Medicine and Health Sciences Commons^™

Servant Leadership Towards Cultural Competency And Critical Thinking: A Mixed Methods Study In Zambia, Jill Marie Brown

Occupational Therapy Program Student Theses, Dissertations and Capstones

There is a paucity of occupational therapy literature related to the professional development process that occurs when students participate in immersive, international servant leadership experiences in developing countries. A scarcity of literature exists on how such culturally rich experiences can influence the development of the participating students’ dispositional critical thinking and cultural competency skill sets. This mixed methods study depicts how a 3-week servant leadership experience in Zambia, Africa, measured the acquisition of dispositional critical thinking and cultural competency skill sets in novice to experienced occupational therapy students. Moreover, this study infuses a constructivist grounded theory approach to uncover a …

A Clinical Documentation Practice Improvement To Increase Insurance Reimbursement, Allison R. Hamilton

Student Theses, Dissertations and Capstones

Background: The National Institute Mental Health (2015) estimated there were about 44.7 million people diagnosed with a serious mental illness and 62.9% of those diagnosed were without mental health services. The loss of services was due to unemployment, reoccurring hospitalization, inabilities to care for themselves, and lack of participation in societal norms (World Health Organization [WHO], 2014). According to Insel (2011/2015), the U.S. cost of mental healthcare was an estimated $57.5 billion in 2006. This cost was not due to actual care but associated with the economic burden of job loss and the excessive use of community resources. The Affordable …

Improved Use Of Interact To Decrease 30-Day Readmissions From A Skilled Nursing Facility, Folasade Omobowale Adewunmi

Student Theses, Dissertations and Capstones

Background: The rising cost of health care in relation to rehospitalizations continues to be a challenge. Medicare 30-day readmissions have an annual estimated cost of $17.4 billion. Irrespective of these costs and the continued improvement in the quality of care, skilled nursing facilities (SNF) still face high readmission rates. Purpose: The purpose of this quality improvement project was to enhance SNF care processes by improving the utilization of the electronic medical record software program “INTERACT” to increase early identification and treatments of patients to minimize 30-day hospital readmissions. Theoretical Framework: The theory of planned behavior by Icek Azjen was used. …

Implementing A Culturally Sensitive Intervention For Haitian Patients Non-Adhering To Hypertensive Medications, Guilaine Gabriel-Percinthe

Student Theses, Dissertations and Capstones

Background: The pervasiveness of hypertension (HTN), morbidity, and mortality in Haitians immigrants are frightening. Nonadherence with hypertensive medications, disease management, lifestyle modifications, and cultural and spiritual beliefs, including prayer; faith healing; use of herbal teas; and a diet that is deficient in potassium, rich in sodium, high in fat, cholesterol, and carbohydrates result in increased prevalence of HTN and disability in the Haitian community. Purpose: The purpose of this quality improvement project was to examine the existing system for adherence to hypertensive medications, standardized clinical practice guidelines, identify patients at risk for nonadherence to hypertensive medications, disease management, medical follow-up, …

Lived Experience Of Post-Licensure Nurses In A Perioperative Clinical Rotation, Amy Stahley

Student Theses, Dissertations and Capstones

A projected deficit in the perioperative workforce of 32,000 perioperative nurses retiring by 2024, creates an inability to meet the nursing needs of the United States population. The need for experienced perioperative nurses has been increasing while the availability of nurses with perioperative education has been decreasing. The purpose of this phenomenological study was to explore the lived experience of post-licensure nurses who participated in a perioperative clinical rotation within their baccalaureate nursing program and did that experiential experience affect the recruitment and employment for perioperative nursing to halt the impending shortage. The integrations of Kolb’s experiential learning theory and …

Use Of Evidence-Based Test Development In Pre-Licensure Nursing Programs: A Descriptive Study Of Faculty Beliefs, Attitudes And Values, Richild Berrick

Student Theses, Dissertations and Capstones

Background: Effective testing in pre-licensure nursing programs is a challenge in nursing education. Implementing evidence-based test development is essential to successful assessment of students’ competence and preparation for licensure. Purpose: Identifying the beliefs, attitudes and values of nursing faculty will contribute to the use of best practices in student assessments, ultimately contributing to increased retention of competent students and increasing the workforce within the healthcare industry. Theoretical Framework: This study is based on Rokeach’s theory of beliefs, attitudes and values. Methods: A quantitative descriptive research methodology was used in this study using survey data collection. A purposive, non-probability, convenience sample …

Chinese Immigrants With Non-Insulin-Dependent Diabetes Mellitus: Nutritional Self-Management Approach, Winnie Manlai Wong

Student Theses, Dissertations and Capstones

Background: Chinese immigrants (CIs) with non-insulin dependent diabetes mellitus (NIDDM) generally have poor control in their diet regimen. Due to the variation in body mass, physiology, and cultural differences as compare with the general American population, special attention must be conducted in treating diabetes in Cis, emphasizing culturally sensitive care and nutrition therapy that acknowledge the differences. Purpose: The purpose of this project was to assess cultural challenges in self-management for CIs living with non-insulin dependent diabetes mellitus and evaluate the effectiveness of a diabetic nutritional self-management guide tailored to this population. Theoretical Framework: Havelock’s theory of change is a …

Lose To Win: Fighting Obesity In The Workplace, Latoya Dotson

Student Theses, Dissertations and Capstones

Background: Obesity is a significant healthcare problem in modern American society. It has led to decreased longevity of employees and decreased productivity in day-to-day duties of healthcare workers. There are more negative attributes to obesity than positive, regardless of the race affected. One of the leading causes of death in 2012 was cardiovascular disease. Due to poor dietary choices, the promotion of sedentary lifestyle has led to complications of obesity such as high blood pressure and diabetes. Major improvements can be made within a community that acknowledges the risks of obesity and seeks to implement preventive programs. Increasing one’s physical …

Implementation Of The Essential Competencies For Evidence-Based Practice In Baccalaureate Nursing Education, Elizabeth Whorley

Student Theses, Dissertations and Capstones

Integrating evidence-based practice into healthcare education has been a recommendation for the past 16 years. Despite this, barriers still exist with the utilization of evidence-based practice. The purpose of this study was to describe the current state of EBP scholarship in the curriculum of baccalaureate pre-licensure nursing programs. Essential Competencies for Evidence-Based Practice in Nursing (Stevens, 2009) was utilized to measure the state of EBP scholarship. The research question stated: how is evidence-based practice scholarship addressed within baccalaureate pre-licensure nursing programs? The research design was guided by Rogers’ diffusion of innovations theoretical framework and the star model of knowledge transformation …

Senior Nursing Students' Knowledge, Attitudes, And Perceived Competency About Older Adults, Deborah Denise Brabham

Student Theses, Dissertations and Capstones

Background: Nurses entering the workforce may have limited education in gerontological nursing. Therefore, many nurses are unprepared to provide quality care to older adults. An unprepared nursing workforce could negatively influence older adults’ health outcomes and care experience. Purpose: To determine differences in senior nursing students’ knowledge, attitudes, and perceived competency about older adults based on enrollment in a bachelor of science in nursing degree (BSN), associate’s degree nursing (ADN), and practical nursing (PN) program that offers geriatric content in curricula. Theoretical Framework: Bandura’s social cognitive theory, triadic reciprocal determinism model provided the theoretical framework. Methods: A non-experimental, descriptive survey …

Improving Breastfeeding Education Among Hospital Nurses, Kara R. Connelly

Graduate Dissertations and Theses

Breastfeeding is well-documented as the most beneficial method of infant feeding worldwide. There are numerous national initiatives present to improve breastfeeding outcomes. Despite knowledge and health care organization efforts, the recommendations of exclusive breastfeeding through six months of life with continued breastfeeding through one year of age are not being met. The purpose of this DNP project is to determine if a structured self-study educational program on breastfeeding recommendations, the 4^th Edition of the Lactation Management Self-Study Modules created by Wellstart International™, provided to hospital nurses on a maternity unit in Central, New York with a Level One nursery, …

The Effects Of A Digital Educational Intervention On Undergraduate Nursing Students' Attitudes, Knowledge And Self-Efficacy With Female Genital Cutting, Najla Barnawi

Graduate Dissertations and Theses

Background: Due to increasing transmigration, care of women with female genital cutting FGC has become a national and global public health and human rights issue. The US is one of the Western countries that have a large number of women who underwent or are at risk to undergo FGC. Based on the US Population Reference Bureau (PRB) (2013), there were more than 507,000 females with different migration status who were subjected to some form of FGC. Around 55% of these women were during their reproductive cycle (15 to 49 years old). Caring for immigrant women with FGC, especially those who …

Exploring Incivility Among Nursing And Health Science Students: A Descriptive Study, Diane Louise Smith

Student Theses, Dissertations and Capstones

Incivility has infiltrated our institutions of higher learning as well as the world of nursing. All too familiar in nursing is the phrase “eating their young,” which aptly describes how nurses treat other nurses, even though they should be nurturing and caring professionals.

The investigator explored nursing and health science students’ perceptions of student and faculty uncivil behaviors within the academic environment, seeking the levels and frequency of the problem. Bandura’s social learning theory presents a sound theoretical framework for this dissertation. The research methodology consisted of a quantitative descriptive approach. The Incivility in Higher Education-Revised (IHE-R) Survey was used …

Importance Of And Satisfaction With Characteristics Of Mentoring Among Nursing Faculty, Jacklyn Gentry

Graduate Theses and Dissertations

The nursing faculty shortage and its contributing factors have been well documented in the literature. Contributory factors include lack of graduate prepared faculty, difficulty recruiting and retaining faculty, and a decrease in job satisfaction within the faculty role. The use of mentoring programs has the potential to impact the nursing faculty shortage by increasing job satisfaction while providing novice faculty with additional support during the transition from clinical nurse to nursing faculty.

The purpose of the study was to examine the relationship between the importance of and satisfaction with characteristics of mentoring in full time nursing faculty teaching in baccalaureate …

Correctional Nurses: Adult Opioid Dependence Referral Process, Christine Hilary Edmund

Student Theses, Dissertations and Capstones

Background: Correctional nurses make up a large part of the corrections workforce and have increasing responsibility for making decisions about patient care in the opioid dependent incarcerated patients. The National Commission on Correctional Health Care (NCCHC) has intoxication and withdrawal standards that advocate individuals entering a correctional facility under the influence or undergoing withdrawal from opioids have their therapy continued, or a plan for appropriate referral for treatment. The NCCHC standard that incarcerated opioid dependent inmates have their therapy continued or a plan for appropriate referral for treatment is not adhered to consistently, as the current process lacks organization. Purpose: …

The Lived Experience In Relation To The Educational Needs Of Nurses Caring For Induced Hypothermia Patients, Marie Regina Hankinson

Student Theses, Dissertations and Capstones

Background: Ongoing educational development is essential to ensure the effectiveness of professional nurses’ learning experiences. Understanding the ways in which workplace learning occurs is fundamental to enabling nurse educators to deliver that knowledge. Induced hypothermia was introduced as a new treatment modality in 2005 and education surrounding the care of the hypothermia patient is lacking in the literature. Purpose: The purpose of this study is to illuminate how nurses learn new knowledge in the clinical setting. Theoretical Framework: The learning theory chosen for this study is the three dimensions of learning by Illeris (2004). Methods: Semistructured interviews were conducted with …

Transition To Practice Experience: The Impact On Newly Licensed Rn Performance, Patricia P. Lawson

Student Theses, Dissertations and Capstones

This quantitative non-experimental descriptive correlational design sought to answer the question if there was a difference in newly licensed RN (NLRN) performance at one-year post hire after participation in a nurse residency program that offers a formalized curriculum that extends throughout the entire year, one that offers a formalized curriculum that does not extend throughout the entire year, or one that does not provide a formalized curriculum. The study utilized the Six Dimension Scale of Nursing Performance (SDNP) and evaluated NLRN performance on six subscales: leadership, critical care, teaching/collaboration, planning/evaluation, interpersonal relations/communication, and professional development at one-year post hire. Benner’s …

Professional Nursing Value Development In Nursing Students Who Participate In International Service Learning, Heather Ferrillo-Diiulio

Student Theses, Dissertations and Capstones

Background: International Service Learning (ISL) is becoming widely used in nursing education as a means to provide global learning opportunities. Concrete outcomes for these experiences have not been clearly supported in previous research. Determining if ISL experience facilitate the development of Professional Nursing Values (PNV) can support the use of ISL as a viable pedagogy. Purpose: The purpose of the study was to determine if there were a difference in PNV development in students who participate in ISL as part of their clinical experiences compared to those who do not. The hypothesis was that there was a difference in the …

Factors That Predit Levels Of Sleepiness Of Advanced Practice Nursing Students, Deana Shevit Goldin

Student Theses, Dissertations and Capstones

Background: Due to arduous demands of graduate education, advanced practice nursing (APN) students who are classified as adult learners are at risk for suffering sleep deprivation. Factors contributing to sleep deprivation include stress, expected academic challenges, and everyday life stressors. Purpose: This study investigated if APN students’ grade-point average (GPA), gender, and employment status predicted levels of daytime sleepiness. Theoretical Framework. The psychological well-being model selected for this study was consistent with the theory that sleep is a resource essential to well-being; adequate sleep is the resource needed to optimally manage stressful life demands. Methods. Bivariate and multiple regression were …

Cancer-Related Fatigue Clinical Guideline And Protocol For Hospitalized Oncology Patients: A Quality Improvement Project, Sulotte Valcin Amilcar

Student Theses, Dissertations and Capstones

Background: Cancer-related fatigue is one of the most common symptom experienced by cancer patients throughout their cancer trajectory. However, very little effort has been made within many oncology practices to assess this clinical problem and to provide timely nursing interventions to reduce its impact. While there have been tremendous advancements in the treatments of the disease aspects of cancer in term of medicine and advanced technology, basic assessment of related physiological concerns, such as fatigue, have not seen the same progress. Purpose: The purpose of this quality improvement project was to develop an evidence-based cancer-related fatigue assessment guideline and a …

Chemotherapy Side Effects At Home: A Nursing Impact, Gwendolyn E. Saint-Clarke

Student Theses, Dissertations and Capstones

Background: Approximately 32% of all lymphoma patients experience immunocompromised severe avoidable side effects of nadir at home after discharge postchemotherapy. The certified oncology nurses employed at a large metropolitan hospital in Atlanta, Georgia, lack standardized discharge guidelines that include regulatory organizations’ recommendations to assist patients/families with at-home self-management of the avoidable side effects. Purpose: The purpose of this quality improvement project was to utilize the institution’s existing postchemotherapy discharge protocol to assess certified oncology nurses’ knowledge of severe avoidable side effects of nadir; modify the existing healthcare institution’s postchemotherapy discharge protocol to reflect standardized practice for promoting clinical practice continuity …

Evidence-Based Diabetic Discharge Guideline: A Standardized Initiative To Promote Nurses' Adherence, Marjorie V. Scarlett

Student Theses, Dissertations and Capstones

Background: Diabetes mellitus (DM) affects more than 29.1 million Americans. Standardized clinical practice guidelines recommended by regulatory healthcare agencies are the standard of care for diabetic patients and must be adhered to by healthcare professionals providing care. Purpose: The purpose of this quality improvement project was to identify Centers for Medicare and Medicaid Services’, Joint Commission on Accreditation of Healthcare Organization’s, and other professional healthcare organizations’ guidelines for nurses’ knowledge of evidence-based discharge practices; determine level of nurses’ knowledge on evidence-based discharge practice process; develop a quality improvement plan, including development of an evidence-based guideline for diabetic discharge instructions; present …

Steroid-Induced Hyperglycemia In Patients With Malignancies: Healthcare Team Adaptation To A Paradigm Shift, Miriam Ingrid Silva

Student Theses, Dissertations and Capstones

Background: Caring for patients with malignancies and presenting hyperglycemia has been an ongoing problem that needed to be addressed. The Endocrinologist Society and the Joint British Diabetes Societies for Inpatient Care suggested a change in the process by which patients in this population are managed. Purpose: The purpose of this project was to implement evidence-based practice guidelines for managing steroid-induced hyperglycemia focusing on the interdisciplinary team and adaptation of nurses who care for patients with malignancies. Theoretical Framework: The theoretical framework selected for this project was Roy’s Adaptation Model. Methods: This project used a mixed method approach, with a triangulation …

Increasing Providers’ Adherence To Ordering Urine Microalbumin Tests, Florence Fadele

Student Theses, Dissertations and Capstones

Currently, a microalbumin urine test is an annual test for diabetic patients recommended by the American Diabetes Association, but primary care providers are not ordering the tests. This may be, in part, attributable to the fact that there are no guidelines for ordering microalbumin urine tests. The purpose of this capstone project was to assess providers' compliance in identifying the need for the microalbumin urine test for patients with diabetes, to develop evidence-based guidelines for monitoring and ordering microalbumin urine tests, and to evaluate providers' compliance. Rogers's theory of the diffusion of innovation provided the framework for this capstone project. …

Health Care Providers' Knowledge Of Childhood Obesity Within The Hispanic Community, Daysi Fardales

Student Theses, Dissertations and Capstones

Background: Recent studies indicate a rise in the prevalence of obesity in children of various age groups. Obesity was officially recognized as a disease by the American Medical Association (AMA) in June 2013. It has been acknowledged as a progressive epidemic public health crisis in the United States for the past 20 years. This is a health care concern that needs examination and the development of new and more effective prevention and treatment modalities for obesity in children. Environmental, hereditary, behavioral, and socioeconomic factors play a significant role in the prevalence of obesity (Rooney, Mathiason, & Schauberger, 2011). Childhood obesity …

Managing Diabetic A1c At A Primary Care Center: A Nurse Practitioner Perspective, Jacqueline Mcdonald

Student Theses, Dissertations and Capstones

Background: At a primary care center in Brooklyn, New York, approximately 27% of diabetic patients with abnormal Hgb A1C fail to return for follow-up appointments, as recommended by the Centers for Disease Control and Prevention (CDC). According to electronic medical records (EMR), healthcare providers demonstrated inconsistency in ordering and monitoring Hgb A1C and clinic follow-up appointments for patients.

Purpose: The purpose of this quality improvement project was to determine retrospectively the healthcare providers’ ordering, monitoring, and follow-up appointments for adult diabetic patients with abnormal Hgb A1Cs; to develop and implement astandardized process for healthcare providers to monitor and follow these …

Addressing Obstetric Health Care Providers' Nutritional Insight In The Low Socioeconomic Population, Nicole Theresa Marshall

Student Theses, Dissertations and Capstones

Background: During a woman's pregnant state, a diet that is adequate in nutrition is critical to the developing fetus, especially in the lower socioeconomic status population. The healthcare provider is charged with the acute fundamental awareness of this additional factor that can grossly impact pregnancy. Nutritional advice from the health care provider is one of many key points that contribute to the successful outcome of the pregnancy. Purpose: The purpose of this quality improvement project was to develop a standardized, evidence-based practice (EBP) protocol for the management of maternal nutrition, gestational weight gain, and physical activity for provider use at …

The Lived Experience Of The English As A Second Language Rn-Bsn Degree Completion Student Integrating To An Online Learning Environment, Sonique S. Sailsman

Student Theses, Dissertations and Capstones

Enrollment in registered nurse-bachelor of science in nursing (RN-BSN) degree completion programs have increased in the last several years. Due to this increase, many programs have begun to offer their RN-BSN programs completely online or in a hybrid format. Often times, students who choose to pursue their degree online come from various cultural and ethnic backgrounds and speak English as a second language (ESL). There is limited research about the experiences of these students in this unique learning environment. The purpose of this study was to explore the lived experience of RN-BSN ESL nursing students who are engaged in learning …

Using An Online Learning Module In A Nursing Program To Improve Knowledge And Skills To Prevent Falls In The Community Dwelling Older Adult Population, Susan Kane Patton

Graduate Theses and Dissertations

Nationally, 28.4% of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence based protocols by providers to identify older adults at risk of falling is limited and rates of participation by older adults in prevention activities is low. Because of nursing’s increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community dwelling older adults and increased access of older adults to falls risk assessment. There is a …

Senior Nursing Students' Knowledge, Attitudes, And Confidence With End-Of-Life Care, Blanca E. Miller

Student Theses, Dissertations and Capstones

Background: Advance directives allow patients to put in writing the type of health care they want if they are unable to make decisions due to their medical condition. Purpose: The purpose of this study was to determine if there were differences in senior nursing students’ knowledge, attitudes, and confidence based on when the information is positioned in the curriculum. Theoretical: Social cognitive learning theory and Zimmerman’s self-regulation model provided the theoretical framework. Methods: This study reflected a non-experimental, exploratory design, with a convenience sample of senior nursing students from 2 different nursing programs in central Illinois. One program offers advance …