Medicine and Health Sciences Commons^™

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test …

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test …

Nurse-Driven Protocols In The Pediatric Emergency Department: A Systematic Review, Roberta Miller

Walden Dissertations and Doctoral Studies

Long wait times in emergency departments across the United States contribute to overcrowding, and adverse patient outcomes. Adult emergency departments use nurse-driven protocols to decrease time to treatment and wait times. However, nurse-driven protocols are not commonly used in the pediatric emergency department (ED). The purpose of this project was to evaluate and appraise current evidence to determine if nurse-driven protocols can be safely implemented to improve ED wait times, time to disposition, patient/family satisfaction, and patient outcomes in the pediatric emergency setting. The Iowa model of evidence-based practice (EBP) was used to guide the mixed methods systematic review. A …

Self-Efficacy Of Registered Nurse Faculty To Facilitate A Flipped Classroom Pedagogy, Sharmeta L. Gibbon

Walden Dissertations and Doctoral Studies

Nurse educators struggle with developing innovative teaching strategies that improve learners’ critical thinking, sound clinical judgment, and ability to provide safe patient care. In the local setting, nurse educators relied on passive teaching strategies. The purpose of this study was to explore the perceptions of nursing faculty members concerning their self-efficacy with implementation of a flipped classroom. The conceptual framework was transformative learning theory. The research question explored how nurse educators described their self-efficacy with implementing student-centered, active teaching methods. Participants included 9 experienced nursing faculty members at the local setting from the Associate Science of Nursing program. Data were …

Rural Practical Nursing Students' And Faculty Members' Perceptions Of Supports And Barriers To Success, Amy J. Randall-Mcsorley

Walden Dissertations and Doctoral Studies

Practical nursing program students at a rural vocational school (RCC) in the midwestern United States were graduating at a low rate that was putting the school at risk to not meet accreditation standards set by the Council on Occupational Education. The purpose of this study was to explore the perceptions of practical nursing program students and faculty at RCC about institutional, situational, and dispositional supports and barriers students faced toward graduation. The conceptual framework, Cross’s model of barriers to adult learning, was used to identify institutional, situational, and dispositional supports and barriers. A bounded case study design was employed to …

Incivility Among Nurses, The Influence Of Structural Empowerment: A Systematic Review, Jennifer Gardner

Walden Dissertations and Doctoral Studies

Workplace nurse-on-nurse bullying is a well-known phenomenon in health care organizations at both national and global levels. Healthcare organizations struggle to find effective solutions to help nurses to mitigate bullying and incivility and create safer work environments. The purpose of this systematic literature review doctoral project was to critically appraise the literature to find the best research evidence to show that higher levels of structural empowerment lead to lower levels of incivility and increase nurses’ ability to create safer and more positive work environments. Kanter’s theory of structural empowerment served as the theoretical framework for this review. The evidence-based question …

Staff Education Program For Nurses Caring For Patients With Medical Decline On A Geriatric Psychiatric Unit, Portia Denise Risper

Walden Dissertations and Doctoral Studies

AbstractElderly patients admitted to psychiatric units are a vulnerable population, some may have mental disorders, physical decline, cognitive challenges; along with other comorbidities in addition to their mental illness. However, their physical health needs may be overlooked due to the presenting behaviors mimicking mental health behaviors. The nurses working in the local hospital facility’s geri-psych unit failed to recognize signs and symptoms of physical decline in their severely mentally ill (SMI) patients. Not recognizing and reporting acute changes resulted in patients’ prolonged hospitalization, decreased quality of life, and increased cost to the facility. The purpose of this DNP project was …

Evaluating The Impact Of Nurse Leader Professional Development, Celeste Rogers Romp

Walden Dissertations and Doctoral Studies

A health care organization’s success is impacted by its leaders’ knowledge, confidence, and training. A quality improvement (QI) project was undertaken by a 300-bed acute care medical center to determine the impact of providing nurse leaders with education and training in increasing the leader’s knowledge and confidence in their role and in improving nursing satisfaction, catheter-associated urinary tract infection (CAUTI) rates, and fall rates. The FOCUS-PDSA QI model and the nurse manager leadership collaborative learning domain framework were used to guide the QI project and its evaluation. There were four primary sources of evidence. A nurse leader professional development pre- …

Nurse Practitioner Approach To Care For Peripheral Vascular Disease, Jessica R. Wozniak

Walden Dissertations and Doctoral Studies

The Amputation Coalition indicates that there were approximately 2 million people with limb loss in the United States primarily caused by peripheral vascular disease in 2019. Those with amputation related to vascular disease have a 5-year mortality rate. The gap in clinical practice at the facility used for this project is that there were no comprehensive program guidelines for nurse practitioners and other health care professionals working with people who are at risk for vascular intervention or limb loss. The practice-focused question was answered that an interprofessional team did develop a prototype for a comprehensive peripheral vascular program that serves …

The Lived Experiences Of Clinical Nursing Faculty With Student Performance Anxiety, Heather Lapoint

Walden Dissertations and Doctoral Studies

The nursing shortage in the United States has led to a call for nursing education reform. Current clinical educational methods precipitate nursing student performance anxiety (PA). PA can inhibit the clinical judgment, reasoning, critical thinking, and the adaptability required for advancing healthcare initiatives and reducing the nursing shortage. PA has not been defined nor addressed in undergraduate nursing education. The purpose of this descriptive phenomenological study was to explore the lived experiences of associate degree (AD) nursing program faculty in addressing student PA as it occurs in the clinical setting. Specifically, how faculty define PA and recognize, address, and assess …

Effects Of A Blended Basic Telemetry Course On The Telemetry Reading Proficiency Of Newly Licensed Registered Nurses, Joan Yankalunas

Walden Dissertations and Doctoral Studies

Telemetry interpretation is a common skill required by registered nurses (RNs) to take care of patients in an acute care setting. Telemetry education guidelines are needed because there are no established standards for the amount, type, or scope of education needed for RNs who take care of patients on continuous telemetry monitoring. The purpose of this retrospective analysis design study, guided by Benner’s skill acquisition model and Kirkpatrick’s learning outcomes measurement theory, was to (a) determine the effect of a blended telemetry course, which is a combination of eLearning and an instructor-led class, on the telemetry reading proficiency of RNs …

Methods To Increase The Rate Of Childhood Vaccinating, Mary Beth Tillman

Walden Dissertations and Doctoral Studies

Vaccinations such as polio, diphtheria, varicella, and meningitis help to protect a child from life-threatening illnesses which have previously been contained by routine vaccinations. However, misinformation, negative press, and other contributing factors, have influenced caregivers to refuse to vaccinate their children placing the children at risk for contracting the disease. The Centers for Disease Control and Prevention recommends regular vaccinations for children beginning as newborns, yet the vaccination rate remains below acceptable levels. This project was developed to provide an educational program guided by Orem’s self-care theory and intended to increase nurses’ knowledge of vaccination and ultimately vaccination rates. A …

Perceptions Of Nurses’ Abilities To Provide Safe Care In Unhealthy Work Environments, Jacqueline Flannery

Walden Dissertations and Doctoral Studies

As many as 90% of nurses report working in an environment where their peers engage in passively and overtly violent activities against other nurses. Working in such an environment is unhealthy and has consequences for the career trajectory of nursing. There is a lack of literature available that specifically addresses nurses’ perceptions of their abilities to provide safe patient care in unhealthy work environments. The purpose of this phenomenological study was to explore the lived experiences of nurses who have experienced lateral violence and their perceptions of their ability to provide safe care. Husserl’s philosophy of phenomenology was used as …

Professional Development For Nurse Educators, Samdaye Ramdial

Walden Dissertations and Doctoral Studies

At a large university on the outskirts of Toronto, Canada, there was an influx of students entering the nursing program. Therefore, the need arose for an updated, restructured, and professional development training guideline with current knowledge for nurse educators to achieve high quality learning and critical thinking. The purpose of this study was to explore professional development leaders’ perceptions of quality training guidelines for nurse educators. The conceptual framework of this study was Knowles’s adult learning theory. The research questions were centered on what professional leaders perceive to be quality professional development. A qualitative case study design was used in …

Review Of A Remediation Program In An Associate Degree Nursing Program, Christopher Thomas Young

Walden Dissertations and Doctoral Studies

New nurse graduates must pass the National Council Licensure Examination (NCLEX) in order to achieve nursing licensure. In Northern New Mexico associate degree nursing program with a large disadvantaged student population, the average pass rate for the licensure exam often falls below the state board of nursing mandated 80% pass rate. This study's purpose was to evaluate the effect of an NCLEX remediation program on students' ability to pass the NCLEX, using Knowles adult learning theory to guide this work. The research questions investigated the relation between the remedial instruction and the 2 dependent variables KAPLAN predictor scores and NCLEX …

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test …

A Comparative Analysis Of Job Satisfaction, Burnout, And Intent To Leave Among Nurses, Randall Lee Mcelreath

Walden Dissertations and Doctoral Studies

There is a significant shortage of qualified registered nurses in the United States which, in part, is due to a lack of job satisfaction and burnout with an intent to leave nursing, especially among nurses who work in specialty areas such as intensive care. There is limited research as to how job satisfaction and burnout contribute to intent to leave among the specialty areas of nursing working at the bedside in an acute care environment. The purpose, guided by the modeling and role modeling theory, was to determine the relationship that exists between burnout, job satisfaction, and intent to leave …

Nurse Directed Palliative Care Discussions In The Emergency Department, Shannon Lorince Landefeld

Walden Dissertations and Doctoral Studies

Emergency department (ED) nurses are in a unique position to discuss with patients who have life-limiting illnesses. However, due to lack of training, ED nurses are often reluctant to have these conversations. Although ED patients receive written information about advanced directives, there is a gap in practice with discussing palliative and end-of-life care, resulting in increased potential for patient isolation, inconsistencies in treatment modalities, and delayed opportunities for patient-centered goal setting. Therefore, the purpose of this project was to address what resources are available to guide evidence-based practice for ED nurses in a small inner city hospital to implement nurse-directed …

Evaluation Of A New Nurse Mentor Program, Corinne Romano

Walden Dissertations and Doctoral Studies

Novice nurses in the facility had a turnover rate of 32% in 2017 and 2018, despite participation in a novice nurse residency program. This project was the 3-month formative evaluation of a 1-year mentor program designed for novice nurses. The mentor program had been created to augment the residency program and support practice transition for novice nurses. The project questions explored the results of the process evaluation at the 3-month mark of the year-long mentorship program for the first cohort and recommendations to the mentor coordinators for continuous quality improvement. This quality improvement project followed the PDSA (plan-do-study-act) methodology. The …

The Relationship Between Practice Environment, Role Overload And Job Satisfaction Of Nurses In Canada, Olabisi Amao Olaniyan

Walden Dissertations and Doctoral Studies

Abstract

The shortage of nurses is a global phenomenon. The problem is particularly pronounced in rural areas and contributes to the health disparities experienced in the healthcare sector. Many factors had been shown to adversely impact the recruitment and retention of nurses, most especially in the rural areas. No study has examined how some factors such as the practice environment variation; geographical locations; and role overload impact job satisfaction of nurses. The Herzberg two-factor theory, with constructs of Motivation and Hygiene factors guided the study. In this quantitative, cross-sectional study, correlational approach was used to examine the association between the …

Improving The Ethical Use Of E-Health And Emr, Josephine Tafie

Walden Dissertations and Doctoral Studies

Improving the Ethical Use of E-health and EMR

by

Josephine Tafie

MS, Walden University

BS, Washington Adventist University

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2020

Abstract

The healthcare industry is experiencing ethical problems with the integration of new technological applications, such as e-health and electronic medical records (EMRs) in service delivery. Thus, the purpose of this capstone project was to conduct a systematic literature review to determine the best practices that are well suited to a large urban hospital, to ensure patients’ privacy with the continued use …

The Impact Of Faculty Bullying On Associate Degree Nursing Students, Angela M. Vitale

Walden Dissertations and Doctoral Studies

Bullying is prevalent in the profession of nursing, impacting the quality of health care and health care costs. The foundation of bullying, in the profession of nursing, may be attributed to bullying behaviors in nursing academia among nursing faculty and nursing students. Using Bandura’s social learning theory, the purpose of this study was to determine the relationship between bullying behaviors of nursing faculty and bullying behaviors of nursing students in associate degree nursing programs. Seventy-one randomly selected registered nurses who graduated from associate degree nursing programs in the past 5 years completed an online Incivility in Nursing Education-Revised survey. Spearman’s …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Hospital Nurses’ Perceptions Of Computer-Assisted Instruction For Professional Development, Katherine Irizarry

Walden Dissertations and Doctoral Studies

Computer-assisted instruction (CAI) is increasingly being used for professional development. However, at one hospital in the northeast region of the United States, it was observed that nurses were not completing their CAI professional development modules and were failing to meet continuous education requirements. This qualitative case study explored professional nurses’ perspectives regarding the usefulness of CAI as a mode of professional development. The conceptual frameworks used to guide this study were Davis’ theory of technology acceptance, and Knowles’s theory of andragogy. The research question explored how professional nurses perceived the usefulness of CAI to assimilate new learning. The participants in …

Barriers To Reporting Workplace Violence In Emergency Departments: A Systematic Review, Kari Gaston

Walden Dissertations and Doctoral Studies

Underreporting of workplace violence by emergency department (ED) nurses is a global practice concern. When workplace violence is not reported, the breadth of the issue is not reflected in the data, which is necessary to support legislative action, regulatory requirements, and organizational changes to prevent violence. The purpose of this systematic review of literature was to appraise and synthesize evidence regarding ED nurses’ barriers to reporting workplace violence. The practice-focused question addressed the barriers to reporting workplace violence according to emergency nurses. The theory of planned behavior was the theoretical framework for this project. Melnyk and Fineout-Overholt’s critical appraisal of …

Relationship Between Skepticism And Nursing Experiences When Treating Chronic Noncancer Pain Patients, Emily Jabour

Walden Dissertations and Doctoral Studies

Chronic pain is common, costly, challenging to manage, and affects patients’ quality of life. High confidence is placed in the nurses caring these patients. Nurses displaying skepticism or doubt about patients’ motives for seeking pain treatment contribute to the challenges of effective pain management. The purpose of this quantitative study was to determine if there was a relationship among the nurses’ professional skepticism, level of compassion, and years of experience during the treatment of chronic noncancer pain patients in the acute care setting. The communications model of pain guided the understanding of factors influencing nursing treatment of this patient population. …

Review Of A Remediation Program In An Associate Degree Nursing Program, Christopher Thomas Young

Walden Dissertations and Doctoral Studies

New nurse graduates must pass the National Council Licensure Examination (NCLEX) in order to achieve nursing licensure. In Northern New Mexico associate degree nursing program with a large disadvantaged student population, the average pass rate for the licensure exam often falls below the state board of nursing mandated 80% pass rate. This study's purpose was to evaluate the effect of an NCLEX remediation program on students' ability to pass the NCLEX, using Knowles adult learning theory to guide this work. The research questions investigated the relation between the remedial instruction and the 2 dependent variables KAPLAN predictor scores and NCLEX …

Educating Staff On The Benefits Of Vitamin D Therapy For Multiple Sclerosis, Cheniece Harris

Walden Dissertations and Doctoral Studies

Clinical competency is an important factor when delivering care to those with chronic conditions such as multiple sclerosis. Vitamin D therapy through diet, supplements, and sunlight may decrease physical complications. The gap in practice this doctoral project addressed is the lack of education provided to healthcare professionals to promote the benefits of vitamin D. The project examined whether registered nurses who are provided education on the benefits of vitamin D therapy can apply the knowledge into the plan of care for patients with MS within 6 months versus those provided no education. Paradigms and models that were used include the …

Nurses’ Aesthetic Responses And Emotional Judgements To Senior Leaders’ Symbolism, Lucinda A. Easler

Walden Dissertations and Doctoral Studies

Stress can be heightened during a merger; understanding how acute care nurses who work in a hospital undergoing a merger, experience senior leaders’ use of symbolism may help to promote hospital and leader sustainability. Executive symbolism unfolds into aesthetic experience, normally considered a response to art, with few studies of its existence and benefit to organizational life. The purpose of this phenomenological-hermeneutic study guided by Parker’s aesthetic theory was to examine acute care nurses’ emotional responses and experiences with senior leaders’ use of executive symbolism in the midst of the organizational change. Interviews with 11 acute care registered nurses were …