Medicine and Health Sciences Commons^™

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 …

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 Effect Of Continuing Professional Development From The Perspective Of Nurses And Midwives Who Participated In Continuing Education Programs Offered By Global Health Alliance Western Australia: A Mixed-Method Study, Yan Ing (Jenni) Ng

Theses

Continuing professional development (CPD) opportunities for nurses and midwives are central to improving knowledge, broadening skills and maintaining competencies to provide best practice and clinical care. This is gained through participating in continuing education (CE). CPD is readily accessible and a mandatory requirement for nurses and midwives in developed nations, such as Australia. However, in developing countries, such as Tanzania, while CPD is promoted, it has limited availability. As such, the Global Health Alliance Western Australia (GHAWA), an international health development program, seeks to provide further sustainable CPD opportunities for nurses and midwives in Tanzania.

The purpose of this research …

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 …

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 …

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 …

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 …

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. …

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 …

Reducing Preoperative Anxiety In Adolescents Facing Spinal Fusion Surgery, Anna Gayle Parke

DNP Projects

Reducing preoperative anxiety for adolescents facing spinal fusion surgery for the treatment of scoliosis has significant implications for clinical practice and patient outcomes for this specific population. The reality of a pending surgery creates a difficult, uncomfortable, and exhausting state of being that can lead to increased postoperative pain, sleep disturbances, and maladaptive behaviors. This final capstone project inquiry report presents three manuscripts which focus on the reduction of preoperative anxiety in adolescents facing spinal fusion surgery. The first manuscript is a literature review examining current evidence related to preoperative anxiety, adolescents undergoing spinal fusion surgery, and teaching programs aimed …

Pain Management In Patients With Fibromyalgia, Linsey Fischer

Honors Undergraduate Theses

Fibromyalgia is a chronic widespread pain disorder that can also cause fatigue, depression, sleep disturbances, and cognitive symptoms. Because the etiology of fibromyalgia is unknown, it is difficult to treat. Research shows that medication alone is insufficient to treat the symptoms of fibromyalgia and that complementary therapies are required to fully manage this disorder. The purpose of this research was to determine what complementary therapies patients with fibromyalgia were currently using. The sample for the survey was taken from fibromyalgia support groups throughout the state of Florida. A total of 15 people diagnosed with fibromyalgia participated in the survey. The …

Goals Of Exclusive Breastfeeding And The Effectiveness Of Programs And Initiatives In Attaining Them, Natalie Scott

Senior Honors Theses

Over recent years, breastfeeding has gained renewed significance in research and practice. Both in the United States and around the world, especially in poor countries that do not have easy access to quality healthcare, breastfeeding has been shown to dramatically and positively affect the health and lifespan of infants. However, there is still a low prevalence of effective breastfeeding practices universally. Even with the presence of global programs and goals that are geared toward exclusive breastfeeding habits, global rates are lower than what is desired. There are various determinants of breastfeeding that factor into a woman’s decision and practice of …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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, …

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 …

Simulation Using A Standardized Patient To Measure Perception And Congruency Of Spiritual Care For A Veteran From Three Perspectives To Inform Nursing Education And Practice, Mary E. Desmond

Dissertations

Spiritual care refers to a purposeful process of helping another find meaning and purpose

in life through a mutual connection. Providing spiritual care is a professional nursing mandate, yet nurses report barriers in education and practice. Veterans want spiritual care to promote quality of life, and to cope with military experiences and chronic conditions. Patients report receiving less than desired spiritual care and nurses report infrequent provision of spiritual care. It is also unclear how congruent patients and nurses are in their perceptions of spiritual care. A spiritual care simulation and performance checklist was developed using a review of the …

Practicing Sacred Encounters: A Narrative Analysis Of Relational, Spiritual, And Nursing Leadership, Margaret Woodrow Mark

Antioch University Dissertations & Theses

This research examined one large health system that has, through a stated mission outcome that every encounter is a sacred encounter, sought to enhance relationships occurring within the health care environment. Seeking to understand the lived experience of sacred encounters through the lens of nurse leaders in one acute care hospital settings this study examined how nurse leaders experienced their leadership role in realizing sacred encounters. Participants were defined as nurse leaders from one hospital setting and included nurse managers, directors and one vice president. A narrative thematic analysis framed by situational analysis was the method of inquiry. Data was …

The Impact Of Communication Satisfaction On Paediatric Nurses’ Job Satisfaction And Intention To Stay, Gemma Doleman

Theses: Doctorates and Masters

Effective communication is the most central process within an organisation and is essential to organisational values, norms and expectations. There is a documented connection between job satisfaction, work commitment and organisational communication. However, nurses’ and nursing middle managers’ satisfaction with organisational communication has not been extensively studied in recent years and not at all among paediatric nurses. Therefore, the purpose of this study was to develop and test a theoretical model that examined paediatric nurses’ and middle managers’ satisfaction with organisational communication and the effect this has on paediatric nurses’ job satisfaction and intention to stay in their job.

Employing …

An Assessment Of Nurses’ Experiences Of Work Related Stress Through Self-Reporting And Hair Cortisol Analysis, In A Metropolitan Hospital In Western Australia, Kim Oliver

Theses: Doctorates and Masters

The aim of this study was to assess how years of experience and practice area influence work related stress amongst 1,200 nurses employed in a metropolitan hospital environment in Western Australia. A combination of self-administered questionnaires and hair cortisol, an objective stress biomarker, was utilised to measure stress levels and to relate these to practice area, age and experience. Questionnaire results indicated that there was a higher level of perceived stress for 40% of this cohort of nurses; the study methodology was able to unearth noteworthy factors within a local WA nursing population that impacted on their perceived stress. These …

Casual For A Cause: Exploring The Employment Status Of Nursing In Australia And China, Carol Wang, Sadie Geraghty

Research outputs 2014 to 2021

This paper outlines obligatory nursing education and the registration process required to become a nurse in Australia, including nurses' workload, career structure and pay. It also provides an overview of the nursing workforce in Australia, with particular reference to casual employment, and its implications. The aim of this paper is to outline the development strategies that may assist with China's increasing need for nursing education, and how changes to healthcare policy and management are required to increase the recruitment and retention of nurses in hospitals worldwide.

Recovery-Oriented Care And Inpatient Psychiatric Nursing Practice, Julia M. Mclaughlin

Master's Projects and Capstones

For the past 15 years, major organizations such as the World Health Organization (WHO), Substance Abuse and Mental Health Services Administration (SAMHSA), and U.S. federal government have been committed to shifting mental health services from the medical model of care to the recovery-oriented model of care (Moller & McLoughlin, 2013). However, not all identified recovery-oriented practices have been fully implemented throughout mental health services, specifically in acute care settings. In 2015, San Mateo Medical Center’s acute psychiatric nursing staff completed McLoughlin’s (2005) Recovery Self-Assessment- Registered Nurse (RSA-RN). Data showed that 34% of nursing staff did not believe that the nurses …

Admission Handoff Between Emergency Department And Inpatient Units, Amanda A. Briones

Master's Projects and Capstones

When admitting a patient from the emergency department (ED) to an inpatient unit, a handoff report is conducted. There are many ways the ED nurse can go about delivering this report to the inpatient or floor nurse. Each ED nurse tends to this task in their own way, providing the information they deem important. Due to the absence of standardization, handoff reports have the ability to lack important information regarding the patient and can even lead to compromising the safety of the patient.

The purpose of this project was to gain a comprehensive understanding of the current handover process of …

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects and Capstones

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys were …

An Apn-Led Copd Discharge Education Program To Decrease 30-Day Readmission Rates, Moira Elizabeth Kendra

Seton Hall University DNP Final Projects

The purpose of this project was to implement an APN-led COPD discharge education program to decrease 30-day readmission rates. This Doctorate of Nursing (DNP) project combined strategies obtained in the literature search and blended these into a cutting-edge and state-of-the-art discharge education program at a major medical center. The significance of chronic obstructive pulmonary disease (COPD) readmission rates include financial implications, a large number of Medicare patients who return to the hospital within 30 days, poor quality of patient care, and poorly coordinated discharge processes. An APN-led transitional care COPD education discharge plan was implemented on the pulmonary floor at …