Medicine and Health Sciences Commons^™

Effects Of Education On Victims Of Domestic Violence, Julette N. Anderson

Walden Dissertations and Doctoral Studies

The purpose of this project was to improve support for victims of domestic violence. To that end, this project developed an evidence-based program to provide information about domestic violence including safe and confidential ways to seek assistance, rights as cohabiting intimate partners, and the resources available to community members. Several approaches were used to develop, validate, and plan for implementation and evaluation of this program, which was developed for 3 sites in Broward and Miami-Dade counties where the project is situated. The program logic model and the social ecological model, including the individual, relationship, community, and societal levels, were used …

The Impact Of Caring For Seniors On The Caregiver's Stress Level, Georgina Ugochi Njoku

Walden Dissertations and Doctoral Studies

The number of Canadian seniors with 2 or more chronic health conditions living into their late 90s or older has never been greater. As such, concerns have been raised that the Canadian healthcare system will be unable to meet the growing healthcare needs of the aging population. In this project, an Advanced Practice Nursing needs assessment was used to identify the impact that caring for a senior has on caregivers' stress levels, and what resources caregivers need to in order to cope with their role. Guided by Neuman's system model theory and Rogers' diffusion of innovation model, a convenience sampling …

A Transition-To-Practice Residency That Supports The Nurse Practitioner In A Critical Access Hospital, Nancy Jean Stock

Walden Dissertations and Doctoral Studies

Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs or physician assistants without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in education and practice expectations and leading to significant role transition stress and turnover. The purpose of this project was to construct an evidence-based transition-to-practice residency program to support NPs providing emergency department care in the CAH. Theoretical frameworks used to …

Oral Care Practice Guidelines For The Care-Dependent Hospitalized Adult Outside Of The Intensive Care Unit Setting, Cynthia Susan Drapal

Walden Dissertations and Doctoral Studies

Many nurses lack evidence-based knowledge to deliver appropriate oral care, view oral care in the care-dependent patient as a comfort measure, and give it a low clinical priority. An estimated 44%-65% of hospitalized care-dependent patients do not receive adequate oral care, an intervention that can prevent aspiration pneumonia or pneumonitis. The purpose of this project was to develop a policy for use of an oral assessment tool and evidence-based guidelines for oral care in hospitalized care-dependent adults outside of the intensive care unit setting at a regional health system in the Southeast United States. The project used the theoretical foundations …

Exploring Strategies For Implementing Barcode Medication Administration Systems, Julie A. Frederick

Walden Dissertations and Doctoral Studies

The number of medication errors associated with preventable deaths in healthcare facilities remains at a high rate for healthcare leaders. Practices of medication delivery remain similar to those 10 years ago. Hospitals that have implemented barcoding medication administration systems have reported a decrease in medication errors ranging from 60% to as high as 93%. Despite this utility of barcoding, only 50% of U.S. hospitals have implemented barcode medication administration. This comparative case study explored the strategies hospital leaders used to implement barcode medication administration systems, utilizing the sociotechnical theory for a conceptual framework. Face-to-face, semistructured interviews were used to identify …

The Design And Implementation Of A Relationship-Based Care Delivery Model On A Medical- Surgical Unit, Paula Ann Rodney

Walden Dissertations and Doctoral Studies

The Design and Implementation of a Relationship-Based Care Delivery Model on a Medical- Surgical Unit

by

Paula A. Rodney

MSN, California University of Pennsylvania, 2011

BSN, University of Virginia, 1979

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

April 2015

Patient satisfaction and clinical outcomes have become important issues in healthcare since the introduction of the Value Based Purchasing Program. Patient satisfaction, as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, was declining and hospital-acquired pressure ulcers (HAPU), falls, and catheter-associated urinary tract infections (CAUTI) were …

The Use Of A Standardized System Of Communication To Change The Perception Of Handoff Communication In A Psychiatric Setting, Alicia Renee' Plunkett

Walden Dissertations and Doctoral Studies

The Use of a Standardized System of Communication to Change the Perception of Handoff Communication in a Psychiatric Setting

by

Alicia Renee' Plunkett

MSN, Walden University 2007

MSHA, University of St. Francis, 2005

BSN, University of Memphis, 1995

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

December 2014

The Joint Commission's review of sentinel events indicated that communication errors were the cause of over 65% of the sentinel events occurring in healthcare. The nursing profession has the responsibility of providing 24-hour care in an acute care setting and nurses are …

Incorporating Ada Best Practice Guidelines In Electronic Medical Records To Improve Glycemic Management In Hospitals, Jennifer Claudette Benjamin

Walden Dissertations and Doctoral Studies

Aggressive management of diabetes using American Diabetes Association (ADA) best practice guidelines in hospitalized patients reduces morbidity and mortality. Inpatient electronic medical records systems improve care in chronic diseases by identifying care needs and improving the data available for decision making and disease management. The purpose of this quality improvement project was to evaluate the impact of ADA best practice guidelines of glycemic management once they have been entered into the electronic medical record (EMR) of hospitalized diabetics. Kotter's organizational change process guided the project. The project question investigated whether nurses' use of ADA Best Practice Guidelines incorporated into the …

Baker Act Project, Lucy Arcila, Evelyn Quinones Lassalle, Carla Green, Melinda Patton, Melinda Collins

All Publications

No abstract provided.

Ebola Preparedness - An Ed Perspective, Bettina Laier

All Publications

No abstract provided.

Facing Falls By Staying In The Zone, Beatriz Taboada, Charles Juste, Rocio Ramirez

All Publications

No abstract provided.

Pain Management Of Medical-Surgical Patients At Homestead Hospital: The Role Of Nurse-Patient Communication, Dianne Crabtree, Kathy Gruny, Kimberly Figueroa, Veronica Zamoyski, Carrie Bilek, Rachael Rodriguez, Luchie Anne Dwyer

All Publications

No abstract provided.

The Effect Of Breastfeeding Self-Efficacy On Breastfeeding Initiation, Exclusivity, And Duration, Adria Vincent

Walden Dissertations and Doctoral Studies

Breastfeeding self-efficacy is considered one of the key components of a successful breastfeeding experience. The benefits of breastfeeding are well established in the literature and have been widely communicated to the public, resulting in an increasing trend of breastfeeding initiation. However, the United States still falls short of Healthy People 2020 breastfeeding goals. The purpose of this project was to examine the effects of a standardized hospital-based prenatal breastfeeding class on breastfeeding self-efficacy. Dennis's breastfeeding self-efficacy theory was the foundation for the breastfeeding self-efficacy tool used in this project. A quasi-experimental design used a convenience sample of 30 breastfeeding class …

Screening And Intervention For Women With Hyperglycemia During Pregnancy, Ladonna Lynn Williams

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus occurs in up to 10% of pregnancies and often leads to labor and delivery complications for both the mother and the baby. Early identification of gestational diabetes and educational intervention are needed to improve the self-management and knowledge among pregnant women. The purpose of the project was to implement newly established national guidelines to ensure that women with gestational diabetes are identified during the first trimester of pregnancy and begin diabetes education early in gestation. Lewin's planned change theory was selected as the theoretical framework, and the six sigma approach was used to facilitate the change process. …

Laying The Foundation For New Approaches In Evidence-Based Sex Education Curriculum Programs: A Family Life Policy Change, Rina Marie Prosser

Walden Dissertations and Doctoral Studies

The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the …

Development Of An Electronic Health Record Educational Project For Staff Nurses, Nanah Sheriff Sesay

Walden Dissertations and Doctoral Studies

Abstract

The use for electronic health records (EHRs) by 2015 is being mandated through incentive payments for health care providers. Evidence-based literature has shown that almost half of the hospitals in the Unites States have not adopted EHRs, and many nurses have not been educated to effectively use them. In order to enhance and sustain EHR adoption by hospitals, nurses need to be educated on EHRs' usability. The purpose of this project was to develop an evidence-based EHR educational project for nurses on how to enter nursing assessments, document patients' medical data, and communicate effectively with patients and health care …

A Clinical Pathway Education Program For Pediatric Nurses, Lisa M. Scheiber-Case

Walden Dissertations and Doctoral Studies

Clinical pathways have been studied to promote best practices in nursing and enhance patient satisfaction. For 10 years a pediatric orthopedic surgical team at a Midwest hospital has not had a clinical pathway to treat or standardize care for adolescents following posterior spinal fusion surgery. Pain scores and patients' length of stay were collected using a retrospective chart review. This information was used to revise preoperative education materials and develop a visual poster. The purpose of this project was to identify and develop a way to educate the pediatric nursing staff on the use of the developed educational materials, poster, …

Systematic Review Of Retention Of Direct-Care Workers In Long-Term Care Facilities, Regina Evonne Goins

Walden Dissertations and Doctoral Studies

Turnover among direct-care workers in long-term care (LTC) facilities is high, and has a significant impact on residents, leaders, and owners of LTC facilities. The overall turnover costs are also substantial and constitute a significant financial burden in LTC facilities. This systematic review of the literature examined, retention strategies for direct-care workers in the LTC workforce. The information may be used to develop and provide practice recommendations that will help improve retention rates among direct-care workers in LTC facilities. The project design involved a systematic examination of English-only studies from 2001-2004, retrieved from 3 major databases: CINAHL with Medline simultaneous, …

The Effectiveness Of Combining Simulation And Role Playing In Nursing Education, Shari Lynn Redden

Walden Dissertations and Doctoral Studies

The profession of nursing is affected by a nursing and nursing faculty shortage that is impacting the ability to produce adequate numbers of nurse graduates to address the healthcare needs of the future. Nursing schools are increasingly using simulation and/or role-playing to supplement the decreased number of nurse faculty and clinical sites in order to be able to continue to enroll nursing school applicants. The purpose of this phenomenological study was to examine the experiences of nursing students with role-playing and simulation and the extent to which role-playing with simulation is perceived by students as beneficial for learning within the …

Development Of An Evidence-Based Influenza Vaccination Program For Nurses, Marlene Reid

Walden Dissertations and Doctoral Studies

The purpose of this educational influenza vaccination project was to increase nurses' influenza vaccination rates. Nationally, 41% of nurses were vaccinated, which is far below the Healthy People 2020 goal of an influenza vaccination rate of 90%. Literature suggests that the low nurses' vaccination rate is responsible for inpatient healthcare associated influenza, mortality, and influenza-like illness. Healthcare facilities will not be reimbursed for treatment of healthcare associated infection. Despite recommendations from the Centers for Disease Control and Prevention for nurses to become vaccinated, only 20% of the 800 nurses at a healthcare facility in Baltimore were vaccinated for the past …

A Guide For Delivering Evidence - Based Discharge Intructions For Emergency Department Patients, Andre Walker

Walden Dissertations and Doctoral Studies

Discharge instructions provided to patients discharged from the emergency department (ED) are often provided in a way that is neither clear nor concise. Patients are often discharged home without a clear understanding of their diagnosis, medications, reasons to return to the ED, follow-up instructions, or how to manage their care at home during their illness. Therefore, a guideline needed to be developed in order to help the ED staff provide clear and concise discharge instructions to patients discharged from the ED. The Ace Star Model of Knowledge Transformation was the foundation for the development of the evidence-based guideline. A formative …

Development Of An Evidence-Based New Graduate Nursing Orientation Program For The Emergency Department, Mary Ellen Zaleski

Walden Dissertations and Doctoral Studies

The traditional new graduate nurse (NGN) orientation process places NGN with an experienced preceptor for 24 weeks and requires clinical skills checklists to be completed by the preceptor, a practice which is not an evidence-based practice for orienting NGNs. The purpose of this quality improvement project was to develop an evidence-based orientation to decrease time requirements and standardize the processes and evaluation of the NGN in the emergency department. The project was informed by Benner's novice to expert theory and focused on acquisition of clinical skills. The project team included 6 stakeholders: the Doctor of Nursing Practice student-leader, the unit …

A Proposal For The Development Of An Exercise Program To Treat Post Thrombotic Syndrome, Christy Jean Hansen

Walden Dissertations and Doctoral Studies

Healthcare costs continue to escalate and hospitals need to use programs that encourage cost effectiveness, reduce resources and staffing, and increase patient accountability for their own healthcare risk factors, comorbidities, and participation in their healthcare decisions. Post Thrombotic Syndrome (PTS) is a debilitating disease with few treatment options. Allowing patients to have shared decision making in a care plan for this disease process that involves an exercise program may be a significant factor in the success or failure of their own healthcare goals and outcomes. The development of a proposal for an exercise program for PTS should provide patients with …

Educational Intervention To Impact Parental Decisions To Consent To Human Papillomavirus Vaccine, Tawa Bimbola Ibikunle-Salami

Walden Dissertations and Doctoral Studies

Educational Intervention to Impact Parental Decisions to Consent to Human Papillomavirus Vaccine

by

Tawa B. Ibikunle-Salami

MSN, Indiana Wesleyan University, 2010

BSN, Indiana Wesleyan University, 2005

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

September 2015

Human Papillomavirus (HPV) is a global health issue that is transmitted sexually and affects both genders. Evidence shows that approximately 79 million people are affected in the United States with 14 million newly affected yearly. The Centers for Disease Control and Prevention indicates that teens and young adults under age 25 are at particular …

Attitude, Subjective Norm, And Perceived Behavioral Control As Indicators For Nurse Educators’ Intention To Use Critical Thinking Teaching Strategies: A Structural Equation Model Analysis, Angerlita Yolanda Smith

Dissertations

Problem

Deficiencies in new nursing graduates’ ability to use critical thinking skills have been documented. Researchers have found that the continued use of traditional teaching methods and less student-centered approaches for critical thinking development has contributed to this problem. This particular issue has evoked much concern for institutions and organizations involved with the safe delivery of patient care. The purpose of this study was to examine (a) the relationship between the factors educator characteristics, attitude, subjective norm and perceived behavioral control in a hypothesized model that may influence nurse educators’ intention to use instructional methods that promote critical thinking in …

Prevention Of Icu Delirium Through Implementation Of A Sleep Promotion Bundle, Victoria Bennett

Master's Theses and Capstones

Background: Intensive care unit (ICU) delirium is the prevalence of delirium in ICU patientswho do not have a history of drug/alcohol abuse, an admission for a mental status change, or anadmission to the ICU for less than 24 hours. Serious adverse outcomes have been linked to thepresence of ICU delirium resulting in overall longer hospital lengths of stay, longer duration ofmechanical ventilation, higher rates of mortality, and long-term neuropsychological deficits afterdischarge. At the site of this quality improvement project, the prevalence of ICU delirium was92.3% in a population determined to be high risk using the PRE-DELIRIC screening tool. Aim: The …

Be Seen And Heard Being Clean: A Patient-Centered Approach To Hand Hygiene At Concord Hospital, Ashley Pinkham

Master's Theses and Capstones

Background: Regular hand washing is recognized as the most effective means to combat the spread of infectious illness; however hand washing behavior amongst health care workers (HCW’s) is inconsistent. Furthermore, measurement of hand washing behavior is subject to bias.

Aim: This quality improvement project aimed to remove the Hawthorne effect and improve the behavior of HH at Concord Hospital.

Methods: A quasi-experimental, pre-posttest design was used to evaluate HH rates on a 32 bed med-surge unit at Concord Hospital. Baseline data was collected for 30 days by asking patients if they had seen or heard staff cleaning their hands. Using …

An Evidence-Based Approach To Prepare Interdisciplinary Team Members For Implementation Of The Abcde Bundle, Jessica Murner Hamilton

Theses and Dissertations

Quality improvement projects contribute to the development of evidence-based management strategies for successful implementation of evidence-based practices in health care, thus reducing the risk of change implementation failure. This study assessed practice change implementation strategies for the awakening and breathing trial coordination, delirium assessment and management, early exercise and mobility (ABCDE) bundle. The ABCDE bundle is an evidence-based, interdisciplinary framework for managing pain, agitation, and delirium, reducing the duration of mechanical ventilation, and supporting early mobility in critically ill patients. The purpose of this study was to implement a nurse-driven initiative to design and put into place an evidence-based approach …

Easing My Burden: A Grounded Theory Study Of Kidney Transplant Recipients' Experience With Their Transplant Coordinators, Gwen E. Mcnatt

Dissertations

Organ transplantation holds the promise of new life or better life for thousands of Americans every year. Transplantation involves a process that stretches over time beginning at referral, moving to transplantation and long term care. The transplant coordinator is considered an integral part of this care. Transplant coordinators are considered so important to the care of these patients that transplant centers are required to have at least one transplant coordinator by federal regulations.

The role of the transplant coordinator, however, is not well defined. Although many of the role dimensions attributed to transplant coordinators are consistent with nursing practice, the …

Models Of Survivorship Care Provision In Adult Patients With Haematological Cancer: An Integrative Literature Review, K Taylor, R Chan, L Monterosso

Nursing Papers and Journal Articles

Purpose: Increasing numbers of haematology cancer survivors warrants identification of the most effective model of survivorship care to survivors from a diverse range of haematological cancers with aggressive treatment regimens. This review aimed to identify models of survivorship care to support the needs of haematology cancer survivors.

Methods: An integrative literature review method utilised a search of electronic databases (CINAHL, Medline, PsycInfo, PubMed, EMBASE, PsycArticles, Cochrane Library) for eligible articles (up to July 2014). Articles were included if they proposed or reported the use of a model of care for haematology cancer survivors.

Results: Fourteen articles were included …