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Nurses’ Perception Of Facilitators And Barriers To The Community College Faculty Role, Hallie Roselie Coppi Jan 2023

Nurses’ Perception Of Facilitators And Barriers To The Community College Faculty Role, Hallie Roselie Coppi

Walden Dissertations and Doctoral Studies

There is an increased nursing faculty shortage throughout the United States (U.S.) which can have a significant impact on student enrollment in nursing programs. The purpose of this descriptive qualitative study, which was guided by Herzberg’s two-factor theory, was to explore perceptions of nursing faculty about their role in community college associate degree nursing (ADN) programs in the western U.S. Data were collected via in-depth semi-structured interviews with 14 nurse educators to gain insights regarding experiences with role transition, work expectations, and plans in academia. Transcribed interview data were thematically analyzed to reveal seven overarching themes which were motivation, role …


Exploring Moral Distress, Ethical Climate, And Psychological Empowerment Among New Registered Nurses, Luz Bruel Mauro Jan 2022

Exploring Moral Distress, Ethical Climate, And Psychological Empowerment Among New Registered Nurses, Luz Bruel Mauro

Walden Dissertations and Doctoral Studies

Moral distress in nursing has been an issue for decades and has consequences on nurses’ physical, emotional, and psychological well-being. Nurses in different settings experience a high intensity and frequency of moral distress particularly in intensive care units (ICU), but few studies have examined the moral distress of non-ICU nurses. The purpose of this 3-manuscript dissertation was to assess the frequency and level of moral distress, ethical climate, and psychological empowerment among new registered nurses (NRNs) who work in non-ICU settings. The conceptual framework of Jameson's moral distress guided this study. Twenty-three NRNs with fewer than 3 years of experience …


Effect Of Covid-19 On Comprehensive Predictor Exam Scores And Nursing Program Scores And First Generation College Students, Heather Marie Austin Jan 2022

Effect Of Covid-19 On Comprehensive Predictor Exam Scores And Nursing Program Scores And First Generation College Students, Heather Marie Austin

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic forced nursing education programs to change traditional face-to-face teaching to virtual education and simulated experiences. Therefore, research is needed to determine how this change affected nursing students’ academic performance and their performance on standardized exams. The purpose of this three-part study, guided by Knowles’s adult learning theory, was to determine if there was a difference in Associate of Science in Nursing (ASN) students’ performance on: (a) Assessment Technology Institute (ATI) Comprehensive Predictor (CP) scores, (b) end of program scores, and for (c) CP scores for first generation students before the COVID-19 pandemic compared with nursing students’ scores …


Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara Jan 2022

Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara

Walden Dissertations and Doctoral Studies

Ethnic diversity in the U.S. nursing workforce had not been well researched. This aspect of nursing is important to the advancement of the profession because ethnic diversity of nursing helps reduce health care disparities. The purpose of this quantitative correlational study was to examine the possible relationship between the perceived ethnicity of nurse leaders and the engagement of bedside nurses. Culture of care theory was the theoretical foundation for this study. The Utrecht Work Engagement Scale with additional demographic questions was used to survey 53 bedside nurses with 2 or more years of experience. Simple regression was used to analyze …


Nursing Education For Central Line-Associated Bloodstream Infections In Intensive Care Units, Carren Sandra Mullings Jan 2022

Nursing Education For Central Line-Associated Bloodstream Infections In Intensive Care Units, Carren Sandra Mullings

Walden Dissertations and Doctoral Studies

Central line associated blood stream infections (CLABSIs) are the most acquired hospital infection in the United States. CLABSI is caused by bacteria that enter the bloodstream through a central line. In the United States, CLABSI has a mortality rate of 18%, and every year 250,000 people are infected. Of these, 30,000 patients die due to CLABSI infections, hospital stays are prolonged, and hospital costs are increased. Patients in an intensive care unit (ICU) are more exposed to CLABSI because of procedures that break tissues and skin, such as the insertion of a central line. A gap in practice was identified …


Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall Jan 2022

Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall

Walden Dissertations and Doctoral Studies

The Veteran’s Health Administration (VHA) is the largest employer of registered nurses in the United States. The American Association of Colleges of Nursing predicts there will be a nursing shortage through the year 2030 and replacing and training each nurse is expensive and negatively impacts patient care. A review of the literature showed organizations with high levels of organizational citizenship behavior (OCB) had high levels of job satisfaction, which reduces turnover, but there was no research on the existence and impact of OCB in a federal health care facility, specifically the VHA. The purpose of this quantitative, correlational research was …


Let My People Go:Improving Nurses’ Knowledge To Decrease Physical Restraint Use, Trisha Marie Zehrung Jan 2022

Let My People Go:Improving Nurses’ Knowledge To Decrease Physical Restraint Use, Trisha Marie Zehrung

Walden Dissertations and Doctoral Studies

Despite extensive research revealing the dangers of physical restraint use, it remains a common practice in critical care settings across the globe. Nurses stand at the forefront of clinical decision-making regarding the use of physical restraints but are doing so with a lack of education and evidence-based practices. The project addresses whether an evidence-based educational program regarding the use of physical restraints and alternative measures is an acceptable method for intensive care unit (ICU) nurse education according to six local subject matter experts (SMEs). The project’s purpose was to create an educational program outlining physical restraint evidence and alternative measures …


An Educational Program For Nurses To Incorporate Spiritual Care Into Clinical Practice, Alicia J. Thomas Jan 2022

An Educational Program For Nurses To Incorporate Spiritual Care Into Clinical Practice, Alicia J. Thomas

Walden Dissertations and Doctoral Studies

Spiritual well-being is associated with several positive outcomes, including a greater tolerance of the emotional and physical demands of illness. Spiritual care is a basic element of holistic nursing, yet nurses generally lack spiritual care knowledge and abilities and are often unable to satisfy patients’ spiritual care needs. Therefore, nurses are in urgent need of relevant training to enhance their abilities to provide patients with spiritual care. Evidence-based education was lacking at the project site, a privately owned long-term care facility. Primary care attention was focused on the patients’ physical care; however, insufficient attention was being paid to spiritual care, …


Physical Activity Assessment And Staff Education For Oncology Nurses, Laurie Jean Tyer Jan 2022

Physical Activity Assessment And Staff Education For Oncology Nurses, Laurie Jean Tyer

Walden Dissertations and Doctoral Studies

Physical activity and mobility are key indicators of treatment and disease tolerance in cancer patients. Patients are living longer during and after cancer treatment, and staying active prevents many side effects of the disease and the treatment. Staying mobile also prevents some conditions from occurring including bone and muscle loss. A nursing educational platform was identified as a need in the facility site’s cancer center on the importance of patients staying physically active throughout cancer treatment. Nurses did not feel confident to coach patients on their activity levels which was an identified gap in their nursing practice. A nursing educational …


Generational Differences In Nursing Turnover, Adam Bennett Jan 2022

Generational Differences In Nursing Turnover, Adam Bennett

Walden Dissertations and Doctoral Studies

Nursing is currently the largest job category in U.S. health care requiring proper recruitment and retention of nurses. As the current generation of nurses ages out of the workforce due to retirement, new nurses will need to cover the gaps in the workforce. The purpose of this quantitative correlational study was to examine the relationship between voluntary turnover, involuntary turnover, and career change among nurses who were born between 1980 and 1995 (Millennials) and those born between 1965 and 1979 (Generation X). The theoretical framework was Mannheim’s theory of generations. Secondary data were collected from exit interviews with 811 respondents …


Nurses’ Perceptions Of Culturally Competent Care At The Bedside, Judith Cox Jan 2022

Nurses’ Perceptions Of Culturally Competent Care At The Bedside, Judith Cox

Walden Dissertations and Doctoral Studies

The population served by health care systems in the United States is widely diversified, which requires nurses to be culturally competent in their care practices. However, studies have shown that nurses do not consistently deliver culturally competent care. This basic qualitative study was designed to explore nurses’ perceptions of cultural competence at the bedside to understand what is needed to improve cultural competency practices. Campinha-Bacote’s conceptual framework for cultural competency was used to guide this study that included face-to-face, videoconference interviews using semi structured and open-ended questions from 13 voluntary, acute care bedside nurses. Interviews were audio recorded and uploaded …


Retention Strategies For The Current Nursing Workforce, Jennifer Higgins Jan 2022

Retention Strategies For The Current Nursing Workforce, Jennifer Higgins

Walden Dissertations and Doctoral Studies

Retaining a robust nursing workforce is essential to care delivery. As the generation gap in the nursing field widens, retention strategies that align with the current nursing workforce must be considered. Rapid turnover is a looming concern as baby boomers retire and millennials become the leading generation in the nursing workforce. Nurse leaders must identify and deploy strategies that will provide a meaningful work environment to retain nurses in this majority group. The purpose of this project was to address the gap in practice of rising turnover, low nurse engagement, and reliance on premium labor to deliver care. The sources …


An Educational Program To Enhance Knowledge And Communication For Nursing Staff Who Care For Dementia Patients, Behnaz Mohammadi Jan 2022

An Educational Program To Enhance Knowledge And Communication For Nursing Staff Who Care For Dementia Patients, Behnaz Mohammadi

Walden Dissertations and Doctoral Studies

AbstractDementia is a progressive chronic disease that requires skilled nursing care. Staff at a skilled nursing facility were not using best practices to prevent and manage the psychological and behavioral symptoms of dementia. The purpose of this DNP project was to implement a dementia care education to address this gap in knowledge. The question for the evidence-based educational project was whether the program increased knowledge, promoted positive attitudes, and increased confidence in dementia care staff. A 5-hour workshop was presented in person, twice in two weeks. The person-centered care model served as a framework for the project. Nursing staff (N …


Second Victims In Nursing, Ofelia O'Donnell Jan 2022

Second Victims In Nursing, Ofelia O'Donnell

Walden Dissertations and Doctoral Studies

Nurses involved with an unexpected adverse patient event can experience guilt, depression, stress, and anxiety and relive the incident, known as the second victim phenomenon. Nurses would benefit from education on the topic of the second victim. The project holds significance for nursing practice as implementing second-victim education increased knowledge and awareness while promoting a just culture that fosters a psychologically safe environment focused on process and system improvement. Use of the analysis design development implementation evaluation (ADDIE) model and the Walden Manual for Education guided the project planning and implementation. The sources of evidence were obtained through a combination …


Increasing Nurses’ Knowledge Of Richmond-Agitation Sedation Score Assessment And Documentation Through Education, Kara Jeanne Beaulieu Jan 2022

Increasing Nurses’ Knowledge Of Richmond-Agitation Sedation Score Assessment And Documentation Through Education, Kara Jeanne Beaulieu

Walden Dissertations and Doctoral Studies

Patients in the intensive care unit (ICU) are critically ill and faced with numerous physical and psychological stressors that often require a multidisciplinary approach to improve outcomes and relieve suffering. Patients are given sedation to tolerate invasive treatments and procedures. Using the Richmond-Agitation Sedation Score (RASS), nurses assess objective findings and the level of sedation a patient is experiencing, and titrate sedation according to an ordered RASS score. Ineffective and inaccurate use of the RASS score leads to patients being oversedated and demonstrates a lack of understanding of how to appropriately use the RASS score assessment tool. The purpose of …


Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed Jan 2022

Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed

Walden Dissertations and Doctoral Studies

AbstractThe National Academy of Medicine (NAM) has called for more leadership, more accountability, and increased education and training of health care leaders. The NAM has demanded that nurses participate in health care policy making, increase their knowledge of research and data collection, advise leaders across the business world, train and educate seamlessly, and practice to the full extent of their licensure. The purpose of this qualitative phenomenological study was to explore the lived experiences of 12 influential nurse leaders from the state of Arizona. Transformational leadership theory provided the framework for the study. Semi-structured interview data were transcribed, coded, and …


Adult Day Care Staff Education To Improve Communication And Behavioral Management Skills, Kathy Davis Jan 2021

Adult Day Care Staff Education To Improve Communication And Behavioral Management Skills, Kathy Davis

Walden Dissertations and Doctoral Studies

AbstractIneffective communication and behavioral management skills are quality and safety issues that were identified at a local adult day care facility in the Southwest United States. Administrators at the facility identified a knowledge gap in communication and behavior management techniques for patients with cognitive impairment. An educational program, with a PowerPoint presentation and verbal feedback as key components, was developed and used to address the identified gap in practice related to individuals with cognitive impairments at the facility. The adult learning theory and the plan-do-study-act model provided supportive frameworks for program development and staff education. The project question explored whether …


Nursing Majors’ Attitudes Toward Suicide And Mental Health Training, Beverly Arleen Burton Jan 2021

Nursing Majors’ Attitudes Toward Suicide And Mental Health Training, Beverly Arleen Burton

Walden Dissertations and Doctoral Studies

AbstractThe mental health training of nursing majors may play a role in their levels of confidence in attending to suicide patients as working professionals. The purpose of this quantitative study was to explore what impact, if any, attitudes toward suicide had on nursing majors’ levels of confidence in their mental health training. Pender’s health promotion theory was the theoretical framework. A descriptive correlational survey was used to explore individuals majoring in nursing confidence and perceived skills in mental health training. The 4 research questions asked the relationship between the level of confidence in helping someone with a mental health problem …


Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich Jan 2021

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff’s confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …


Staff Education On The Use Of The Lace Index In Clinical Settings, Carrole Dorcent Jan 2021

Staff Education On The Use Of The Lace Index In Clinical Settings, Carrole Dorcent

Walden Dissertations and Doctoral Studies

As of 2008, the Centers for Medicare and Medicaid Services has instituted monetary penalties for institutions with excess readmissions. As a result of these initiatives, hospitals are investing resources and efforts to educate their staff to use tools aimed at reducing readmission rates. The LACE index tool is one metric used to identify patients at high risk for readmission. The practice-focused question addressed in this project was whether the use of a teaching module is effective at improving clinical staff knowledge on the LACE index. The purpose of the project was to develop a teaching module to educate advanced practice …


Nursing Home Nurse Turnover And The Association To Workload, Absenteeism, And Number Of Beds, Justin Ryan Gracieux Jan 2021

Nursing Home Nurse Turnover And The Association To Workload, Absenteeism, And Number Of Beds, Justin Ryan Gracieux

Walden Dissertations and Doctoral Studies

The aging population in the United States has resulted in an increased need for quality nursing home care, which includes a stable nursing staff and reduced workforce instability. The purpose of this quantitative correlational study was to examine the relationship between direct care nursing staff turnover rates for RNs, licensed vocational nurses (LVNs), and certified nursing assistants (CNAs) concerning workload, absenteeism, and number of beds in Texas nursing homes. The relational coordination theory provided the theoretical framework for understanding the underlying issues and communication needs that may relate to staff turnover. Secondary data from 11,336 direct resident care nursing staff …


Effects Of Education On Rural Emergency Department Preceptors’ Self-Efficacy And Knowledge, Katherine Marie Jasper Jan 2021

Effects Of Education On Rural Emergency Department Preceptors’ Self-Efficacy And Knowledge, Katherine Marie Jasper

Walden Dissertations and Doctoral Studies

The Emergency Nurses Association recommends nurse preceptorship programs for emergency departments (EDs) to give nurses the skills needed for precepting new nurses; however, many rural areas do not have nurse education for preceptorship, and no standardized training is available for preparing preceptors for their roles. Rural ED preceptors therefore lack knowledge and skills needed for precepting new nurses. The purpose of this study, guided by Benner’s skill acquisition and self-efficacy theory, was to determine if there were significant differences in 33 rural ED nurse preceptors’ knowledge and self-efficacy after they completed an online informational PowerPoint presentation. The PowerPoint education program …


Clinical Practice Guidelines For Assessing And Reporting Workplace Violence Against Nurses, Janice Lynn Canfield Jan 2021

Clinical Practice Guidelines For Assessing And Reporting Workplace Violence Against Nurses, Janice Lynn Canfield

Walden Dissertations and Doctoral Studies

AbstractWorkplace violence consists of physically and psychologically damaging actions while on duty. In healthcare, under a cloak of secrecy concerning workplace violence, an underreported epidemic exists. This problem is important to address because workplace violence can affect the quality of care delivered and patient care outcomes.. The purpose of this project was to develop a nursing clinical practice guideline (CPG) to assist hospital-based nurses to identify risk factors for workplace violence, identify strategies to mitigate violence, and report workplace violence. This CPG can be an effective tool for nurses to better understand the scope and nature of violence in the …


The Lived Experiences Of African American Nurses In South Carolina Emergency Rooms, Debra A. Dixon Jan 2021

The Lived Experiences Of African American Nurses In South Carolina Emergency Rooms, Debra A. Dixon

Walden Dissertations and Doctoral Studies

The underrepresentation of African American (AA) nurses in South Carolina (SC) emergency rooms (ERs) may affect quality patient care for AAs and all other patients in culturally diverse populations. This qualitative interpretive (hermeneutic) phenomenological study explored the lived experiences of AA nurses in several SC ERs concerning quality patient care in culturally diverse populations. Herzberg's two-factor theory and Maslow's hierarchy of needs theory framed the study. The research question investigated the lived experiences of AA ER nurses in SC ERs concerning quality patient care in culturally diverse populations. Interpretive phenomenology was used to gain insight from a sample of 17 …


Leadership Empowerment Behavior And Psychiatric Nurses Intent To Leave, Temitope Kikelomo Gold Jan 2021

Leadership Empowerment Behavior And Psychiatric Nurses Intent To Leave, Temitope Kikelomo Gold

Walden Dissertations and Doctoral Studies

There is a shortage of registered nurses (RNs) who work in the specialty of psychiatric nursing. Attrition among psychiatric RNs is partly due to lack of leadership empowerment which includes autonomy and access to professional development opportunities. The purposes of this study, guided by Kanter’s theory of structural empowerment, were to determine (a) if there was a relationship between leadership empowerment behavior and psychiatric RNs’ intent to leave within the first 2 years of practice in inpatient psychiatric settings and (b) if there was a relationship between leadership empowerment behavior and intent to leave among psychiatric registered nurses who are …


Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas Jan 2021

Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas

Walden Dissertations and Doctoral Studies

AbstractHeart failure (HF) is a progressive and life -threatening disease that places a large burden on the health care systems worldwide with increased rates of re-hospitalization, readmissions, and outpatient visits. With the use of telehealth monitoring and support from nursing case managers, HF patients are able to manage this disease at home. The focus of this project was to evaluate a home health agency (HHA) telehealth program, exploring if there was an improvement in 30-day readmission rates, and patient satisfaction scores for the HHA telehealth program one year after revising the program incorporating nursing virtual case managers. This project used …


Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich Jan 2021

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff's confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …


Territoriality As A Factor In Nursing Incivility, Carolyn Wright Jan 2021

Territoriality As A Factor In Nursing Incivility, Carolyn Wright

Walden Dissertations and Doctoral Studies

AbstractIncivility and hazing in health care results in unsafe environments, not only for the nurse but also for the client, facility, and other health professionals. The project site, a privately owned medical clinic, has a high employee turnover rate with exit interviews indicating bullying and incivility from long-term nursing staff toward new employees as critical reasons for employee resignation. The literature offers minimal information regarding territoriality, a concept associated with aggressive (i.e., alpha) behaviors in animals and humans and incivility in nursing. The purpose of the project was to identify whether territoriality was a behavioral factor that may have contributed …


Professional Nurse Attitudes Of Poverty Before And After Participation In A Poverty Simulation, Beth Mueller Jan 2021

Professional Nurse Attitudes Of Poverty Before And After Participation In A Poverty Simulation, Beth Mueller

Walden Dissertations and Doctoral Studies

Implicit bias in healthcare toward those living in poverty may contribute to inequalities in care and increase the likelihood of patient noncompliance. The purpose of this study was to determine if participation in a poverty simulation had an impact on the attitudes of professional nurses toward those in poverty. Mezirow’s transformational theory was used to guide the study by allowing the learner to examine meaning and revise perspective after participation in an online module. This module included an online poverty simulation created by The United Way of Connecticut titled Making Tough Choices as well as a pre- and post-simulation survey …


The Political Astuteness Of The New Mexico Registered Nurse, Gloria Sue Doherty Jan 2021

The Political Astuteness Of The New Mexico Registered Nurse, Gloria Sue Doherty

Walden Dissertations and Doctoral Studies

The United States spends the most per capita of all the developed countries on healthcare but demonstrates the worst healthcare outcomes. National agencies have turned to Registered Nurses (RNs) to improve healthcare outcomes through participation in healthcare policy development. Although the recommendation for participation in policy development exists, RNs, including those in the U.S. state of New Mexico have not participated at high levels. The purpose of this quantitative cross-sectional study was to measure the political astuteness of RNs in New Mexico and to determine to what extent nursing leaders have been successful in diffusing Institute of Medicine recommendations. Rogers’s …