Medicine and Health Sciences Commons^™

Evidence-Based Practice Project Proposal: Reducing Chfrr Through The Get Well Networks Chf Prevention Education Materials, Susan Kay Richmond

Walden Dissertations and Doctoral Studies

In the United States, congestive heart failure (CHF) impacts 6.5 million adults and costs about $39 billion year with a projected incidence increasing by 25% by 2030. CHF can be addressed by advancing patient self-care knowledge through interactive patient education. For this project, the Health Beliefs Model guided a strategy to stimulate behavior modification based on perceived benefits of self-care. The purpose of this quality improvement project was to implement an interactive patient education video system, called the Get Well Network, to encourage patient self-care to reduce CHF readmission rates at a veteran's administration hospital. Four evidence-based CHF video order …

The Relationship Between Pre-Licensure Employment And Student Nurse Self-Efficacy, Khristina Lee Grimm

2017 Program & Posters

Lack of self-efficacy in nursing practice contributes to high levels of stress as new nurses enter the workforce, which causes turnover during their first year of practice. Little is known about how the type and amount of pre-licensure employment affects the selfefficacy in nursing practice of the student nurse.

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 …

Appraisal Of Nonpharmacological Chronic Pain Management, Yvonne Larue Anthony

Walden Dissertations and Doctoral Studies

Chronic pain is a condition that impacts millions of men and women around the globe. It is a compelling disease that particularly impacts quality of life (QOL) for many veterans with undertreated or untreated pain. The focus of this systematic literature review was the appraisal of articles and clinical practice guidelines to better understand best-practice nonpharmacological strategies for management of chronic pain. Key words used in the literature search included chronic pain and veterans, complementary alternative medicine (yoga, tai chi, music therapy, acupuncture, and massage), and cognitive behavioral therapy (CBT). The articles included in the review were limited to those …

Development Of A Plan For A Navigator Program, Linda Dunaway

Walden Dissertations and Doctoral Studies

Following implementation of the Patient Protection and Affordable Care Act, hospitals have seen a reduction in Medicare reimbursement for 30-day post-discharge readmissions of acute myocardial infarction patient. The purpose of this project was to develop a plan for a navigator program to improve a patient's health status post discharge and reduce readmission rates. The Johns Hopkins nursing evidence-based practice model and guidelines were used in determining the quality of obtained experimental and non-experimental studies with or without meta-analysis and popular source articles. The literature revealed the most successful programs involved providing best practices for a navigator program allowed better patient …

Effective Communication And Teamwork Improve Patient Safety, Helene M. Anderson

Walden Dissertations and Doctoral Studies

Work environment influences the effectiveness of care for patients in any healthcare setting. It is even more important in settings such as the neonatal ICU (NICU) where this project took place. When the environment is not healthy, communication may suffer and result in poor patient outcomes and, family, patient, and staff dissatisfaction. The purpose of this quality improvement project was to understand how the implementation of the TeamSTEPPS program, for nurses in the NICU, could impact the safety culture as measured by the AACN Healthy Work Environment (HWE) tool. Lewin's professional practice change theory and the AHRQ change model were …

Nursing Approaches For Use And Sustainability Of Barcode Medication Administration Technology, Jackson Ngigi Njeru

Walden Dissertations and Doctoral Studies

Approximately 43.4% of medication errors occur at the time of administration despite the use of bar code medication administration (BCMA) System. This trend has prompted a national effort to mitigate this problem in the United States. Implementing BCMA in health care settings is one of those efforts. Studies focusing on the approaches employed by nurses when using this system are scant. The purpose of this qualitative case study was to investigate strategies nurses and their leaders use to ensure BCMA is implemented, maximized, and sustained. The technology acceptance model was used to guide the study. The 2 research questions addressed …

Design And Development Of An Educational Intervention On Nurse Perceptions Of Caring, John S. Norris Iii

Walden Dissertations and Doctoral Studies

Caring is central to the nursing profession and important to patients and family members who expect nurses to display caring attributes. The acute care hospital in this study did not have an education program on caring practices for nursing staff although the organization acknowledged the importance of and need for a culture of caring practices in the organization. The purpose of this project was to design an educational program based on Watsons' theory of caring for registered nurses at the acute care hospital where the project took place. Rosswurm and Larrabee's model for change and Watson's theory of caring were …

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …

Advanced Triage Protocols In The Emergency Department, Lijuan Zhao

Walden Dissertations and Doctoral Studies

Overcrowded emergency departments (EDs) are a major problem in the United States resulting in inefficiency in operation and performance. A Southern California hospital ED was the site for this project because it had operated over its maximum capacity during the last decade. Advanced triage protocols integrating standard order sets were implemented to improve quality of care; however, no evaluation of the protocols had been done. The purpose of this project was to evaluate the effect of the advanced triage protocols. Two project questions determined whether advanced triage protocols reduced ED length of stay (LOS), number of patients who left without …

Barriers Cardiac Nurses Face In Addressing Psychosocial Issues Of Heart Failure Patients, Debra Kay Disbrow

Walden Dissertations and Doctoral Studies

Heart failure is a chronic disease and a common cause of hospitalizations and readmissions within 30-days of discharge. To decrease the cost of care for patients with heart failure, the Centers for Medicare and Medicaid Services initiated the Readmissions Reduction Program that reduces payment to hospitals with preventable readmissions. Among the causes for readmissions of patients with heart failure are concurrent behavioral health issues that can lead to decreased medication compliance and increased risk for disease progression. The prevalence of comorbid depression is as high as 77% among patients with heart failure and may be an important factor in readmissions. …

Promoting Policy Advocacy In Nursing Via Education, Carolyn Sue Jurns

Walden Dissertations and Doctoral Studies

Nurses have a professional, ethical, and social responsibility to advocate for optimal healthcare and an optimal professional environment. However, nurses often default on that responsibility. Leadership at a national nursing organization's state affiliate (SNO) perceived a need to optimize its members' policy advocacy. To meet that need, the Policy Advocacy Toolkit for Nurses (PATN) was developed for this doctoral project. The evidence-based PATN relied on established theories and frameworks, notably Knowles' adult education theory and Kingdon's multiple streams approach; research specific to this project; evidence from other researchers, healthcare organizations, and government websites; and input from a statistician, nursing education …

Introduction Of Evidence-Based Practice To Acute Stroke Center Nursing In Jakarta, Indonesia, Tonya Sue Stagner

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is a relatively new concept for nurses in Indonesia; it has not

been integrated into nursing care. This project sought to introduce EBP to nurses at an acute stroke center (ASC). The knowledge transfer team approach guided the project. The goal was to identify and analyze current data and to develop an EBP guideline for clinical nursing practice in the ASC. Sources of evidence that was used to address the practice-focused question included project team members, organizational documents, and a database search to identify EBP guidelines for the nursing care of acute stroke patients. A database search …

Examining Venous Thromboembolism Post-Operative Orthopedic Care Using Electronic Order Sets, Kelly Remancus

Walden Dissertations and Doctoral Studies

Venous thromboembolism (VTE) is a serious health concern of patients undergoing orthopedic surgery. Analysis of the study site semiannual reports from January 2014 through March 2015 indicated 10 VTE events in 546 orthopedic cases. The community hospital was classed as an outlier performing in the bottom 10th percentile when compared to other hospitals. To standardize the ordering of VTE prophylaxis, the hospital developed a postoperative electronic VTE order set. The purpose of this project was to assess the difference in orthopedic VTE occurrences in the postoperative total hip arthroplasty (THA) patients before and after the implementation of the electronic VTE …

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

Walden Dissertations and Doctoral Studies

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

College Health Clinic Population Health Improvement Plan Project, Kathryn M. Flynn

Walden Dissertations and Doctoral Studies

A college community health improvement plan (CHIP) focusing on the indicators of nutrition and weight status, and physical activity and fitness is designed with the goal of reducing obesity risk, improving health, and preventing chronic disease. The precede proceed model, logic model, innovative care for chronic conditions model, self-care theory, and Bandura's social cognitive learning theory were used as a research design framework for assessing, planning, and managing sustainability through a two-year college health clinic. The research questions were: what are the current health promotion inputs and activities in terms of environment, ecology, education, and policy and what could be …

Patients, Preferences, And Portals: Barriers Identified To Accessing Personal Health Information Through A Secure Online Website, Helen Patricia Fox-Mccloy

Walden Dissertations and Doctoral Studies

Patient engagement is one of the 6 quality directives issued by the Institute of Medicine for patient-centered care. Federal meaningful use regulations require health care organizations to offer patients a secure online website, or patient portal, to access their health information. Although the patient portal offers patients the opportunity to be more involved in their care, the portal has not been widely used. However, barriers to utilization are best understood from the perspective of the patient. Any barriers to patients accessing the portal are also barriers to patient engagement. The purpose of this project was to understand from the patient …

Body Piercing And Health Complications Among College Students In Puerto Rico, Elsie Goicochea

Walden Dissertations and Doctoral Studies

The incidence and prevalence of body piercing health complications among students is a public health matter that has not been researched in Puerto Rico. College students are the most consistent participants in body piercing activities and have reported health complications resulting in visits to medical offices and emergency rooms. Based on the health belief model, which is used to explain and predict health attitudes, the purpose of this quantitative nonexperimental study was to analyze the health risks and possible complications occurring after body piercing and to investigate the association between sex and age and medical complications. Data were collected from …

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

Walden Dissertations and Doctoral Studies

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

Improving Nurse Mentor Retention Through The Use Of Nurse Residency Programs, Morgan Newman

Walden Dissertations and Doctoral Studies

Graduate nurses beginning their nursing career require a collaborative relationship with an expert nurse mentor to make this transition successful. However, high turnover among these experienced nurse mentors is causing a problematic gap in knowledge transfer, experience, and expertise in the nursing workforce. This project investigated whether nurse mentors who mentored in a Nurse Residency Program (NRP) remained with the organization longer and were more satisfied with their mentoring experience than nurse mentors who mentored outside of a NRP. The diffusion of innovations theory was used to support the project and process of dispersing information on the outcome of the …

Development Of A Transformational, Relationship-Based Charge Nurse Program, Kimetha D. Broussard

Walden Dissertations and Doctoral Studies

Leaders of a rural Southwest Oklahoma hospital requested the development of an evidence-based program that could transform unit charge nurses into effective leaders in order to improve the leadership of direct care nurses. Nursing executive leadership discovered staff members were demonstrating high levels of stress, dissatisfaction, and burnout. Press-Ganey survey results revealed that staff felt they were not supported and did not believe nurses cared for patients' or other co-workers' well-being or safety. The Hospital Consumer Assessment of Healthcare Providers and Systems outcome scores, which were below hospital and national desired benchmarks, revealed that patients were not satisfied with the …

A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy

Walden Dissertations and Doctoral Studies

Lung cancer affects many individuals each year and accounts for many deaths around the globe. Lung cancer screening is a preventative health measure that has the ability to detect lung cancer earlier. The purpose of this project was to focus on the education of nursing staff within a community health system, with subsequent implementation of an electronic health record clinical decision support system, to create a direct referral pathway to lung cancer screening, delivered through patient education. The concept of prevention was the framework for this project design, which was further organized around the plan-do-study -act model, while taking into …

Perfecting Patient Bed Flow In The Emergency Department, Kim-Sun Moreira

Walden Dissertations and Doctoral Studies

Emergency department (ED) crowding is a serious problem in the United States. Crowding in the ED can result in delays that may negatively affect patient outcomes and increase the cost of care. The purpose of this project was to understand strategies that can help to improve patient flow in the ED. The plan-to-do-study act model for process improvement influenced this project. Secondary data were collected for a 2-month period to determine the impact of workflow processes (patient boarding time in ED, surge capacity and workflow processes including the impact of ancillary departments) on the movement of admitted patients from the …

Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown

Walden Dissertations and Doctoral Studies

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of …

Defining The Scope Of Practice For Nurse Practitioners In Miam, Samantha Lucero

Walden Dissertations and Doctoral Studies

Minimally invasive aesthetic medicine (MIAM) is a relatively new field, which lacks a clearly defined scope of practice. The purpose of this project was to clarify the scope of practice for nurse practitioners in MIAM in California. Without a clearly defined scope of practice, nurse practitioners are unable to practice to the full extent of their license which causes them to be underutilized and face liability issues. This project sought to answer the question: What is the scope of practice of the nurse practitioner in MIAM in the state of California? The model of professional nursing practice regulation was the …

Effectiveness Of A 10-Week Weight Reduction Program In A Retail Clinic, Love Chibuihe Nzeako

Walden Dissertations and Doctoral Studies

Obesity is a serious health problem that leads to several chronic diseases and premature deaths. TheIn this project,was used to evaluate the effectiveness of the the Weigh Forward (WF) program, a 10-week weight-loss program administered in retail clinics, was evaluated, and it is provided in retails stores. The project analysis was completed on a limited data set on The population consisted of 15 obese participantsmembers of the program, 18 years and above, at 13 dispersed clinics in Maryland and Virginia.in the WF program from 13 dispersed clinics in Maryland and VirgiObesity is a body mass index (BMI) > 30 kg/m2. Participants …

Nurse-To-Nurse End Of Shift Report, Winifred N. Nzeribe

Walden Dissertations and Doctoral Studies

Handing over patient care at the end of a shift is a complex part of nursing practice that is commonly fraught with challenges. Ineffective communication continues to be the leading cause of sentinel events in the hospital setting. In response to this practice problem, this project involved the implementation of a standardized bedside reporting protocol in a surgical unit in line with the best available evidence. The overarching goal of this project was to determine how an end of shift reporting tool would impact communication, involvement of patient in care provision, and continuity of care at the bedside. The protocol …

Violence Against Nurses, Terri Lynne Declerck

Walden Dissertations and Doctoral Studies

Workplace violence against nurses causes stress, job dissatisfaction, injury, and financial burden. The purpose of this project was to examine training for nurses on violence, risk factors and on reporting workplace violence. The practice-focused question was designed to examine the effectiveness of educating nurses regarding violent patients and how to report episodes of violence. Benner's novice to expert theory guided the skill acquisition training of a convenience sample of 25 Midwestern medical nurses. The nurses participated by completing a survey prior to and following a violence simulation. A qualitative design was used with the 25 nurse participants who completed the …

Strategies To Improve Job Satisfaction And Reduce Voluntary Employee Turnover Of Nurses, Stewart Proctor

Walden Dissertations and Doctoral Studies

Job satisfaction and employee turnover affect the health care industry in the form of overworked staff, inadequate health care, and loss of profits. In 2015, the United States health care industry had a shortage of over 923,000 registered nurses. Health care organizations lose an estimated $1.4 to $2.1 billion each year because of registered nurse (RN) turnover. These factors indicate that some managers lack the strategies to increase job satisfaction and reduce RN turnover. The purpose of this single case study was to use the Herzberg 2-factor theory to explore strategies 5 health care leaders use to improve nurses' job …

Barriers To Membership In A Professional Organization For Advanced Practice Nurses, Kesha Renee Walton

Walden Dissertations and Doctoral Studies

Professional organizations offer nurses services and resources for professional growth throughout their careers; yet, membership has declined over the past 10 years. Accordingly, this study was to understand the barriers in membership and identify positive changes that will increase membership and retain members. A quantitative descriptive design was employed within a convenience sample of 150 advanced practice registered nurses (APRNs) who were past or nonmembers of a professional organization. Exchange theory was applied and the Professional Association Membership Questionnaire (PAMQ) was administered to assess the barriers to APRNs participating in a specific professional organization. Statistical analysis included mean scores for …