Medicine and Health Sciences Commons^™

Physical Activity Improves Depressive Symptoms In Older Adults, Karen Lee Fahey

Walden Dissertations and Doctoral Studies

Engaging in physical activity can help older adults to take part in community activities, maintain relationships, and initiate new friendships, thus preventing loneliness and depression. The purpose of this quality improvement (QI) project was to evaluate whether participation in physical activity improved depressive symptoms in 15 older adults at a local senior center. Pender’s health promotion model was used to determine nursing and behavioral science views on components that affect health behavior. The Exercise Benefit/Barrier Scale (EBBS) survey was evaluated before implementation of the walking program to measure the benefits of and barriers to exercise. The EBBS results showed that …

Health Care Clinicians' Compliance With Conducting Spiritual Assessments And Providing Spiritual Care To Infertile Women, Lesa Miller

Walden Dissertations and Doctoral Studies

Infertility is a disease that can cause psychological impairments in women, and the inability to achieve motherhood brings about cultural and social stigma. Spirituality is a protective element that may provide consolation to women experiencing infertility, yet the literature has shown that few clinicians conduct spirituality assessments or provide spiritual care to patients. The objectives of this scholarly project were to conduct an assessment to determine the needs of health care clinicians in regard to spirituality and spiritual patient care and to develop an educational module based on identified knowledge deficits. Guided by the knowledge-to-action cycle, a needs assessment was …

Managing Acute Pain In Postoperative Surgical Patients, Sabrina Gregory

Walden Dissertations and Doctoral Studies

Every year, millions of Americans suffer from either chronic or acute pain that results in tremendous healthcare cost, rehabilitation, and loss of work productivity. Pain is an unpleasant sensation associated with sensory and emotional experiences that can cause potential or actual tissue damage. One plausible solution to managing pain is the use of nonpharmacological modalities such as guided imagery. The purpose of this project was to determine if there was a difference in pain scores following pharmacological interventions and the use of guided imagery among postoperative same day surgical patients. Guided imagery is a nonpharmacological modality that uses pictures, music, …

The Aftermath Of Violence: The Lived Experience Phenomena Of Assault In Nursing, Kathleen Clark

Walden Dissertations and Doctoral Studies

Despite the high incidence of violence directed at registered nurses while on duty, there is limited qualitative data that explores the lived experience of returning to the workplace after an assaultive incident. This phenomenological study sought to explore and analyze the phenomena of registered nurses who are employed in high-risk settings. The research questions considered the detailed descriptions of the experiences of nurses returning to the workplace. The conceptual framework was resiliency, as these participants continued to survive and thrive after the adverse assaultive events. Data were collected using in-depth interviews from purposeful sampling. Registered nurses working in the high …

Evidence-Based Alternative Therapy To Reduce Anxiety In Ambulatory Mental Health Patients, Renee Ann Denobrega

Walden Dissertations and Doctoral Studies

Evidence-Based Alternative Therapy to Reduce Anxiety in Ambulatory Mental Health Patients

by

Renee Denobrega

MS, Widener University, 2013

BS, Alvernia University, 2007

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

January 2016

Employee Engagement In A Cardiac Catherization Lab, Rhonda J. Smith

Walden Dissertations and Doctoral Studies

Employee Engagement in a Cardiac Catheterization Lab

by

Rhonda J. Smith

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2016

This study adds to the existing body of knowledge on employee engagement and workplace climate in the catheter laboratory setting. The study goals were to discover the current state of workplace satisfaction and then to share the results with the staff to determine what to improve and how to guide them through the Lean process. This study was guided by Kanter's structural empowerment theory, which holds that structural factors …

The Relationship Of General Science Grades To Program Completion In An Associate Degree Nursing Program, Catherine Edlebeck

Walden Dissertations and Doctoral Studies

High attrition of nursing students in the United States may contribute to a shortage of registered nurses and inefficient use of scarce resources. The purpose of this study was to explore the relationship between nursing student grades in 3 science prerequisites and length of time to program completion on each of the study college's 4 campuses. Ausubel's theory of subsumption, wherein a learner's ability to meaningfully learn new data depends on the existing cognitive structure within which the new material is assimilated, was used as a theoretical framework. Prerequisite science course grades for 575 nursing students attending a Midwestern technical …

Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink

Walden Dissertations and Doctoral Studies

Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided …

Developing Policies And Guidelines To Prevent Medication Errors And Ades In Nursing Homes, Marion Johnson

Walden Dissertations and Doctoral Studies

According to the National Patient Safety Foundation, more than 1.5 million Americans are affected by medication errors because of varied factors including miscommunication, bad handwriting, name confusion, poor packaging, and metric or other dosing unit errors. This project addressed medication errors and adverse drug events by developing policy and practice guidelines to support and aid the utilization of health information technology (HIT) systems in addressing medication errors and adverse drug events at a local nursing home in Cincinnati, Ohio. The National Quality Strategy Framework was used by a team of interdisciplinary stakeholders as a guide for the development of policies …

Development Of A Practice Guideline For Dnp Prepared Nurse Practitoners Working In Long-Term Care Facilities, Ashley M. Marshall

Walden Dissertations and Doctoral Studies

Clinical evidence-based practice guidelines providing recommendations for health care decision making have become vital components of long-term health care practice in the United States. Frequently changing guidelines have complicated nurse practitioners' (NPs) efforts to implement evidence-based practice into the daily care that they provide to patients. The purpose of this project was to develop an evidence-based practice guideline for doctoral-prepared NPs working in long-term care facilities. This project is important because practitioners use practice guidelines to provide patients with the most appropriate, evidence-based care. Kolcaba's comfort theory was used to guide this project. Kolcaba's theory holds that comfort exists in …

Initiating Nicotine Cessation In A Community Mental Health Center, Rosalind R. Keith

Walden Dissertations and Doctoral Studies

Individuals suffering from mental illness are often adversely affected by tobacco use. Historically, clinicians are reluctant and inadequately prepared to recognize and treat comorbid nicotine addiction in the chronic mentally ill (CMI) client. As evidenced by a review of the literature, healthcare providers are missing opportunities for nicotine cessation treatment. There is a lack of educational preparation amongst clinicians to treat nicotine addition and a concern that treatment of nicotine addiction can negatively impact existing psychiatric disorders. The purpose of this project was to create an educational plan for nicotine cessation for CMI clients at a community health center. The …

An Evaluation Of Service Learning For Associate Degree Nursing Students, Valerie Marie Pauli

Walden Dissertations and Doctoral Studies

The purpose of this study was to evaluate outcomes of the service-learning requirement in the Associate of Science in Nursing (ASN) curriculum at the local college. The problem addressed in this study was that the local ASN program lacked formal evaluation of the service-learning requirement. Guided by Kolb's model of experiential learning, a goal-based, summative evaluation employed as a qualitative case study explored the perceptions of 20 stakeholders including graduates, faculty members, and key community informants. The research questions focused on how service learning influenced a student's learning of cultural competence and the impact service learning had on the community. …

Development Of A Guide To Successful Onboarding Of New Nurse Graduates, Jacquelyn Estelle Young

Walden Dissertations and Doctoral Studies

The literature indicates that serving as a preceptor for new nurse graduates can be challenging and stressful without proper training in this role. Many organizations appoint preceptors without providing training and support for the role, which negatively impacts both the new nurse and the preceptor. Evidence shows that a preceptor workshop can cultivate the knowledge and skills needed to train and precept new nurse graduates. Further, there is evidence that preceptorship programs ease new graduates' transition to practice, increase employee satisfaction, and improve the quality of care provided to clients. The purpose of this developmental project was to develop a …

Standardized Assessments, Care Planning, And Improved Quality Of Life For Residents Of Adult Family Homes, John A. Rogers

Walden Dissertations and Doctoral Studies

Quality of life for adults living in adult family homes requires further attention as the elderly population continues to grow and moves from minority to majority. There is a lack of data on residents in adult family home settings and their quality of life. The purpose of this project was to identify if individualized nursing care plans had an impact on the residents' quality of life in the adult family home. In this study, a registered nurse assessed the residents to create an individualized nursing care plan that would be implemented to improve quality of life. These care plans were …

Barriers To Exclusive Breastfeeding Among Mothers During The First Four Weeks Postpartum, Jessy V. Thomas

Walden Dissertations and Doctoral Studies

According to the World Health Organization, breastfeeding is natural and the most effective way of nourishment to feed infants and young children to ensure child health and survival. Currently, the World Health Organization, the American Academy of Pediatrics, and other health organizations recommend exclusive breastfeeding during the first 6 months of life. Although exclusive breastfeeding has been shown to reduce the occurrence of adverse health outcomes to the infant and mother, the duration of exclusive breastfeeding remains relatively low in the United States. The theory of planned behavior was used as a theoretical framework for this study. The purpose of …

New Graduate Nurses: Evaluating An Innovative Mixed Method Orientation Program, Mary Josette Armendariz-Batiste

Walden Dissertations and Doctoral Studies

Institutions are recruiting new graduate nurses to fill their vacancies. The aim of this project was to create a new graduate nurse orientation program that consists of the Essentials of Critical Care Orientation (ECCO) program created by the American Association of Critical Care Nurses (2014), scenarios, and simulation that will result in an increase in nurses' sense of their ability to provide safe patient care, communicate effectively, perform skills, and increase their sense of institutional support. The theoretical framework for this mixed methods project was Benner's "From Novice to Expert." The convenience sample participants consisted of 17 baccalaureate-prepared new graduate …

An Evidence-Based Educational Intervention To Improve Nursing Staff's Critical Thinking And Decision-Making Skills, Rene Norene Barron-Kagan

Walden Dissertations and Doctoral Studies

An Evidence-Based Educational Intervention to Improve Nursing Staff's Critical Thinking and Decision-Making Skills

by

Rene N. Kagan

MSN, University of New Mexico, 2009

BS, University of Phoenix, 2000

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

September 2016

Hospitalized patients in acute care settings are at a high risk of developing health complications that can eventually lead to failure to rescue (FTR) situations. The aim of this project was to deliver a structured comprehensive medical-surgical competency plan for acute care nurses to detect deterioration in a patient's condition through the …

Development Of A Mentorship Program To Help Support And Retain New Nurses, Sherrie Marie Jones

Walden Dissertations and Doctoral Studies

Many newly graduated registered nurses (NGRNs) leave the nursing profession within the first 2 years of employment in a rural hospital located in the Southwestern region of Oklahoma. A strategy to address this problem was to introduce a mentorship process that would help support the NGRNs as they transition into independent practice in the clinical setting. The goal of this project was to develop a mentorship program for future implementation. The Partners In Nursing (PIN) program sponsored by the Robert Wood Johnson Foundation, and developed by the American Association of Colleges of Nursing and the American Nurses Association, was selected …

Fostering An Environment Of Magnet Recognition By Using Internet Technology, Shyneka Montgomery

Walden Dissertations and Doctoral Studies

Magnet Recognition, a nurse-driven certification, is an acknowledgement of nursing excellence within a hospital. Magnetic Recognition supports the highest quality of patient outcomes and is the standard for nursing care and professionalism in nursing practice. The site for this project has engaged in the process of seeking Magnet Recognition but lacked a method of communicating their progress to staff, prompting the need for the institutional intranet Magnet webpage. Guided by Roger's diffusion of innovation theory and Lewin's change management model, the purpose of this quality improvement project was to develop an evaluation plan for this webpage on the institutional intranet. …

The Underuse Of Hospice Care In The African American Military Beneficiary Population, Wanda Castleberry Richards

Walden Dissertations and Doctoral Studies

Hospice services provide a holistic approach to end-of-life care to terminally ill patients though there is some evidence to suggest that African American military beneficiary populations may not access hospice care as often as expected. The purpose of this nonexperimental study was to evaluate reasons for the low use of hospice care among the terminally diagnosed members of this population, between the ages of 18 and 64. Kolcaba's comfort theory provided the theoretical framework for this study. The research explored whether a statistically significant difference exist among African Americans military beneficiaries population as compared to non-Hispanic Whites pertaining to their …

Impact Of Simulation On Nurses' Satisfaction, Confidence, And Communication In Neonatal Resuscitation, Kathryn Rudd

Walden Dissertations and Doctoral Studies

Teamwork and communication in clinical practice improves with simulation using the TeamSTEPPS program. However, there is limited research about simulation efficacy for improving neonatal resuscitation through enhanced communication. Based on a needs assessment and literature review specific to quality improvement strategies for neonatal resuscitation, an enhanced neonatal resuscitation provider (NRP) course was infused with TeamSTEPPS communication strategies, and an NRP case was adopted for simulation training. Also, utilizing clinician feedback, the flow of the resuscitation documentation was revised. The purpose of this project was to evaluate the perceived level of confidence, satisfaction, and communication skills in nurses performing neonatal resuscitation …

Reducing Length Of Hospital Stay For Intellectually Disabled Psychiatric Patients With Chronic Medical Problems, Joseph Wigwe

Walden Dissertations and Doctoral Studies

Length of hospital stay (LOS) is a major indicator for measuring efficient care. Intellectually disabled psychiatric patients (IDPP) with chronic medical problems have longer LOS due to challenges faced by providers in jointly managing both psychiatric and medical problems. The purposes of this study were to understand the significance of LOS for IDPP, create an intervention toolkit to reduce LOS, establish the content validity of the toolkit, and recommend its implementation. The items of the toolkit are pharmacology, somatic, rehabilitation, psychosocial, and monitoring patients' psychiatric and medical symptoms across care domains. The toolkit was created from the constructs of the …

Case Study Of Stakeholders' Views On Retention And Self-Efficacy In Texas Nursing Programs, Durcilla Kay Williams

Walden Dissertations and Doctoral Studies

Retention of students through the completion of the nursing degree is a problem that exists at local Texas nursing programs, adding to the nursing shortage at local Texas hospitals. The purpose of this qualitative research study was to identify the best practices used by a local Texas college with graduation rates above the benchmark of 85% set by the Texas Higher Education Coordinating Board. The study framework was based on Bandura's theory of self-efficacy and Tinto's theory of student retention. The research questions for the study focused on reasons the college maintained a high retention rate, best practices currently used, …

Reducing The Use Of Indwelling Urinary Catheters During Cesarean Deliveries, Michelle Renee Borland

Walden Dissertations and Doctoral Studies

One concern for medical professionals and women experiencing cesarean deliveries is the use of indwelling urinary catheters, which is associated with a delay in first void time, slower ambulation time, increased discomfort, longer hospital stays, and an increased risk for urinary tract infections. The purpose of this project was to determine if a practice change regarding the use of urinary catheters among pregnant women decreases the number of women receiving a catheter prior to having a cesarean section in a small community hospital. The knowledge to action and Rosswurm and Larabee's models were used to guide this project, which was …

Promoting Diabetes Self-Managment Eduaction And Training In Out-Patient Clinics, Inemesit Godwin Udo

Walden Dissertations and Doctoral Studies

Abstract

Type 2 diabetes mellitus (T2DM) is a long term metabolic disorder characterized by high blood sugar, insulin resistance, and relative lack of insulin. T2DM is a leading cause of cardiovascular disease, blindness, kidney failure, lower-limb amputation, and other complications that are costly to patients and the U.S. health care system. Lack of knowledge and underdeveloped skills for self-management of diabetes continues to be the biggest problem for patients with T2DM. Using a team approach and Rosswurm and Larrabee's (1999) conceptual model as a framework, the purpose of this doctorate of nursing practice quality improvement project was to develop an …

An Effective Succession Planning Educational Program For Operating Room Nurses, Sherly Bejoy Alexander

Walden Dissertations and Doctoral Studies

The current nationwide shortage of registered nurses is a growing problem impacting patient care and hospital operations. The operating room is the area most affected by the nursing shortage. Reasons cited for this shortage include ineffective nursing orientation programs and a decline in job satisfaction. The purpose of this project was to develop a best practice succession planning educational program to provide novice operating room nurses with an introduction to the operating room. The Dreyfus model of skills acquisition and Benner's novice to expert theory guided this project. A 2-step process was used to assess and validate the content and …

The Use Of The Illness Perception Questionnaire: Enhancing Clinical Staff Understanding, Typhanie Beasley

Walden Dissertations and Doctoral Studies

Women with Type II diabetes face unique challenges coping with the physiologic complications of the disease, which can be enhanced or hindered by their perception of their ability to effectively manage their diabetes. The Illness Perception Questionnaire (IPQ-R) is a tool that evaluates factors influencing patient-provider communication and assesses patient's perception of their health. Guided by the common sense model of self-regulation, this quality improvement project focused on familiarizing health care providers with the IPQ-R and evaluating their receptiveness to implement it with women with Type II diabetes. Seven Primary Care providers participated in an educational in-service that included information …

Transition To The Professional Role For Graduate Nurses In A Hospital Orientation Program, Shirley Denise Richardson

Walden Dissertations and Doctoral Studies

This study focused on the transitioning of graduate nurses (GNs) employed by a teaching hospital in the eastern United States to the professional role of registered nurse after a 6-week orientation was the focus of this study. Benner's novice-to-expert theory served as the framework for this qualitative case study. Twelve participants were chosen from 3 specific populations: GNs, nursing preceptors, and nurse managers. Three research questions asked about the perceptions of newly licensed nurses after completion of the orientation process related to their ability to make critical decisions in the professional role of RN, how the preceptor educational training program …

The Influence Of Nursing Academic Leadership On Faculty Retention, Carol Turrin Turrin

Walden Dissertations and Doctoral Studies

The critical nursing faculty shortage in the United States affects the ability of nursing schools to train an adequate number of nurses to meet increasing health care demands. Researchers have focused on the nursing faculty shortage; however, insufficient information exists on the relational influence leadership has on faculty retention. The research problem addressed in this study was the lack of information identifying how and in what ways leadership influences retention and intent to stay in academia. The purpose of this phenomenological study was to explore the perceptual views of current faculty, using the leader-member exchange theory. Focusing on baccalaureate nursing …

An Integrative Review Focusing On Accuracy And Reliability Of Clinical Thermometers, Julie Black Black

Walden Dissertations and Doctoral Studies

Technological advances in clinical thermometers have resulted in a variety of minimally invasive devices that give rapid results but may not have the accuracy necessary for use in acutely ill adults. Inaccurate temperatures can result in missed opportunities for the early identification and treatment of infection and sepsis. Following the methodology outlined by Whittemore and Knafl, the purpose of this project was to conduct an integrative review of the research on the accuracy of clinical thermometers used for acutely ill adults. The evidence was categorized using the Hierarchy of Evidence for Interventional Studies, and the quality of the studies was …