducted to compare the impact of technology-centered instructional methods on student performance in literacy to the impact of non-digital instructional practices. Additionally, this research was designed to identify specific program implementation measures used during the implementation of the prevailing instructional method and identify what link existed between these measures and the performance of students. The researcher examined quantitative and qualitative data obtained from both public data sources and from a survey administered to teachers in eight school districts in Missouri. The participants responded to questions that provided the researcher with quantitative and qualitative data to be used …

Effects Of Neuraxial Anesthesia On Readiness For Ambulation Following Total Knee Arthroplasty, James Thomas Papesca

Dissertations

Total knee arthroplasty (TKA) is the most commonly performed inpatient surgical procedure within the USA and is estimated to reach 3.48 million procedures annually by 2030. An aging population with multiple health conditions coupled with value-based care initiatives focusing on the trend toward outpatient care and patient satisfaction, has prompted healthcare providers to develop and implement an anesthetic approach to enhance TKA outcomes. The American Association of Hip and Knee Surgeons acknowledges the movement toward outpatient TKAs emphasizing minimal complications and maximizing patient safety. A review of current literature identifies causative factors delaying hospital discharge following TKA ranging from postoperative …

Decreasing Pre-Procedure Anxiety In School-Aged Patients In An Outpatient Surgery Setting Using A Video Prior To Anesthesia Induction, Michelle Charette

Dissertations

Anxiety occurs when a human feels a threat in response to a situation. Having surgery can heighten this psychological reaction, especially in pediatric patients undergoing anesthesia. Many children fear anesthesia for they do not understand what is expected of them nor what to expect when entering an operating room. When anxiety and fear are elevated, it can lead to behavioral changes, increases in postoperative pain, delays in wound healing, and postponement of discharge. Eliminating or reducing anxiety can result in positive outcomes for patients with pain, healing, and discharge. Literature supports the use of an educational video to aid in …

A Web-Based Learning Adaption Of The Ending Self-Stigma (Ess) Program, Shari Harding

Dissertations

The purpose of this practice project (SPP) was to implement and evaluate a web-based learning adaptation of the Ending Self Stigma (ESS) curriculum, a group-based program to reduce mental illness self-stigma. The literature currently supports group-based, psychoeducational, face-to-face interventions for self-stigma. This project adapted current evidence-based content to the web-based learning modality as an individual, technology-based, intervention. The intervention was evaluated using a mixed methods approach with a pre- and post-test design among adults receiving outpatient mental health services. The dependent variables of interest in this project were the self-stigma of mental illness and recovery orientation. This study found that …

The Effectiveness Of Preoperative Preparation Program In Decreasing Parental Preoperative Anxiety, Thao L. Tran

Dissertations

This project aimed to examine the effectiveness of a preoperative preparation program (PPP) in decreasing parental anxiety. When children needed anesthesia to get outpatient procedures completed, the accompanying parents received verbal education about the process on the day of the procedure and were assisted by a support person during and after the child's induction anesthesia. Parental anxiety was measured using the State-Trait Anxiety Inventory (STAI) tool before preoperative preparation and after the induction of anesthesia to assess whether the PPP improved parents' anxiety levels. The parents' decreased anxiety score in post-intervention would suggest that the PPP can be effectively and …

Toward Enhancement Of Clinical Judgment And Critical Thinking Simulation In The Classroom, Roxie L. Barnes

Dissertations

Health-care systems are changing, thus changing the expectations and requirements for nursing students entering the profession (Kaddoura, 2011). Nursing education must address the changes and focus on the development of critical thinking and clinical reasoning. When students are unable to apply clinical reasoning or clinical judgment into practice, there is an increase in potential for negative patient outcomes (Jones, Passos-Neto, & Braghiroli, 2015). Case-based learning (CBL) and simulation-based learning (SBL) are both active learning methods that can enhance development of critical thinking, clinical reasoning, and clinical judgment (Forneris et al., 2015). The purpose is to compare the use of CBL …

Oral Medication Adherence, Attitude, And Quality Of Life In Older Adults With Cancer: The Impact Of Motivational Interviewing, Janelle Tipton

Dissertations

Oral medication adherence in the older adult with cancer, age 65 years and older, is a significant clinical problem. Adherence rates are estimated at only 50%, which can lead to suboptimal treatment efficacy, poor symptom control, and reduced survival. Patient attitudes and beliefs can improve oral medication adherence and quality of life, while reducing unnecessary emergency room visits, and hospitalizations. Motivational interviewing (MI) is a communication intervention that has been shown to improve oral medication adherence in persons with chronic illness, including cancer. The purpose of this evidence-based practice (EBP) project was to explore the influence of MI on adherence …

The Student Voice: Experiences Of First-Generation, Adult, Latino Male Tutees Learning Within A Peer Tutoring Environment, Shawn M. Carney

Dissertations

Purpose: The purpose of this qualitative, single-site case study was to identify and describe the lived experiences of first-generation, adult, Latino male tutees utilizing peer tutoring services within the Solano Community College (SCC) learning assistance center (LAC), concerning readiness, challenge, support, and balance as they applied to motivation to learn and personal academic growth.

Methodology: Fifteen participants were selected through a purposeful sampling process, and data were collected and analyzed through semi-structured, open-ended interviews to develop common themes with tabulated results presented via frequency tables.

Findings: First-generation, Latino, male tutees (1) sought tutors who were confident in the subject matter, …

The Marginalization Of Social Studies In Missouri: An Analysis Of Elementary Instructional Time And High School Standardized Assessment Scores, Stephanie Lovette

Dissertations

Social studies education plays a vital role in an evolving American society. Through social studies, students are equipped with skills to become active and informed citizens in a democracy (National Council for Social Studies, 2017a). With the implementation of the No Child Left (NCLB) Act in 2001, educational reforms have increasingly emphasized student performance in mathematics, communication arts, and science (Libresco, 2015). As a result, instructional time has been drastically shifted to these subjects (Heafner & Fitchett, 2015). This mixed-methods study was conducted to explore the impact of NCLB and subsequent federal education policies on the marginalization of social studies …

Perceptions Of Associate Degree Nursing Students Regarding The Effects Of Pervious Work Experiences On Their Academic Progress, Latifah Davis

Dissertations

The purpose of this basic qualitative study was to explore how ADN nursing students eligible to graduate, with prior or concurrent healthcare work experience, describe their academic experiences and progress in an associate nursing degree program. The theoretical framework was Kolb's (1984) experiential learning theory and Knowles's (1980) adult learning theory. ADN students from three community colleges in the South Atlantic region of the United States were asked ten questions via face-to-face and telephone interviews. Three themes arose from the data analysis, valued work experience, financial obligations, and faculty support. All students verbalized that future nursing students should have some …

Relationship Between Perceptions Of Home Discharge Readiness And Parental Health Literacy (Phl) Of Nicu Parents Of Black Preterm Infants, Mia K. Waldron

Dissertations

The United States (U.S.) ranks last among western nations in overall infant mortality rates and ranks second highest in rates of preterm birth among the same nation group (MacDorman, Matthews, Mohangoo & Zeitlin, 2014). The U.S. infant mortality data show that Black infants have the highest incidence among all groups (Ely, Driscoll & Matthews, 2018; Murphy, Xu, Kochanek & Arias, 2018). Infants born prematurely are among those at highest risk for infant death with Black women delivering premature infants at rates higher than all other U.S. groups (Ely, Driscoll & Matthews, 2018; Murphy, Xu, Kochanek & Arias, 2018; Xu, Murphy, …

Minority Nurse Representation In Upper Level Management, Keisha Chaffee

Dissertations

The advancement of minority nurses to executive and leadership positions, due to their firsthand knowledge to cultural health and lifestyle practices, could assist in ensuring a higher quality of care for an increasing minority population. The purpose of this study was to examine the perceived barriers to minority nurse representation in upper level management. Thematic areas were developed in the research questions to aid in understanding the perceived barriers. Research questions followed concepts derived from the conceptual framework established for this research. To adequately understand these barriers, a qualitative methodology with a purposive and snowball sampling approach was used to …

The Impact Of Breathing Retraining Education On Adults With Asthma For Improving Quality Of Life, Symptom Control And Reducing Short-Acting Beta-Agonist Inhaler Use In A Primary Care Setting, Danny Barazi

Dissertations

Quality of life related to asthma is negatively impacted when asthma is uncontrolled, which is characterized by frequent symptoms and rescue inhaler use which lead to limitations in normal daily activities. The goals of asthma therapy include infrequent use of short-acting beta-agonist (SABA, rescue) inhalers, prevention of acute and chronic symptoms while maintaining normal activity levels. While these goals of therapy employ infrequent use of SABA inhalers as the primary metric of effective asthma symptom management, measuring quality of life is also recommended as an important outcome of therapy and an approach to promote self-management in patients with asthma. One …

The Effectiveness Of Nurse-Led Diabetes Self-Management Education Among Adults With Uncontrolled Type 2 Diabetes Mellitus, Consolata G. Oronsaye

Dissertations

Ample evidence has supported the efficacy of diabetes self-management education (DSME) in diabetes care. However, specific evidence that supports the effects of nurse-led DSME on glycemic control and prevention of diabetes complications remains limited. The purpose of this quantitative, quasi-experimental project was to determine if any, and to what extent a relationship existed between a nurse-led DSME intervention and the lowering of FBS levels to 100mg/dl or below, and the reports of improved self-efficacy among patients with poorly controlled T2DM at a primary care clinic located in an underserved community in Northwest, Texas. Theoretical support for the project was drawn …

Communication Technology Within Community Colleges, Nicole Dunne

Dissertations

Purpose: The purpose of this mixed methods study was to explore and describe the communication technologies that community college students perceive are effective ways to receive information from their college. A secondary purpose was to explore and describe communication technology channels students perceive would be effective ways to receive information from their college that are not being used.

Methodology: This mixed methods research design used quantitative and qualitative data to inform the research questions in relation to community college students’ perception of communication technology effectiveness. The study was a sequential mixed methods study; the quantitative survey results helped to inform …

Contributing Factors To Diaper Dermatitis In The Nicu, Media S. Esser

Dissertations

Purpose: Describe the prevalence of diaper dermatitis (DD) and clinical characteristics of the infants in the Neonatal Intensive Care Unit (NICU) that develop DD. Explore the relationships between clinical characteristics and the development of DD.

Design: Retrospective, exploratory, descriptive study

Setting: Level IV NICU in an urban community in Southeast Wisconsin.

Participants: A convenience sample of 611 infants who were born and admitted to the NICU within 12 hours of life and discharged from the same NICU. A final total of 537 infants remained after exclusion criteria were met.

Methods: Data were collected from the participant's electronic health records from …

Perinatal Experiences Of Childbearing Women With Physical Disabilities, Serah M. Nthenge

Dissertations

Purpose: The aim of this secondary qualitative analysis was two-fold: to explore perinatal experiences of 22 women with physical disabilities guided by the perinatal health framework of women with physical disabilities and; construct two perinatal life stories of childbearing women with physical disabilities.

Method: The study participants were 22 women with physical disabilities who, at the time of pregnancy, used a mobility device, and had given birth within the last 10 years. The principal investigator of the primary study interviewed all the participants.

Findings: Nine themes were identified in our study. All the participants reported both a lack of disability-specific …

Community College Esl And English Composition Faculty Collaboration, Lynn Hovde

Dissertations

Purpose. The purpose of this study was to examine the collaboration between ESL and English composition instructors at the community college level using the Kolb and Gray (2005) collaboration leadership model in the areas of common mission, collective responsibility, necessary resources, respective and supportive climate, awareness of group process, creativity, and capacity to deal with conflict. A secondary purpose was to explore barriers to collaboration and describe what strategies and practices could improve collaboration.

Methodology. An explanatory sequential mixed method study was chosen because it offered a multifaceted and in-depth view of current practice, which allowed for a …

Assessment Technologies Institute Test Results And Blended Experiences For Senior Community Health Nursing Students, Linda Lacomb-Williams

Dissertations

The purpose of the study was to examine the relationship between senior community health nursing students' ATI test scores and their clinical community health nursing experiences, either in-country or out-of-country. The ATI test results are a reliable predictor of whether the student will pass their nursing board exams (NCLEX-RN). The study also examined whether the two groups of students reported any similarities and differences in their sense of confidence or transcultural self-efficacy and conceptual knowledge and their clinical experiences.

ATI test scores were reviewed for the two groups. Focus groups were held to discuss any similarities or differences in the …

Cultural Practices, Knowledge, And Beliefs Of Newborn Care And Health-Seeking In Rural Zambia, Julie M. Buser

Dissertations

Decreasing newborn morbidity and mortality remains a serious global health challenge. For this reason, interventions like maternity waiting homes (MWHs) and the Saving Mothers, Giving Life (SMGL) initiative may improve maternal-newborn newborn health and delivery outcomes. The overarching goal of this dissertation was to explore and describe the cultural practices, knowledge, and beliefs of essential newborn care and health-seeking in the context of MWHs and the SMGL initiative in rural Zambia. Guided by the Ecological Systems Theory, this goal was met through three studies with the following aims: (1) Describe knowledge and beliefs of newborn care and illness from the …

Guided Reflective Writing And Student Clinical Judgment Development: A Descriptive Study Of Nursing Student And Faculty Perspectives, Tanya L. Smith

Dissertations

Literature supports guided reflection and clinical judgment development as key components to enhancing students' knowledge and preparation for complex nursing care. Faculty are challenged to prepare new nurses to enter the complex health care arena and often note problems in helping students transition classroom learning to clinical application. The National Council of State Boards of Nursing (NCSBN) recognizes and supports teaching clinical judgment in nursing curricula to better prepare nursing students for professional practice (2018).

The Use Of Flexible Seating In The Elementary Classroom, Pamela Erin Swofford

Dissertations

The purpose of this study was to examine the use of flexible seating in southwest Missouri classrooms. Four research questions guided the study based on the conceptual framework of Eric Jensen. The work of Jensen (2005) was selected as the conceptual framework due to his focus on the use of movement and how it impacts the brain. The research population consisted of 119 school districts from 25 counties in southwest Missouri. Participants in the study included elementary principals and classroom teachers in the first through fourth grades. Of the participants, 107 teachers completed a survey specific to the use of …