Nursing Commons^™

Perioperative Nurses' Perceptions And Barriers To Implementing The Colorectal Surgery Care Bundle, Kaydian Kerry-Ann Grant

Walden Dissertations and Doctoral Studies

AbstractDespite evidence that surgical care bundle usage prevents surgical site infections (SSIs) in colorectal surgeries, there is a consistent increase in SSIs. Perioperative nurses are in a unique position to provide insight into the process for colorectal surgical care bundle usage, yet little is known about how perioperative nurses view the process. The perioperative patient focused model was used in this qualitative interpretative phenomenological study to examine the perceptions of perioperative nurses regarding the use of colorectal surgery care bundle and its role in preventing SSIs in patients undergoing colon and rectal surgeries. Sixteen perioperative nurses who were members of …

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 …

Educating Acute Care And Emergency Nurses On Infant Safe Sleep Practices, Kimberly Catherine Mackeil-White

Walden Dissertations and Doctoral Studies

Rates of infant deaths due to sudden infant death syndrome, asphyxia, and sudden unexplained infant death dropped significantly during the original marketing and education push for infant safe sleep practices during the 1990s following the recommendations from the Center for Disease Control and the American Academy of Pediatrics, but a plateau has occurred with no further recent decreases. Safe sleep practices are inconsistent in the practicum site and guidelines for safe sleep practices do not exist. Although aware of the concepts, staff do not consistently educate families about maintaining the practices within the hospital environment, as evidenced by non-compliance with …

Doctoral Study Effects Of Mandatory Staffing Requirements On Quality Indicators In Long-Term Care, Melissa Reed

Walden Dissertations and Doctoral Studies

Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimbursement. The purpose of this study was to evaluate if state-mandated staffing ratios affected Centers for Medicare and Medicaid Services (CMS) survey ratings for CMS Region 7, which consisted of Iowa, Kansas, Missouri, and Nebraska. The theoretical framework was grounded by Donabedian’s quality theory, which described quality is made up of the elements of structure, process, and outcomes. This study included two research questions evaluating if there was a correlation between minimum staffing ratios and quality of care in long-term care …

Integrating Palliative Care In The Cardiac Surgery Icu, Katherine Rodman

Walden Dissertations and Doctoral Studies

Over the last decade, patients who remain critically ill but in the chronic stage have become a subset of patients who often remain in the cardiac intensive care unit (CICU) for many months. Palliative care in the ICU has an important role and is well recognized by various studies to alleviate physical symptoms due to invasive treatments, to set patient-centered goals of care, and to provide end-of-life care. This acute care facility does not have guidelines for clinicians to use when introducing and managing palliative care for terminal heart failure patients during long term stays in the ICU. The clinical …

Diabetes Self-Management Education, Jean David Thomas

Walden Dissertations and Doctoral Studies

AbstractAccording to the World Health Organization, Type 2 diabetes mellitus (T2DM) is a chronic, metabolic disease that can lead to damage throughout the body and development complications if self-care management is not implemented. Studies have demonstrated a lack of preparedness of nursing staff on T2DM self-care. At the federally qualified health clinic where this Doctor of Nursing Practice project occurred, a gap in practice existed related to the use of outdated American Diabetes Association (ADA) guidelines and lack of patient education documentation on self-care management of T2DM. The purpose of this staff education project was to plan, implement, and evaluate …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

Nurse Perceptions Of Nonacademic Factors That Influence Undergraduate Nursing Student Retention And Persistence To Graduation, Marianne Gray

Walden Dissertations and Doctoral Studies

Having an adequate supply of nurses is critical to maintaining the health care system. The problem for this study was that undergraduate nursing students were leaving a local Midwest community college’s nursing program before obtaining a degree. The purpose of this qualitative study was to explore the perceptions of the program’s recent graduates, regarding nonacademic factors that they believe helped to facilitate their success. Jeffreys’s nursing universal retention and success model served as the conceptual framework. The research question was focused on identifying nurse graduate perceptions of nonacademic factors that contributed to their success. A basic qualitative research design was …

Managing Nurse Leader Stress To Promote Leader Retention, Rebecca Sue Hawkins

Walden Dissertations and Doctoral Studies

Nurse leaders are a health care group that has been provided limited support to managestress and burnout symptoms, yet the impact of leader stress burden on staff satisfaction, patient outcomes, and their own health is vital to the provision of safe, high-quality health care. The problem of leader fatigue and burnout is the ability to retain current leaders and recruit the next generation. The purpose of this staff education project was to address leadership burnout due to stress and the lack of knowledge of how to manage stress in the moment. A combination of Watson’s theory of caring and Ray’s …

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 …

Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder

Walden Dissertations and Doctoral Studies

Newly licensed nurse turnover can be costly, causing a mismatch between supply and demand for nurse staffing needs, lowering quality outcomes, and decreasing patient satisfaction. This quantitative study was conducted to identify the relationship between why newly licensed nurses selected their first position and their retention in that initial position. Other factors examined in relation to retention were unit most worked, age, race, sex, and education level. Irvine and Evans’s theory of job satisfaction and Maslow’s hierarchy of needs guided the analysis of the data. Secondary data used were the Newly Licensed Registered Nurse New Cohort 3 Survey from 2016 …

Staff Education On Workplace Violence And Prevention Measures, Fatu Koroma

Walden Dissertations and Doctoral Studies

Forensic nurses are essential in helping forensic mental health patients at an inpatient/outpatient forensic psychiatric health care facility. The practice gap that the forensic psychiatric health care facility experienced was a deficit in knowledge among forensic nurses on the importance of workplace violence and prevention. The practice-focused question guiding the project was to determine if education on the American Nurses Association’s workplace violence and prevention measures would increase forensic nurses’ and staff’s education scores. The purpose of the project was to close the gap by educating nurses and staff on measures to increase a safer environment. The instructional design was …

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 …

Staff Education Of Diabetic Foot Care In An Ambulatory Setting, Riza Grace Nielsen

Walden Dissertations and Doctoral Studies

One of the most important factors affecting the quality of diabetes care is the association between a patient’s knowledge and their practices. The practice gap in this primary care clinic was a lack of standardized diabetic foot care. The purpose of this DNP project was to provide nursing staff with an evidence- based, culturally congruent diabetic footcare curriculum that could help decrease inconsistencies in care. The practice-focused question for this project addressed whether an educational program for nursing staff on diabetic footcare would increase their knowledge and translate this knowledge into practice to prevent diabetic foot infections and its complications. …

Oncology Nurses, Compassion Fatigue And General Health: A Mixed-Methods Study, Michelle Rampersad

Walden Dissertations and Doctoral Studies

Current literature on compassion fatigue is expansive, but there is a lack on the relationship between compassion fatigue and general health complaints in oncology nurses; how they perceive compassion fatigue and its relation to their general health. Using Pender’s health promotion model, this mixed methods study addressed how oncology nurses perceive compassion fatigue and whether a correlation exists between compassion fatigue and general health complaints. Data were collected from a sample of 55 oncology nurses through two separate Survey Monkey links. All 55 participants completed quantitative data points including a demographic questionnaire, the Professional Quality of Life 5 tool, and …

Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa

Walden Dissertations and Doctoral Studies

AbstractMany patients whose primary or secondary chronic condition is hypertension present to their first follow-up appointment in a primary care facility in the north of Puerto Rico with uncontrolled high blood pressure. Nurses’ knowledge of hypertension is vital to addressing a gap in practice for this patient population and patient quality of life and the prevention of cardiovascular diseases. The practice-focused question guiding this project focused on a nurse educational session for increasing hypertension management knowledge as well as a follow-up phone call protocol that aimed to improve patient care. The theoretical framework guiding this project was Pender’s health promotion …

Educating Nursing Staff On Code Lavendar, Melanie Gumapas Webb

Walden Dissertations and Doctoral Studies

The role of the nurse has changed considerably over the past decade. Nurses are facing alarming rates of burnout that is causing them to leave the profession prematurely. The practice-focused question was to determine if a nurse staff education program on Code Lavender that focused on wellness and resiliency strategies helped to decrease nurse burnout. The purpose of this doctor of nursing practice project was to educate nurses on an 11-bed inpatient oncology unit at a hospital located in Maryland. A comprehensive literature review was conducted utilizing several databases and using inclusive terms such as nurse burnout, wellness, patient safety …

Implementation Of Night Shift Rounding To Improve Nursing Communication And Reduce Days Of Intubation In The Intensive Care Setting, Lisa Wilkinson

Walden Dissertations and Doctoral Studies

Multidisciplinary rounds are the gathering of various health care providers who have a shared interest in a patient’s well-being to discuss the plan of care and the patient’s progress through their hospital stay. This multidisciplinary group of staff can be the providers, the nurse, charge nurse, social worker, pharmacist, dietician, respiratory, chaplaincy, and occupational and physical therapists. On night shift at the project site, this rounding process did not occur, leaving the staff feeling they were not involved in the plan of care. The purpose of this quality improvement evidenced-based project was to create a process change, introduced to the …

Thirty-Second Mindful Body Scan Meditation For Bedside Nurses, Shruti Balwalli-Udyawer

Walden Dissertations and Doctoral Studies

Compassion fatigue, or secondary traumatic stress, is a state of physical and mental exhaustion caused by an inability to cope with the everyday environment that reduces the ability of the nurse to provide high-quality health care to a patient. The purpose of this staff education project, guided by Selye’s general adaption syndrome , was a 6-week, 30-second mindfulness exercise program to promote stress reduction for cardiac step-down and medical-surgical nurses. In this quantitative, pre- and posttest study, the Perceived Stress Scale was completed by a sample of 24 nurses who met the inclusion criteria. The practice focused whether educating nurses …

Nursing Staff Education Program On Using The Ask Suicide-Screening Questions Tool Kit, Camarita Titang

Walden Dissertations and Doctoral Studies

The absence of adequate knowledge, skills, and competencies in screening for suicide risk in adolescent and young adult patients is a significant problem facing nurses in outpatient settings. An evaluation of the project site facility’s main performance metrics revealed shortcomings in locating patients who pose a serious risk of self-harm and suicide. Staff dealing with the patients may, as a result, overlook preemptive measures that could stop a suicide event. The project aimed to create a training program to introduce the ask suicide-screening questions (ASQ) tool kit, an evidence-based suicide screening tool, to ambulatory nurses. The goal of the project …

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

A Nursing Staff Education Module On Survivorship Care Plans In Primary Care, Janette Francis

Walden Dissertations and Doctoral Studies

Survivorship care plans (SCPs) bridge the gap in the transition of care from oncology to primary care providers (PCPs) for breast cancer survivors. Despite strong recommendations for SCPs, their use remains limited. Guided by Knowles’ adult learning theory, the project focused on, first, determining whether a predeveloped staff education activity was valid using the Lynn model criteria for validation. Second, if in a rural clinic where SCP were not consistently used providers, nurses, and staff knowledge regarding the importance of SCP would increase following an educational program. An expert panel of 5 educational experts validated the educational module for appropriateness …

Experiences Of New Graduate Nurses Who Transitioned To Practice Using Virtual Conferencing Software, Sara Moran

Walden Dissertations and Doctoral Studies

Orientation is a pivotal moment for new graduate nurses as they transition into the acute care setting. The COVID-19 pandemic changed in-person orientation to virtual orientation, but little is known about the experiences of new graduate nurses who attended the virtual orientation process. The purpose of this qualitative interpretive descriptive study, guided by Duchscher’s theory and the technology adaptation model 2, was to understand the experiences of new graduate nurses who transitioned to practice utilizing video-based conference software for nursing orientation. Twelve new graduate nurses were interviewed using virtual conferencing software. Data were analyzed using interpretive description and then were …

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. …

Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg

Walden Dissertations and Doctoral Studies

Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …

Improving A Culture Of Knowledge Transfer In A School Of Nursing, Margareth S. Zanchetta, Kateryna Metersky, Bridget Miller, Danielle Strachan, Elena Blackwood

Journal of Educational Research and Practice

Introduction: A series of 19 unfunded knowledge transfer hands-on workshops were implemented (2017–2019) and delivered by 22 facilitators from disciplines of nursing, business, communication, plastic arts, engineering, and community studies. The purpose of this paper is to report on the post-appraisal of the workshops’ implementation; uncovering the attendees’ new ideas and reflections on the content; and the process of expanding knowledge for practice.

Methods: The qualitative program evaluation approach, using the standards of utility, feasibility, accuracy, and propriety of a given program, inspired the design of the immediate appraisal of the workshops delivered within a Canadian school of nursing located …

Factors Influencing The Development Of Social Change Involvement, Linda Johanson, Patti P. Urso, Kimberly Priode

Journal of Excellence in Nursing and Healthcare Practice

How to cultivate and encourage the motivation to become an agent of positive social change has not been studied to a great degree. For example, what kind of factors influence the development and growth in nurses toward a desire to be involved in changing society for the better? Knowledge of these factors could help educators and nurse leaders provide and encourage those growth opportunities. The purpose of this research was to interview nurses known to be deeply involved in various types of positive social change and discover what factors influenced this development. Three overall themes emerged as influencing factors for …

A Quality Improvement Evaluation On A Nurse Residency Program, Mary Christine Richards

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this DNP project was to explore new graduate nurse (NGN) residency program retention data in a large healthcare system to assess if participant retention met or exceeded identified retention benchmarks. The second project question explored NGNs’ reasons for leaving the organization after the first year of experience. The Plan Do Study Act model framed this quality improvement evaluation project. The total number of NGN residency participants for the system in 2020 was 586 and 680 in 2021.Year one retention in 2020 was 539 (92%). Year one retention in 2021 was 625 (92%). Year two retention data were …

Oncology Nurses' Development Of Coping Mechanisms To Avoid Burnout And Foster Resilience, Alberto N. Sarmiento

Walden Dissertations and Doctoral Studies

Cancer is a leading cause of death in the United States. Individuals diagnosed with the disease experience physiological and psychological burdens due to its effects. As a result, cancer care constantly exposes health care professionals to challenging personal and professional demands. Effective coping mechanisms are associated with better well-being and career longevity for nurses and improved outcomes for patients. Although researchers have examined resilience and burnout among health care professionals, they have not fully considered these concepts in terms of oncology nurses' professional experiences or explored what factors may mitigate burnout for these professionals. The purpose of this qualitative study …

Shift Reporting: Educating Nurses On Effective Communication, Cheryl Iris Smith

Walden Dissertations and Doctoral Studies

Effective communication is vital to nursing practice, as it can ensure quality care delivery and promote positive patient and organizational outcomes. In most organizations, the exchange of information between nurses is done during the end of shift (EOS) reporting. The purpose of this DNP project was to determine if an educational intervention focused on effective communication in EOS reporting increased knowledge and confidence among nurses working in a home healthcare setting. Fifty-seven nurses were invited to participate in the educational intervention, and 49 nurses took part for an 85% response rate. The average age of the sample was 45.51 years …