Medicine and Health Sciences Commons^™

Wright's Competency Model And Quality And Safety Competencies, Staci Shanks

Walden Dissertations and Doctoral Studies

Competent nurses are instrumental in assuring that a patient receives safe patient care of the highest quality. Patient care that lacks quality places patients at risk of poor health outcomes and results in negative financial impacts for the organization. The purpose of this staff education project was to develop nurse competency education for a facility's competency program, which merged the Wright competency model with quality and safety education for nurses' competencies. The nurse competency staff education program was evaluated by the organization's stakeholders for inclusion in the competency program. The whole-part-whole model, Knowles's adult learning theory, and Lewin's change theory …

Promoting Nurses Management Of Night Shift Sleepiness, Sunday Iken Okundolor

Walden Dissertations and Doctoral Studies

Nurses are largely unaware of the problems of night-shift-nurse sleepiness and available strategies to manage night-shift sleepiness. The purpose of this project was to examine nurses' self-perception, awareness of sleepiness, and current strategies to manage this problem in the emergency medicine department of a major academic hospital in the western United States. The validated de-identified Karolinska Sleepiness Scale (KSS) was used to measure the prevalence and intensity of night shift nurses' sleepiness prior to the development of an educational program on strategies to manage sleepiness. Of the 164 registered nurses surveyed, 72 (43.9%) reported sleepiness greater than 7 on the …

Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson

Walden Dissertations and Doctoral Studies

Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also …

Counselors' Knowledge And Attitudes Of The Recovery Paradigm, Kathleen Ruscitto

Walden Dissertations and Doctoral Studies

As of 2014, an estimated 18.1% or approximately 43.6 million adults, 18 years of age or older in the United States experienced a form of mental illness. Professional counselors subscribe to a wellness or holistic paradigm; however the recovery paradigm, using collaborative strategies and unique treatment planning is the directed approach of mental health services in the United Stated. The purpose of this quantitative study was to understand what factors contribute to counselors' knowledge and attitudes of the recovery paradigm. Survey methodology was used to examine whether, among professional counselors, years of experience, gender, professional setting, and licensure status, as …

Graduate Nurse's Perspective Of Simulation To Address The Theory-Practice Gap In Nursing, Joset Elaine Brown

Walden Dissertations and Doctoral Studies

Graduate nurses are being employed to provide care in high acuity care areas, and this becomes a problem of significance as the literature suggests that graduate nurse's experience a deficit in integrating theoretical concepts in the clinical environment, described as the theory-practice gap; which can result in a risk to patient safety and the potential for negative outcomes. Cognitive constructivism was the conceptual framework that guided this study. A qualitative phenomenological design was used to explore the lived experiences of 13 graduate nurses employed at a community hospital in northern New Jersey. After recruiting the participants through purposive sampling, semi-structured …

Perceptions Of Nursing As A Career By African American College Students Attending Historically Black Colleges And Universities, Brenda Marie Owens

Walden Dissertations and Doctoral Studies

Previous studies and official organizations have indicated that African Americans are underrepresented in the healthcare workforce and that patients belonging to minority groups feel they are treated slightly differently in healthcare settings. Limited research examines perceptions of the nursing profession among a variety of demographic groups, and exploratory investigations into the perceptions of nursing as a career by African Americans are limited. The purpose of this quantitative descriptive study was to explore perceptions of nursing as a career by African American students who attend an undergraduate program at a historically black college or university (HBCU) in an attempt to further …

Nurse Practitioners' Experiences With Role Transition: Supporting The Learning Curve Through Preceptorship, Viktoriya Y. Pleshkan

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role transition is difficult and ill-supported before and after graduation. Although preceptorships are essential in supporting a NP's role transition, there is a paucity of data on student and novice NPs' experiences with their role transition and how it is supported through preceptorships. The purpose of this hermeneutic phenomenological study was to understand and describe the meaning of NPs' role transition experiences while in a preceptorship before and after graduation. Schlossberg's transition theory and the cognitive apprenticeship models were used to guide the exploration of concepts of role transition and preceptorship. One face-to-face, 3 Skype, and …

Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá

Walden Dissertations and Doctoral Studies

There is an identified problem with patients receiving suboptimal pain management at a hospice agency in the northwestern United States. At this agency, undertreatment of pain is prevalent. Evidence indicates that this may be a result of a lack of guidelines, education, and knowledge of appropriate prescribing. Known barriers to the correct prescription and administration of potent opioids in the hospice setting include prevailing beliefs, knowledge, skills, and attitudes, all of which can impact care negatively. Contextually, hospice principles mandate patient comfort and caregiver involvement in continuous quality improvement, which includes adequate and informed pain management. Moreover, hospice metrics demand …

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …

Facilitating Environmental Enrichment In Senior Care Activities With Professional Development, Celia Mary Ross

Walden Dissertations and Doctoral Studies

There is little known about the current state of professional development and continuing education practices for empowering activity professionals to better enhance environmental enrichment in long term care. The purpose of this qualitative study was to explore the activity professional's perceived role and best strategies for professional development to enrich the long-term care environment. The study used social cognitive theory as its theoretical framework to develop research questions focused on the views of activity professionals concerning professional development and continuing education to support care for long-term care residents. Using a narrative approach, 9 activity professionals were recruited through networking at …

Relationship Between Educational Leisure Motivation And Recovery From Mental Illness Among Members Of Clubhouse International, Dianna Rene Pearce

Walden Dissertations and Doctoral Studies

Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles's theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses …

Factors Related To Nursing Student Persistence In An Associate Degree Program, Patricia Ann Farley

Walden Dissertations and Doctoral Studies

The retention of nursing students remains a challenge in higher education, and the need for nurses in the United States is projected to increase. The purpose of this study was to investigate nursing student persistence in an associate degree program by examining differences in the presence of key social, environmental, and academic factors across 2 types of students: completers and non-completers of the 1st course in a registered nursing program. The study framework was based on Tinto's Student Integration Model and the Nursing Undergraduate Retention and Success Model, which identify key social, environmental, and academic factors as critical to student …

Experiences And Barriers For Patient Safety Officers Conducting Root Cause Analysis, Cynthia Lightner

Walden Dissertations and Doctoral Studies

Research shows that, when unintentional harm to patients in outpatient and hospital settings occurs, root cause analysis (RCA) investigations should be conducted to identify and implement corrective actions to prevent future patient harm. Executives at a small healthcare consulting company that employs patient safety officers (PSOs) responsible for conducting RCAs were concerned with the low quality of RCA outcomes, prompting this postinvestigation assessment of PSOs' RCA training and experiences. Guided by adult learning theory, the purpose of this study was to assess PSOs' RCA training and investigation experiences by examining self-reported benefits, attitudes, barriers, and time since training, and the …

Relationship Between Student Characteristics And Attrition Among Associate Degree Nursing Students, Wendy Elizabeth Watson

Walden Dissertations and Doctoral Studies

High nursing student attrition has been a pervasive problem in the nursing program at the research site of this study. The purpose of this project study was to investigate the relationship between attrition and nursing student characteristics, including age, gender, ethnicity, English as Second Language (ESL) background, licensed practical nurse (LPN) licensure, grade point average (GPA), the number of preadmission college credits, and the Test of Essential Academic Skills (TEAS) scores. This correlational study of archival data was guided by Jeffreys's nursing undergraduate retention and success model and included a convenience sample of 240 students admitted to the program between …

Relationship Between Admission Criteria And Program Completion In A Radiation Therapy Program, Adrienne Mae Dougherty

Walden Dissertations and Doctoral Studies

Poor completion rates in the radiation therapy associate's degree program offered through a community college did not meet the standards set by the college and damaged the program's reputation. The relationship between admission criteria and program completion was not known. The purpose of this study was to determine if there were any relationships between the admission criteria (GPA in prerequisite courses, interview scores, writing sample scores, and preadmission testing scores) and students' completion of a radiation therapy associate's degree program. This correlational study used 2 stages of Tinto's retention theory: (a) recruitment and admission to college and (b) pre-entry assessment …

The Effect Of Health Literacy In Low Estimated Glomerular Filtration And Diabetes, Nicklett Johnston Johnston

Walden Dissertations and Doctoral Studies

Health literacy is widespread, but its potential is not recognized. By not recognizing health literacy, patients have the burden of coping with diabetes with renal complications without full knowledge of their responsibility to their health. The focus of the project was to assess participants with diabetes with low health literacy and low mean glomerular filtration rate (eGFR). The project goal was achieved by the assessment of the participants' health literacy and eGFR before and after education for their diabetes, then assessed to determine if teaching the participants would improve their health literacy, lab values, and overall health. Participants were recruited …

Losing New Graduate Bedside Nurses, A Practice Improvement Initiative, Beverly Elaine Miller

Walden Dissertations and Doctoral Studies

New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention levels. Nonetheless, evidence from reviewed literature has indicated that the use of residency programs can increase NGNs' stay at bedside, improve retention, reduce costs of operations, and return employees' turnover. The purpose of this quality improvement project was to identify the likelihood of NGNs remaining …

Nursing Informatics Competency Program, Kristina Ann Dunn

Walden Dissertations and Doctoral Studies

Currently, C Hospital lacks a standardized nursing informatics competency program to validate nurses' skills and knowledge in using electronic medical records (EMRs). At the study locale, the organization is about to embark on the implementation of a new, more comprehensive EMR system. All departments will be required to use the new EMR, unlike the current policy that allows some areas to still document on paper. The Institute of Medicine, National League of Nursing, and American Association of Colleges of Nursing support and recommend that information technology be an essential core competency for nurses. Evidence of the need for nursing informatic …

The Development And Validation Of A Novice Nurse Decision-Making Skills Education Curriculum, Joanne Stephanie Simmons

Walden Dissertations and Doctoral Studies

Novice nurses (NNs) are entering critical care environments with limited knowledge, skills, and decision-making expertise. They are expected to care for complex patients in a dynamic healthcare setting. The research question for this project examined whether NNs improve their knowledge and skills by participating in a nursing decision-making skills curriculum. The purpose of the project was to develop and validate a nursing decision-making skills education curriculum working in an intermediate critical care unit. Taba's instructional theoretical model was used to guide the new curriculum development along with current evidence based practice found in the current literature. Scaffolding approach theory encouraged …

Understanding The Importance Of Culturally Appropriate Patient-Provider Communication In Diabetes Self-Management, Anita Mwalui

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when …

Mandated Continuing Education And The Competency Of Illinois Physical Therapists, Denise Lynn Hunter Ethington

Walden Dissertations and Doctoral Studies

Continuing education (CE) mandate laws are passed by states because it is in the public interest. The intent behind the passage of Illinois's CE law for physical therapists is to protect public health and safety through ensuring the competency of providers. However, studies into the impact of mandated CE on competency have been mixed. The problem addressed by this study was whether Illinois's CE law was effective in improving the competency of physical therapists and its impact on patient care. The purpose of this study was to understand what role mandated CE played in developing the competency of physical therapists …

Nurses' Occupational Trauma Exposure, Resilience, And Coping Education, Sherry Lynn Jones

Walden Dissertations and Doctoral Studies

Nursing education courses and professional development (PD) do not include coping and resilience training for registered nurses (RNs) who work in emergency departments (EDs). Exposure to traumatic events, death, and dying may lead to health issues, substance abuse, stress symptoms, nursing staff turnover, and compassion fatigue among ED RNs. Without training, the pattern of adverse outcomes may continue. The purpose of this study was to explore ED RNs' experiences with occupational traumatic stress (OTS), and their recommendations for change to nursing PD programs, using a qualitative bounded intrinsic case study. The conceptual framework for this study included social learning and …

Making A Difference: Evidence Based Palliative Care Education For Neonatal Nurses, Sherry Elaine Pye

Walden Dissertations and Doctoral Studies

The death of a neonate is a life-changing and tragic experience for the individuals involved in the final moments of the infant's life. As the frontline provider in this clinical scenario, the bedside nurse supports the patient and family through their individual journey of loss. If the nurse does not possess the palliative care educational background and communication skills to support this unique care delivery process, the journey of death can evolve into a particularly negative experience for the parents and the nurse. This specific delivery of care concern was identified and gleaned from a parental bereavement exit interview after …

Nurses' Experiences Transitioning From Staff Nurse To Management In A Community Hospital, Jennifer Sylvia Buffenbarger

Walden Dissertations and Doctoral Studies

This project study addressed the problem of frequent turnover of nurse managers at a Northeastern community hospital. The lack of retention of nurse managers has led to attenuated support for the nursing staff who continued to hold the front line in patient care. The purpose of this qualitative bounded case study was to explore nurse managers' experiences with turnover in order to identify strategies for enhancing retention. Work empowerment and servant leadership theories served as the frameworks for the study. Research questions focused on nurse managers' perceptions of empowerment and servant leadership characteristics that were important in decisions to assume …

Student Perceptions Of Factors Affecting Retention In A Rural Associate Degree Nursing Program, Jodi Garcia

Walden Dissertations and Doctoral Studies

High nursing student attrition rates at a community college in a southwestern state were noted as a significant problem by nursing faculty and college administration because of a nursing shortage and subsequent health care issues in the surrounding community. The purpose of this project study was to explore the perceptions of nursing graduates regarding the influences that led to or impeded their success in completion of the associate degree nursing program. Additionally, perspectives of the usefulness of remediation sessions provided for students failing a course were investigated. This qualitative case study, guided by transformative learning theory, included a sample of …

Videotaped Role-Play Simulation In Teaching Transcultural Self-Efficacy To Interprofessional Healthcare Students, Holldrid Aner Odreman

Walden Dissertations and Doctoral Studies

Increased demand for culturally sensitive healthcare services suggests that interprofessional beginning healthcare students need to gain the necessary cultural competency skills to be successful in delivering positive health outcomes for diverse patients. Bandura's theory of observational learning, Mezirow's theory of transformative learning, and Purnell's and Paulanka's model of cultural competence informed the framework for this research. The purpose of this quasi-experimental quantitative study was to determine the relationship between mode of instruction (observing role models in videotaped role-play simulation) and increased transcultural self-efficacy in cultural competence instruction. A convenience sample of 196 students enrolled in an interprofessional education (IPE) course …

Self-Efficacy And Select Characteristics In Nurses Who Respond To A Pediatric Emergency, Nancy Mcneill

Walden Dissertations and Doctoral Studies

Self-Efficacy and Select Characteristics in Nurses Who Respond to a Pediatric Emergency

by

Nancy McNeill

MA, New York University, 1996

BS, New York University, 1987

Doctoral Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Education

Walden University

June 2016

Nurses at a suburban northeastern U.S. community hospital reported that they felt unprepared to effectively respond to a pediatric emergency. Empirical data were not available to identify if this local problem was due to a lack of the nurses' self-confidence or if other factors were involved. The purpose of this study was to determine …

Improving Quality Of Life In Older Adults With Depression And Diabetes Through Medication Compliance Education, Valreen Hinds-Beharrie

Walden Dissertations and Doctoral Studies

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education

by

Valreen Hinds-Beharrie

MSN, Adelphi University, 1997

BSN, Adelphi University, 1986

Project Submitted in Partial Fulfillment

of the Requirement for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, …

Adult Learning-Focused Professional Development For Dental Hygiene Clinical Instructors, Meghan Ann Mcguinness

Walden Dissertations and Doctoral Studies

At a dental hygiene program within a community college in New York State, clinical instructors are hired based on their expertise as practitioners. Most clinical instructors lack a background in adult learning theory and practice, which is an issue because their students are adult learners whose average age is 26. The instructors' lack of knowledge in this area challenges their effectiveness. The purpose of this qualitative case study was to explore dental hygiene instructors' views about what kind of professional development offerings related to adult learning might help improve their teaching effectiveness. The conceptual framework for this project study was …

Nurse Practitioner Residency Programs: An Educational Journey, Gregory Paul Rys

Walden Dissertations and Doctoral Studies

Primary care is in a state of crisis due to the lack of clinicians and increasing numbers of insured patients. Encouraging more students to go directly through school for their doctor of nursing practice degree and nurse practitioner (NP) certifications is one proposal to alleviate this crisis. However, this approach would deliver graduates with minimal leadership and clinical experiences directly into practice. One resolution to mitigate this concern would be an NP residency program. Evaluating the knowledge and attitudes of stakeholders prior to the implementation of a NP residency program is an important first step to this implementation plan. The …