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Articles 1 - 30 of 31
Full-Text Articles in Medicine and Health Sciences
Development Of A Plan For A Navigator Program, Linda Dunaway
Development Of A Plan For A Navigator Program, Linda Dunaway
Walden Dissertations and Doctoral Studies
Following implementation of the Patient Protection and Affordable Care Act, hospitals have seen a reduction in Medicare reimbursement for 30-day post-discharge readmissions of acute myocardial infarction patient. The purpose of this project was to develop a plan for a navigator program to improve a patient's health status post discharge and reduce readmission rates. The Johns Hopkins nursing evidence-based practice model and guidelines were used in determining the quality of obtained experimental and non-experimental studies with or without meta-analysis and popular source articles. The literature revealed the most successful programs involved providing best practices for a navigator program allowed better patient …
Effective Communication And Teamwork Improve Patient Safety, Helene M. Anderson
Effective Communication And Teamwork Improve Patient Safety, Helene M. Anderson
Walden Dissertations and Doctoral Studies
Work environment influences the effectiveness of care for patients in any healthcare setting. It is even more important in settings such as the neonatal ICU (NICU) where this project took place. When the environment is not healthy, communication may suffer and result in poor patient outcomes and, family, patient, and staff dissatisfaction. The purpose of this quality improvement project was to understand how the implementation of the TeamSTEPPS program, for nurses in the NICU, could impact the safety culture as measured by the AACN Healthy Work Environment (HWE) tool. Lewin's professional practice change theory and the AHRQ change model were …
Medical Floor Confusion Assessment Method: Implementation And Assessment Of Risk Factors, Michaelynn R. Paul
Medical Floor Confusion Assessment Method: Implementation And Assessment Of Risk Factors, Michaelynn R. Paul
Walden Dissertations and Doctoral Studies
An estimated 50% of older hospitalized patients experience delirium. This has created significant complications costing an estimated $164 billion or more per year worldwide. The ability to identify patients developing delirium would allow the implementation of specific interventions to decrease or eliminate the adverse effects of delirium. The purpose of this quality improvement project was to provide high quality delirium education to determine if medical unit nursing staff could successful implement the Confusion Assessment Method (CAM) screening tool to identify patients experiencing delirium as the first phase of an overall plan. Implementation of the project followed Roger's diffusion of innovations …
Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser
Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser
Walden Dissertations and Doctoral Studies
Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …
Improving The Quality Of Electronic Documentation In Critical Care Nursing, Brent Alan Stevens
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 …
Barriers Cardiac Nurses Face In Addressing Psychosocial Issues Of Heart Failure Patients, Debra Kay Disbrow
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
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 …
Caring For Patients With Delirium In The Intensive Care Unit, Susan Archer
Caring For Patients With Delirium In The Intensive Care Unit, Susan Archer
Walden Dissertations and Doctoral Studies
Patients in hospital intensive care units are at increased risk to develop delirium, a condition which is characterized by a disturbance of consciousness and a change in cognition. Critical care nurses must have the knowledge to assess, recognize, and manage delirium. The purpose of this project was to develop an evidence-based policy for the assessment of delirium and a comprehensive nursing education plan which included an analysis and synthesis of the literature, a curriculum plan, and a pretest/posttest. The Johns Hopkins Evidence-Based Practice Model framed the project, which used a multidisciplinary team approach. Two nursing leaders, each with a doctor …
Body Piercing And Health Complications Among College Students In Puerto Rico, Elsie Goicochea
Body Piercing And Health Complications Among College Students In Puerto Rico, Elsie Goicochea
Walden Dissertations and Doctoral Studies
The incidence and prevalence of body piercing health complications among students is a public health matter that has not been researched in Puerto Rico. College students are the most consistent participants in body piercing activities and have reported health complications resulting in visits to medical offices and emergency rooms. Based on the health belief model, which is used to explain and predict health attitudes, the purpose of this quantitative nonexperimental study was to analyze the health risks and possible complications occurring after body piercing and to investigate the association between sex and age and medical complications. Data were collected from …
A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy
A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy
Walden Dissertations and Doctoral Studies
Lung cancer affects many individuals each year and accounts for many deaths around the globe. Lung cancer screening is a preventative health measure that has the ability to detect lung cancer earlier. The purpose of this project was to focus on the education of nursing staff within a community health system, with subsequent implementation of an electronic health record clinical decision support system, to create a direct referral pathway to lung cancer screening, delivered through patient education. The concept of prevention was the framework for this project design, which was further organized around the plan-do-study -act model, while taking into …
Clinical Simulation And Nursing Student Perceptions Of Satisfaction, Self-Confidence, And Critical Thinking, Jaime Magnetico
Clinical Simulation And Nursing Student Perceptions Of Satisfaction, Self-Confidence, And Critical Thinking, Jaime Magnetico
Walden Dissertations and Doctoral Studies
Although the number of nursing programs has increased in Florida, the number of hospital sites available for clinical experiences have not, resulting in limited clinical time for each nursing program. To address this shortage of clinical time, local colleges are increasing the use of simulations in the curriculum. Guided by andragogy, this sequential mixed methods study was conducted to explore differences in students' perceptions of satisfaction, self-confidence, and critical thinking between two groups of students with different amounts of clinical simulation. In an associate degree nursing program, 34 nursing students completed a single survey on student perceptions of satisfaction and …
Servant Leadership And Its Effect On Employee Job Satisfaction And Turnover Intent, Dennis M. Mitterer
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, …
Nurses' Reflection, Compassion Fatigue, And Work Burnout - A Correlational Analysis, Sarah Urban
Nurses' Reflection, Compassion Fatigue, And Work Burnout - A Correlational Analysis, Sarah Urban
Walden Dissertations and Doctoral Studies
Compassion fatigue and work-related burnout are harmful reactions to patient situations and work environments that negatively affect nurses' well-being and ability to provide safe, effective patient care. However, research is needed to understand how reflection as a self-care response to patient situations is related to nurses' development of work burnout, compassion fatigue, and secondary traumatic stress, a type of compassion fatigue. The purpose of this correlational, cross-sectional quantitative study was to determine the relationship between hospital-based acute care nurses' levels of reflection and their levels of compassion fatigue, secondary traumatic stress, and work burnout. The study was based on Hentz …
Nursing Leadership Influence On Evidence-Based Practice Culture And Integration, Natalie Kay Lenhart
Nursing Leadership Influence On Evidence-Based Practice Culture And Integration, Natalie Kay Lenhart
Walden Dissertations and Doctoral Studies
Translating research to practice takes 10-20 years or more and evidence-based practice (EBP) integration remains at 10%-20%, despite recommendations requiring EBP-guided decisions. EBP integration has been associated with up to 30% decreases in healthcare system spending, improved quality outcomes, and increased staff satisfaction. Nurse leaders are accountable for EBP enculturation, yet rate quality and safety as the highest priority and EBP as the lowest. This knowledge gap perpetuates low EBP integration rates and hinders EBP enculturation. Asking whether EBP facilitative interventions for nurse leaders increase scores on organizational culture and readiness, beliefs, and EBP use scales addressed the knowledge gap …
The Impact Of Nursing Interventions On Pediatric Pressure Injuries, Charleen Singh
The Impact Of Nursing Interventions On Pediatric Pressure Injuries, Charleen Singh
Walden Dissertations and Doctoral Studies
Hospitalized children are vulnerable to pressure injuries. Multiple methods are available to decrease pressure injuries. One specific method is the pediatric pressure injury prevention bundle, which includes device rotation, moisture management, positioning, skin assessment, and support surface management. Although this prevention bundle is available nationwide, it is not known if this type of bundled methodology helps decrease pressure injuries in hospitalized children. Secondary data regarding nursing interventions implemented as a bundle and pressure injury rates from a large pediatric hospital consortium were used to address this gap in the literature. The research questions explored the impact of the pressure injury …
Leadership Development For The Formal Nurse Leader, Lori Neu
Leadership Development For The Formal Nurse Leader, Lori Neu
Walden Dissertations and Doctoral Studies
Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …
Development Of A Quality Improvement Initiative To Screen For Postpartum Depression, Renee Traube
Development Of A Quality Improvement Initiative To Screen For Postpartum Depression, Renee Traube
Walden Dissertations and Doctoral Studies
Postpartum depression (PPD) is a mood disorder affecting approximately 20% of women within 6 months of delivery. Untreated PPD diminishes a woman's functioning and may result in short and long-term consequences for her infant. Screening with evidence-based tools can identify prenatal and postpartum women at risk for PPD, ensure early treatment, and limit adverse maternal and infant effects. Using Rosswurm and Larrabee's evidence-based practice model, a multidisciplinary team of 7 key stakeholders, including directors and a nurse from the departments of OB/GYN, Pediatrics, and Primary Care, a psychiatrist specializing in women's health, and a member of nursing leadership, formed to …
Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz
Using Health Literacy To Improve Emergency Department Discharge, Alicia Ortiz
Walden Dissertations and Doctoral Studies
Patients with limited health literacy often fail to understand verbal and written discharge instructions, and they frequently return to the emergency department (ED) for care. Patients returning to the ED and 30-day readmission rate are core quality performance measures. The purpose of this project was to decrease repeat visits and readmissions to the ED by implementing components of health literacy programs within the ED on patient education and written discharge instructions. Change implementation consisted of (a) use of teach back method (b) modifying medical terminology to language that patient could understand (c) limiting use of words with more than three …
Educating To The Collaborative Care Model, Darcy N. Duncan
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 …
Exploration Of Nurses' Experiences Transitioning To A Team-Nursing Model Of Care, Melissa E. Pestill
Exploration Of Nurses' Experiences Transitioning To A Team-Nursing Model Of Care, Melissa E. Pestill
Walden Dissertations and Doctoral Studies
In response to the needs of patients, coupled with nursing workforce predictions and the pressure of cost containment, a shift to a new team nursing model of care has been seen in Canada and Australia. Today's patients require multiple resources, nurses with additional skillsets and vast amounts of experience during their hospital stays, and a team of nurses can meet these needs. This project explored the experiences and perspectives of nurses during the implementation of a team nursing model of care on a 32-bed, inpatient, cardiology floor in southern Ontario. The purposes of this project were to conduct a formative …
The Meaning Of Feeling Fearful For New Community/Public Health Nurses, Demetrius Ann Jones
The Meaning Of Feeling Fearful For New Community/Public Health Nurses, Demetrius Ann Jones
Walden Dissertations and Doctoral Studies
This study examined the meaning of feeling fearful for nurses entering community/public health (C/PH) nursing. Nurses are entering the C/PH workforce with less experience and education than ever before, and may feel afraid or fearful in their jobs. Additionally, the autonomous nature of C/PH nursing poses significant challenges for this population such as fear of isolation and/ or abandonment. Therefore, the purpose of this qualitative descriptive study was to explicate the meaning of feeling fearful for new C/PH health nurses. Ten nurses with up to 2 years of C/PH experience volunteered for this study. The research questions were guided by …
Health Literacy Of Nursing Students And Their Awareness Of Patient Literacy Needs, Jennifer Potter
Health Literacy Of Nursing Students And Their Awareness Of Patient Literacy Needs, Jennifer Potter
Walden Dissertations and Doctoral Studies
Research has suggested that providers of health services must be aware of health literacy tools as elements of communication with patients. Poor health literacy is an epidemic that affects quality of care. The purpose of this study was to examine the functional health literacy of associate-degree nursing (ADN) students and their awareness of patients' health literacy needs. This correlational study was designed to examine the relationship between the functional health literacy of ADN students and their awareness of their patients' health literacy needs using the asset model and the health literate care model. A convenience sample of 131 ADN students …
The Use Of A Patient Mobility Sensor To Decrease Hospital-Acquired Pressure Ulcers, Monica Vassallo Shallow
The Use Of A Patient Mobility Sensor To Decrease Hospital-Acquired Pressure Ulcers, Monica Vassallo Shallow
Walden Dissertations and Doctoral Studies
Pressure ulcers are a serious health condition that have negative consequences for patients and organizations. The primary cause of pressure ulcers is intense and/or prolonged pressure or pressure in combination with shear that results in damage to the skin and underlying soft tissue. Early identification of patients at risk for pressure ulcers and 2-hour repositioning to off-load pressure are key components in reducing pressure ulcer development. Despite ongoing efforts to prevent pressure ulcers, the incidence and prevalence of hospital-acquired pressure ulcers (HAPUs) at the practicum site exceeded the benchmark for Magnet hospitals and the health system's goal of 1%. Patient …
Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd
Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd
Walden Dissertations and Doctoral Studies
Inefficiencies in leadership and limited leadership strategies in hospitals contribute to delayed hospital discharges and an increased financial burden on a hospital. Three administrators from 2 hospitals who are part of a hospital conglomerate in Chicago, Illinois were selected for interview in this qualitative multiple case study to explore how hospital discharge strategies reduce delayed hospital discharges and improve profitability. Contingency was the primary theoretical theory for this study. The purposive sampling consisted of the selections of individual who were knowledgeable and had experience to organize, manage, and implement processes in an organization. Data collection occurred using face-to-face semistructured interviews, …
Interprofessional Collaborative Care Educational Program For Nurses, Lynn Ann Mcewen
Interprofessional Collaborative Care Educational Program For Nurses, Lynn Ann Mcewen
Walden Dissertations and Doctoral Studies
Interprofessional collaboration and collaborative patient and family-centered practice is increasingly advocated as a means of improving patient outcomes and the cost effectiveness of health care. The Canadian Interprofessional Health Collaborative and Registered Nurses Association of Ontario identified best practices and competencies required for interprofessional collaboration and collaborative practice. Despite the widespread dissemination of these competencies and best practice guidelines to health professional schools, there remains a gap in nursing practice regarding nursing knowledge about the core competencies required for interprofessional collaboration. The purpose of this project was the planning of an education program for nurses on interprofessional collaboration and collaborative …
The Effects Of Structured Health Policy Education On Connecticut Registered Nurses' Clinical Documentation, Rosale Lobo
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 …
Nursing Student's Breast Cancer Knowledge And Breast- Self Examination Technique Confidence, Lydia E. Gaud
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 …
Quality Improvement Through Evidence-Based Education: Advancing Obesity Awareness And Clinical Management Strategies For People Living With Mental Disorders, Ellis Ehizele Opusunju
Quality Improvement Through Evidence-Based Education: Advancing Obesity Awareness And Clinical Management Strategies For People Living With Mental Disorders, Ellis Ehizele Opusunju
Walden Dissertations and Doctoral Studies
People living with mental disorders (PLWMDs) are at an increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the general-population obesity rate is 36% compared to more than 50% for PLWMDs. Mental health professionals (MHPs), focused on addressing psychiatric conditions, seldom recognize and clinically manage obesity. Furthermore, this population is socioeconomically disadvantaged with poor dietary habits while consuming psychiatric medications that stimulate hunger, further exacerbating the risk for obesity. The Promoting Action on Research Implementation in Healthcare Services (PARISHS) framework guided this quality improvement project to improve obesity awareness and management …
Examining Nurse Satisfaction With A Bedside Handover Report Process, Imelda C. Principe
Examining Nurse Satisfaction With A Bedside Handover Report Process, Imelda C. Principe
Walden Dissertations and Doctoral Studies
Nurses' job satisfaction affects work performance at the point of care in hospitals. The incoming nurses who are able to receive a comprehensive patient report at shift change are more prepared in comparison to incoming nurses who are not able to receive a comprehensive patient report to provide care that is safe. The purpose of this project, guided by the theory of organization change, was to explore whether the use of a bedside handover process impacts nurses' satisfaction in an adult postoperative orthopedic and spine unit. A post-implementation survey of the bedside handover process was conducted after one month and …
Concept Of Self: Approach To Behaviors In Mental Health, The Tapout Program, Tina Goodrow
Concept Of Self: Approach To Behaviors In Mental Health, The Tapout Program, Tina Goodrow
Walden Dissertations and Doctoral Studies
Violence in mental health care continues to be a problem. The incidence of violent episodes in healthcare settings with aggressive behavior of patients aimed at staff members or other patients is almost four times greater in healthcare than in other industries. Reducing violent episodes enhances the quality of care and improves safety for staff members and for patients. The project focused on development of a staff education program exploring the practice-focused question: Will this program effectively guide staff member approaches to mental health patients with challenging behaviors? The purpose of this project was to address the identified gap in practice …