Medicine and Health Sciences Commons^™

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Situation-Background-Assessment-Recommendation During Hand-Off In A Mental Health Nursing Unit, Renel Ramos

Walden Dissertations and Doctoral Studies

AbstractCommunication failures, especially inadequate hand-off communication, in U.S. hospitals has accounted for 30% of malpractice claims, resulting in 1,744 deaths over 5 years. This prompted the Joint Commission to recommend utilizing standardized communication tools to reduce the number of medical errors related to miscommunication. The Situation-Background-Assessment-Recommendation (SBAR) Communication Tool has been used to improve the effectiveness of communication among health care providers. The partner organization noted failures to communicate patient-care-related information between psychiatric mental health nurses (PMHN) during hand-off, given the absence of standardized communication. This project aimed to develop a program to educate PMHNs on the SBAR Communication Tool. …

Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott

Walden Dissertations and Doctoral Studies

Despite the 2009 mandate from the U.S. Government that healthcare organizations adopt and implement electronic medical records (EMR) systems to avoid fines and take advantage of the benefits EMR systems provide, adoption of EMR systems in the United States has been low. Since 2011, medical facilities have received incentive payments if they demonstrated “meaningful use” of certified EMR systems; however, medical facilities unable to demonstrate meaningful use beginning in 2015 have faced up to 5% penalties. Grounded in the diffusion of innovation theory, the purpose of this qualitative single case study was to explore strategies that hospital project managers use …

Leveraging Electronic Alerts And Telemonitoring For Early Detection Of Maternal Hypertension, Philidah Seda

Walden Dissertations and Doctoral Studies

AbstractThe United States has the highest maternal mortality rate among industrialized nations, and hypertension is one of the leading causes of maternal morbidity and mortality. Given that pregnancy-related hypertension can develop anytime during the perinatal period, and complications arising from this condition can cause harm, early detection is associated with better outcomes. Best practice alerts in the electronic health record and Blue-tooth-enabled medical devices linked to health information systems can provide real-time notification of critical values to health care professionals. This project evaluated the clinical usefulness of two health care technologies—preeclampsia e-alerts and remote blood pressure monitoring—in facilitating early detection …

Motivational Interviewing: A Strategy To Improve Health Professional's Communication, Lanita James

Walden Dissertations and Doctoral Studies

Miscommunication between patients and healthcare professionals is common in U.S. hospitals and is considered one of the chief factors in reduced patient satisfaction with care. Collaboration with the nurse researcher who reviewed the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) data for a local hospital noted that negative ratings were directly related to the miscommunication between the patient and care providers. Further identified that the nursing staff was not knowledgeable about evidenced-based strategies needed to communicate effectively with the patients. The purpose of this DNP project was to develop an education program to increase nurses' knowledge about …

Relationship Between Social Media Screen Time, Sedentariness, And Bmi Among Young Adults, Helen Golod

Walden Dissertations and Doctoral Studies

Obesity has quickly become an epidemic that affects adults and youth not only in the United States, but also increasingly elsewhere in the global community. Research suggests that most children and adolescents spend a significant amount of time indulging in screen-based leisure, especially on social media. Such behavior may also be linked to sedentary lifestyle, which can impact an individual’s body mass index (BMI). There is a lack of understanding concerning how sedentary behavior moderates the relationship between screen time spent on different types of social media and BMI among young adults in the United States. To address this research …

Adult Day Care Staff Education To Improve Communication And Behavioral Management Skills, Kathy Davis

Walden Dissertations and Doctoral Studies

AbstractIneffective communication and behavioral management skills are quality and safety issues that were identified at a local adult day care facility in the Southwest United States. Administrators at the facility identified a knowledge gap in communication and behavior management techniques for patients with cognitive impairment. An educational program, with a PowerPoint presentation and verbal feedback as key components, was developed and used to address the identified gap in practice related to individuals with cognitive impairments at the facility. The adult learning theory and the plan-do-study-act model provided supportive frameworks for program development and staff education. The project question explored whether …

The Role Of Online Support For Anaplastic Thyroid Cancer Patients And Survivors, Bevin J. Nixon

Walden Dissertations and Doctoral Studies

The rate of thyroid cancer diagnosis has risen, and researchers' findings point to improved diagnostic testing and overdiagnosis as well as increases in actual incidences as the reasons behind this rise. With improved treatments and testing methods, the number of thyroid cancer survivors has also increased. Thyroid cancer presents challenges to coping and can cause significant stress in an individual's life. More specifically, anaplastic thyroid cancer (ATC) creates complicated challenges for patients and survivors. The problem is patients need support during diagnosis and treatment when adjusting to their 'new normal' and may be reaching to Internet based social support groups …

Policy Knowledge Communication In Nursing, Curtiss John Vavra

Walden Dissertations and Doctoral Studies

Evidence-based practices in nursing improve patient outcomes, decrease healthcare costs, and can be implemented with policies and procedures. However, there is limited literature describing how nurses acquire policy knowledge, the dissemination of which may require a significant investment of resources by a hospital. The purpose of this study was to learn more about how nurses obtain policy knowledge. Rogers's diffusion of innovations theory guided the examination of communication channels and how they relate to the formation of policy knowledge. The research questions were designed to gather information on the relationship of policy communication channels, demographic factors, and the frequency of …

Patient Views On Social Media Communication With Their Health Care Providers, Brenda Elaine Welch

Walden Dissertations and Doctoral Studies

Communication between patients and health care providers at hospital discharge is a critical factor that determines whether a patient understands their treatment plan and self-care instructions. Lack of effective health management after hospital discharge can decrease the quality of life for a patient and increase the likelihood of costly hospital readmission. The purpose of this phenomenological study was to explore factors affecting the receptivity of patients using social media as a platform for post discharge, provider-client communication, and assessment. This was explored using social presence theory. Twenty patients between 45 to 65 years of age, who received care from hospitals …

Positive Deviance Behaviors And Definition In Nursing, Stacy L. January

Walden Dissertations and Doctoral Studies

The concept of positive deviance (PD) has not been studied in the context of nursing. Grounded in narrative inquiry and combined with vocabularies of motive and symbolic interactionism, the purpose of this study was to explore whether PD behaviors existed in nursing, and if so, to develop an operational definition of PD for nursing. The research question addressed what PD behaviors, if any, were present in nurses’ workplace stories. Using posted flyers, eight participants either self-selected or were selected by snowball method to participate. Interviews were conducted in locations decided on by each participant. Interview data were obtained, transcribed, then …

Department Structure And Leadership Functions For Advanced Practice Providers, Deondela Love

Walden Dissertations and Doctoral Studies

Department structure and leadership functions can influence work climate. In one healthcare system, advanced practice providers (APPs) worked in a decentralized structure with multiple leaders. This project explored the impact of the change to centralized leadership for APPs working in an academic healthcare system in which employee turnover was high and satisfaction was low. An ad hoc committee led by the chief medical officer created a centralized department with a designated leader. Surveys and interviews were used to identify the benefits of the strategies implemented and understand whether the change in organizational structure resulted in an improved work climate for …

Influence Of Media Messages On Obesity And Health Perceptions Among African American Women, Carolyn Grant

Walden Dissertations and Doctoral Studies

African American women have the highest prevalence of overweight and obesity in the United States, thus increasing their risks for chronic diseases. Their understanding of their health status and response to it could be triggered by messages in the media, yet few researchers have examined this topic with African American women. The purpose of this phenomenological study was to explore how advertisement and editorial content in media contributed to perceptions African American women have about overweight and obesity. Following the theoretical foundation of the social cognitive theory, the research questions explored what messages study participants encountered and which messages prompted …

Consensus In Anesthesia Handoff Reporting, Robin Lee Anselm

Walden Dissertations and Doctoral Studies

Despite some improvement, no consensus exists to perfect quality in anesthesia handoff practice and policy. This quality improvement project was designed to assist a local anesthesia and perioperative workforce questioning the quality of its current handoff. Theories and models used to inform the project included the Inter-Professional Team Collaborative, Lewin's change theory, the continuous quality improvement theory, and the knowledge to action model. The communication assessment tool (CAT) functioned as a needs assessment yielding a gap in handoff practice of 25 participants. The CAT also served as the post project evaluation survey. The situation, background, assessment, and recommendation (SBAR) tool …

Referral And Treatment Settings For Pregnant Women, Linda D. O'Daniel

Walden Dissertations and Doctoral Studies

Drug and alcohol addiction in pregnant women is a significant public health issue. The purpose of this study was to assess drug and alcohol addiction in pregnant women and the setting in which they sought service or treatment to determine whether U.S. census regions and race data could predict the type of addiction service or treatment that pregnant addicts chose. The theories of self-efficacy, cognitive behavioral therapy, and rational emotive behavioral therapy were used as the theoretical framework for this study. The research questions were used to examine whether there was a relationship between the source of addiction treatment referral …

Education Program For Nurses Working In An Immigration Detention Facility, Dr. Tiney Elizabeth Ray

Walden Dissertations and Doctoral Studies

Nursing response to medical emergencies has been an ongoing issue in immigration detention centers. Lack of teamwork and poor communication with medical and security staff have resulted in detainees sustaining injuries during medical emergencies. This project was developed to persuade Immigration and Customs Enforcement Health Service Corps (IHSC) leaders to consider piloting the TeamSTEPPS emergency response curriculum for nurses working in the immigration detention center. Tuckman and Jensen's model of group development will provide guidance to IHSC leaders in understanding the transformational stages of forming a successful team. TeamSTEPPS will address gaps in emergency health care competency by improving collaboration, …

Analysis Of How Newly-Hired Nurses Are Educated To Provide Customer Service, Patricia Mcafee

Walden Dissertations and Doctoral Studies

As part of healthcare reform through the Affordable Care Act of 2010,

hospitals across the United States are being held accountable for

providing a positive patient experience and will lose up to 2% of

their reimbursement by 2017 if they fail to reach targeted scores.

The purpose of this quality improvement project was to review the

process used by a Georgia hospital to educate newly-hired nurses

about customer service expectations and to provide recommendations

for process improvement. Theoretical foundations supporting

customer service included the caring philosophy of Mayeroff; the

caring theories of Watson, Leininger, Boykin, and Nyberg; and

Roy's adaptation …

Case Study Of Learning And Instruction For Members Of An Online Reflex Sympathetic Dystrophy Support Group, Heather Rae Gilmore

Walden Dissertations and Doctoral Studies

Research has shown that individual members of traditional support groups gain a sense of identity and community and feelings of respect and support. Online support groups provide individuals avenues to find medical information and thus learn more about a given condition or illness. Little has been studied about the learning and instruction that occurs in online social support groups, especially in groups about chronic pain. The purpose of this qualitative case study was to explore the perceptions and experiences of members who participated in one open social support group. Siemen's constructivism theory served as the basis for comprehending the learning …

Improving Communication Between Cancer Patients And Providers During A 15-Minute Office Visit: A Systematic Review Of The Literature, Dr. Tammy Elizabeth Manganelli

Walden Dissertations and Doctoral Studies

Patients undergoing chemotherapy treatments for cancer often experience adverse side effects, including cognitive deficits. These deficits impact the patient's ability to communicate effectively with their oncology provider. Ineffective communication can adversely affect patient outcomes and decrease patient-provider satisfaction. The resulting poor communication can contribute to poor patient outcomes. This systematic literature review focused on assistive communication tools that could be used in an outpatient oncology setting to improve patient-provider communication. The literature review findings led to the development of a resource for providers that includes 15 communication tools that can be used to assess and improve communication in cancer care. …

Examining Barriers With Implementing Augmentative And Alternative Communication In A Midwest School, Ashley Renee Fields

Walden Dissertations and Doctoral Studies

Many speech-language pathologists (SLPs) in a Midwest urban public school system have experienced barriers that prohibit the effective use of augmentative and alternative communication (AAC). The result has left some students with speech language impairments (SLI) without the communication skills for meaningful relationships and success in and out of school. The purpose of this exploratory case study was to determine the perceived barriers of 8 local school SLPs regarding the successful implementation of AAC and their suggestions for addressing the problem. Data were collected from semi-structured interviews with the SLPs. Data collection and analysis were grounded by Ely's conditions of …

The Use Of A Standardized System Of Communication To Change The Perception Of Handoff Communication In A Psychiatric Setting, Alicia Renee' Plunkett

Walden Dissertations and Doctoral Studies

The Use of a Standardized System of Communication to Change the Perception of Handoff Communication in a Psychiatric Setting

by

Alicia Renee' Plunkett

MSN, Walden University 2007

MSHA, University of St. Francis, 2005

BSN, University of Memphis, 1995

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

December 2014

The Joint Commission's review of sentinel events indicated that communication errors were the cause of over 65% of the sentinel events occurring in healthcare. The nursing profession has the responsibility of providing 24-hour care in an acute care setting and nurses are …

Nursing Care Of Terminal Patients In Intensive Care Units, Pervell Velethia Dunbar

Walden Dissertations and Doctoral Studies

Nursing Care for Terminal Patients in Intensive Care Units

by

Pervell Dunbar

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Although the goal of the ICU has always been to save lives, ICU now additionally provides end-of life (EOL) care. The objective of this project was to provide ICU nurses with a comprehensive awareness of physical, emotional, and spiritual EOL care issues of patients and their families in order to be better equipped to handle EOL care. The framework used was Jean Watson's Caring model (10 Caritas). A …

Transforming Vulnerable Interactions To Effective Communication: An Application Of Evidence For The Tele-Intensive Care Unit Nurse, Bethann Mendez

Walden Dissertations and Doctoral Studies

Tele-intensive care collaboration in care of critically ill patients improves both the safety and quality of nursing care. However, the full benefits of the telemedicine service may not be realized unless tele-critical care nurses have the ability to communicate clearly with their remote nursing peers. The purpose of this DNP project was to create and validate an acronym style communication tool to assist the tele-critical care nurses with their communication. The relational coordination theory was the primary communication theory utilized for tool development. The tool creation phase of the project included informal observations and discussion with a convenience sample of …

Reducing The Surgical Patient's Family Member's Anxiety Using An Electronic Patient Tracking Board, Pamela M. Barberi

Walden Dissertations and Doctoral Studies

Family members of surgical patients experience anxiety due to lack of consistent communication during the surgical process. Attending to the needs of the surgical patient's family members is an important factor easily forgotten in a busy clinical arena. The purpose of this project was to decrease the surgical patient's family member's anxiety by providing family members with timely and consistent information regarding the patient's progress through surgery. The theoretical foundation used was general systems theory showing that a change in one part of a system leads to change in the whole system with the use of improved communication and feedback. …

Augmentative And Alternative Communication Systems In The Classroom, Helen Angela Mezzomo

Walden Dissertations and Doctoral Studies

Augmentative-alternative communication (AAC) systems are used to give voice to individuals who are nonverbal. As AAC systems become more complex and prevalent in the classroom expectations of school-based professionals expand. However, the roles of those expected to support AAC systems, primarily teachers and speech-language pathologists (SLPs), are not clearly defined. Without clearly defined roles, professionals may not provide needed support to students who use AAC. Dewey's theory of community suggests that role confusion leads to insufficient and ineffective services. The purpose of this cross-sectional quantitative study was to determine how teachers and SLPs view their roles in supporting AAC. The …

Who Shares? Managerial Knowledge Transfer Practices In British Columbia's Ministry Of Health Services, Gwendolyn Elizabeth Lock

Walden Dissertations and Doctoral Studies

The British Columbia government's Ministry of Health Services will experience significant loss of operational knowledge from an aging managerial workforce, increased staff turnover, and difficulties in recruitment. The purpose of this study is to provide the ministry's Strategic Human Resources Planning branch staff with a map and description of knowledge transfer practices used by approximately 40 managers within the ministry's Health Sector Information Management/Information Technology division and its Vital Statistics Agency. The study is a mixed-methods case study of knowledge retention and transfer practices founded on a knowledge management and social network theoretical foundation. To understand the ministry's complex nature …