Medicine and Health Sciences Commons^™

Improving Transitions Of Care In The Perioperative Setting, Brian Wayne Selig

UNLV Theses, Dissertations, Professional Papers, and Capstones

It is estimated that nearly 200,000 Americans die each year due to preventable medical mistakes (Gupta, 2012), and nearly 80% of all medical errors involve some form of miscommunication between healthcare providers (Joint Commission Center for the Transformation of Healthcare, 2013). Handoffs, or the transitioning of patient care from one provider to another, occur multiple times each day in the hospital setting and done incorrectly can lead to significant mistakes in patient care.

The purpose of this project was to improve the quality of handoffs that occurred between perioperative and inpatient nurses at an urban, tertiary medical center. A shared …

Pink Goes Red For A Day: Is Your Heart Healthy?, Quierra W. Jones

Honors College Theses

There is a major lack of public health education among college aged students at many colleges and universities across the country. Even further, many minority college students are unfamiliar with one of the most life-threatening health issues that affect them the most: heart health. As a nursing student and member of Alpha Kappa Alpha Sorority Inc., I strive to uphold our “service to all mankind” motto and also educate the public about important heart health matters. On February 4, 2014, I presented a program through my sorority entitled Pink Goes Red for a Day in which I educated the primarily …

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 …

The Effects Of 12 Weeks Of Instructor-Led Yoga Classes On Balance In Older Adults, Patricia C. Hart

Evidence-Based Practice Project Reports

Participation in a regular exercise program is an effective way to reduce and/or prevent a number of functional declines associated with aging (Chodzko-Zajo et al., 2009). Older adults are advised to participate in regular aerobic activity and practice muscle strengthening activities and exercise that maintains or improves balance (U.S. Department of Health and Human Service, [USDHHS], 2012). Less than one third of older adults engage in 30 minutes of low to moderate intense physical activity at least five days a week as recommended in current guidelines (USDHHS, 2012), and these guidelines fail to address losses in strength and flexibility seen …

Sternal Precautions: Is It Necessary To Restrict Our Patients?, Lauren Belyea

Honors College Theses

This paper is based on the inquiry about the effects of sternal precautions as part of a patient’s recovery following a sternotomy. It is important to explore this because nurses should always be asking themselves “why am I doing what I am doing with my patients?” “Which of my practices are evidence based and which do not have any evidence to support them?” (MeInyk, 2009). If sternal precautions are indeed overly restrictive and preventing patients from achieving the best possible recovery outcomes, it is the job of the nurse and other healthcare providers to make changes to the current practice.

Diabetes Distress: Transforming A Practice, Goff M. Jeannie

Doctor of Nursing Practice Scholarly Projects

Diabetes mellitus affects millions of people in the United States, placing them at risk for other disease related complications. This makes the management of diabetes and the prevention of complications an important challenge. The psychological aspect of diabetes care may present a barrier to patients that inhibit them from achieving optimal self-care.

Diabetes distress (DD) is the psychological aspect of diabetes that is specific to the emotional distress caused from living a chronic disease. DD has been linked to poorer self-management behaviors which makes it a significant problem that should be taken into consideration for effective management of the diabetic …

Effect Of An Adaptive Thinking Training Methodology On Critical Thinking Disposition Using Human Patient Simulators: A Catalyst For Preparing Advanced Nursing Students, Robert Joseph Fitkin Jr.

Teaching & Learning Theses & Dissertations

Critical thinking decision making is the foundation for effective, safe, nursing practice. Nurses have to assess patient issues rapidly regardless of whether it is emotional, psychological, or physical, and then sort through "rapid fire" questions resulting in invisible sorting, discerning, and drawing of conclusions. Doing this "invisible sorting" well requires practice. Nursing education provides practice through preceptors or scenarios-driven human patient simulators to practice critical thinking. This study examines Adaptive Thinking Training Methodology with simulation exercises as a possible catalyst for growth in critical thinking disposition, and help in addressing the preparation-practice gap for novice nurses.

A class of advanced …

Simulation In Assisting Nurses To Better Recognize Early Signs Of Clinical Deterioration Of Patients, Loretta Elder

Doctor of Nursing Practice Projects

The need to enhance the knowledge and skills of nurses caring for patients who exhibit signs of clinical deterioration has been validated in the literature. The literature has further supported the registered nurse as the key individual expected to recognize signs of clinical deterioration in the patient. The use of simulation as an effective teaching strategy has been well documented in the literature. The purpose of the project was to use simulation as an educational intervention to increase nurse knowledge, self-confidence, and competency when caring for patients exhibiting signs of clinical deterioration. The findings of this project are supported by …

The Effect Of A Facilitated Educational Program And Experiential Learning On Nursing Workplace Incivility, Nancy E. Armstrong

Doctor of Nursing Practice Projects

Workplace incivility is a well-documented issue in nursing. It has the potential to cause emotional and physical distress in victims, and potentially affect the quality of care provided. Research in acute care settings found that facilitated educational training sessions related to workplace incivility, in combination with experiential learning activities, assisted nurses in improving their understanding of workplace incivility and their communication skills. It has also been found to reduce workplace incivility. The purpose of this Capstone Project was to implement a civility training program that included education about incivility through facilitated discussions, as well as teambuilding exercises and experiential learning …

Evaluating The Effectiveness Of A Heart Improvement Toolkit Program: A Pilot Project, Cheryl L. Mitchell

Doctor of Nursing Practice Projects

Heart failure (HF) is a chronic, debilitating disease resulting in over one million hospitalizations with an estimated 30.7 million dollars in total health care cost per year (Go et al., 2014). Evidence shows that HF education programs that promote adherence to pharmacological and non-pharmacological provider recommendations are effective in reducing 30-day HF recidivism rates, increasing self-care behavior, and decreasing adverse clinical events. The purpose of this evidence-based project was to implement the Heart Improvement Toolkit (HIT) Program which is a one-on-one, comprehensive HF-specific education program, for patients with a HF diagnosis who have been admitted to non-cardiac specialty units. Program …

Recent Graduates' Perspective On The Efficacy Of Nursing Simulation Laboratory Experiences, Holli Sowerby

Walden Dissertations and Doctoral Studies

It has become progressively difficult to find suitable clinical placement for nursing students. To help meet this need, local schools of nursing are turning to high-fidelity simulation manikins to substitute for clinical experience. There is a lack of research that explores recently graduated nurses' perceptions about the efficacy of simulation experiences. Guided by the constructivist theory, this qualitative case study identified how recent RN graduates viewed simulation experiences and whether associate's-degree RN program graduates and bachelor's-program RN graduates viewed simulation differently. Nine recent graduates participated in individual face-to-face interviews. The data were coded and grouped into 5 major themes in …

Visual Arts And Chronic Pain: Thematic Analysis To The Artistic Statements Of Visual Artists, Susan Beth Janicke

Walden Dissertations and Doctoral Studies

The relief of pain is an essential element of nursing practice. Nursing has begun to successfully use art to assess and reduce pain among hospitalized children, surgical patients, and oncology patients. Structured art projects have been used to provide distraction from pain and patient drawings have allowed nurses to assess pain. This project employed grounded theory and thematic analysis to uncover significant concepts in the artists' statements. The Roy adaptation model and Saunders' total pain theory provided the project theoretical framework. The artistic statements and the art of chronic pain patients were examined using thematic analysis to identify recurrent themes. …

The Creation Of A Pacemaker Clinic At A Federally-Funded Patient-Centered Medical Home: A Quality Improvement Project, Tony Anno

Walden Dissertations and Doctoral Studies

It is common for clinicians to implant medical devices, such as permanent pacemakers and implantable defibrillators, for cardiac diseases. These medical devices require follow-up care at regular intervals to ensure proper device function and optimal outcomes. Currently, many individuals without insurance or financial resources lack access to recommended follow-up care after implantation of a cardiac device. The purpose of this project was to determine the number of individuals who have had a medical device implanted without insurance coverage over a 3-year period, and then to establish a clinic that provides this service. The standard of care and operating procedure for …

Factors Contributing To Loss Of Nursing Intellectual Capital, Vera Ligia Grover

Walden Dissertations and Doctoral Studies

In a Level II trauma center, experienced nurses are retiring from nursing positions, which is causing an unstable workforce. According to the literature, there are not enough experienced nurses to mentor the new nurses. Evidence suggests that experienced nurses are associated with improved patient outcomes and that experienced nurse mentors can improve the work environment for less experienced nurses. Focusing on Watson's theoretical framework of caring and Covell's theoretical framework of intellectual capital, this phenomenological study explored the lived experiences of a small group of nurses. Five nurses with 15 years of experience and who had served as mentors were …

The Role Of Nursing Practice In Promoting Sleep During Brain Injury Rehabilitation, Jill Massengale

Walden Dissertations and Doctoral Studies

During hospitalization, sleep can be interrupted or even elusive. It has been established that quality sleep is essential in neural repair. Previous research has indicated that many nurses are unaware of the impact of sleep disturbance on brain injury recovery and do not understand how to promote sleep in the neurorehabilitation setting. The purpose of this project was to determine whether educational intervention would influence nurses' knowledge and attitudes toward sleep. Benner's (2001) novice to expert theory provided a framework for the project. With the collaboration of a neuropsychologist, this study produced a sleep knowledge and attitudes instrument. Pulmonary sleep …

Barriers To Receiving The Influenza Vaccine In Adults 65 Years And Older, Melissa Madalone

Walden Dissertations and Doctoral Studies

Vaccination is regarded by many as the most effective means of reducing influenza infection and disease; however, many people in the United States are hospitalized from flu-related illness each year. Adults 65 years and older account for more than half of these hospitalizations and almost all flu-related deaths. This project aimed to identify barriers to receiving the influenza vaccine among the adult population (> 65 years of age) in a community setting. The goal was to develop a teaching tool that would assist practitioners towards improving influenza vaccination rates among this population. The Health Belief Model was the theoretical framework …

Physical Activity In Nature And Children's Mental Health, Stephanie Marcia Bless

Graduate College Dissertations and Theses

The aim of this study was to determine if there is a relationship between children's physical activity and wellbeing, and if that relationship is enhanced by physical activity in nature. This study was a non-experimental retrospective multi-informant data review conducted at an outpatient pediatric psychiatric clinic in the Northeast. The theoretical framework used to guide this study was the Health Promotion Model, suggesting Advanced Practice Nursing investigate the relationship between health promoting behaviors and personal factors that support mental wellness in children and protect against mental illness. Data collected included age, sex, and exercise and wellbeing subsections of the Vermont …

Academic And Non-Academic Variables As Predictors Of Nclex-Rn Success Among Traditional Associate Degree Students At Southern Adventist University, Christine Moniyung

Dissertations

Problem

The School of Nursing at Southern Adventist University offers both Associate of Science and Bachelor of Science in nursing degrees. A majority of the students who sit for the NCLEX-RN are associate of science in nursing graduates. The pass rate dropped from 94.9% in 2010 to 88.8% in 2011. The pass rate went up to 93.3% in 2012, but dropped again by almost 5% in the following year, and to an all-time low of 76.5% in 2014.

Unlike most AS nursing program student populations in the nation, the majority of SAU students are young and considered traditional-age college students. …

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 …

The Effects Of A Concept-Based Curriculum On Nursing Students' Nclex-Rn Exam Scores, Patricia Allen Edwards

Walden Dissertations and Doctoral Studies

The Institute of Medicine and the National League of Nursing have called for curricular reform that promotes high first-time pass rates on the National Counsel of Licensure Examination for Registered Nurses (NCLEX-RN). A campus in the southeastern region of the United States implemented a concept-based curriculum; however, the effect on the first-time NCLEX-RN pass rates was unknown. The purpose of this comparative study was to determine if the concept-based curriculum improved student scores on the NCLEX-RN. Dreyfus' model of learning guided this study because of the andragogy tenets, which in turn supported the concept-based curricula. The research questions examined the …

The Association Between Core Science Course Timing And Completion Of An Associate Degree Nursing Program, Patricia Ann Pfeiffer

Walden Dissertations and Doctoral Studies

The aging population in the United States has led to an increased demand for registered nurses. Nursing program administrators must examine ways to increase nursing program completion, which will increase the supply registered nurses. The purpose of this study was to determine the associations among length of time between core science course completion and nursing program admission, on-time completion, and National Council Licensure Examination for Registered Nurses (NCLEX-RN) success for students at a southeastern community college. A convenience sample of 288 community students admitted to an associate degree level nursing (ADN) program between 2007 and 2012 was selected. The guiding …

An Educational Program For Nurses On Therapeutic Misconception In The Oncology Setting, Debra Magnanelli

Walden Dissertations and Doctoral Studies

A key component of informed consent to participate in research is the understanding that research is not the same as treatment and that scientific goals have priority over therapeutic ones. However, studies have found many research participants do not understand these important differences between research and treatment, a phenomenon termed therapeutic misconception (TM). The problem addressed in this project was research nurses' lack of education regarding the existence and concepts of TM, and their struggles to assess and address research participants' TM of clinical trials. Matutina's conceptual model of TM was used to guide this project. The purpose of this …

Automated Medication Dispensing Cabinet And Medication Errors, Marie Helen Walsh

Walden Dissertations and Doctoral Studies

The number of deaths due to medical errors in hospitals ranges from 44,000 to 98,000 yearly. More than 7,000 of these deaths have taken place due to medication errors. This project evaluated the implementation of an automated medication dispensing cabinet or PYXIS machine in a 25-bed upper Midwestern critical access hospital. Lewin's stage theory of organizational change and Roger's diffusion of innovations theory supported the project. Nursing staff members were asked to complete an anonymous, qualitative survey approximately 1 month after the implementation of the PYXIS and again 1 year later. Questions were focused on the device and its use …

Bedside Nurses' Influence On Patients' Continuum Of Care Through Effective Discharge Teaching, Mary Ann Whicker

Walden Dissertations and Doctoral Studies

The evolution of person-centered healthcare reinforces the need for nursing to provide effective patient education. Literature suggests nurses desire to provide strong discharge education to patients, but are challenged by knowledge gaps and other barriers. This DNP project developed a plan for integrating teach-back on a 30-bed cardiac unit, focusing on heart failure patients. Following a logic model, the process improvement plan to implement teach-back includes education on teach-back, empowerment of unit champions to support the project and evaluation of effectiveness of the education plan and impact on heart failure patients. The sample size of 15 cardiac nurses provides a …

Quest For Health: An Early Beginning To A Lifelong Journey, Kerry P. Appleton

Theses and Graduate Projects

Childhood obesity has been cited as a modern day public health crisis. Despite the creation of many health education programs and interventions, the prevalence of childhood obesity remains largely unchanged. In response to this growing epidemic, nurses have been called to action to help mitigate health education disparities. The purpose of this project is to pool existing community resources to impact the general health of school-age children while influencing the health norms of their surrounding communities. A partnership between local school districts and a non-profit children's hospital has been created to provide health education to school age children in the …

A Grounded Theory Model For Faculty Evaluation Of Nursing Student Performance During A Simulation, Penni Isla Watts

All ETDs from UAB

This qualitative grounded theory study explored the process of faculty evaluation of student performance during simulation in the southern United States. In the last decade, simulation experiences have been found to be useful in nursing education as a teaching methodology and as a potential method for evaluation of student performance. While clinical experiences are limited, unpredictable, and difficult to truly evaluate, simulation experiences provide an opportunity for students to manage care through pre-planned patient scenarios without potential harm to real patients. This allows faculty to observe students making decisions and caring for simulated patients in a context designed to elicit …

Relationship Between Stages Of Change And Hpv Vaccine Attitudes And Beliefs In Baccalaureate Nursing Students, Megan M. Stein, Michael Sabo, Julia Caverly

Williams Honors College, Honors Research Projects

The purpose of this study was to: (a) determine if there is a relationship between attitudes/beliefs about Human papillomavirus (HPV) vaccination and stages of change and (b) investigate gender differences in attitudes/beliefs and stages of change in undergraduate baccalaureate nursing students. The study employs a cross-sectional and descriptive correlational design and it was guided by the Trans-theoretical Model of Change (TMC). The convenience sample was comprised of 131 participants at a large urban public university in Midwest United States. Data were collected with online surveys distributed via university email. A positive, moderate relationship was found between HPV vaccination attitudes/beliefs and …

A Quality Improvement Project To Evaluate Auditor Satisfaction With Different Data Collection Methods For Auditing Compliance With Catheter Associated Urinary Tract Infection (Cauti) Prevention Standards, Andrea S. Balzer

Regis University Student Publications (comprehensive collection)

Executive Summary A Quality Improvement Project to Evaluate Auditor Satisfaction with Different Data Collection Methods for Auditing Compliance with (CAUTI) Prevention Standards Problem Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infection (HAI) in the United States, representing about 40% of all HAIs (Palmer, Lee, Dutta-Linn, Wroe & Hartmann, 2013). Approximately 25% of indwelling urinary catheters are unnecessary and may potentially lead to CAUTIs if not maintained, cleaned, and cared for appropriately (Nazarko, 2012). Literature suggests that preventing CAUTIs is possible by implementing evidence based prevention standards. The PICO research question for CAUTI prevention and prevention standard …

Prenatal Nutrition Counseling Designed To Reduce The Intake Of Moderate And High Glycemic Index Foods Among Selected Normal, Overweight, And Obese Patients From A Nonprofit Faith-Based Patient Medical Care Home, Debra T. Gogatz

Regis University Student Publications (comprehensive collection)

Executive Summary

Prenatal Nutrition Counseling Designed to Reduce the Intake of Moderate and High Glycemic Index Foods Among Selected Normal, Overweight, and Obese Patients from a Nonprofit Faith-based Patient Medical Care Home

Problem

Minority and economically disadvantaged clients at a faith based nonprofit patient medical care home were identified as needing dietary counseling in the first trimester of pregnancy. There has existed a preponderance of evidence linking excessive weight gain in pregnancy to multiple complications for mother and child with a suggested relationship specific to the inflammatory processed initiated within the human body related to the ingestion of excessive calories …

Comparison Of Home Medication Adherence In Adults Age 65 And Older After Completion Of Standardized Discharge Medication Education Or Non-Standardized Discharge Medication Education, Jill Weller

Regis University Student Publications (comprehensive collection)

Executive Summary

Comparison of Home Medication Adherence in Adults Age 65 and Older After Completion of Standardized Discharge Medication Education or Non-Standardized Discharge Medication Education
Problem
The older patient (age 65 and older) is at higher risk of medication induced illness because of numerous co-morbid conditions treated with multiple medications, a standardized approach to medication education at hospital discharge can reduce adverse medication events for this at risk population (Esposito, 1995; Jack et al., 2009). The primary driving force for this project is the limited number of research studies published to date that include this specific age bracket and setting. …