Medicine and Health Sciences Commons^™

The Impact Of A Structured Civility Educational Module And Cognitive Rehearsal Training (Crt) On Job Satisfaction And Turnover In Rural Healthcare Employees: A Quality Improvement Pilot Project, Laurel Matthews

Doctor of Nursing Practice (DNP) Manuscripts

Incivility is a top-cited stressor resulting in decreased job satisfaction and turnover. Uncivil behaviors jeopardize patient safety through poor communication and team ineffectiveness. This project aimed to determine if a structured civility educational module with CRT positively impacted job satisfaction and turnover of healthcare employees.

A pretest using the Workplace Civility Index (WCI) and investigator generated questions determined current civility behaviors, notable civility issues, and attitudes surrounding job satisfaction and turnover. The interactive, virtual modules highlighted dilemmas regarding incivility and their consequences to patient care. During CRT, the participants responded to filmed, uncivil conflicts using provided frameworks to curate civil …

Use Of A Remote Patient Home Telemonitoring System (Engage Practice Solutions) In A Rural Health System To Decrease Rural Patients’ Utilization Of Acute Healthcare Services: A Quality Improvement Project, Christopher Baker

Doctor of Nursing Practice (DNP) Manuscripts

Individuals in rural areas of the U.S. have less healthcare access in large part due to access barriers, and include travel and wait time, distance to a provider, cost, transportation, and social and cultural components. Rural individuals have been found to be in poorer health and have higher rates of being uninsured and having chronic disease. These disparities lead to rural individuals requiring more expensive acute care once they are at the point of receiving care. A significant burden is placed on the individual and health system. The rates of emergency department (ED) use in rural areas increased 70% from …

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Sepsis Initiative: Champion Series, Ashlie Barnes

Doctor of Nursing Practice Projects

Sepsis is defined as a life-threatening organ dysfunction syndrome caused by a dysregulated host response to infection. Septic shock is defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a higher risk of mortality than with sepsis alone. Each year, more than 1.7 million people are diagnosed with sepsis in the United States, and at least 270,000 Americans die. There is no confirmatory diagnostic test to diagnose sepsis. Therefore, clinical judgment based on evidence of infection and organ dysfunction is key.

Despite thousands of articles and hundreds of trials, sepsis plays …

Improving Health Literacy For Diabetics In A Rural Community, Elissa Purvis

Doctor of Nursing Practice Projects

Adults with type II diabetes mellitus need to understand the disease and manage their chronic condition to live a healthy and comfortable life. This project aimed to educate adults with type II diabetes mellitus in self-management of their chronic illness to increase their health literacy to improve their heart health, kidney health, nutrition, and exercise. The project utilized a Doctor of Nursing Practice (DNP) approach to education for adults with type II diabetes mellitus on the disease process.

METHODS: This project is a quality improvement project focused on educating adults with type II diabetes mellitus in managing their chronic conditions …

Nursing Orientation And Effect On Retention In A Rural Medical Facility, Miranda Plumlee

Doctor of Nursing Practice Scholarly Project

New graduate registered nurses (NGRNs) need post-graduate support to ease their transition into professional practice and to decrease turnover. Orientation programs have been identified as a method to increase NGRN retention, job satisfaction, and competence. With the current nursing shortage, it is essential to maintain NGRNs in the profession, especially since they encompass the largest population of nurses leaving the profession each year. The purpose of this project was to develop an understanding of the effect that nursing orientation has on job satisfaction, competence level, and the retention of NGRNs in a rural Kansas medical facility. A quantitative approach was …

Understanding The Emotional And Treatment Impact Of Recurrent Miscarriages For Women Living In Rural Medically Under-Served Areas, Whitney Dickerson

Doctor of Nursing Practice Scholarly Project

Purpose: The main purpose of this study was to identify woman’s feelings, support system, and their grieving process after repeating miscarriages. It was also used to identify any medications or treatments sought for miscarriages and pregnancies.

Design: A qualitative study was completed using a series of interviews performed in the rural area of Southeast Kansas regarding miscarriage history and the women’s experiences. Locating women to interview was done through social media, women were chosen who had a series of three or more miscarriages. The study examined access to fertility care in rural communities and the impact of access on …

Rural Young Adult Health: Drivers And Barriers To Accessing Care, Maggie Thompson

DNP Qualifying Manuscripts

Adolescents and young adults are developmentally inclined to seek autonomy and take risks. This propensity for risk and challenging boundaries is essential for personal identity formation and belief systems development. During the transition to adulthood, adolescents and young adults often place a high value on peer group acceptance and adhering to perceived social norms. As a result, adolescents and young adults are more likely to engage in pleasure-seeking behaviors despite the associated risks.

The potential for harm often grows in young adulthood, as newfound freedoms present more significant opportunities to engage in risk-taking behaviors. Despite some enduring controversy, age-specific, preventative …

Are Nurses Joining The Ride? Equine-Assisted Activities And Therapies Review, Khalid Bandar Almasloukh, Pamela Stewart Fahs

People and Animals: The International Journal of Research and Practice

Background: Equine-assisted activities and therapies (EAAT) is a rapidly growing practice that is described as therapeutic and entertaining. Complementary therapies such as EAAT are gaining acceptance as the health care needs of the population are changing.

Method: This systematic review draws from four databases. The final review included 52 articles.

Purpose: To explain what is known about EAAT and identify literature gaps. Nursing and rural perspectives are included in the analysis and recommendations.

Findings: There are more than eight types of EAAT and different organizations around the world are providing certification for EAAT. Rural communities and organizations may benefit from …

Satisfaction Of Telehealth For The 55+ Population, Cynthia Schweizer

Doctor of Nursing Practice Projects

There is a primary care need for the 55+-year-old population related to the increasing aging population, physician shortages, and, more recently, Coronavirus Disease 2019 (COVID-19) to implement Telehealth care. The Telehealth project will include the 55+ population to provide more participants for the project at an internal medicine clinic. Telehealth's contribution and interventions will affect causal factors such as moderating or mediating factors of health problems. Some of those factors include insufficient primary care coverage due to decreasing numbers of primary care providers (PCP), the increasing older population, complex health issues that come with aging, the need for frequent follow-up …

Effects Of Education On Rural Emergency Department Preceptors’ Self-Efficacy And Knowledge, Katherine Marie Jasper

Walden Dissertations and Doctoral Studies

The Emergency Nurses Association recommends nurse preceptorship programs for emergency departments (EDs) to give nurses the skills needed for precepting new nurses; however, many rural areas do not have nurse education for preceptorship, and no standardized training is available for preparing preceptors for their roles. Rural ED preceptors therefore lack knowledge and skills needed for precepting new nurses. The purpose of this study, guided by Benner’s skill acquisition and self-efficacy theory, was to determine if there were significant differences in 33 rural ED nurse preceptors’ knowledge and self-efficacy after they completed an online informational PowerPoint presentation. The PowerPoint education program …

An Integrative Review: Best Practices In Advanced Practice Registered Nurse (Aprn) Telehealth Services To Improve Outcomes For Children With Chronic Health Conditions, Tamara Sue Moyer

Doctoral Dissertations and Projects

Telehealth is a rapidly growing field that affords individuals the opportunity to receive access to specialty providers, reduce expenses and travel, break down geographic barriers, deliver equality of care, and improve patient outcomes. Equality of healthcare for pediatric patients with chronic health conditions in rural areas face geographic barriers to delivery of care, resulting in poor patient outcomes, and increased costs. An integrative review was completed to identify and describe research findings in an attempt to answer the clinical questions proposed and identify areas in research that can lead to improved patient outcomes. The need to receive access to specialty …

Collaborating With Rural Practice Partners To Address The Need For Registered Nurses In Primary Care, Robin Brown, Heidi Mennenga, Alham Abuatiq, Linda Burdette, Christiana Plemmons

College of Nursing Faculty Publications

Purpose: Primary care in rural areas of the U.S. urgently need competent healthcare providers, especially registered nurses (RNs). Registered nurses are ideal team members to help meet the primary care needs in rural communities, yet RNs are underutilized in primary care settings and rarely practice to the full scope of their license in these settings. The purpose of the project was to conduct a needs assessment with rural primary care practice partners to address the need for RNs in primary care.
Sample: A needs assessment was sent to nurse leaders at 13 rural primary care facilities via an online survey …

The Effect Of Asynchronous Versus Synchronous Online Course Delivery On Hesi Scores And Student Engagement For Rural Pre-Licensure Nursing Students, Susan Luke Belliston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since nurses are the primary providers of direct patient care in the United States, a shortage in any community can impact the quality of health care available. Rural areas were among the first to be affected by the current nursing shortage. Further challenges to the rural nurse supply include a lack of access to nursing education, particularly baccalaureate education.Both distance and online education options allow for the increased reach of higher education to rural areas. Existing nursing education literature focuses on graduate nurse education and baccalaureate completion education. The pre-licensure nursing student is mostly absent from the existing literature concerning …

A Program Evaluation Of A Rural Nursing Academic Partnership, Meagan A. Spencer

Electronic Theses and Dissertations

As the American Association of Colleges of Nursing and Commission on Collegiate Nursing Education continue to promote the implementation and creation of literature on academic partnerships, a Christian university, sought to evaluate its academic partnership with a for-profit hospital for the first time in regard to student perspectives. The purpose of this mixed-methods program evaluation was to describe the student perceptions of the academic partnership in trusting, collaborating, and engaging nursing students and recruiting and retaining nursing graduates to rural hospitals and health care facilities. Measurable impacts included both qualitative and quantitative coding of the levels of trust, collaboration, and …

Determining The Effectiveness Of System-Based Solutions To Improve Fragmented Care For Oncology Patients Living In Rural And Remote Regions: An Integrative Review, Andrea Nicole Fulmer

Doctoral Dissertations and Projects

The purpose of this integrative review is to review, critique, and synthesize the current literature to determine the state of the science related to the established systems approach for improving healthcare management and care coordination of the oncology patient population in rural and remote regions. The oncology patient population with co-existing chronic disease living in rural and remote regions experience fragmented health care. New cancer diagnoses take precedence over other existing comorbidities and require focused and specialized care for lengthy periods of time. Research is significantly limited for the current state of science for the identified patient population living in …

A Study Of Job Satisfaction And Turnover Intention Among Acute Care Nurses Working In Rural And Urban Settings, Yasin Yasin

Electronic Thesis and Dissertation Repository

In Canada, a close look at the nursing workforce shows a decline due to limited supply and increasing demand resulting in a looming shortage in the near future. Retaining nurses’ is a key strategy to overcome the shortage by limiting nurses’ turnover. Nurses’ job dissatisfaction is the most significant predictor of turnover intention and is associated with undesired outcomes such as nurses’ absenteeism, burnout, low service quality, and patient dissatisfaction. The differences in factors affecting job satisfaction between rural and urban nurses have not been fully studied. This study aimed to identify the differences and similarities in the extrinsic and …

Assessing The Health Literacy Levels Of Diabetic Patients Located In Rural Southeast Kansas, Meghan Murray

Doctor of Nursing Practice Scholarly Project

Data shows that limited health literacy is prevalent throughout the United States. This data has also found a correlative relationship between limited health literacy and poor health outcomes. An individual’s health literacy level affects many areas of their health, including their ability to effectively manage chronic diseases, such as diabetes mellitus. Awareness of an individual’s health literacy level allows for targeted interventions and a potential improvement for a patient’s health outcomes. The Newest Vital Sign (NVS) is a validated screening tool that allows for the identification of a patient’s likely health literacy level. The purpose of this Doctor of Nursing …

Improving End-Of-Life Care On Navajo Through Education, Johanna G. Bahe

Doctor of Nursing Practice Scholarly Projects

End-of-life care (EOLC) is an essential component of comprehensive healthcare and has been shown to improve the quality of life of patients and their families by preventing and relieving pain caused by physical, psychosocial, and spiritual complications. Many rural communities lack access to EOLC, specifically certified palliative and hospice services. The lack of this specialty in rural areas directly affects the experience of healthcare staff. The absence of education for rural healthcare staff and the importance of culturally sensitive care among indigenous people are key concepts in this study.

The purpose of this study was to measure the knowledge, confidence, …

Report: Creating And Piloting A Survey To Determine Readiness In Rural Populations In Ohio, Annie Bowen, Kay Ball

Doctor of Nursing Practice Scholarly Projects

In 2015, the Affordable Care Act and Medicaid expansion allowed over 700,000 Ohioans to gain access to healthcare insurance, but having health insurance did not improve access to healthcare providers. In rural populations in Ohio, there are several counties in which less than five healthcare providers are available for the entire county with little or no specialists available for patients. People in rural areas of Ohio may have significant travel time and distance to see a provider which decreases preventative health visits. Telehealth is the next big wave of technology and advancement for healthcare, but most rural populations in Ohio …

Poster: Creating And Piloting A Survey To Determine Readiness In Rural Populations In Ohio, Annie Bowen, Kay Ball

Doctor of Nursing Practice Scholarly Projects

In 2015, the Affordable Care Act and Medicaid expansion allowed over 700,000 Ohioans to gain access to healthcare insurance, but having health insurance did not improve access to healthcare providers. In rural populations in Ohio, there are several counties in which less than five healthcare providers are available for the entire county with little or no specialists available for patients. People in rural areas of Ohio may have significant travel time and distance to see a provider which decreases preventative health visits. Telehealth is the next big wave of technology and advancement for healthcare, but most rural populations in Ohio …

Implementing A Health Promotion Physical Activity Program For Middle School Youth In A Rural, Faith-Based Organization, Karmin Maher-Hasse

Doctor of Nursing Practice Projects

Problem: Childhood obesity is more prevalent in rural areas, and these areas have fewer resources to address it. Geographic distance to available resources, health care provider shortages, parental obesity, and poverty contribute to higher prevalence of obesity in rural children compared to urban children.

Rationale: Obesity prevention and treatment often requires long-term healthy lifestyle behavior changes including nutrition counseling and physical activity (PA). It is likely an obese pre-adolescent will have obesity as an adult, and the likelihood increases if obesity continues into adolescence. Pre-adolescence provides a window of opportunity to influence healthier PA habits to prevent overweight (OW) and …

Barriers To The Implementation Of Telehealth In Rural Communities And Potential Solutions, Mariana Barreiro, Ashley Coles, Caris Conradt, Emma Hales, Elizabeth Zellmer

Nursing Undergraduate Work

Telehealth is an ever-growing health care system, providing health services from a distance. Telehealth provides medical care through teletechnologies and two-way video and audio communication to connect doctors to patients. A detailed review was created to show the barriers and interventions of implementing a telehealth program in a rural area. The overall purpose of the systematic review was to find and explore relevant research and answer the question, “What are commonly encountered barriers to implementing telehealth in rural areas and what interventions can nurses implement to overcome these barriers?” The approach used to obtain quality data and research was convenience …

Multidisciplinary Team Approach To Prevent Hf Readmissions In Rural Areas, Naydu Lucas, Rn, Msn, Mba

Doctor of Nursing Practice Projects

Background: Despite the national efforts to decrease 30-days hospital readmissions, readmission remains a challenge for healthcare organizations across the continuum of care. The aim of this quality improve project was to develop and implement a multidisciplinary team approach to provide education to patients hospitalized with congestive heart failure (CHF) to improve 30-day hospital readmissions.

Method: This project was conducted in a critical access hospital in Northeast Washington. Using a pre-post design, we evaluated the 30-day readmission before and after implementing the multidisciplinary education program for patients hospitalized with CHF. The education focused on disease management, discharge education, pharmacy consult and …

Leading Rural Nurse Academic Progression, Cynthia Jean Larsen

Dissertations (1934 -)

Higher levels of nurse education have been associated with improved patient outcomes and lower healthcare costs. Members of rural populations are vulnerable, having poorer outcomes than urban inhabitants on a number of health indicators. Rural nurses are more likely than urban nurses to enter practice with associates degrees. Hence, academic progression is important for rural nurses and for the health of rural patients and communities. Rural nurse leaders work to promote the academic progression of rural nurses. Grounded theory methodology was used in this study to describe the concerns of and the actions taken by nurse leaders in the promotion …

Rural Definition Consistency Among U.S. Veteran Studies: A Rapid Review Of The Literature, Jed Hansen, Abbey Klein, Christine Eisenhauer, Marcia Shade

Posters and Presentations: College of Nursing

No abstract provided.

Enhancing Access To Parenting Services Using Digital Technology Supported Practices, Elaine Bennett, Wendy Simpson, Cathrine Fowler, Ailsa Munns, Jane Kohlhoff

Nursing Papers and Journal Articles

Background: Early parenting services (EPS) in Australia provide a range of expanding and rapidly changing services, including innovative digital technologies to improve service access for metropolitan and rural families.

Aim: This research aims to provide comprehensive information required for the planning, implementation and evaluation of the use of digital technologies for service delivery with parenting/child and family services in Australia and New Zealand in metropolitan and rural settings.

Methods: An interpretive descriptive approach was applied using semi-structured interviews from 23 EPS practitioners and managers in five sites.

Findings: These are presented as five main themes – preparing the way, practitioner …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Presenting The Good Mother: Experiences Of Canadian Adolescent Mothers Living In Rural Communities, Karen A. Campbell, Corinne Hart

The Qualitative Report

Adolescent mothers and their children are at risk for suboptimal health outcomes making adolescent motherhood a public health concern. However, the experiences of rural-living adolescent mothers are not well understood. Using Lieblich, Tuval-Mahiach, and Zilber’s (1998) narrative methodology approach, the experiential accounts of three rural-living adolescent mothers was explored. Reflecting Goffman’s (1959) presentation of self, the findings of this study revealed how adolescent mothers attempted to construct and present their notion of being a good mother, while coping with complicating rural factors. The need to present as a good mother, the lack of anonymity associated with rural living, and geographical …

Improving Access To Youth-Friendly Health Services In A Rural California Community, Elena Higley

Doctor of Nursing Practice (DNP) Projects

Adolescents and young adults experience relatively high rates of preventable morbidity and mortality due to injuries, mental health disorders, suicide, substance use, and reproductive health issues. It is paramount for healthcare providers to address risky behaviors early to thwart future adverse outcomes. Rural communities especially struggle with meeting the healthcare needs of their youth because there are fewer resources specifically dedicated to serving adolescents and young adults. This issue is evident in Grass Valley, California, a rural community in Nevada County, an area located in the foothills of the Sierra Nevada mountains. In response to limited access to youth-friendly healthcare …