Medicine and Health Sciences Commons^™

Relationships Between Early Academic Indicators And Accelerated-Baccalaureate Student Nurse Success, Bonnie J. White

Walden Dissertations and Doctoral Studies

In 2013, the National Council Licensure Examination for Registered Nurses' (NCLEX-RN) passing standard was increased, leading to a decrease in NCLEX-RN pass rates. The passing standard increase was prompted by an advisory panel's determination that a gap in safe, competent practice existed among new graduate nurses. New graduates' success on NCLEX-RN is critical to meet workplace demand for new nurses. The purpose of this study was to examine whether cumulative grade point average at completion of 200-level nursing courses and scores on the standardized final exam in the 200-level fundamentals course were related to on-time nursing program completion and a …

Relationship Between Admission Criteria And Program Completion In A Radiation Therapy Program, Adrienne Mae Dougherty

Walden Dissertations and Doctoral Studies

Poor completion rates in the radiation therapy associate's degree program offered through a community college did not meet the standards set by the college and damaged the program's reputation. The relationship between admission criteria and program completion was not known. The purpose of this study was to determine if there were any relationships between the admission criteria (GPA in prerequisite courses, interview scores, writing sample scores, and preadmission testing scores) and students' completion of a radiation therapy associate's degree program. This correlational study used 2 stages of Tinto's retention theory: (a) recruitment and admission to college and (b) pre-entry assessment …

Toolkit For Implementation Of Temporal Artery Thermometers For Neonates, Linda Hargreaves

Walden Dissertations and Doctoral Studies

Accurate temperature assessment is essential in neonatal patients and allows for prompt recognition of illness. Temperature can be measured by rectum, which is subject to injury, axillary, which is time-consuming, and temporal artery, which is safe and fast. The purpose of this evidence-based practice quality improvement project was to create an educational toolkit for nurses teaching temporal artery thermometers for routine temperature measurement on neonates, to establish the content validity of the toolkit, and to make recommendations for implementation of the toolkit. The format applied was the Kellogg Logic Model that proceeded from the assumption, to planned work, and results. …

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 …

Losing New Graduate Bedside Nurses, A Practice Improvement Initiative, Beverly Elaine Miller

Walden Dissertations and Doctoral Studies

New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention levels. Nonetheless, evidence from reviewed literature has indicated that the use of residency programs can increase NGNs' stay at bedside, improve retention, reduce costs of operations, and return employees' turnover. The purpose of this quality improvement project was to identify the likelihood of NGNs remaining …

Nursing Informatics Competency Program, Kristina Ann Dunn

Walden Dissertations and Doctoral Studies

Currently, C Hospital lacks a standardized nursing informatics competency program to validate nurses' skills and knowledge in using electronic medical records (EMRs). At the study locale, the organization is about to embark on the implementation of a new, more comprehensive EMR system. All departments will be required to use the new EMR, unlike the current policy that allows some areas to still document on paper. The Institute of Medicine, National League of Nursing, and American Association of Colleges of Nursing support and recommend that information technology be an essential core competency for nurses. Evidence of the need for nursing informatic …

Senior Students' Experiences, Perspectives, And Attitudes Of Technological Competencies In Nursing Education, Patricia C. Bennett

Walden Dissertations and Doctoral Studies

Technological standards appear to be needed in undergraduate nursing education, as existing research has yet to establish technological standards for undergraduate nursing students. The purpose of this qualitative study was to examine the lived experiences of senior nursing students with respect to their perceptions regarding exposure to and abilities gained in the areas of information management, information literacy, and computer literacy. The framework of the study was based on Bandura's theory of self-efficacy and the Dreyfus model of skills acquisition. Using a phenomenological approach, in-depth face-to-face interviews were used with a purposive sample to collect data about the technological competencies …

Relationship Between Educational Leisure Motivation And Recovery From Mental Illness Among Members Of Clubhouse International, Dianna Rene Pearce

Walden Dissertations and Doctoral Studies

Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles's theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses …

Faculty Perspectives On Effective Integration Of Simulation Into A Baccalaureate Nursing Curriculum, Linda Jane Howell

Walden Dissertations and Doctoral Studies

Research shows that use of high fidelity simulation (HFS) as a teaching strategy requires extensive amounts of faculty time and financial resources for faculty development and equipment. This project study addressed the challenges encountered in the integration of HFS into a Midwestern metropolitan baccalaureate nursing program. The purpose of this qualitative case study was to explore perceptions of nursing faculty about best practice elements for successful integration of HFS into undergraduate nursing programs. Guiding questions were developed using Donabedian's structure-process-outcome model and focused on faculty perceptions related to successful implementation of simulation in their programs. Purposeful sampling was used to …

Higher Education Leaders' Transformative Learning And Leadership Experiences Responding To Student Drug Abuse, James Vernon Battin

Walden Dissertations and Doctoral Studies

Today's academic and social environment creates uncertainties, new roles, frequent changes, and challenging situations for student affairs academic leaders. The purpose of this study was to explore how student affairs academic leaders described their recent challenging experiences in addressing student drug abuse in higher education. The conceptual framework was based on adult transformative learning theory and applied transformative leadership perspectives. An interview format with open-ended questions was used to explore the experiences of 8 student affairs leaders who had faced challenging situations in the context of student drug abuse. A qualitative interpretive analysis was used that involved open coding of …

Mandated Continuing Education And The Competency Of Illinois Physical Therapists, Denise Lynn Hunter Ethington

Walden Dissertations and Doctoral Studies

Continuing education (CE) mandate laws are passed by states because it is in the public interest. The intent behind the passage of Illinois's CE law for physical therapists is to protect public health and safety through ensuring the competency of providers. However, studies into the impact of mandated CE on competency have been mixed. The problem addressed by this study was whether Illinois's CE law was effective in improving the competency of physical therapists and its impact on patient care. The purpose of this study was to understand what role mandated CE played in developing the competency of physical therapists …

The Development And Validation Of A Novice Nurse Decision-Making Skills Education Curriculum, Joanne Stephanie Simmons

Walden Dissertations and Doctoral Studies

Novice nurses (NNs) are entering critical care environments with limited knowledge, skills, and decision-making expertise. They are expected to care for complex patients in a dynamic healthcare setting. The research question for this project examined whether NNs improve their knowledge and skills by participating in a nursing decision-making skills curriculum. The purpose of the project was to develop and validate a nursing decision-making skills education curriculum working in an intermediate critical care unit. Taba's instructional theoretical model was used to guide the new curriculum development along with current evidence based practice found in the current literature. Scaffolding approach theory encouraged …

Understanding The Importance Of Culturally Appropriate Patient-Provider Communication In Diabetes Self-Management, Anita Mwalui

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when …

Educating To The Collaborative Care Model, Darcy N. Duncan

Walden Dissertations and Doctoral Studies

The problem addressed in this project was the lack of experienced RNs needed in the acute care setting to deliver safe, quality patient care, while effectively managing resources and providing job satisfaction. The purpose of this project was to determine if an education module designed to educate charge and rover nurses on the Collaborative Care Model (CCM) would enhance staff nurses' abilities to provide safe, high quality care to patients, and improve staff nurse retention on one unit in an acute care setting. The theoretical frameworks utilized to guide the education module included: Lewin's theory of planned change, Benner's novice …

K-5 Educators' Perceptions Of The Role Of Speech Language Pathologists, Dr. Karmon D. Hatcher

Walden Dissertations and Doctoral Studies

Rarely is a school-based speech language pathologist (SLP) thought of as an active contributor to the achievement of students or to the learning community in general. Researchers have found benefits for students when members of the learning community collaborate, and the SLP should be a part of this community collaboration. This qualitative case study examined elementary school teachers', administrators', and reading specialists' perspectives related to knowledge of and the inclusion of the SLP in the learning community at a local elementary school in central Georgia. Schon's theory of reflective practice and Coleman's theory of social capital provided the conceptual framework. …

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …

Differentiating Successful And Unsuccessful Nursing Students, Trilla Mays

Walden Dissertations and Doctoral Studies

Administrators of nursing programs in community colleges are aware of the need to retain and to graduate students to meet the growing demand for licensed practical nurses (LPNs). High attrition in a 2-year nursing program in South Carolina affected the number of students either graduating as a LPN after completing the third semester, or continuing in the program to become a registered nurse (RN). Guided by Jeffreys's nursing undergraduate retention and success model, this causal comparative study investigated the differences between students who were and were not successful in the initial 3 semesters of the program. Archival student records for …

A Case Study Of Student Success In Physical Therapist Assistant Programs: A Systems Approach, Penelope Lescher

Walden Dissertations and Doctoral Studies

Graduating sufficient numbers of healthcare providers to fill the needs of an aging population in the United States is a major social concern. To address this problem physical therapist assistant (PTA) programs need to improve their graduation rates to keep up with the demand for qualified personnel. Applying Senge's theory of effective systems, 1 medium-sized community college with an average pass rate of over 90% on the National Physical Therapist Assistant Examination (NPTAE) was selected to address the research question: What are the systems factors and how do they operate together to support student success in an associate degree PTA …

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 …

Facilitating Environmental Enrichment In Senior Care Activities With Professional Development, Celia Mary Ross

Walden Dissertations and Doctoral Studies

There is little known about the current state of professional development and continuing education practices for empowering activity professionals to better enhance environmental enrichment in long term care. The purpose of this qualitative study was to explore the activity professional's perceived role and best strategies for professional development to enrich the long-term care environment. The study used social cognitive theory as its theoretical framework to develop research questions focused on the views of activity professionals concerning professional development and continuing education to support care for long-term care residents. Using a narrative approach, 9 activity professionals were recruited through networking at …

Nursing Student's Breast Cancer Knowledge And Breast- Self Examination Technique Confidence, Lydia E. Gaud

Walden Dissertations and Doctoral Studies

Breast cancer is the second leading cause of cancer death in women in the United States. Several factors have been identified that interfere with women's breast cancer screening practices, including lack of knowledge and confidence in the breast self-examination (BSE) technique, and lack of information provided by health care provider. One of the reasons nurses do not teach breast cancer detection could be the little emphasis given to breast cancer examination in nursing schools. The BSE is a measure of significant value in detecting cancer of the breast. However, less than half of the women in the United States are …

Factors Related To Nursing Student Persistence In An Associate Degree Program, Patricia Ann Farley

Walden Dissertations and Doctoral Studies

The retention of nursing students remains a challenge in higher education, and the need for nurses in the United States is projected to increase. The purpose of this study was to investigate nursing student persistence in an associate degree program by examining differences in the presence of key social, environmental, and academic factors across 2 types of students: completers and non-completers of the 1st course in a registered nursing program. The study framework was based on Tinto's Student Integration Model and the Nursing Undergraduate Retention and Success Model, which identify key social, environmental, and academic factors as critical to student …

Development Of An Evidence-Based Practice Guideline For Prevention Of Diaper Dermatitis, Nanita Flavier Lim-Sulit

Walden Dissertations and Doctoral Studies

Diaper dermatitis, an acute inflammatory reaction of the skin, is one of the most common forms of dermatitis among neonatal and pediatric patients. The problem addressed in this quality improvement project was the absence of an evidence-based practice (EBP) guideline for perineal care which resulted in 4 unexpected cases of diaper dermatitis per 100 hospital days at a non free standing children's hospital. Framed within Rosswurm and Larrabee's model for EBP, the purpose of this project was to develop an educational initiative encompassing an EBP guideline for perineal care, an educational curriculum plan for staff members, and a Power Point …

Experiences And Barriers For Patient Safety Officers Conducting Root Cause Analysis, Cynthia Lightner

Walden Dissertations and Doctoral Studies

Research shows that, when unintentional harm to patients in outpatient and hospital settings occurs, root cause analysis (RCA) investigations should be conducted to identify and implement corrective actions to prevent future patient harm. Executives at a small healthcare consulting company that employs patient safety officers (PSOs) responsible for conducting RCAs were concerned with the low quality of RCA outcomes, prompting this postinvestigation assessment of PSOs' RCA training and experiences. Guided by adult learning theory, the purpose of this study was to assess PSOs' RCA training and investigation experiences by examining self-reported benefits, attitudes, barriers, and time since training, and the …

Development Of A Guideline For Hospice Staff, Patients, And Families On Appropriate Opioid Use, Trenika Alexander-Goreá

Walden Dissertations and Doctoral Studies

There is an identified problem with patients receiving suboptimal pain management at a hospice agency in the northwestern United States. At this agency, undertreatment of pain is prevalent. Evidence indicates that this may be a result of a lack of guidelines, education, and knowledge of appropriate prescribing. Known barriers to the correct prescription and administration of potent opioids in the hospice setting include prevailing beliefs, knowledge, skills, and attitudes, all of which can impact care negatively. Contextually, hospice principles mandate patient comfort and caregiver involvement in continuous quality improvement, which includes adequate and informed pain management. Moreover, hospice metrics demand …

Videotaped Role-Play Simulation In Teaching Transcultural Self-Efficacy To Interprofessional Healthcare Students, Holldrid Aner Odreman

Walden Dissertations and Doctoral Studies

Increased demand for culturally sensitive healthcare services suggests that interprofessional beginning healthcare students need to gain the necessary cultural competency skills to be successful in delivering positive health outcomes for diverse patients. Bandura's theory of observational learning, Mezirow's theory of transformative learning, and Purnell's and Paulanka's model of cultural competence informed the framework for this research. The purpose of this quasi-experimental quantitative study was to determine the relationship between mode of instruction (observing role models in videotaped role-play simulation) and increased transcultural self-efficacy in cultural competence instruction. A convenience sample of 196 students enrolled in an interprofessional education (IPE) course …

Using The Power Of 3 With Total Joint Surgery Patients, Lynda M. Sanchez

Walden Dissertations and Doctoral Studies

The purpose of patient education is to provide patients and their families with the tools needed to care for themselves after discharge from the hospital, but shortened hospital stays, limited health literacy, language, and age can impede the patient's comprehension of the information provided. Researchers have found that the lack of effective patient education is related to 30-day hospital readmissions. The Power of 3 educational tool, designed by Sanchez and Cooknell, addressed the factors that impeded effective patient teaching by using the adult learning theory and low health literacy concepts. The Power of 3 was implemented as a quality improvement …

Experiences Of Black Msm At An Hbcu Regarding Stigma And Hiv Risk Behavior, Natasha Harden Jeter

Walden Dissertations and Doctoral Studies

Black men who have sex with men (MSM) on Historically Black College/University (HBCU) campuses face a unique set of challenges. In addition to being disproportionately affected by HIV, Black MSM are impacted by risk behavior, stigma, and environmental policies and practices that adversely influence their experiences. The purpose of this study was to explore the experiences of Black MSM at a HBCU and how stigma, culture, social practices and the collegiate environment impact HIV risk-taking behavior. Utilizing the ecological framework and qualitative analysis, the behaviors of 13 Black MSM on a HBCU campus were examined. Personal interviews and risk assessment …

Improving Quality Of Life In Older Adults With Depression And Diabetes Through Medication Compliance Education, Valreen Hinds-Beharrie

Walden Dissertations and Doctoral Studies

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education

by

Valreen Hinds-Beharrie

MSN, Adelphi University, 1997

BSN, Adelphi University, 1986

Project Submitted in Partial Fulfillment

of the Requirement for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, …

Health Science Adminstrators' Perception Of Remediation With Students In The Professional Track Programs, Yvonne Jackson Jackson

Walden Dissertations and Doctoral Studies

Remediation to improve student retention is rapidly becoming an important part of health science programs in higher education. A career college located in the midwestern United States implemented remediation for students to address declining enrollment health science professional-track programs. The purpose of this qualitative case study was to explore how remediation was carried out by college instructors and their perceptions of instructional best practices for students in health science programs in the context of current research. The conceptual framework that guided this study was based on constructivism and adult learning theory. Research questions focused on how instructors were carrying out …