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Reinventing The Medical Request Process In A Correctional Healthcare Setting, Leah Murphy

Master's Projects and Capstones

This project was developed as part of a Clinical Nurse Leader course of study with the goal of gathering and evaluating microsystem data, and the creation and implementation of a process improvement project. The project was conducted in a correctional setting which houses male and female detainees with a wide variety of medical needs. The project addressed long wait times for detainees who have submitted a request for services from the medical department. The goal of this project was to reduce wait times for medical requests, and provide service for a greater number of patients. This project is needed because …

Life Balance In Nurse Educators: A Mixed Methods Study, Joan Marie Owens

Dissertations

No abstract provided.

The Effects Of 12 Weeks Of Instructor-Led Yoga Classes On Balance In Older Adults, Patricia C. Hart

Evidence-Based Practice Project Reports

Participation in a regular exercise program is an effective way to reduce and/or prevent a number of functional declines associated with aging (Chodzko-Zajo et al., 2009). Older adults are advised to participate in regular aerobic activity and practice muscle strengthening activities and exercise that maintains or improves balance (U.S. Department of Health and Human Service, [USDHHS], 2012). Less than one third of older adults engage in 30 minutes of low to moderate intense physical activity at least five days a week as recommended in current guidelines (USDHHS, 2012), and these guidelines fail to address losses in strength and flexibility seen …

Automated Medication Dispensing Cabinet And Medication Errors, Marie Helen Walsh

Walden Dissertations and Doctoral Studies

The number of deaths due to medical errors in hospitals ranges from 44,000 to 98,000 yearly. More than 7,000 of these deaths have taken place due to medication errors. This project evaluated the implementation of an automated medication dispensing cabinet or PYXIS machine in a 25-bed upper Midwestern critical access hospital. Lewin's stage theory of organizational change and Roger's diffusion of innovations theory supported the project. Nursing staff members were asked to complete an anonymous, qualitative survey approximately 1 month after the implementation of the PYXIS and again 1 year later. Questions were focused on the device and its use …

The Effects Of A Concept-Based Curriculum On Nursing Students' Nclex-Rn Exam Scores, Patricia Allen Edwards

Walden Dissertations and Doctoral Studies

The Institute of Medicine and the National League of Nursing have called for curricular reform that promotes high first-time pass rates on the National Counsel of Licensure Examination for Registered Nurses (NCLEX-RN). A campus in the southeastern region of the United States implemented a concept-based curriculum; however, the effect on the first-time NCLEX-RN pass rates was unknown. The purpose of this comparative study was to determine if the concept-based curriculum improved student scores on the NCLEX-RN. Dreyfus' model of learning guided this study because of the andragogy tenets, which in turn supported the concept-based curricula. The research questions examined the …

Is There An Economic Case For Investing In Nursing Care – What Does The Literature Tell Us?, Diane E. Twigg, Helen Myers, Christine Duffield, Margaret Giles, Gemma Evans

Research outputs 2014 to 2021

Aim

To determine the cost effectiveness of increasing nurse staffing or changing the nursing skill mix in adult medical and/or surgical patients?

Background

Research has demonstrated that nurse staffing levels and skill mix are associated with patient outcomes in acute care settings. If increased nurse staffing levels or richer skill mix can be shown to be cost-effective hospitals may be more likely to consider these aspects when making staffing decisions.

Design

A systematic review of the literature on economic evaluations of nurse staffing and patient outcomes was conducted to see whether there is consensus that increasing nursing hours/skill mix is …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

Influence Of A Palliative Care Protocol On Nurses' Perceived Barriers To Palliative Care And Moral Distress, Christina Cavinder

Evidence-Based Practice Project Reports

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported …

The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

The Effects Of Education On Cardiovascular Disease Knowledge, Lauren A. Ostrowski-Winkler

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for adults in the United States. The three main risk factors for the development of CVD include hypertension, high cholesterol, and tobacco use; these factors are largely prevented or reduced through lifestyle modifications. Researchers indicate that knowledge of CVD mortality has been linked with individual action to reduce one’s CVD risk. Researchers have also indicated that segments of our underserved society, particularly those with the highest CVD mortality rates, are also the least knowledgeable about CVD and their own personal risk. These risk factors were a concern within the …

An Evidence Based Web Intervention To Facilitate Nurse Practitioner Participation In The Policy Making Process Related To Scope Of Practice, Toni Dichiacchio

Graduate Theses, Dissertations, and Problem Reports (ETD)

Historically nurses have been strongly engaged in the political process, however in recent decades the profession has moved away from the policy arena. Without political engagement, issues that are important to the nursing profession are not addressed timely, if at all. One such issue is that of full practice authority for advanced practice registered nurses (APRNs). Well over 100 studies have been completed over the past 40 years showing the safe and quality care APRNs provide independently. Numerous well-respected, non-nursing organizations support the removal of state laws that impede the ability of APRNs to practice to the full extent of …

Partnership Functioning And Sustainability In Nursing Academic Partnerships: The Mediating Role Of Partnership Synergy, Chris-Tenna Marie Perkins

Dissertations

The United States is presently challenged with numerous high profile issues in health care. The nursing profession is composed of the greatest number of healthcare providers in the system and has the opportunity to effect extensive change. Creating and sustaining academic practice partnerships is a method to meet these profound challenges more efficiently; however, nursing partnerships have not been studied. The purpose of this cross-sectional, descriptive research study is to enhance knowledge about the process by which nursing academic practice partnerships (APP) generate partnership synergy and sustainability. The research sample included participants that are involved in established nursing APP in …

Factors That Relate To Registered Nurses' Readiness For Interprofessional Learning In The Context Of Continuing Professional Development, Collette Williams

Dissertations

Today’s health-care professionals practice in a highly technological, multidisciplinary environment. In order to provide safe, effective, and high-quality patient care, collaboration is required among all professionals. Traditionally each profession has operated independently in regard to continued professional development. The purpose of this study was to assess practicing registered nurses’ readiness toward interprofessional learning in order to align learning with current practice.

Method. An ex post facto study design was used to gather data to examine if there is a relationship between variables of demographics and readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) assesses the readiness for …

The Development Of A Comprehensive Adhd Program For Elementary School Educators, Angie Lee Echoles

Doctoral Projects

On average, teachers will teach at least one student with Attention Deficit Hyperactivity Disorder (ADHD) in any given school year without receiving any instructions at all on ADHD. ADHD affects 3% to 7% of school-age students and one in every twenty children (Centers for Disease Control and Prevention (CDC), 2010). It is classified as one of the most common mental health disorders affecting school-age students. The American Psychiatric Association (APA, 2013) defines ADHD as a hereditary, non-curable, common childhood disorder. A triad of symptoms is associated with this disorder: inattention, hyperactivity, and impulsivity, which all have a major impact on …

Introducing A New Cadre Into Uganda’S Health Care System: Lessons Learnt From The Implementation Process, Gerald M. Amandu, Leana R. Uys, Joseph Mwizerwa, Alex Erejo, Irene A. Cheruto, Margaret Chota

School of Nursing & Midwifery, East Africa

Uganda introduced Registered Comprehensive Nursing (RCN) and Enrolled Comprehensive Nursing (ECN) training programs in 1994 and 2003 respectively, to create certificate and diploma level cadre of nurses with competencies in general nursing, midwifery, public health, psychiatry, paediatrics and management. This paper is based on an evaluation study undertaken to assess how the programs were implemented including stakeholders’ perceptions about the graduates. Despite being relevant, the implementation process of both programs failed to meet acceptable standards. We conclude that introducing a new cadre of nurses without proper preparation hinders realization of their full potential including their contribution to the healthcare system.

An Educational Approach: Increasing College Freshmen's Knowledge Regarding Sexually Transmitted Infections, Jennie Mcclain

Evidence-Based Practice Project Reports

According to the Centers for Disease Control (2009), young adults account for only 25% o fsexually active persons in the United States, but account for 50% of the newly diagnosed cases of sexually transmitted infections (STIs). Some young adults may not have received appropriate or credible information on sexual health by which to make knowledgeable decisions that may influence the rest of their lives. High schools are not required to offer comprehensive sex education. Therefore, some students may have received abstinence-only sex education. Risk reduction and disease prevention are important in college health. This evidenced-based practice project included the creation, …

The Effects Of A Violence Assessment Checklist On The Incidence Of Violence For Emergency Department Nurses, Sarah Knapp

Evidence-Based Practice Project Reports

Workplace violence (WV) is commonplace in American culture, and nurses working in emergency departments (ED) are not immune to its effects. Violence against emergency department nurses is prominent in current nursing literature, and a cause for major concern. Regrettably there is no consistent tool being used to assess for potential patient violence specific to the emergency department. Current assessment tools have been developed and are commonly used in the mental health arena. This evidence-based practice project concentrated on answering the clinical question of whether or not a violence risk assessment checklist reduced the incidence of violence and increased perception of …

What Can We Learn From The Existing Evidence Of The Business Case For Investments In Nursing Care: Importance Of Content, Context, And Policy Environment, Olga Yakusheva, Douglas Wholey, Kevin D. Frick

Economics Faculty Research and Publications

Decisions of health care institutions to invest in nursing care are often guided by mixed and conflicting evidence of effects of the investments on organizational function and sustainability. This paper uses new evidence generated through Interdisciplinary Nursing Quality Research Initiative (INQRI)-funded research and published in peer-reviewed journals, to illustrate where the business case for nursing investments stands and to discuss factors that may limit the existing evidence and its transferability into clinical practice. We conclude that there are 3 limiting factors: (1) the existing business case for nursing investments is likely understated due to the inability of most studies to …

Examining Generational Differences Across Organizational Factors That Relate To Turnover, Kimberly Asuncion

All Graduate Theses, Dissertations, and Other Capstone Projects

Turnover continues to pose a problem for all organizations across industries. This study examines the complex nature of turnover, by examining the relationship of turnover intentions with perceptions of distributive justice, procedural justice, growth opportunities, and recognition across age groups. Age groups will be used as a proxy for generational cohort membership. Results of the study confirm previous research that generational differences do exist; however, those differences are fairly small. Perceptions of distributive justice, procedural justice, growth opportunities, and recognition were found to be significant predictors of turnover intentions regardless of the age group.

The Role Of Internal Communication And The Effect On Employee Engagement, Cherie Gaither

Graduate Theses, Dissertations, and Capstones

The purpose of this project was to build and evaluate internal communication interventions that would enhance employee engagement. The desired outcome of the communication team’s efforts was to show a significant increase in employee engagement, as compared to peer institutions.

Implementation Of Shared Governance, Sheryl Glasscock

Graduate Theses, Dissertations, and Capstones

Implementation of shared governance in any facility presents challenges for leadership as well as the nursing staff. The implementation of shared governance for this organization yielded positive results operationally, and for the development of nursing overall.

Parents Living Within The Paradoxes Of Infant Death From Life-Limiting Anomaly: A Grounded Theory Study, Susan Bush Welch

Graduate Theses, Dissertations, and Problem Reports (ETD)

BACKGROUND: Life-limiting congenital anomalies are the leading cause of death of infants in the United States. Most of these infants die in intensive care units with limited access to adequate palliative/end-of-life care. There is an extensive knowledge gap about the experience of the parent of infants who died from life-limiting anomaly. PURPOSE: The aims of the study was to explore the process a parent goes through as they experience the birth, life and ultimate death of an infant from a life-limiting explore the process a parent goes through as they experience the birth, life and ultimate death of an infant …

The Effect Of Heart Failure Education On Intermediate Care Unit Nursing Staff's Knowledge Of Heart Failure, Self-Care, And Best Practice Guidelines, Carol Budgin

Evidence-Based Practice Project Reports

Heart failure (HF) is a chronic disease affecting nearly six million people in the United States with an annual cost of nearly 33 billion dollars. If nurses are inadequately prepared to care for and/or educate patients with HF, evidence-based (EB) nursing care will be suboptimal and hospital readmission rates with the subsequent increased costs for care will continue to soar. To address their higher-than-national average HF readmission rates, an EB nursing project was implemented at a local, urban community hospital to assess intermediate care unit (IMCU) nursing staff’s knowledge of HF, selfcare, and best practice guidelines. The Rossworm & Larrabee …

Moving Toward Culture Change: Defining Skilled Nursing Facility Residents Dining Style Preferences, Katheryn Adams

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

Background Public policy fulfillment coupled with skilled nursing facility's desire to increase quality of service to meet changes in residents' expectations and improve marketability warrant a new look at culture change and home like dining as defined by the residents in skilled nursing facilities.

Objective The objectives of this study were to determine residents' home dining practices, define residents' desired dining style practices in the skilled nursing facility and determine the relationship between at home dining and dining preferences in skilled nursing facilities.

Design The quasi-experimental study started with a convenience sample taken from a facility generated potential participant list. …

Nurse Manager Transformational Leadership Practices And Patient Outcomes Among Magnet And Non-Magnet Hospitals, Bridgett Byrd Sellars Phd, Msn, Ma, Rn

Dissertations

In 2004 the Institute Of Medicine called for healthcare leaders to embrace and adopt transformational leadership practices to promote quality of care and favorable patient outcomes. Nurse managers are accountable for 24-hour operations of their departments and influence patient outcomes. The purpose of this research was to examine the relationships among nurse manager transformational leadership practices, patient outcomes and hospital types (Magnet, On The Journey, and Non-Magnet). A correlational study examined relationships between self-reported transformational leadership practices of nurse managers and patient outcomes by hospital types. The study was conducted using a purposive sample of Association of California Nurse Leader …

Tobacco Treatment In College Health, Joanne Brown

DNP Projects

ABSTRACT: Tobacco Treatment in College Health

The college years are a critical time in the development of smoking behavior and tobacco use. Smoking is linked to 30% of cancer deaths, 80% of deaths from chronic obstructive pulmonary disease and early cardiovascular disease and death. Effective treatment interventions at this time provide an opportunity to drastically reduce premature morbidity and mortality.

This document follows the progression from the discussion of the problem to evaluation of an intervention. The first manuscript is a review of existing literature on Internet interventions with young adults, including methodology, theoretical frameworks and outcome measures for tobacco …

Interventions To Improve The Management Of Medically Uninsured Adult Patients With Type 2 Diabetes Mellitus In Primary Care, Community-Based Settings, Lynn Miskovich

Evidence-Based Practice Project Reports

This project measured the effect of a clinical algorithm on the provision of care to medically uninsured adult patients with type 2 diabetes and a low socioeconomic status (SES). Primary providers often fail to implement established standards for diabetes care to their maximal benefit and do not achieve American Diabetes Association (ADA) treatment standards. Saydah, et al. (2004) reported that only 48% of patients with diabetes achieved the recommended HbA1c goal, and 33% reached blood pressure and LDL targets. Goals for all three clinical parameters were obtained by only 7% of patients. The Stetler Model of Evidence-based Practice (EBP) provided …

Evaluation Of A Protocol Change To Improve Screening Of Mineral Bone Disorders In Patients With Stage 3 Chronic Kidney Disease, Jarena Kelly

Graduate Theses, Dissertations, and Problem Reports (ETD)

Chronic kidney disease (CKD) is a growing worldwide problem. Patients with CKD are at great risk for multiple health problems and ultimately face end stage renal disease (ESRD). One of the problems of concern is the loss of bone mass, termed mineral bone disorders (MBD). The literature reveals that bone mass loss can begin as early as stage 3 CKD. The National Kidney Foundation (NKF) Clinical Practice Guideline (2003), and The Kidney Disease: Improving Global Outcomes (KDIGO, 2009) recommend that persons identified in stage 3 CKD be screened for hypovitamintosis D, elevated intact parathyroid (iPTH) levels, and abnormal calcium and …

How To Organizationally Embed The Magnet Culture, Rachel Behrendt, Dnp, Rn, Acons, Donna Molyneaux Phd, Rn

College of Nursing Faculty Papers & Presentations

PowerPoint presentation given at 2010 National Magnet Conference in Phoenix Arizona.

The Role Of Higher Education In Advancing Nurse Practitioners: A Look At The Institutional Decision Calculus Of A Health Sciences University, Debra Jo Johnson Phd

Dissertations

In 2004, professional nursing joined the ranks of other health professions by altering accreditation standards for nurse practitioners, which now mandate that their terminal degree advance beyond the master's degree currently required for the doctor of nursing practice (DNP). This research examines the decision-making process involved in implementing a web-based DNP program in 2008 at a college of graduate nursing embedded in a health sciences university. Findings from two case studies, one of faculty and one of administrators, provide a narrative description of the institution, the decision process, and then describe how institutional and external factors influenced the process. Institutional …