Medicine and Health Sciences Commons^™

The Impact Of Faculty Bullying On Associate Degree Nursing Students, Angela M. Vitale

Walden Dissertations and Doctoral Studies

Bullying is prevalent in the profession of nursing, impacting the quality of health care and health care costs. The foundation of bullying, in the profession of nursing, may be attributed to bullying behaviors in nursing academia among nursing faculty and nursing students. Using Bandura’s social learning theory, the purpose of this study was to determine the relationship between bullying behaviors of nursing faculty and bullying behaviors of nursing students in associate degree nursing programs. Seventy-one randomly selected registered nurses who graduated from associate degree nursing programs in the past 5 years completed an online Incivility in Nursing Education-Revised survey. Spearman’s …

Hospital Nurses’ Perceptions Of Computer-Assisted Instruction For Professional Development, Katherine Irizarry

Walden Dissertations and Doctoral Studies

Computer-assisted instruction (CAI) is increasingly being used for professional development. However, at one hospital in the northeast region of the United States, it was observed that nurses were not completing their CAI professional development modules and were failing to meet continuous education requirements. This qualitative case study explored professional nurses’ perspectives regarding the usefulness of CAI as a mode of professional development. The conceptual frameworks used to guide this study were Davis’ theory of technology acceptance, and Knowles’s theory of andragogy. The research question explored how professional nurses perceived the usefulness of CAI to assimilate new learning. The participants in …

Nurse Perception Of Pain And Innovative Approaches To Pain Management, Tracey-Ann Nichole Knight

Walden Dissertations and Doctoral Studies

AbstractInsufficient assessment and management of pain among the patient population during their hospital stay may result in ineffective delivery of care, increased length of stay, poor clinical outcomes, and decreased patient satisfaction. The quality report at a local facility showed compliance scores of 78% for administration of pain medication and 79% for reassessment of pain. These scores and the weekly patients’ satisfaction survey results suggested a substandard adherence to the facility’s pain management guidelines. One identified barrier to properly managing patients’ pain was nurses’ lack of knowledge and understanding of the theoretical foundation of pain management. The purpose of this …

Nursing Staff Development For Novice Nurse Practitioners In Acute Care, Carolyn Berglund

Walden Dissertations and Doctoral Studies

An acute care practice site reported 75% turnover of novice nurse practitioners (NPs),

which indicated a gap in the transition from student to practitioner within the first year of

clinical practice. This gap can leave novice NPs unprepared to manage patients

effectively and contribute to high turnover. The practice-focused question addressed

whether an evidence-based staff development program for novice NPs at an acute care

site could be developed. The purpose of this project was to create a framework based on

evidence to transition novice NPs successfully into practice. Benner's skill-acquisition

in-nursing theory informed this project. Evidence was obtained by searching …

Development Of Nursing Education For An Observation Unit, Donna Mckinney

Walden Dissertations and Doctoral Studies

As healthcare continues to face scrutiny related to the cost and quality of patient care, organizations are challenged with providing the right care to patients in the right setting. Some healthcare organizations are implementing observation units to provide appropriate care to a specific subset of patients. The purpose of this project was to develop education for nursing staff who will work on the dedicated observation unit and are unfamiliar with the care requirements. Benner's novice-to-expert theory was used as the framework for the project. This theorist posits that nurses transitioning to a new area require new knowledge and skills to …

Development Of An Interactive Game For Education Regarding Sexually Transmitted Infections, Sherri Arrington

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) prevalence rates are increasing in the United States and globally. Education has been found to be an important strategy for increasing STI testing and treatment rates among sexually active young adults. The goal of this project was to develop an interactive educational game suitable for young adults to decrease the social and economic burden of STIs. The health belief model informed the project. A moderated usability evaluation was conducted using the concurrent think-aloud technique. The participants (N = 5) were a purposive sample of professionals who played the interactive game and then completed Schnall, Cho, and …

Tobacco Treatment Education Module For Nurses Working In The Inpatient Psychiatric Setting, Marchell Rene Spielmann

Walden Dissertations and Doctoral Studies

Tobacco use among people with mental illness remain a significant problem in the western United States. At the project site, there is widespread tobacco use among patients with mental illness and lack of training for nurses to address the issue. The purpose of this project was to educate nurses working in the acute psychiatric setting about evidence-based tobacco treatment interventions. The practice-focused question addressed whether a tobacco education program would increase nurses' knowledge, confidence, and skills to provide tobacco treatment interventions to patients with a mental illness. Self-determination theory and the transtheoretical model of change provided the theoretical framework for …

Undergraduate Nurse Educator Perceptions Of Preparation To Teach Interprofessional Collaboration, Tamara Powell Berghout

Walden Dissertations and Doctoral Studies

If nurse educators do not teach students to function in interprofessional teams, students may lack communication and teamwork skills, which can result in patient harm; however, nurse educators do not always understand the concept of interprofessional collaboration (IPC) and may, therefore, fail to teach it to students. The purpose of this multiple case study was to understand how undergraduate nurse educators prepared to teach IPC and how their preparation informed their teaching. The theory of transformative learning and the Interprofessional Education Collaborative core competencies of IPC framed this study. Data included semistructured interviews and associated documents from 9 nurse educators …

Evidence-Based Practice Self-Study Education Program For Staff Nurses On Genomics, Nancy L. Norman-Marzella

Walden Dissertations and Doctoral Studies

Nurses routinely obtain genomic data when collecting family health histories. However, they report low confidence in their knowledge and understanding of genomics and the genetically engineered medications prescribed for their patients. The purpose of this project was the development and implementation of an evidence-based online education program about genetics and genomics to increase the nurses' understanding and ability to provide competent care for their patients receiving treatments based on the science of genomics. Knowles's principles of adult learning theory guided the development and delivery of the online education project to 12 medical-surgical registered nurses employed in a hospital in the …

Improving Nursing Knowledge Of African American Heart Failure Self-Care Management, Sharnee Moore-Jervis

Walden Dissertations and Doctoral Studies

Heart failure is a complex chronic disease affecting 6.6 million people in the United States, with an annual cost of $39.2 billion per year. African Americans are at an especially high risk for poor outcomes and readmissions from heart failure complications, as they are 2.5 times more likely to develop heart failure than other ethnic groups. This disease requires a high level of patient self-care management, and evidence suggests that African Americans do not always receive culturally sensitive education, which can lead to suboptimal self-care practices. The practice-focused question for this educational program asked whether nurses of African American patients …

Development Of A Nurse Residency Program In Perinatal Nursing, Elizabeth W. Roberts

Walden Dissertations and Doctoral Studies

Staffing turnover created a challenge for the women’s services department of a hospital in the southern United States, potentially compromising care for women and infants during childbirth. The gap in practice was the lack of a structured nurse orientation/residency program for nurses new to perinatal nursing, which requires specific competencies not learned at the prelicensure level of education. The guiding practice-focused question was whether a multidisciplinary team could develop a formal evidence-based perinatal nurse residency program that would meet the needs of on-boarding and support for the new nursing hires at this facility. A team of experienced nurses, which included …

Community Education Through A Stroke Champion Program, Michele Gribko

Walden Dissertations and Doctoral Studies

Stroke is the fifth leading cause of death and primary cause of long-term disability in the United States. Public awareness of stroke symptoms and ability to activate the emergency medical system (EMS) quickly are essential for early treatment. At a large Joint Commission-certified Comprehensive Stroke Center with over 6,000 employees, a stroke champion program that included both clinical and nonclinical volunteers was initiated to determine whether stroke champion volunteers could learn and disseminate information about stroke symptoms and the importance of activating EMS within their community. Roger's diffusion-of- innovation framework was used to design and evaluate the outcome of the …

Educating Staff Nurses For Successful Patient Discharge, Julie First-Williams

Walden Dissertations and Doctoral Studies

The definition of a successful discharge is a discharge that results in patients successfully managing a chronic disease for at least 30 days without requiring an acute inpatient hospitalization. Many chronic disease readmissions are preventable. Successful discharge planning takes a multidisciplinary team that includes nurses who assess the discharge plan and provide additional education where needed. The purpose of this project was to determine staff nurses' understanding of their role in discharge education. Dorothea Orem's self-care deficit theory guided the project and root cause analysis was used in the development of the problem statements. Staff nurses (n=12) from evening and …

Direct Care Staffs’ Experiences And Perceptions Of Person-Centered Care Training, Jennifer Miranda Strollo

Walden Dissertations and Doctoral Studies

Many long-term care (LTC) facilities within the United States have replaced the institutional model of care with one that accepts person-centered care (PCC) as the guiding standard of practice. Quality training ensures that direct care staff have the skills and the knowledge in the delivery of quality PCC. However, many nurses and nursing assistants have expressed the desire for further training in PCC practices to effectively deliver quality care. The purpose of this study was to explore the types and length of training and education provided based on the perceptions and experiences of direct care staff related to their implementation …

Effect Of Multiple Entry Levels Into Nursing Practice And Professionalism, Ogechi Abalihi

Walden Dissertations and Doctoral Studies

Entry into professional nursing practice in the United States occurs at varied education levels including a diploma, an associate degree, and a baccalaureate degree. These multiple entry levels into practice create a situation where academic preparedness for nursing practice varies, which may influence the professional behavior of nurses and, consequently, patient care and outcomes. The purpose of this quantitative comparative study, guided by Miller's wheel of professionalism in nursing, was to determine if there is a difference in the professional behaviors of associate degree prepared registered nurses (RNs) compared to the professional behaviors of baccalaureate degree prepared RNs. The Behavior …

Barriers To Male Faculty In Nursing Education, Troy Jeffrey Palmer

Walden Dissertations and Doctoral Studies

Men are underrepresented among nursing faculty, providing few role models for male students who might benefit from interaction with male faculty. Male nursing faculty may face barriers similar to those faced by women in male-dominated professions. Diehl and Dzubinski's model of gender-based barriers served as the framework for this quantitative study conducted to identify disparities between male and female nursing faculty that may prevent men from entering, continuing, and advancing in nursing education. The association between the percentage of male nursing faculty with geographic region; institution type (i.e., public, private secular, or private religious); and 4 career variables (i.e., education …

Cultivating Cultural Competence To Address Childhood Obesity In Ethnic Minority Youth, Tia Knight-Forbes

Walden Dissertations and Doctoral Studies

Obesity is an increasingly prevalent health issue, especially among children who live in high poverty, low income, and low education areas that lack needed resources and health care to promote quality of life. African American youth have a higher rate of obesity than other populations. The purpose of this project was to address an identified gap in practice by improving health care professionals' ability to provide culturally competent care to African American youth. An educational intervention framed by the Purnell model for cultural competence was developed to address the question, Will cultural competency staff education improve knowledge to prevent and …

Evidence-Based Care In Urgent Care Centers, Kelly Wagner

Walden Dissertations and Doctoral Studies

Concussions are brain injuries--also called mild traumatic brain injuries--that affect the function of the brain temporarily or permanently. The purpose of this doctoral project was to develop an education module for staff at an urgent care center to address the lack of knowledge and low level of comfort regarding the care for patients with a head trauma. This project introduced and educated the clinical staff on an evidence-based protocol for the treatment and management of a patient with a concussion. The Rosswurm and Larrabee model for evidence-based change was used as a foundation for refining the practice question, gathering evidence, …

Nonfatal Strangulation Continuing Education Program For Forensic Nurses, Pamela Susan Holtzinger

Walden Dissertations and Doctoral Studies

Patients experiencing nonfatal strangulation during intimate partner violence (IPV) are suffering the consequences of unrecognized injuries and delayed life-threatening medical sequela. Forensic nurses offer expertise in the physical assessment and documentation to a variety of assault victims including those impacted by IPV. This project addressed whether an educational program on nonfatal strangulation increased the knowledge and assessment skills of forensic nurse examiners. The purpose of this doctoral project was to develop a continuing education program on the topic of nonfatal strangulation for forensic nurse examiners. The project design was created using Knowles's adult learning theory principles. The content outline was …

Transitioning From Student To Nurse Practitioner Using The One-Minute-Preceptor Model, Yetrevias Seymour

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) are significant members of the health care team. Variation and lack of standardization in the practicum preparation of the NP has been identified as problematic. There is a need to improve NPs preparation to efficiently and independently impact health care. This project presented the 1-minute-preceptor (OMP) model as a standard tool in the practicum preparation of the NP through a preceptor-focused continuing education session. The aim of the OMP is to help ensure that students are exposed to the level of critical thinking and problem solving needed in the role of an independent, efficient NP. Knowles's adult …

Educating Oncology Nurses On The Benefits Of Patient Exercise, Roberta Anderson

Walden Dissertations and Doctoral Studies

Exercise benefits patients with cancer during and after treatments. A formalized educational program is lacking at the project's site for oncology nurses on the benefits of exercise for their patients during and after treatment. The purpose of the project was to address the identified gap in practice at the project's site by providing education to oncology nurses on the benefits of exercise for their patients during and after treatment. The ARCS model of motivational design was used as a theoretical foundation to develop and guide the educational program presented to the oncology nurses. The question addressed in the project was: …

Evaluating Nursing Pain Assessment Documentation With The Pediatric Client, Aziza Alexander

Walden Dissertations and Doctoral Studies

Pain is often seen as a primary complaint in the pediatric emergency department (ED). Assessment and documentation of pain are integral to effective pain management, and nurses are responsible for documenting pain assessment. Nursing documentation is essential for ensuring continuous, safe, high-quality care. Evidence shows nurses are inadequately documenting pain assessment and reassessment and not always using appropriate pain scales in a busy, cosmopolitan children's hospital ED. The practice-focused question that guided this project was: How does an educational module and change in electronic health record pain assessment flowsheet increase the nurses' compliance with initial documentation of pain? An educational …

Use Of Antipsychotic Medications In Individuals With Alzheimer's Disease In Nursing Facilities, Michelle M. Dionne-Vahalik

Walden Dissertations and Doctoral Studies

Patients with Alzheimer's disease or other types of dementia often require long-term care in nursing facilities (NF) where they may display out-of-character behaviors complicating their care. While antipsychotic medications are sometimes prescribed for NF residents, their use is considered inappropriate for the control of dementia behaviors. The Centers for Medicare and Medicaid Services have rated Texas the worst state in the country for the inappropriate use of antipsychotic medications for NF residents with dementia. This project was guided by the star model of knowledge transformation with the goal to reduce inappropriate use of antipsychotic medications through NF staff education. The …

Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing

Walden Dissertations and Doctoral Studies

Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …

A Chronic Obstructive Pulmonary Disease Self-Management Packet To Reduce 30-Day Readmissions, Josette Askratni

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's …

Education Protocol For Type Ii Diabetes Mellitus, Raegan Elizabeth Quandt

Walden Dissertations and Doctoral Studies

Diabetes mellitus is one of the leading causes of death in the United States, contributing to rising health care costs and increased morbidity and mortality rates. Researchers demonstrated that aggressive heath measures involving ongoing diabetes self-management education are paramount in minimizing associated complications of diabetes. The management and prevention of diabetes is not standardized and providers within a health clinic in Illinois reported challenges in providing self-management education during scheduled patient appointments due to limited resources and time. The purpose of this DNP project was to develop a clinical practice guideline to be used by all providers within the health …

Improving Health Literacy Assessments In Pediatrics, Kristina Michelle Wright

Walden Dissertations and Doctoral Studies

Low health literacy (LHL)--when patients do not understand their treatment or medications--has been linked to poor healthcare outcomes. Nurses need to know how to assess health literacy (HL) and teach pediatric patients and their families to help ensure that patients and family members can understand and follow health education messages. Evidence-based HL tools were obtained from a literature search and used to create a nursing staff education program on pediatric patient HL assessment and education. The project answered the practice-focused question that asked whether a staff education program on HL assessment and management would improve nursing knowledge of HL for …

Medical Floor Confusion Assessment Method: Implementation And Assessment Of Risk Factors, Michaelynn R. Paul

Walden Dissertations and Doctoral Studies

An estimated 50% of older hospitalized patients experience delirium. This has created significant complications costing an estimated $164 billion or more per year worldwide. The ability to identify patients developing delirium would allow the implementation of specific interventions to decrease or eliminate the adverse effects of delirium. The purpose of this quality improvement project was to provide high quality delirium education to determine if medical unit nursing staff could successful implement the Confusion Assessment Method (CAM) screening tool to identify patients experiencing delirium as the first phase of an overall plan. Implementation of the project followed Roger's diffusion of innovations …

Nursing Leadership Influence On Evidence-Based Practice Culture And Integration, Natalie Kay Lenhart

Walden Dissertations and Doctoral Studies

Translating research to practice takes 10-20 years or more and evidence-based practice (EBP) integration remains at 10%-20%, despite recommendations requiring EBP-guided decisions. EBP integration has been associated with up to 30% decreases in healthcare system spending, improved quality outcomes, and increased staff satisfaction. Nurse leaders are accountable for EBP enculturation, yet rate quality and safety as the highest priority and EBP as the lowest. This knowledge gap perpetuates low EBP integration rates and hinders EBP enculturation. Asking whether EBP facilitative interventions for nurse leaders increase scores on organizational culture and readiness, beliefs, and EBP use scales addressed the knowledge gap …

Designing And Evaluating An Educational Initiative Promoting Condom Use Among Hiv+ Hispanic Men, Gilberto Andino

Walden Dissertations and Doctoral Studies

In 2013, the Centers for Disease Control and Prevention estimated that between 252,000 and 312,000 Hispanic men and women in the United States were unaware of their risk for transmitting HV/AIDS. Guided by the logic model and Leininger's theory, the purpose of this project was to design a culturally sensitive HIV/AIDS educational program for HIV+ Hispanic males and to evaluate the program content with the staff at a medical center in South Florida, with the goal of implementing the program at that center. The educational program content focused on increasing the knowledge of Hispanic HIV+ men on the effectiveness of …