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Improving Nurses' Knowledge On The Assessment And Documentation Practices In The Pediatric Settings Of A Jamaican Hospital, Binol Rajesh Balachandar Jan 2022

Improving Nurses' Knowledge On The Assessment And Documentation Practices In The Pediatric Settings Of A Jamaican Hospital, Binol Rajesh Balachandar

Walden Dissertations and Doctoral Studies

AbstractThere have been anecdotal reports from the on-site Quality Assurance team, administrators, and educators that a theory-practice gap exists in pediatric nursing practice settings relating to the specific assessment and documentation. A deidentified chart review confirmed the reported practice gaps in 80% of the patient records. Therefore, in collaboration with the in-service unit, this staff education project and the educational interventions were implemented, and the knowledge improvement was appraised using a pre and posteducation survey. Mozirow’s reflective learning theory formed the basis for staff education, utilizing adult learning principles. Twenty-five consenting nurses completed the preeducation survey (N = 25); however, …


Perceptions Of Associate Degree Nursing Faculty Of A Primary End-Of-Life Care Course Within Prelicensure Nursing Curricula, Katherine Zaharchuk Jan 2022

Perceptions Of Associate Degree Nursing Faculty Of A Primary End-Of-Life Care Course Within Prelicensure Nursing Curricula, Katherine Zaharchuk

Walden Dissertations and Doctoral Studies

AbstractThe responsibility for educating U.S. nursing students on end-of-life (EOL) care concepts lies with prelicensure nursing programs; however, the majority of all prelicensure nursing programs offer only a few lectures, and only a small percentage offer EOL and palliative care courses. The lack of education on EOL care results in greater stress for nurses, poor symptom management for patients, and reduced support for family caregivers. There is limited knowledge on why primary EOL education has not yet been adopted by many Associate Degree in Nursing (ADN) programs. The purpose of this qualitative study was to explore the perceptions of ADN …


Creating A Clinical Practice Guideline For Patients With Uncontrolled Hypertension, Nar'cissa Mcdonald Jan 2022

Creating A Clinical Practice Guideline For Patients With Uncontrolled Hypertension, Nar'cissa Mcdonald

Walden Dissertations and Doctoral Studies

Cardiovascular disease is the leading cause of death globally, with hypertension (HTN)the primary causal factor. The nursing professions' role as a critical agent in facilitating the management of patients should be based on best practices. No specific standard exists in the United States for nurses despite the publication of Clinical Practice Guidelines (CPGs) on HTN for adults. A gap in practice was identified in an outpatient primary care clinic located on the Gulf Coast of Mississippi, as there is no comprehensive CPG for nurses to provide patients with complete HTN diagnosis and management care. A literature review revealed that clinical …


Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey Jan 2022

Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey

Walden Dissertations and Doctoral Studies

Retail health care clinics (RHCCs) were designed to ease the shortage of access to primary care by having nurse practitioners (NPs) provide quality care to patients on a walk-in approach. RHCCs can be stressful work environments and when NPs become dissatisfied, they may leave RHCCs which creates a shortage of primary care access. The purpose of this descriptive study, guided by Herzberg’s dual-factor theory, was to determine if there was a relationship between: (a) challenge/autonomy, and professional growth and job satisfaction among NPs who work at RHCCs and (b) intrapractice partnership/collegiality, professional, social and community interaction, time and benefits and …


Increasing Nurses’ Knowledge Of Richmond-Agitation Sedation Score Assessment And Documentation Through Education, Kara Jeanne Beaulieu Jan 2022

Increasing Nurses’ Knowledge Of Richmond-Agitation Sedation Score Assessment And Documentation Through Education, Kara Jeanne Beaulieu

Walden Dissertations and Doctoral Studies

Patients in the intensive care unit (ICU) are critically ill and faced with numerous physical and psychological stressors that often require a multidisciplinary approach to improve outcomes and relieve suffering. Patients are given sedation to tolerate invasive treatments and procedures. Using the Richmond-Agitation Sedation Score (RASS), nurses assess objective findings and the level of sedation a patient is experiencing, and titrate sedation according to an ordered RASS score. Ineffective and inaccurate use of the RASS score leads to patients being oversedated and demonstrates a lack of understanding of how to appropriately use the RASS score assessment tool. The purpose of …


Nonpharmacological Pain Control Following Hip And Knee Replacements In Older Adults, Adraine Cox Jan 2022

Nonpharmacological Pain Control Following Hip And Knee Replacements In Older Adults, Adraine Cox

Walden Dissertations and Doctoral Studies

Abstract Over prescribing opioids after hip and knee replacements in older adults is closely linked to the opioid epidemic. Despite being a public health concern associated with increased mortality rates, opioids are the most frequently used method for controlling postoperative pain. Therefore is important to know whether nonpharmacological pain control methods may effectively reduce the burden of opioid addiction, thus reducing the risk of opioid-related fatalities. The purpose of this study was to determine whether a systematic review of the literature provided evidence supporting nonpharmacological methods of pain control following hip and knee replacements in older adults compared to use …


Perceptions Of Instructor Caring Behaviors Between English As A Second Language And Non-English As A Second Language Nursing Students, John Chukwuemeka Dike Jan 2022

Perceptions Of Instructor Caring Behaviors Between English As A Second Language And Non-English As A Second Language Nursing Students, John Chukwuemeka Dike

Walden Dissertations and Doctoral Studies

AbstractEnglish as a second language (ESL) nursing students have a significantly higher attrition rate and lower National Council Licensure Examination (NCLEX) pass rate than their non-ESL counterparts. Instructor caring behaviors (ICBs) are the ways nursing instructors treat students with respect, taking care to avoid prejudices, stereotyping, and judgments in the teaching-learning process which present prelicensure faculty to grapple with the challenge of effectively meeting the learning needs of both ESL and non-ESL students. The purpose of this cross-sectional, comparative study, guided by Watson’s theory of human caring, was to explore the differences in perceptions of ICBs between ESL and non-ESL …


Focused Surrogate Decision-Maker Identification In The Traumatically Injured Adult, Kelly Ann Evans Jan 2022

Focused Surrogate Decision-Maker Identification In The Traumatically Injured Adult, Kelly Ann Evans

Walden Dissertations and Doctoral Studies

AbstractPatients in the trauma care setting are often dependent on their families and physicians to decide medical treatments when they cannot participate in the process.But in up to one-third of cases, the surrogate decision-maker (SDM)selected by the patient is not the emergency contact listed in the electronic medical record (EMR).SDM identification and documentation will ensure that the patient is best represented by someone who knows their values and goals if they become incapacitated.Nurses can facilitate identifying a patient’s SDM and document this choice in the EMR.The purpose of this study was a staff education program to improve intensive care unit …


Development Of Staff Education On Improved Compliance Adherence In Sleep Apnea, Mayla F. Garcia Jan 2022

Development Of Staff Education On Improved Compliance Adherence In Sleep Apnea, Mayla F. Garcia

Walden Dissertations and Doctoral Studies

The increasing prevalence of sleep disorders such as obstructive sleep apnea (OSA) affects approximately 25% of adults in the United States and an estimated 34% of men and 17% of women in the primary care population. In the clinical project site, the practice problem involved the increasing clinicians’ knowledge about OSA and being able to implement screening tools for further treatment and evaluation. The purpose of this project was to develop an educational training and intervention for staff to increase their knowledge of OSA conditions and have it validated by a panel of experts before dispersing it to the intended …


A Self-Guided Educational Program Based On Informatics Competency Self-Assessment, Brenda J. Kulhanek Jan 2022

A Self-Guided Educational Program Based On Informatics Competency Self-Assessment, Brenda J. Kulhanek

Walden Dissertations and Doctoral Studies

The informatics competency gap for nurses has existed since the first use of technology in healthcare. Although numerous informatics competencies for nurses have been identified over the past 20 years, there is a lack of standardized educational content to help address the informatics competency gap. In a digital healthcare environment, the ability for nurses to understand and use informatics competencies is essential and the lack of informatics competency has a far-reaching impact. Based on the identified gaps, an informatics competency self-assessment tool with associated microeducation was developed to provide a standardized learning approach that would be supported by stakeholders in …


An Educational Program For Standardization Of Care For The Acute Opioid Withdrawal, Jessica Ann Larson Jan 2022

An Educational Program For Standardization Of Care For The Acute Opioid Withdrawal, Jessica Ann Larson

Walden Dissertations and Doctoral Studies

Opioid addiction is a widespread chronic disease affecting millions of Americans each year, resulting in medical, social, financial, and societal detriments. Patients experiencing opioid withdrawal benefit from a standardized and evidence-based approach to care. The purpose of this doctoral nursing project was to provide inpatient nursing education for a standardized clinical practice approach to optimize patient outcomes. The research question examined the impact of an educational program for nurses presenting a new standardized opioid withdrawal clinical practice guideline inclusive of assessment, nursing interventions, a symptom triggered order set, and follow up plan of care in terms of knowledge gained and …


Education Of Staff On Promoting Yoga Activities In Women With Depression, Ahaoma Roselima Nnebedum Jan 2022

Education Of Staff On Promoting Yoga Activities In Women With Depression, Ahaoma Roselima Nnebedum

Walden Dissertations and Doctoral Studies

AbstractMajor depression is a serious global health issue and one of the most common mental health problems women face in the United States. The problem in this DNP project, Education of Staff on Promoting Yoga Activities in Women with Depression, was the lack of staff knowledge in using yoga activity to treat women with depression resulting in suboptimal care of women with depression. The DNP project questions were addressed by collecting evidence-based information from the literature to develop the education and to explore if the DNP project would improve the staff knowledge of yoga allowing for the application of the …


Exploring Moral Distress, Ethical Climate, And Psychological Empowerment Among New Registered Nurses, Luz Bruel Mauro Jan 2022

Exploring Moral Distress, Ethical Climate, And Psychological Empowerment Among New Registered Nurses, Luz Bruel Mauro

Walden Dissertations and Doctoral Studies

Moral distress in nursing has been an issue for decades and has consequences on nurses’ physical, emotional, and psychological well-being. Nurses in different settings experience a high intensity and frequency of moral distress particularly in intensive care units (ICU), but few studies have examined the moral distress of non-ICU nurses. The purpose of this 3-manuscript dissertation was to assess the frequency and level of moral distress, ethical climate, and psychological empowerment among new registered nurses (NRNs) who work in non-ICU settings. The conceptual framework of Jameson's moral distress guided this study. Twenty-three NRNs with fewer than 3 years of experience …


Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts Jan 2022

Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts

Walden Dissertations and Doctoral Studies

A healthy work environment for nurses is critical to staff recruitment, retention, patient safety, and the financial sustainability and viability of a healthcare organization. The specific research problem under study was whether a lack of advancement opportunity or a lack of good leadership has an impact on African American female nurses leaving the nursing profession. Researchers have investigated the impact of leadership and advancement opportunity on the general population, but there is a dearth of research specific to African American female nurses and their reason for leaving the profession. Secondary quantitative data analysis was performed using survey data from the …


Staff Education Program: Increasing Nursing Knowledge Of Exclusive Breastfeeding, Leigh Anne Panek Jan 2022

Staff Education Program: Increasing Nursing Knowledge Of Exclusive Breastfeeding, Leigh Anne Panek

Walden Dissertations and Doctoral Studies

AbstractIn the initial postpartum period, exclusive breastfeeding (EBF) improves women's and children's health status and outcomes. Gaps in nursing practice that decrease the rate of EBF during hospitalization at this site were identified by the lactation consultant using a standard chart audit during the last two years. The purpose of this Doctor of Nursing Practice education project was to provide a comprehensive education program that included the purpose, philosophy, nursing practice, and evaluation tools for increasing the EBF rates to meet the Joint Commission’s standard of improvement for perinatal care core measures. A formal educational program that included didactic and …


Clinical Practice Guidelines For Type 2 Diabetes Patients, Rajeena Varghese Jan 2022

Clinical Practice Guidelines For Type 2 Diabetes Patients, Rajeena Varghese

Walden Dissertations and Doctoral Studies

In the United States, Type 2 diabetes mellitus (T2DM) is a public health concern and a primary cause of readmissions to hospitals. Many patient readmissions may be avoided if quality, evidence-based clinical practice guidelines (CPGs) are developed and followed using a comprehensive approach. The project site’s retrospective analysis of electronic health records indicated a lack of consistency in following best practice recommendations, as shown by higher readmission rates. The purpose of this project study was to create a current evidence-based CPG that nurses can use to educate T2DM patients before being discharged from the hospital. The practice-focused question addressed whether …


Perceptions Of Human Interactions In Adult Patients After Using Digital Therapeutic Mobile Applications, Traci Brakefield Jan 2022

Perceptions Of Human Interactions In Adult Patients After Using Digital Therapeutic Mobile Applications, Traci Brakefield

Walden Dissertations and Doctoral Studies

AbstractWhile the use of technology in healthcare has been present for many years, the recent rise of digital therapeutics in healthcare has been understudied, specifically regarding the perceptions and experiences of patients using mobile applications. Traditional healthcare involves face-to-face human interactions, requiring scheduled check-ins and provides structured interventions. Conversely, Digital therapeutics is primarily comprised of human to machine interactions. Digital therapeutics allows the user to access intervention in their time of individual need. The decrease of human-to-human interaction and the rise of human-to-machine interaction was explored in this qualitative descriptive phenomenological study from the patient perspective. Watson’s theory of human …


Experiences Of Bsn Graduates Integrating Cultural Competence When Caring For Multicultural Patients, Judith A. Daniels Jan 2022

Experiences Of Bsn Graduates Integrating Cultural Competence When Caring For Multicultural Patients, Judith A. Daniels

Walden Dissertations and Doctoral Studies

Registered nurses entering the workforce with baccalaureate of science degrees in nursing (BSN) are expected to be knowledgeable and skilled in planning and caring for multicultural patients, but there is little information on what experiences new nurses have in implementing culturally competent care. The purpose of this descriptive phenomenological study, guided by the Campinha-Bacote process of cultural competence in the delivery of health care services model, was to understand the lived experiences of BSN graduates with one year or less experience in implementing cultural competence in planning care for their multicultural patients. The research question directly addressed this purpose. Ten …


Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig Jan 2022

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …


Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen Jan 2022

Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen

Walden Dissertations and Doctoral Studies

AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …


Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth Jan 2022

Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth

Walden Dissertations and Doctoral Studies

In the United States, 34 million people have diabetes and 79 million have prediabetes. Currently, one in nine Americans are diagnosed with diabetes and it is projected that one in five will have diabetes by 2025 and one in three by 2050. The practice-focused question answered by this project addressed the question if implementing a staff education program improved staff’s knowledge about self-management education and intent for providers and staff to promote a formal diabetes self-management education (DSME) program in an overseas military treatment facility. The site has 47% of empaneled beneficiaries with diabetes mellitus Type II with an elevated …


The Lived Experience Of Expectant Mothers During The Covid-19 Pandemic, Bridgette Schulman Jan 2022

The Lived Experience Of Expectant Mothers During The Covid-19 Pandemic, Bridgette Schulman

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic has resulted in many changes to obstetric care practices. While the changes aimed to decrease transmission and protect mothers and infants, the study revealed unintended consequences of the changes put in place during COVID-19. Currently, there is a gap in knowledge and understanding of how the changes in obstetric care practices affect women’s perceptions of the birth experience. The purpose of the study was to explore the lived experience of mothers who gave birth in the health care setting during the COVID-19 pandemic through the eyes of those who experienced it. The research question was: What is …


Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli Jan 2022

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …


Bmi Screening Tool To Identify Elementary School Children At Risk For Obesity, Talia S. Thompson-Jones Jan 2022

Bmi Screening Tool To Identify Elementary School Children At Risk For Obesity, Talia S. Thompson-Jones

Walden Dissertations and Doctoral Studies

Obesity is a public health epidemic and is as relevant in the pediatric population as it is in adults. The purpose of this DNP project was to develop a clinical practice guideline (CPG) that would use existing evidence to support the development of body mass index (BMI) screening in primary schools for the early detection of childhood obesity. Globally, more than 41 million children were obese or overweight by 2018. Due to incidence rates, developing an effective strategy to address childhood obesity is critical. The practice-focused question asked whether the evidence supported the development of a CPG for implementing BMI …


Systematic Literature Review Of Residency Program For Transition To Intensive Care, Sonja Marguerite Thornton Jan 2022

Systematic Literature Review Of Residency Program For Transition To Intensive Care, Sonja Marguerite Thornton

Walden Dissertations and Doctoral Studies

The purpose of the systematic literature review project is to present the benefits of a nurse residency program (NRP) to assist new graduate nurses (NGNs) in transition to intensive care nursing. A theory-to-practice gap in knowledge and experience results in the need to support these nurses during their transition to professional practice. This project focused on compiling a systematic review of existing literature to provide evidence and insights into the optimal structure and process of transitioning new graduate nurses to intensive care nursing practice. The American Associations of Critical Care Nurses synergy conceptual model and Patricia Benner's novice to expert …


Staff Education On Hepatitis C Screening Guidelines, Duy Le Trinh Jan 2022

Staff Education On Hepatitis C Screening Guidelines, Duy Le Trinh

Walden Dissertations and Doctoral Studies

Hepatitis C virus (HCV) is found worldwide, but the burden is much higher in correctional settings compared to general populations. In a detention centered located in Washington, the nurses at booking do not know who are at risk for Hepatitis C. This Doctor of Nursing (DNP) project attempted to answer the question of if educating nursing staff at the detention facility in Washington increase their knowledge of the importance of screening inmates for hepatitis C.The purpose of this project was to educate nursing staff about the risk factors for HCV so that proper screening can be done. Knowles’s adult learning …


Opioid Naloxone Education Clinical Practice Guideline, Tat'yana Sahleem Alethia Worthy Jan 2022

Opioid Naloxone Education Clinical Practice Guideline, Tat'yana Sahleem Alethia Worthy

Walden Dissertations and Doctoral Studies

As a result of an institution-wide campaign to train providers on the administration of opioid reversal agents within a large medical center in the northeastern United States, the practice problem emerged that there was no patient/family education document for healthcare providers to use as a guide to educate patients on opioid risk and proper administration of naloxone to prevent opioid overdose in the outpatient setting. This scholarly project used an interprofessional team to develop comprehensive opioid naloxone education guidelines to close the gap in clinical practice. The purpose of this project was to develop a patient education clinical practice guideline …


Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams Jan 2022

Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams

Walden Dissertations and Doctoral Studies

AbstractDiabetes is among chronic or lifestyle-related illnesses posing health care challenges at epidemic proportions, pressuring health care systems infrastructure for positive outcome-driven practices and sustainable costs, as continued research suggests that obese people are up to 80 times more likely to develop type 2 diabetes. In June 2021, a weight-loss and wellness center serving this high-risk population established recommended guidelines for Hemoglobin A1C (HbA1C) screening and education. During the initial 3 months of implementation, data findings captured 37% in a total of 220 with elevated HbA1C levels. The gap in practice is that the Wellness Center did not have a …


Overcoming Barriers To Executive Leadership Advancement Of Nurses From Racial And Ethnic Minority Backgrounds, Ena M. Williams Jan 2022

Overcoming Barriers To Executive Leadership Advancement Of Nurses From Racial And Ethnic Minority Backgrounds, Ena M. Williams

Walden Dissertations and Doctoral Studies

The social problem is the underrepresentation of nurses with racial and ethnic minority backgrounds in executive nursing leadership positions as compared to the general population. The management problem is that even when academically prepared, nurses with racial and ethnic minority backgrounds perceive that they face both singular and systemic barriers to promotional opportunities to executive nurse positions, which can lead to negative organizational and societal outcomes. A literature gap exists as to why this phenomenon persists. The purpose of this qualitative, narrative inquiry study was to explore the personal stories and lived experiences of a purposive sample of 17 executive …


Nursing Faculty Experiences With Interactive Games And Gaming And Student Preparedness, Laura S. Dana Jan 2022

Nursing Faculty Experiences With Interactive Games And Gaming And Student Preparedness, Laura S. Dana

Walden Dissertations and Doctoral Studies

Although instructional strategies to enhance student learning is a critical component of the faculty role, nursing education has been slow to incorporate games and gaming into the learning environment. The primary purpose for this qualitative phenomenological research study was to explore the lived experiences of nursing faculty of associate degree programs, specifically regarding the use of games and gaming as interactive, experiential teaching and learning strategies. This study was designed to answer the question, “What are the lived experiences of faculty who use games and gaming as instructional approaches in associate degree nursing (ADN) education.” Through one-on-one interviews via Zoom …