Nursing Commons^™

Educating Staff Nurses On Opioid Use Disorder, Moses Ikejiofor

Walden Dissertations and Doctoral Studies

Opioid use disorder (OUD) is a public health epidemic causing a rise in morbidity and mortality in the United States with disruption of victims and their families’ lives and a financial burden on the nation’s economy. The problem identified for this DNP project was nurses’ lack of knowledge of OUD and the impact on care and attitudes toward OUD patients. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose was to plan and evaluate a staff education program on OUD. The evidence from the literature to support the need for this project showed that …

Clinical Practice Client Education Guideline For Early Detection Of Thyroid Cancer, Marcia Miller

Walden Dissertations and Doctoral Studies

AbstractThyroid cancer (TC) incidences over the last decade have increased significantly. The practice problem addressed in this project was nurses’ lack of knowledge on how to perform or teach clients how to perform self-exams of the neck region for early detection of TC. This lack of knowledge limits the nurses’ ability to properly educate their clients about TC and recognizing when to seek medical interventions. The purpose of this project was to develop of an evidence-based, clinical practice client education guideline (CPCEG), based on an in-depth literature review, to address the nurses’ lack of knowledge and enable clients to engage …

Development Of A Detox Clinical Practice Guideline For Pregnant Women Suffering From Opioid Addiction, Becca Ward

Walden Dissertations and Doctoral Studies

AbstractThe number of women suffering from opioid use disorder during pregnancy is a national epidemic. The gap in nursing practice is the lack of detoxification and medication-assisted treatment facilities that are equipped to care for this vulnerable population. The purpose of this project was to develop a clinical practice guideline (CPG) that is safe for both the fetus and the pregnant mother. Opioid dependence during pregnancy is on the rise with the nation’s current opioid epidemic. In this project, a meta-synthesis review was used to gather evidence from various sources and to develop a detox CPG that is safe for …

Staff Education Regarding Breastfeeding For Perinatal Nurses, Shannon Nicole Long

Walden Dissertations and Doctoral Studies

AbstractExclusive breastfeeding in the U.S. is the optimal form of nutrition up to the age of 1 year; however, the current U.S. rate of 49% and Kentucky rate of 39% fall below the Healthy People 2020 goal of 60.6%. Researchers have shown that perinatal nurses often lack knowledge to ensure mothers begin and maintain this optimal form of human nourishment. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to present a continuing education program on breastfeeding for 10 staff nurses at the target hospital. The program presented was the …

New Graduate Nurses’ Transfusion Training Views: Reflection On Experiences With Adverse Reactions, Hind Jaber-Daou

Walden Dissertations and Doctoral Studies

Abstract:New graduate nursing students transitioning to becoming professionals undergo education and training to gain knowledge and competence about transfusions. Nonetheless, new graduate nurses experience stress during a blood transfusion adverse reaction, which can be associated with lack of knowledge and inadequate training. The purpose of this qualitative study was to gather data from new graduate nurses who described their lived experiences with patients exhibiting symptoms of adverse reactions, how they reflected on their emotional effects, and the influences of the training on their knowledge and confidence. The research was grounded in social cognitive theory that centers on the concept of …

Diabetic Education For Nurses To Enhance Patient Outcomes, Jacklyn Obeng

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus is metabolic disease that causes elevated blood glucose levels resulting in long-term health complications and medical costs. This project was aimed at addressing the lack of confidence and knowledge staff had when teaching patients diabetes self-management interventions. The purpose of this project was to develop an evidence-based educational program for staff working in an outpatient clinic in the northeastern United States. The analysis, design, development, implementation, and evaluation model and Watson’s theory of human caring provided frameworks for the project development and implementation. A diabetic nurse educator, a family nurse practitioner, and the chief medical officer served as …

Evidence-Based Hospice Care Education For Healthcare Clinicians, Nonie E. Weir

Walden Dissertations and Doctoral Studies

Vulnerable populations with a terminal illness, who reside in a nursing home setting, continue to experience psychological, physical, and emotional effects that lead to end-of- life (EOL) suffering and discomfort. Globally, millions of individuals receive care from a hospice provider. By 2030, this figure will triple due to the increased lifespan of the geriatric population. The literature review has revealed that the practical problem is the lack of hospice care education received by healthcare clinicians. It is, therefore, important to prepare and educate healthcare clinicians about a peaceful death through an individualized plan-of-care (POC) from a holistic approach. The purpose …

Staff Education Inservice For Preventing Discrimination Against Lgbt, Florence Titilola Eze

Walden Dissertations and Doctoral Studies

Lesbian, gay, bisexual and transgender (LGBT) members live in the community, yet they are prone to various types of oppression, mistreatments, and denial of services from most institutions including health care settings. Concerns, such as being denied access to caregivers or being given a lower quality of care continue despite the community’s fighting for their voices to be heard across the globe and various movements that have been established, especially the United States and the United Kingdom, and laws that call for equitable healthcare. The purpose of this project was to explore whether a change in knowledge and attitudes would …

Developing A Presimulation Protocol For Prostate Cancer Patients Undergoing Radiotherapy, Jennifer Wieworka

Walden Dissertations and Doctoral Studies

Inadequate preparation of prostate cancer patients undergoing radiation therapy (RT) can damage healthy tissue and cause long-term complications. Proper setup can reduce side effects. Currently, there are no standardized guidelines to help prepare patients for prostate radiation. Guidelines will help nurses coordinate care and manage symptoms for these patients. The purpose of this doctoral project was to address the gap in practice of the lack of a standardized process for implementing presimulation interventions for patients with prostate cancer undergoing RT by developing an evidence-based clinical practice guideline (CPG). The practice question for this project focused on the best practices contributing …

Osteoporosis Risk Assessment Impacts Bone Densitometry, And Fall Fractures In Primary Care, Ifeoma Ude-Okoro

Walden Dissertations and Doctoral Studies

Abstract

In the United States, approximately 10 million adults 50 years and older are plagued by osteoporosis; this number has been projected to climb to 14 million by 2020. Osteoporosis is a debilitating disorder characterized by significant loss of bone mass and mineral density. Without proper screening and diagnosis, patients may not receive the appropriate medical treatments to avoid worsening of their condition and its associated complications. Nurses can help identify patients at risk for osteoporosis by administering osteoporosis screening during routine office visits. The practice-focused question asked whether the Fracture Risk Assessment Tool (FRAX) increased the proportion of bone …

Improving The Patient Experience With Case Management Follow Up Phone Calls: A Quality Improvement Project Evaluation, Karen Jarrell

Walden Dissertations and Doctoral Studies

In January of 2020, a follow-up phone call quality improvement initiative was implemented by the case management department of an acute care facility located in the Mid-Atlantic region of the United States, to improve the patients’ healthcare experience. The intent was to improve the Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores. This quality improvement (QI) project was conducted using the Plan-Do-Check-Act Cycle along with the Kotter’s 8-step change model. The purpose of the QI project evaluation was to determine if a QI initiative using follow up phone calls had a positive effect on increasing CAHPS survey scores. The …

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 …

Staff Education On Medication Screening Tool For Nursing Home Residents, Jinkee Sarah Beltran

Walden Dissertations and Doctoral Studies

The prevalence of potentially inappropriate medications (PIMs) among nursing home residents continues to be high. Researchers have demonstrated that the use of a medication screening tool identifying PIMs can improve medication safety among older adults. Screening tools, such as the Beers criteria and the Screening Tool for Older Persons’ Prescriptions (STOPP), are evidence-based guidelines that use several validated criteria to identify PIMs in older adults’ medication regimens. While the use of these tools is standard in the acute care setting, limited studies have been conducted regarding their use in the nursing home setting. The purpose of this project was to …

Effect Of Video Recording And Self-Reflection On Skill Acquisition In Nursing Students, Lisa Aloy

Walden Dissertations and Doctoral Studies

Applications to nursing programs have grown at exponential rates causing a shortfall of clinical locations and lack of available clinical experiences. This negatively affects nursing students’ access to bedside patient care, affecting nursing students’ ability to safely learn and practice basic nursing skills. Nurse educators need to create robust learning experiences for students to learn basics nursing skills and gain confidence and competence in these skills. Video recording in nursing education is an underutilized teaching method that supports various aspects in student learning of skill acquisition. The purpose of this study was to explore Associate Degree Nursing (ADN) nursing students’ …

Increasing Nurse Knowledge Of The Underutilization Of Hospice Services For African Americans, Vicki Schmidt

Walden Dissertations and Doctoral Studies

The focus of this doctoral project was increasing knowledge of underutilization ofhospice services for African Americans (AAs) and the need to increase cultural competence among nurses regarding this issue. The identified gap in practice was nurses’ lack of cultural competence and knowledge regarding the underutilization of hospice specific to AAs. The practice-focused question focused on whether a staff educational intervention increased nurses’ knowledge of the cultural implications regarding the introduction of hospice services for AAs. The education was guided by the Purnell model for culturally competent health care, Healthy People 2030, and the National Hospice and Palliative Care Organizations AA …

Clinical Practice Guidelines For Community-Based Resources For Substance Abuse Patients In An Emergency Department, Julie Ann Thompson

Walden Dissertations and Doctoral Studies

Substance use disorder (SUD) has plagued the United States for decades and has been an ongoing issue in a Midwest hospital emergency department where SUD patients were provided discharge information that did not include SUD specific recovery and rehabilitation resources available in the community. The purpose of this project was to develop a clinical practice guideline (CPG) for nurses to use when discharging a SUD patient with an accompanying evidence-based recovery and referral resource list including Narcan, medication-assisted treatment, crisis hotlines, needle exchange programs, and treatment options. The Johns Hopkins Nursing Evidence-Based Practice framework was used to grade the levels …

Staff Education To Improve Pain Management In Skilled Nursing Patients, Keitta Evans

Walden Dissertations and Doctoral Studies

One of the key ethical principles in nursing is the promotion of health and wellness and ensuring that patients are free from unnecessary pain and suffering. It is estimated that at least 65% of patients in skilled nursing centers in the United States report the presence of pain, indicating that there are opportunities for improvement with effective pain management within this practice setting. A key factor that has been identified as an opportunity for improvement is education for clinical staff who practice within this setting. This Doctorate of Nursing Practice (DNP) project provided education to a group of clinical team …

Nursing Interventions For Reducing Falls Among Older Adults On Polypharmaceutical Agents, Kevin O. Onuekwusi

Walden Dissertations and Doctoral Studies

In the United States, the cost of treating a resident of a long-term care facility (LTC) after a fall with injury is between $10,000 and $26,000. Current nursing interventions for fall prevention among older adults aged 65 years and over at the local LTC do not address the risk of polypharmacy and are focused on environmental and intrinsic factors. The purpose of this systematic literature review was to find the nursing interventions that have been used to reduce falls in older adults aged 65 years and over in nursing homes and LTCs who are on polypharmaceutical therapy. Primary research articles …

Caring For The Caregiver: Second Victim Recovery Following A Serious Medical Error, Beulah Patrice Vance

Walden Dissertations and Doctoral Studies

In 1999, it was estimated that 98,000 deaths were attributed to medical errors and were the fourth most common cause of death in the United States. In 2016, medical errors were estimated as the third leading cause of death, with a mean death rate of 251,454 each year. Nurse involved in errors are known as second victims. Almost one in seven staff members reported that they had experienced a patient safety event within the last year that caused personal problems such as anxiety, depression, or concerns about their ability to perform their job. This project explored whether nurses are able …

Comparative Analysis Of Systemic Lupus Erythematosus Support Group Type On Quality Of Life, Mary Louise Giles

Walden Dissertations and Doctoral Studies

When individuals are diagnosed with systemic lupus erythematosus (SLE), they tend to go through emotional, psychological, and physical anguish that requires support. Studies have shown that a support group can provide SLE patients with an outlet in which they can share firsthand feelings and experiences and receive emotional support but it is not known if how the individual with SLE accesses online or face to face support makes a difference. The purpose of this study, guided by the Chronic Care Model, was to determine if there were differences in quality of life (QoL) for persons with SLE participating in an …

Increasing Access To Diabetic Self-Management Education Using Telehealth In Rural Kentucky, Gina Good

Walden Dissertations and Doctoral Studies

The lack of diabetic self-management education (DSME) can affect generations of families who have suffered from diabetes. More than 80% of Appalachian Kentucky counties lack access to DSME and care due to high incidence of diabetes. The purpose of this quality improvement project was to determine whether the use of telehealth increased patient access to DSME in Southeast Kentucky. Application of Peplau’s theory of interpersonal relations to patient relationships in nursing practice provided a framework for the project. De-identified retrospective data 6 weeks before intervention and 6 weeks postintervention were collected by the project facility for secondary data analysis to …

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 …

Nurse-Patient Ratios And Falls In The Acute Care Setting: A Staffing Educational Program, Trinia Shawell Williams

Walden Dissertations and Doctoral Studies

AbstractThe correlation between patient falls and nurse-patient ratios in acute care has been a prevalent topic for decades. The lack of nurse-patient ratio guidelines to direct nurse staffing has restricted nursing leaders’ efforts to address this issue. The purpose of this staff education project was to educate nursing leaders on nurse-patient ratios and their association to patient falls. The practice-focused question centered on whether education would increase nursing leaders’ knowledge about appropriate staffing ratios and practices to reduce falls at a long-term acute care facility. Rogers’s diffusion of innovations theory was the change model used to guide this project. There …

Exploring The Effects Of Generation And Leadership Style On Nurses’ Organizational Commitment, Kim M. Hedley

Walden Dissertations and Doctoral Studies

There is an impending shortage of nurses; therefore, healthcare leaders must use strategies that promote staff nurses’ organizational commitment (OC) to retain a clinically competent workforce. The purpose of this quantitative descriptive cross-sectional study guided by the transformational leadership theory and generational theory was to determine whether OC differs according to generational cohort (GC) and leadership style (LS) and then explore the combined effects of GC and LS on staff nurses’ OC. One-hundred sixty acute care staff nurses in the United States responded to the survey that included the Multifactor Leadership Questionnaire 5x-Short and Three-Component Model Employee Commitment Survey. A …

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 …

A Systematic Review Of Tobacco Cessation Strategies Tailored For Military Personnel, Ni Ketut Supiyati

Walden Dissertations and Doctoral Studies

AbstractA Systematic Review of Tobacco Cessation Strategies Tailored for Military Personnel by Ni Ketut Supiyati

MS, Walden University, 2000

Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021

Use Of Critical Thinking Strategies By Nurse Educators, Josephine Tundun Akintonde

Walden Dissertations and Doctoral Studies

AbstractNew graduate nurses often lack the clinical decision-making skills that are essential for developing clinical competency. Critical thinking abilities are essential for nursing excellence and professional competency. However, little is known about nurse educators' techniques and teaching practices for developing students’ critical thinking. The purpose of this phenomenological study, guided by constructivist learning theory, was to understand the lived experiences of nurse educators who used critical thinking teaching strategies in a baccalaureate nursing program to develop critical thinking skills in nursing students. Thirteen nurse educators from baccalaureate nursing programs were interviewed using open-ended questions. Interviews were transcribed and manually coded. …

An Integrated Approach To Hand Hygiene, Tarsha Renee Stewart

Walden Dissertations and Doctoral Studies

AbstractHealthcare-associated infections (HCAIs) threaten the quality and safety of the services provided. HCAIs are infections that occur while a patient is receiving treatment for another condition in any type of healthcare. The Centers for Disease Control estimates that approximately one in every 20 inpatients will become infected with an HCAI during their hospital stay. Proper hand hygiene is the most significant intervention in preventing HCAIs. Despite hand hygiene's effectiveness, evidence suggests that only 50% of healthcare workers are compliant with proper hand hygiene techniques. The purpose of this project is to increase nurse’s knowledge the via education. Kotter's eight-step change …

Staff Education Program On Smoking Cessation In Patients With Cardiovascular Disease, Jennifer Shipp

Walden Dissertations and Doctoral Studies

Cigarette smoking in the United States constitutes a public health crisis, with millions of people having cigarette-related diseases and comorbidities. Although there is an increased prevalence of uncontrolled smoking among patients with cardiovascular diseases, many healthcare facilities, including the project site, lack adequate screening for tobacco use among cardiovascular patients. The 5As (asking, advising, assessing, assisting, and arranging) model of behavioral change provided the framework for the project. The practice-focused question for this project addressed whether a staff education program specifically designed to instruct healthcare providers on using the 5As intervention with cardiovascular patients would increase their knowledge of smoking …

Lived Experiences Of Nurses Caring For Limited English Proficient Patients During A Pandemic, Thomas Cain

Walden Dissertations and Doctoral Studies

This study addressed the need to better understand how a patient’s healthcare is influenced by lack of health literacy for limited English proficient patients during the COVID-19 pandemic. While registered nurses are a key component in the patient care continuum, there is a lack of evidence to understand the experiences caring for this vulnerable population during a pandemic. Framed by Roy’s adaptation model and Orem’s self-care deficit nursing theory, the purpose of this interpretative phenomenological study was to explore the lived experiences of registered nurses who cared for limited English patients diagnosed with COVID-19 in 2020. Seven registered nurses participated …