Medicine and Health Sciences Commons^™

Quality And Safety Education In Newly Hired Rns And Rns In Staff Leadership Roles, Dennis Alan Bertch

Doctoral Dissertations

The intent of this project was to examine the potential knowledge, skills, and attitudes (KSA) gap of practicing bedside registered nurse (RN) care providers regarding the quality and safety education for nurses (QSEN) core competencies. Based on this perceived gap two key questions were explored: (a) do newly hired RNs and RNs in staff leadership roles demonstrate an understanding of the KSAs of the QSEN core competencies?; and (b) was there a difference in the understanding of the KSAs of the QSEN core competencies related to RN educational preparation, years of RN experience, and/or previous quality improvement training within and …

“I’Ve Accomplished Something Here” The Lived Experience Of Employed Breastfeeding Mothers: A Phenomenological Analysis, Jennifer Diane Stewart-Glenn

Doctoral Dissertations

Abstract

The purpose of this study was to describe the experience of employed breastfeeding mothers. Using a phenomenological approach based on the works of Merleau-Ponty, the researcher completed 13 interviews in which mothers with experience working full-time while breastfeeding were asked to describe their experiences. The interviews were transcribed verbatim and analyzed using a hermeneutical approach developed by Pollio and applied to nursing research by Thomas. Each interview was examined within the context of all the interviews to identify themes found throughout.

While participants’ experiences were grounded in the unsupportive world of the workplace, aspects of their experience became figural …

How Do Psychiatric Healthcare Workers Prevent The Use Of Restraint And Seclusion?, Kelly A. Carlson

Doctoral Dissertations

The purpose of this grounded theory method study was to understand the complex, interactive, and interrelated processes that psychiatric healthcare workers engage in to prevent the use of restraint and seclusion. Without supporting evidence of therapeutic validity, restraint and seclusion are commonly used by psychiatric healthcare workers to control disruptive patients. The Substance Abuse and Mental Health Services Administration issued a call for the elimination of restraint and seclusion use in psychiatric care settings in 2003. Workplace violence, another major public health concern, is both a cause and effect of the restraint and seclusion use. Individuals continue to be needlessly …

Central Line-Associated Bloodstream Infection Prevention In The Long-Term Acute Care Setting, Mary Lisbeth Dougherty Msn Rn Aocna

Doctoral Dissertations

Sustained reduction of central line-associated bloodstream infections remains elusive in many institutions, including the long-term acute care hospital (LTACH), despite a focus on improving patient outcomes. A clinical practice survey was distributed electronically to nurses working in the LTACH setting. The survey provided for an anonymous assessment of knowledge related to policy/procedure, fidelity to practice as well as site-specific barriers to adherence to clinical practice guidelines. Results revealed opportunities for education related to clinical practice guidelines and basic central line-associated bloodstream infection strategies as well as perceived barriers to adherence to policy/procedure. Strategies aimed at mitigating gaps and barriers are …

It Transforms All Of You: Lived Experiences Of Partners Of Iraq Combat Veterans With Traumatic Brain Injuries, Laurel Sue Cassidy

Doctoral Dissertations

Just over two million service men and women have been deployed to the wars in Iraq and Afghanistan over the past ten years. Conservative estimates suggest that nearly one fifth of those deployed sustain a blast induced mild traumatic brain injury (TBI). Nearly half of those in the service are married, meaning a large number of spouses unexpectedly find themselves navigating a “new normal” after their partner returns from combat with ongoing sequelae from a TBI.

Ultimately, a sizeable number of spouses of Iraq combat veterans with TBIs have found themselves in the role of caregiver. The large majority of …

Effects Of A Home-Based Exercise Program On Perception Of Illness And Adaptation In Heart Failure Patients, Robin Faust Harris

Doctoral Dissertations

Patients experience decreased functional capacity from chronic symptoms associated with heart failure. Exercise increases activity tolerance and quality of life in heart failure patients. Physiologic responses to exercise in heart failure patients have been well-documented. In contrast, the effects of exercise on an individual’s perception of degree of disability due to chronic illness and their adaptive responses to heart failure have not been studied. The purpose of this randomized controlled trial was to examine the effects of a 12-week home-based combined aerobic and resistance training exercise intervention on an individual’s perception of degree of disability and adaptive responses to chronic …

End-Of-Life Culture Care Expressions, Meanings, Patterns, And Practices Among Yup'ik Eskimo, Pamela J. Embler

Doctoral Dissertations

The need for end-of-life care research is exemplified by the fact that the National Institutes of Health has made this topic a research priority. End-of-life care is multifaceted and concepts become complex when cultural perspectives are considered. The purpose of this qualitative ethnonursing study was to discover culture care expressions, meanings, patterns, and practices at end-of-life among Yup’ik Eskimo in community settings. Data was obtained from Yup’ik Eskimo of the Yukon-Kuskokwim Delta, Alaska. The Culture Care Diversity and Universality Theory and the ethnonursing research method directed this study. Key and general informants were interviewed. Interviews and observations were analyzed. The …

The Relationship Of Basic Conditioning Factors, Knowledge, Self-Care Agency, Self-Care Behavior, And Urinary Sodium Excretion Of Hypertensive Older Adults: Testing Orem’S Self-Care Theory, Pratsani Srikan

Doctoral Dissertations

Understanding the powerful factors of sodium reduction benefits older adults by leading to reduce many health risks, lower the health care cost and diminished economic and social burden. This study had two aims: 1) to explore to what degree four factors--selected basic conditioning factors, knowledge of sodium reduction, sodium reduction self-care agency, and sodium reduction self-care behavior predict urinary sodium excretion in hypertensive seniors, 2) to test whether these variables related to sodium reduction were congruent with Orem’s Self-Care Theory.

Based on this theory, internal and external conditioning factors were proposed as either positively or negatively influencing an individual’s knowledge …

Increasing Resilience In Adolescent Nursing Students, Teresa Maggard Stephens

Doctoral Dissertations

Nursing students not only face the same developmental challenges as other college students, but also experience unique stressors that contribute to increased risk for negative outcomes. The intimate nature of patient care, the exposure to workplace adversity, death and dying, and the chaotic nature of healthcare can have cumulative negative effects on students’ health and well-being. Increased resilience could prove useful in helping students confidently face challenges and successfully move forward. The lack of empirical evidence regarding resilience-enhancing interventions with nursing students supports the need for examining the effectiveness of an educational intervention to increase resilience in adolescent baccalaureate nursing …

Presence In Nursing Practice: A Critical Hermeneutic Analysis, Alicia Laurel Bright

Doctoral Dissertations

Research Topic

Presence, although it involves action at times, is a humanitarian quality of relating that is ethically generated and has real-world implications for both patient and nurse. It is an interpersonal process characterized by sensitivity, holism, intimacy, vulnerability, and adaptation to unique circumstances that results in enhanced mental wellbeing for nurses and patients, and improved physical wellbeing for patients. Knowing and being with are foundational to being present.

Theory and Protocol

This research is grounded in critical hermeneutics and follows an interpretive approach to field research and data analysis (Herda 1999). This orientation places the researcher and participants in …