Medicine and Health Sciences Commons^™

Meditation As An Intervention To Help College Students Cope With Stress, Marissa Bottos

Evidence-Based Practice Project Reports

According to the American College Health Association (ACHA) (2017), in a survey of 31,463 students, 31.7% stated that stress negatively impacts their academic performance (lower grades, dropped course, etc.). Additionally, 45.1% of the students stated they have more than average stress levels. The purpose of this evidence-based practice (EBP) project was to determine if mindfulness meditation was effective in helping college students cope with stress. Based on current evidence, Jon Kabat-Zinn’s online application for mindfulness meditation is supported as an effective way to help college students cope with stress (Regehr et al. 2013; Yusufov et al. 2018; Cavanagh et al. …

Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study …

Policy Knowledge Communication In Nursing, Curtiss John Vavra

Walden Dissertations and Doctoral Studies

Evidence-based practices in nursing improve patient outcomes, decrease healthcare costs, and can be implemented with policies and procedures. However, there is limited literature describing how nurses acquire policy knowledge, the dissemination of which may require a significant investment of resources by a hospital. The purpose of this study was to learn more about how nurses obtain policy knowledge. Rogers's diffusion of innovations theory guided the examination of communication channels and how they relate to the formation of policy knowledge. The research questions were designed to gather information on the relationship of policy communication channels, demographic factors, and the frequency of …

Positive Deviance Behaviors And Definition In Nursing, Stacy L. January

Walden Dissertations and Doctoral Studies

The concept of positive deviance (PD) has not been studied in the context of nursing. Grounded in narrative inquiry and combined with vocabularies of motive and symbolic interactionism, the purpose of this study was to explore whether PD behaviors existed in nursing, and if so, to develop an operational definition of PD for nursing. The research question addressed what PD behaviors, if any, were present in nurses’ workplace stories. Using posted flyers, eight participants either self-selected or were selected by snowball method to participate. Interviews were conducted in locations decided on by each participant. Interview data were obtained, transcribed, then …

Male Perspectives Of Lateral Violence In Nursing, Benita Kinard

Walden Dissertations and Doctoral Studies

Lateral violence is an intentional and harmful behavior in the workplace by one employee against another. In nursing lateral violence has impacted the performance of nurses as well as patient care. Research suggests that lateral violence behaviors are still prevalent in the nursing workplace and that there have been few interventions to change these behaviors or address the power dynamics that cause them. Though most of the research on lateral violence has been conducted on female nurses, the population of male nurses is growing. Thus, the purpose of the study was to explore lateral violence in the workplace from the …

The Effect Of Self-Esteem, Bullying, And Harassment On Nurse Turnover Intention, Joyce Richelle Arand

Walden Dissertations and Doctoral Studies

Currently there is a high rate of registered nurse (RN) turnover due in part to bullying and harassment among peers; which fosters lower quality nursing care, jeopardizes patient safety, and increases healthcare costs. The purpose of this quantitative nonexperimental study was to examine the relationship between inpatient nurses' individual self-esteem and reported bullying and harassment with their intent to leave their job. Two theories were used to provide structure to this work: cognitive experimental self theory and oppressed group theory. Data were collected using the Negative Acts Questionnaire, the Rosenberg Self-Esteem Scale, and the Turnover Intentions Measure. All RNs in …

The Effects Of Medical Cannabis Use Among Adults With Chronic Pain: An Integrative Review Of The Literature, Bridget A. Asevedo

Honors Undergraduate Theses

The purpose of this integrative literature review was to understand the effects of medical cannabis for chronic pain management in adults. Anecdotal reports suggest the use of medical marijuana as a pain management therapy could be an alternative to opioids and other medications which have long term consequences. Potential uses span the health care continuum, from prescribed outpatient symptom management, to acute care, extended care, home care, and hospice treatment settings. The methodology included a review and synthesis of relevant research articles from 2012 to 2018, written in the English language. The findings suggest medical cannabis has the potential of …

Developing Cultural Competency In Anesthesia Through Student Registered Nurse Anesthetists, Emma To

Doctoral Projects

Certified Registered Nurse Anesthetists (CRNAs) are the main anesthesia providers in over 70% of rural hospitals providing anesthesia. Each year, over 2,000 student registered nurse anesthetists (SRNAs) graduate and continue as licensed CRNAs. This Doctor of Nurse Practice (DNP) project emphasizes the importance of developing culturally competent providers in anesthesia by promoting early outreach in cultural competence education of SRNAs. Cultural competence is described as possessing characteristics of congruent attitudes, awareness, and conduct that provides and enables effective skills in cross-cultural encounters. Encompassing cultural competency education early in the SRNAs profession may provide valuable lifelong cultural skills that will benefit …

Nursing Faculty And Care Of The Dying, Jessi Balagtas

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: There is a demand for effective and efficient palliative and end of life nursing care that will meet the needs of the aging Baby Boomer generation. Though advancement has been made, palliative and end of life care for the seriously ill adult is still lacking. That deficiency can be traced to deficiency in nursing education. Further still, nursing faculty attitudes, knowledge and self-efficacy in palliative care may present a barrier for adequate palliative care nursing curriculum.

Objective: Explore the current knowledge, attitudes and self-efficacy of nursing faculty regarding care for seriously ill adults.

Methods and Design: A quantitative, descriptive …

Readiness For Assisted Decision-Making: An Exploratory Qualitative Study, Kay Cronin

Theses

Background: Ireland has recently enacted the Assisted Decision-Making (Capacity) Act 2015. The enactment of the legislation has allowed Ireland to ratify the United Nations Convention on the Rights of People with Disabilities (2008). The convention obliges all member states to assist people with disabilities to make their own decisions, with their will and preference taking precedence over what others deem to be in their best interests. Implementation of this legislation requires a change in working practice among health and social care providers to promote autonomy and decision-making among service users. To date, this topic has not been researched in Ireland. …

Hardiness, Adult Attachment Style, And Burnout In Nurses, Kristy A. Negri

Walden Dissertations and Doctoral Studies

The current nursing shortage is a pressing crisis that is expected to worsen over time. A key reason nurses leave nursing is burnout. The purpose of this study was to investigate personality hardiness and adult attachment style in relation to the development of burnout in licensed professional nurses. Hardiness theory and attachment theory indicated that each provided protection against burnout, but no research has been conducted to examine both factors in relation to burnout in nurses. Research Question 1 asked if there was a relationship between attachment style and total hardiness score; Research Question 2 asked if there was a …

Exploring The Cultural Intelligence Of Nurse Leaders, Valerie D. Campbell

Walden Dissertations and Doctoral Studies

Today, nurses represent many cultures and ethnic backgrounds. In their leadership style, nurse leaders must learn to embrace cultural intelligence or cultural quotient (CQ), that is, an extension of emotional intelligence that affords them the ability to manage a culturally diverse workforce. Historically, CQ has been relevant to business, locally and globally. But it is also important to explore the CQ of nurse leaders. Scholarly studies show that leaders with CQ are responsible for developing innovative employee behaviors, forward-thinking ideas, and creativeness in the workplace. CQ has a theoretical foundation in the 2003 research of Early and Ang who focused …

Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano

Evidence-Based Practice Project Reports

Patient/visitor violence against healthcare (HC) employees is a type of workplace violence (WPV) and considered a dangerous hazard within HC occupations (Bureau of Labor Statistics, 2015). Lack of recognition of the true incidence and underreporting of WPV may contribute to a false sense of security within a HC facility (HCF). Therefore, fully addressing the problem may be met with administrative resistance, resulting in poor employee perceptions of support and commitment for a zero-violence environment. A retrospective analysis was conducted on the HCF’s online incident reports, security request calls, and data from a previously deployed WPV employee survey. The emergency department …

Effect Of Activity Trackers And Text Messaging On Exercise, Fitness, And Physical Activity Self-Efficacy Of Middle School Students, Alison F. Pittman

Nursing Theses and Dissertations

A decrease in physical activity as children age is a contributing factor to the U.S. obesity epidemic. Middle school children are particularly vulnerable to sedentary activities. Activity trackers show promise as a means to motivate children and adults to increase physical activity (PA). This study examined the effect of a text messaging intervention and use of activity trackers with a companion social website on the body mass index (BMI), body fat percentage, physical fitness, and PA self-efficacy of middle school children. Children aged 11-14 (n=102) were randomly assigned to one of three groups for a 10-week intervention: activity tracker group; …

The Emotional Cost Of Caring: Compassion Fatigue Experienced By Nurse Staff On An Inpatient Geriatric Behavioral Health Unit, Susan Annette Campbell

Theses and Dissertations from 2017

Purpose: Research studies on the prevalence of compassion fatigue (CF) in nursing have been conducted in various clinical settings. There has been limited empirical research conducted on nurses working within the geriatric behavioral health setting, which can present increased nursing challenges related to the chronic health problems of aging coupled with acute behavioral health crises. The purpose of this quantitative, descriptive research study was to identify the prevalence of CF in RN and LPN staff within an inpatient geriatric behavioral health unit setting in two comparably sized hospitals. Design/Methods: An electronic survey design (consisting of demographics and the ProQOL v. …

The Effect Of Routine Adult Phq-2 Depression Screen And Scheduled Follow-Up Protocol In The Primary Care Setting, Alex F. Bikowski

Evidence-Based Practice Project Reports

Healthy People has projected depression to be the primary cause of disability by 2020; therefore routine depression screening has been prioritized as a national healthcare initiative. The purpose of this Evidence-Based Practice (EBP) project is to demonstrate that routine implementation of the 2-item Patient Health Questionnaire (PHQ-2) depression screener, along with a scheduled follow-up protocol for adults in the primary care setting, can improve current mental health practices regarding the identification of depression by clinicians. The evidence supports use of the PHQ-2 for routine adult depression screening, as long as a scheduled follow-up protocol is available for positive screens. This …

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 …

Servant Leadership And Its Effect On Employee Job Satisfaction And Turnover Intent, Dennis M. Mitterer

Walden Dissertations and Doctoral Studies

Experts expect a shortage of more than 900,000 nurses by 2022, according to the United States Bureau of Labor Statistics Employment Projections. Turnover in nursing contributes significantly to the shortage and often results from poor leadership of nurse managers. The purpose of this quantitative study was to investigate how servant leadership behaviors affected the psychological state and behavioral response of staff nurses as reflected by job satisfaction and turnover intention. Specifically, the research question addressed whether servant leadership positively contributes to the psychological states and the behaviors of staff nurses leading to greater job satisfaction. The study design was correlational, …

Improving The Quality Of Electronic Documentation In Critical Care Nursing, Brent Alan Stevens

Walden Dissertations and Doctoral Studies

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General systems theory and the Donabedian model of health care quality provided the framework for the project. Electronic databases PubMed and the Cumulative Index of Nursing and Allied Health were searched for articles addressing electronic nursing documentation practices. The Cochrane systematic review methodology was used to analyze the articles. Articles were excluded if published before 2001 …

The Effects Of Structured Health Policy Education On Connecticut Registered Nurses' Clinical Documentation, Rosale Lobo

Walden Dissertations and Doctoral Studies

Registered Nurses use clinical documentation to describe care planning processes, measure quality outcomes, support reimbursement, and defend litigation. The Connecticut Department of Health, guided by federal Conditions of Participation, defines state-level healthcare policy to include required care planning processes. Nurses are educated in care planning process standards, however no policy-required competency verification processes in academia or employers exists. Guided by the advocacy coalition framework, the purpose of this quasi-experimental study was to determine if the quality of nurse coalition actors’ clinical documentation, a relatively stable parameter, would increase after attending policy-centered structured education. Data were extracted from 272 electronic medical …

Nurses' Workplace Social Capital: Development And Validation Of A Self-Report Questionnaire, Emily A. Read

Electronic Thesis and Dissertation Repository

Background: Social capital refers to resources created by and embedded in social relationships and has been identified as an important aspect of nurses’ work life. There is limited empirical evidence regarding its role and currently no valid and reliable self-report instruments to measure workplace social capital comprehensively.

Purpose: This study aimed to develop and test a self-report questionnaire to measure nurses’ workplace social capital and examine the nomologicial network of the concept including authentic leadership and structural empowerment as precursors of social capital and team effectiveness and patient care quality as outcomes.

Methods: A cross-sectional survey of 1,000 Registered Nurses …

Implementation Of A Nursing Workload Tool To Reduce Nurse Burnout, Nicole K. Greives

Evidence-Based Practice Project Reports

Nursing burnout and workload is a complicated issue with far-reaching effects. Nursing burnout and inappropriate nursing workload have been linked to increased risk of urinary tract infection, respiratory infections, decreased patient satisfaction, decreased quality and safety of care, and increased mortality. The purpose of the project was to decrease nursing burnout on a Medical Progressive Care Unit (MPCU) by moving patients with high workloads and medical instability to a higher level of care. Within this project, Rosabeth Kanter’s Theory of Structural Power was used for the theoretical framework, and the Stetler Model guided the implementation. The intervention consisted of a …

The Effect Of Standardized Patient Encounters On Undergraduate Nursing Student Empathy And Self-Efficacy In Therapeutic Communication, Alana M. Urness

Evidence-Based Practice Project Reports

Therapeutic communication between the nurse and patient is an essential component of optimal nursing care. Current evidence supports the use of standardized patient (SP) encounters to assist students in learning therapeutic communication skills. In addition to offering students an opportunity to practice in an environment free of clinical consequence, SP encounters have been shown to increase clinical knowledge and skill, improve diagnostic reasoning, and improve communication skills and interviewing skills. The purpose of this evidence-based practice project was to assess the effect of SP encounters on undergraduate nursing student empathy and self-efficacy related to therapeutic communication. Secondary outcomes included participant …

Relationship Among Motivation, Emotion Regulation, And Psychological Well-Being Of Sophomore And Senior Level Nursing Students, Aryene Delgado, Douglas Garner, Nicole Langhals

Williams Honors College, Honors Research Projects

Nursing education and professional work involve stressful circumstances that may lead to attrition, which can further contribute to the projected nursing shortage. This study examines the relationships between motivation, emotional regulation, psychological well-being and academic performance in baccalaureate sophomore and senior level nursing students at a Midwest urban university in the United States. The non-experimental, correlational study is guided by Deci and Ryan’s self-determination theory and uses an online survey data collection and convenience sampling. Measures include: motivation, emotional regulation, psychological well-being (burnout; inauthenticity), and academic performance (GPA), and will be measured using Deci and Ryan’s scale, the Emotion Regulation …

The Relationship Between Nursing Students' Perceptions Of Staff Nurses' Attitudes Towards Them And Self-Efficacy In Sophomore- And Senior- Level Nursing Students, Sarah A. Mueller, Raechel M. Naragon, Rachael R. Smith

Williams Honors College, Honors Research Projects

Clinical teaching gives nursing students practical experience, allowing them to practice skills and to apply theories of nursing alongside a staff nurse. The purpose of this study was to examine the relationship between nursing students’ perceptions of staff nurses’ attitudes towards them and self-efficacy in sophomore- and senior-level nursing students. According to scientist Albert Bandura’s Social Cognitive Theory, self-efficacy is defined as a person’s belief in his or her own abilities. Using non-experimental comparative design, convenience sampling, and Likert scale questionnaires, sophomore- and senior- level baccalaureate nursing students were asked to complete the survey using the Nursing Clinical Self-Efficacy …

An Analysis Of Reinforcers Maintaining Caregiving Behaviors Of Long-Term Care Facility Staff, Sandra Garcia

All Graduate Theses, Dissertations, and Other Capstone Projects

Traditionally, the medical model has been the standard level of care in long-term care facilities. However, many facilities are transitioning from the medical model to a person-centered approach. The core of person-centered care is the relationship between frontline staff and residents. Empirical research has found person-centered care to reduce depressive and behavioral symptoms, levels of loneliness, and increase quality of care in residents; person-centered care has increased job satisfaction in nursing staff. Unfortunately, little is known about what motivates caregiving behavior in nursing staff and whether these motivators are consistent with principles of person-centered care. The current study attempted to …

Utilization Of A Focus Group To Evaluate The Perceived Stress Levels And Coping Mechanisms Of Student Registered Nurse Anesthetists, Cillora Hicks

Doctoral Projects

Each year, thousands of Student Registered Nurse Anesthetists (SRNAs) matriculate into a nurse anesthesia educational program, confronted with unforeseen challenges and stressors. Although a certain amount of stress is essential to stimulate learning, excessive stress can have dire consequences in delaying a students’ academic and clinical progression. The purpose of this Capstone Project was to explore and describe the perceptions of 12 SRNAs relevant to their stress levels and coping behaviors in the management of academic and personal stress. The clinical research questions guiding the study examined the stress levels and coping behaviors of the SRNAs as measured by the …

Exploring The Career Pathways, Professional Integration And Lived Experiences Of Regulated Nurses In Ontario, Canada, Godfred O. Boateng

Electronic Thesis and Dissertation Repository

In the context of an enduring shortage of nurses, this study explores the career pathways and experiences of immigrant and Canadian-born nurses in two Ontario cities utilizing a qualitative research design consisting of 70 in-depth interviews. Differences in career entry and experiences of workplace conflict across immigration status and race are explored.

First, I explore successful immigrants’ pathways into the nursing profession and their social and economic integration into the Canadian economy in light of the traditional assimilation and segmented assimilation theories. The study reveals distinct career pathways taken by foreign-born nurses and Canadian born nurses. While Canadian-born nurses have …

The Effect Of An Antenatal Breastfeeding Intervention On Breastfeeding Self-Efficacy And Intention Among Inner City Adolescents, Jamie El Harit

Evidence-Based Practice Project Reports

According to Healthy People 2020, infants who are breastfed have improved nutritional, immunological, developmental, and social outcomes (USDHHS, 2014). Despite the benefits of breastfeeding and the focused international efforts to increase levels of breastfeeding, adolescents remain largely unaware and continue to have among the lowest levels of breastfeeding initiation (CDC, 2013; Spear, 2006). The purpose of this EBP project was to reduce the disparities of breastfeeding initiation by increasing breastfeeding self-efficacy and intention in an inner city specialty high school. Synthesis of the evidence demonstrated that needs-based, repeated antenatal education delivered by a lactation expert including breastfeeding peer counselor supports …