Medicine and Health Sciences Commons^™

Comparison Of Rural Associate Degree Nursing Students’ Clinical Judgment After Curriculum Change, Karen Bowen

Walden Dissertations and Doctoral Studies

New graduate nurses often lack adequate clinical judgment skills to practice competent nursing care, which may result in increased risk of committing practice errors that threaten patient safety. To mitigate errors in patient safety, industry leaders have called for nursing program improvements in preparation of nursing students’ clinical judgement as they transition to professional practice. Guided by Tanner’s clinical judgment theory, the rural state nursing programs in this study implemented a concept-based curriculum to promote clinical judgment which includes thinking skills, priority setting, and management of care. The purpose of this three-part, quantitative, nonexperimental study was to compare the development …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

Assessing Palliative Care Knowledge Among Medicine/Pulmonary Intensive Care Unit Staff To Identify Barriers And Increase Palliative Care Referrals, Ryan Mckendrick

DNP Projects

Background: To conduct a needs assessment to identify areas of opportunity for increased awareness of the interdisciplinary medicine/pulmonary intensive care unit (MICU) staffs’ knowledge of palliative care and identify potential barriers to initiating referrals for palliative care consultations. Then provide an educational intervention and assess effectiveness with a post interventions assessment of referrals. The goal of this project is to increase referrals for palliative care consults.

Methods: A pre-/post-survey design will be utilized to assess palliative care knowledge to identify barriers to palliative care consultation referrals. An educational intervention that addresses palliative care knowledge deficits and addresses barriers will be …

Improving Nursing Comfort In Relation To Difficult Conversations, Sarah Clifton

DNP Projects

Abstract

Background/Purpose

Conversations between care providers and patients are integral to medicine and are the most performed “procedure” (Luff et al., 2016). In Pediatric Intensive Care Units (PICUs) and Pediatric Cardiac Intensive Care Units (PCICUs), children of all ages with diverse diagnoses and needs are treated for critical illnesses and traumatic events. Therefore, providers frequently have difficult conversations with patients and their families. Pediatric critical care nurses are often invited to participate in these discussions. However, their role during, and after, these conversations is not always clear. The goal of this project was to evaluate the impact of an educational …

Effectiveness Of A Multimodal Educational Program In Increasing Understanding And Utilization Of Tele-Icu Resources By Critical Care Nurses: A Pilot Study, Olga Vulakh

DNP Projects

Background. Integration of tele-intensive care units (tele-ICUs) into healthcare systems is associated with improved patient outcomes and organizational performance. Inadequate bedside nurses’ knowledge about tele-ICU is associated with poor communication and lack of trust between bedside and tele-ICU teams. These problems might diminish tele-ICU’s ability to maximally impact patient outcomes.

Purpose. The purpose of this project was to create a multimodal educational program with the goal of improving knowledge, attitudes, and skills related to tele-ICU among critical care nurses and to assess the effect of the educational intervention on tele-ICU utilization among bedside nurses as evidenced by the number of …

Utilizing Podcast Education To Improve Nurse Knowledge, Confidence, And Behaviors Related To Palliative Care Conversations In The Intensive Care Unit, Brittany Estridge

DNP Projects

Background: The personal connection that Registered Nurses (RNs) build with patients and their families puts them at the forefront of many conversations during the patient’s stay in the intensive care unit (ICU). Some of the most difficult conversations are related to palliative care (PC). It can be challenging to know how to respond to the complex questions posed in palliative care conversations (PCC) when patients and their caregivers are making decisions that will alter the course of the patient’s treatment, as well as affect the quality and length of their life.

Purpose: Nurses receive inadequate training in PCC. The purpose …

Interventions To Alleviate Guilt In Family Caregivers Of Patients Receiving Hospice Or End-Of-Life Care: A Scoping Review, Kyla N. Huelle

Honors Undergraduate Theses

This scoping review contains a literature analysis regarding interventions used by health care workers to alleviate guilt in caregivers of patients during end-of-life care. During end-of-life care, many transitions and decisions are made that add to the burden of caregivers. Family caregivers experience many physical, financial, and emotional stressors during the journey of end-of-life care, and this can result in guilt. Feelings of guilt can lead to poorer health outcomes and coping in family caregivers and should be addressed by health providers. In this scoping review, a literature search was conducted using various key terms like "guilt," "hospice," "end-of-life care," …

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 …

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Educating Nurses On Failure To Rescue Due To Treatment Delay, Ganiyu Olasheni Adewale

Walden Dissertations and Doctoral Studies

Studies have found a shortfall in nurses' skills in caring for patients with a significant risk of failure to rescue in an acute care setting. The practice gap the healthcare facility was experiencing today was a gap in relation to failure to rescue with an increased rate of sentinel cases. There was a knowledge deficit among critical care nurses. The importance of educating nursing staff is to increase their knowledge and help decrease the occurrence of failure to rescue in an acute care setting. The practice-focused question for this education project asked if educating nursing staff with a medical-surgical competency …

Comparison Of Rural Associate Degree Nursing Students’ Clinical Judgment After Curriculum Change, Karen Bowen

Walden Dissertations and Doctoral Studies

New graduate nurses often lack adequate clinical judgment skills to practice competent nursing care, which may result in increased risk of committing practice errors that threaten patient safety. To mitigate errors in patient safety, industry leaders have called for nursing program improvements in preparation of nursing students’ clinical judgement as they transition to professional practice. Guided by Tanner’s clinical judgment theory, the rural state nursing programs in this study implemented a concept-based curriculum to promote clinical judgment which includes thinking skills, priority setting, and management of care. The purpose of this three-part, quantitative, nonexperimental study was to compare the development …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Nursing Knowledge And Breastfeeding Education, Mary Aguirre

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, the Healthy People 2020 breastfeeding goal immediately after birth of 81.9% was surpassed in 2016, with approximately 83.8% of babies breastfed shortly after delivery. However, by seven days post birth, this number decreased to 82.9%, reduced even more for infants who were exclusively breastfed to 64.7%. Local research has shown that breastfeeding decreases at one week after discharge, which may be due, in part, to the lack of nurses' knowledge related to breastfeeding. This lack of knowledge related to breastfeeding by the nurses, in turn, may negatively impact the support staff …

Organizational Characteristics As Predictors Of Hospital Accreditation, Rebecca B. Graystone

Walden Dissertations and Doctoral Studies

Abstract Hospital accreditation has had wide and longstanding acceptance as a key quality tool to drive efficient, effective healthcare. Researchers have more recently questioned factors commonly related with accreditation achievement given accreditation’s general association to better patient care, risk management, and cost reduction. Even less information was known about predictors of accreditation failure, which could be addressed by hospital administrators in advance of seeking application. Accordingly, the purpose of this cross-sectional study was to examine if hospital structures and processes were predictors of accreditation failure. The research questions explored hospital size, ownership status, geographic location, hospital leadership, empowerment, practice, and …

The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik

Walden Dissertations and Doctoral Studies

The intention to stay in nursing staff working with adult patients in a hospital setting is a major concern for healthcare organizations because of its effect on patient health outcomes. Grounded in the social cognitive career theory, the purpose of this quantitative correlational study was to investigate resilience as a moderating factor in the relationship between burnout and intention to stay for licensed registered nurses with BSN degrees working with adults in a hospital setting. The participants were 80 licensed registered nurses with BSN degrees working with adults in a hospital setting in the United States of America. The results …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger

Walden Dissertations and Doctoral Studies

To provide holistic care and ensure positive patient health outcomes, the social determinants of health (SDOH) must be addressed. Research demonstrates that while medical care is a contributor to wellness, the SDOH serve an influential role in patient health outcomes. There is limited literature describing how to best educate practicing nurses about SDOH concepts. The purpose of this DNP project was to provide an educational intervention to increase inpatient staff nursing knowledge of the SDOH. Sources of evidence used to create the education module included scholarly literature describing the SDOH concepts and their application to patient, community, and population health. …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews Protocol, Kelley Kilpatrick, Isabelle Savard, Li-Anne Audet, Abby Kra-Friedman, Reneé Atallah, Mira Jabbour, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Colette Henderson, Lori A. Spies, Heather Mcgrath, Melanie Rogers

Ellmer School of Nursing Faculty Publications

Introduction

In 2020, the World Health Organization called for the expansion and greater recognition of all nursing roles, including advanced practice nurses (APNs), to better meet patient care needs. As defined by the International Council of Nurses (ICN), the two most common APN roles include nurse practitioners (NPs) and clinical nurse specialists (CNSs). They help ensure care to communities as well as patients and families with acute, chronic or complex conditions. Moreover, APNs support providers to deliver high quality care and improve access to services. Currently, there is much variability in the use of advanced practice nursing roles globally. A …

Conservative Anabaptists Descriptions Of Delay, Comfort In Connectedness, And Ease In Cultural Tension When Seeking And Responding To Healthcare, Matthew Donald Hottle

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Conservative Anabaptists description of delay in health seeking behaviors, comfort in connectedness, and ease in cultural tension when seeking and responding to healthcare

Background: Conservative Anabaptists are a large ethnic religious population that continues to grow in the United States. This includes groups of Amish, Mennonites, Hutterites, and Brethren populations residing in rural areas. These groups are known to experience adverse health related outcomes such as community acquired infections, advanced cancer diagnosis, and undiagnosed chronic conditions such as hypertension, diabetes, and heart disease. Therefore, the concept transcending health values has been developed to better understand how conservative anabaptists describe …

Clinical Deterioration As A Nurse Sensitive Indicator In The Out-Of-Hospital Context: A Scoping Review, Kylie Mccullough, Melanie Baker, Dianne Bloxsome, Carol Crevacore, Hugh Davies, Gemma Doleman, Michelle Gray, Nilufeur Mckay, Peter Palamara, Gina Richards, Rosemary Saunders, Amanda Towell-Barnard, Linda L. Coventry

Research outputs 2022 to 2026

Aims: To explore and summarise the literature on the concept of ‘clinical deterioration’ as a nurse-sensitive indicator of quality of care in the out-of-hospital context. Design: The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews. Methods: Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out-of-hospital context were included regardless of methodology. Text and opinion papers were also …

Nurses' Experience Of Managing Adults Living With Multimorbidity: A Qualitative Study, Lisa Whitehead, Peter Palamara, Olutoyin Oluwakemi Babatunde-Sowole, Jennifer Boak, Natasha Franklin, Robyn Quinn, Cobie George, Jacqueline Allen

Research outputs 2022 to 2026

Background: The number of adults living with two or more chronic conditions is increasing worldwide. Adults living with multimorbidity have complex physical, psychosocial and self-management care needs. Aim: This study aimed to describe Australian nurses' experience of care provision for adults living with multimorbidity, their perceived education needs and future opportunities for nurses in the management of multimorbidity. Design: Qualitative exploratory. Methods: Nurses providing care to adults living with multimorbidity in any setting were invited to take part in a semi-structured interview in August 2020. Twenty-four registered nurses took part in a semi-structured telephone interview. Results: Three main themes were …

A Bibliometric Analysis Of Missed Nursing Care Research: Current Themes And Way Forward, Afia A. Sarpong, Diana Arabiat, Lucy Gent, Amanda Towell-Barnard

Research outputs 2022 to 2026

Background. Missed nursing care adversely affects nurse and patient outcomes in healthcare settings. Comprehensive bibliometric overview of research output in this field is limited, which restricts knowledge of this complex phenomenon in terms of research trends, author’s productivity, and thematic focus of scientific publications. This study aims to examine publications on missed nursing care by conducting a comprehensive bibliometric analysis. Methods. A search was performed in the Scopus database to identify 276 published studies on missed nursing care from inception to 20th February 2022. A bibliometric approach was used to comprehensively analyse retrieved publications based on trend, thematic …

Integrative Review: Factors Impacting Effective Delegation Practices By Registered Nurses To Assistants In Nursing, Carol Crevacore, Elisabeth R. Jacob, Linda L. Coventry, Christine Duffield

Research outputs 2022 to 2026

Aim

To identify the evidence on factors that impact delegation practices by Registered Nurses to Assistants in Nursing in acute care hospitals.

Design

An integrative review.

Data Sources

Database searches were conducted between July 2011 and July 2021.

Review Methods

We used the 12-step approach by Kable and colleagues to document the search strategy. The (Whittemore & Knafl. 2005. Journal of Advanced Nursing, 52(5), 546–553) integrative review framework method was adopted and the methodological quality of the studies was assessed using Joanna Briggs critical appraisal instruments.

Results

Nine studies were included. Delegation between the Registered Nurse and the …

Increasing Colorectal Cancer Screening Rates In The Psychiatric Inpatient Unit, Diane R. Ventura

Master's Projects and Capstones

Increasing Colorectal Cancer Screening Rates in the Psychiatric Inpatient Unit

Abstract

Problem: Colorectal cancer is one of the leading cancer deaths in the United States. The Psychiatric Inpatient Unit has a colorectal cancer screening compliance rate of 40% compared to the statewide average of 80%.

Context: The Psychiatric Inpatient Unit is a 58-bed inpatient intermediate care facility mental health program in Northern California. Upon review of the EMR, most PIU nurses give verbal instructions and patient education on colorectal cancer screenings when due. Still, no printed handout was provided to the patients upon review of the EMR.

Intervention: Review of …

Usp<800> Hazardous Drug Safe-Handling In The Medical-Surgical Microsystem: A Cnl Quality Improvement Project, Ananda T. Le

Master's Projects and Capstones

Problem: The USP General Chapter <800> guidelines protect healthcare workers from hazardous drugs (HD) and are enforceable by hospital regulatory organizations. Hospitals should increase their safe handling and administration of these drugs to be compliant and protect their workers. This quality improvement project aimed to improve nurse compliance with the safe handling of USP <800> drugs on the medical-surgical microsystem within 16 weeks.

Context: This clinical nurse leader (CNL) quality improvement project was implemented on two medical-surgical microsystems in a San Francisco Bay Area hospital system.

Interventions: The team conducted passive observational data collection and active observation in the form of a …

Esp In Nursing: Building Communicative Competence For Internationally-Educated Nurses, Sami Vuong

Master's Projects and Capstones

The nursing shortage in the United States has been an ongoing issue due to nursing burnout and retirement. Together with the COVID-19 pandemic, it has further exhausted the healthcare system’s resources and healthcare providers. In order to sustain the healthcare system in society, a large number of internationally educated nurses (IENs) have been transferred to work in the United States. As a result of different nursing practices, cultures, and communication styles, many IENs experience language and cultural barriers at work. Difficulty in communication influences the quality of patient care provided, which can lead to negative health outcomes for patients and …

Effects Of Resilience Coaching On Behavioral Health Nurse Burnout, Dalila Franklin

Dissertations

Abstract

Background: Inpatient, staff nurse burnout negatively impacts nurses’ mental and physical health, hospital nurse retention and turnover, and patient care. The Stress First Aid for Health Workers program attempts to bolster resilience and subsequently reduce burnout among mental health nurses in this project.

Method: This quality improvement (QI) project was an observational pre-post survey design and was conducted on a cohort sample of inpatient, behavioral health nurses at an urban, mid-sized, Midwestern hospital psychiatric unit to assess personal, work-related, client-related, and overall burnout utilizing the Copenhagen Burnout Inventory (CBI) tool to quantitatively measure burnout pre- and three months post-implementation …

Nurse Efficiency & Ultrasound Guided Intravenous Access: Evidence Based Intervention Benchmark, Jacob D. Frost

MSN Capstone Projects

Gaining IV access is this first step into accurate, timely diagnosis and interventions of patients. Nurses are typically the first medical professional a patient sees. If the nurse can establish IV access as early as possible this will lead to faster interventions faster diagnostic results and better management for patients and ultimately better patient outcomes. Ultrasound guided IV can increase first attempt success rates leading to decreased painful IV insertions by multiple nurses. This would increase patient satisfactions scores leading to higher re-imbursement.