Nursing Commons^™

Educational Intervention To Increase Telemedicine Knowledge In Nurses, Jean Sylvestre Ayissi Essono

Walden Dissertations and Doctoral Studies

Limited access to healthcare services is a factor that can reduce quality of care, and it is more pronounced in rural settings. One plausible solution to this concern is telemedicine, the use of electronic information and telecommunication technologies to provide care when an individual and provider are not in the same location. Although telemedicine has been suggested as a solution to the access to care concern, it is not widely integrated into the nursing practice. Using Nightingale’s holistic theory of caring, the purpose of this DNP project was to determine if an educational study geared towards telemedicine increased knowledge and …

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …

Improving Nursing Knowledge On Antibiotic Therapy To Prevent Pneumonia Readmissions, Muskuda Deen

Walden Dissertations and Doctoral Studies

Lack of education on the appropriate use of antibiotic therapy can lead to an increase in early readmissions for patients with community-acquired pneumonia (CAP). The purpose of this project was to educate medical-surgical nurses at an inpatient hospital in the southern region of the United States on the appropriate use of antibiotic therapy to decrease early CAP readmissions. The project practice question was whether the infection control clinical practice guidelines would increase the medical-surgical nurses’ knowledge on the appropriate use of antibiotic therapy to decrease the 30-day readmission rates for patients diagnosed with CAP. The staff education development was guided …

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

Walden Dissertations and Doctoral Studies

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

The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu

Walden Dissertations and Doctoral Studies

Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital …

Effective Postdischarge Communication From Nursing Staff To Mental Health Patients, Paula Renee Garrison

Walden Dissertations and Doctoral Studies

AbstractMental health patients have a history of decreased follow-up appointments, poor diet, and medication noncompliance after discharge from inpatient facilities in addition to multiple co-morbidities, making a return to the community difficult. The practice problem was an increase in hospital readmissions of mental health patients within 30 days postdischarge due to inadequate post-discharge education and follow-up communication. Using Rodgers’s recovery on mental health theory and Revan’s action learning theory, a staff education program was developed to educate 10 nursing staff and two social workers on how to effectively implement postdischarge communication at 3 days and 30 days after discharge from …

Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Harbaugh, Diane Whitehead

Journal of Excellence in Nursing and Healthcare Practice

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and a lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients have been shown to improve quality care, decrease complications, increase the efficiency, and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which are recognized risk factors for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the northeast United States. The purpose …

The Impact Of High-Fidelity Simulation On Nursing Student’S Flexible And Reflective Thinking In Higher Education, Hungwei Tseng, Lori Hill

Higher Learning Research Communications

This study evaluated the effect of high-fidelity simulation with both mannequins and live actors on flexible and reflective thinking of nursing students. Students enrolled in an undergraduate nursing program were recruited to participate in this study. Ninety students, all female, completed both pre- and post-surveys. The researchers conducted a paired samples t-test to determine if there is a statistically significant difference in students’ level of flexible thinking before and after they experienced the high-fidelity simulation. Moreover, we conducted multivariate correlational analysis to examine the relationships between flexible thinking and reflective thinking. In general, statistical results in this study provide …

Predictor Of Turnover Intention Of Register Nurses: Job Satisfaction Or Work Engagement?, Yolanda Edwards-Dandridge, Brandon D. Simmons, Douglas G. Campbell

International Journal of Applied Management and Technology

Both employee job satisfaction (JS) and employee work engagement (WE) have been examined as possible predictors of employees’ intention to voluntarily leave a specific job or company, known as turnover intention (TI). While the body of knowledge has grown concerning the nature of TI, there remains the unsettled question of which of the two concepts most accurately predicates TI. The high turnover rate of registered nurses (RNs) in hospitals in the U.S. presented an opportunity to examine if JS and WE predict, and to what degree, among RNs. For this quantitative correlational research probability sampling was used to identify 155 …

Evaluation Of A New Nurse Mentor Program, Corinne Romano, Diane Whitehead

Walden Faculty and Staff Publications

Novice nurses in a 160-bed inpatient rehabilitation hospital had a turnover rate of 32% in 2017 and 2018, despite participation in a novice nurse residency program. This quality improvement project was a 3-month process evaluation of a 1-year mentor program designed for novice nurses. The purpose of the process evaluation was to explore whether the organization had (a) successfully implemented the program as identified, (b) successfully recruited and retained participants to date, (c) maintained projected timelines, and (d) provided all participants the opportunity to provide feedback at the 3-month mark of the program. The process evaluation provided an opportunity for …

Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Denise Harbaugh, Diane Whitehead

Walden Faculty and Staff Publications

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients has been shown to improve quality care, decrease complications, and increase the efficiency and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which is a recognized risk factor for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the Northeast United States. The …

Managing Uncertainty In Chronic Illness From Patient Perspectives, Amanda Brown, Susan Hayden, Karen Klingman, Leslie C. Hussey

Journal of Excellence in Nursing and Healthcare Practice

Chronic illness is an increasing concern in the United States as the Centers for Disease Control and Prevention reports that 50% of adults have at least one chronic illness. When individuals must adjust to chronic illness, they may experience uncertainty regarding the illness, prognosis, and symptoms. The purpose of this qualitative, phenomenological study was to explore the management strategies of uncertainty in chronic illness from patients’ perspectives. Merle Mishel’s uncertainty in illness theory was the framework used to explore the lives of individuals diagnosed and living with chronic illness. In-depth interviews were conducted with eight individuals who have chronic disease. …

Type 2 Diabetes Prevention And Management Educational Toolkit, Theresa O. Orjiakor

Walden Dissertations and Doctoral Studies

AbstractDiabetes is one of the chronic diseases that are challenging to prevent and manage. Approximately 8.3% of the United States' population has type 2 diabetes. One of the primary challenges in managing the disease entails reducing the associated financial and human costs by preventing new cases and enacting social change. Prevention and management education programs using enhanced toolkit may have positive effects on type 2 diabetes patients, who start enjoying a good quality of life, as well as positive social change in their communities and families. The purpose of this project was to develop and evaluate a type 2 diabetes …

Nursing Clinical Practice Guideline Development For The Care Of Sexual Assault Survivors, Elssy J. Bingham

Walden Dissertations and Doctoral Studies

Sexual assault, a form of sexual violence, is an egregious crime that continues to be a serious and significant public health problem which affects millions of people each year in the United States and globally. Sexual assault may have lasting and devastating negative physical and emotional consequences. Knowledgeable nurses can have a positive impact on a survivor’s safety and recovery. The purpose of this project was to develop a Clinical Practice Guideline (CPG) for nurses who provide the initial care when patients present in the emergency room following sexual assault. The conceptual framework used for this project included Knowle’s Theory …

Program Evaluation Of A Home-Based Primary Care Practice And Patients With Heart Failure, Anne Rose Walsh

Walden Dissertations and Doctoral Studies

Heart failure (HF) affects over 5.5 million adults in the United States with a prevalence of 10%'€“20% in older adults and accounts for 3% of all hospital admissions with a readmission rate as high as 25% within 1 month of discharge. Patients with HF account for approximately 42% of the doctor of nursing practice project site's patient population, and the health system has a 30-day readmission rate of 35% for patients with HF in 2 large hospitals. Thus, the health system loses almost $13 million per year in Medicare penalties. This retrospective quality improvement project reviewed the effectiveness of care …

Pressure Injury Prevention In An Urban Surgical Intensive Care Unit, Kayma P. Ricks

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure injuries (HAPIs) affect approximately 2.5 million patients in the

United States, annually. Prevention requires surgical intensive care unit (SICU) nursing staff to

effectively use evidence-based risk assessment measures to appropriately identify patients at risk

for developing HAPIs and to prevent poor patient outcomes. The Braden Scale risk assessment

tool has demonstrated reliability and validity in the prediction and assessment of patients at risk

for the development of HAPIs. The purpose of this Doctor of Nursing Practice (DNP) project

was to improve nurses’ knowledge of the appropriate use of the Braden Scale risk assessment

tool in the SICU of …

Managing Disruptive Patient Behaviors In A Mental Health Clinic: A Staff Education Program, Mary Odusanya

Walden Dissertations and Doctoral Studies

Disruptive patient behavior is a significant issue in healthcare. Staff education programs are beneficial in managing disruptive patient behaviors. There has been an increase in the occurrence of disruptive patient behaviors at the clinical site, which is an outpatient mental health clinic, and staff members are not well equipped to deal with these situations. The purpose of this project was to develop, implement, and evaluate a staff education program on how to manage disruptive patient behaviors in an outpatient mental health clinic. Using a pre- and posttest design, the project aimed to answer the question of whether a staff education …

Rural Practical Nursing Students' And Faculty Members' Perceptions Of Supports And Barriers To Success, Amy J. Randall-Mcsorley

Walden Dissertations and Doctoral Studies

Practical nursing program students at a rural vocational school (RCC) in the midwestern United States were graduating at a low rate that was putting the school at risk to not meet accreditation standards set by the Council on Occupational Education. The purpose of this study was to explore the perceptions of practical nursing program students and faculty at RCC about institutional, situational, and dispositional supports and barriers students faced toward graduation. The conceptual framework, Cross’s model of barriers to adult learning, was used to identify institutional, situational, and dispositional supports and barriers. A bounded case study design was employed to …

Effectiveness Of Education On Modified Early Warning System For Nurses, Shanmugavalli Janakaraj

Walden Dissertations and Doctoral Studies

The research problem at the practicum site was a delay in recognizing patient’s deterioration due to lack of nurses’ knowledge with early warning signs. It is important to address the problem as the Quality Department noted the delay in identification of patient decline and treatment from mortality case reviews, rapid response team and Code Blue debriefing analysis and missed sepsis identification. A further gap analysis revealed an inadequacy of staff knowledge with warning signs. The purpose of this project was to educate nurses on the Modified Early Warning System (MEWS), a patient assessment scoring system based on six physiological parameters. …

Accelerated Baccalaureate Nursing Student And Faculty Perceptions Of Blended Learning, Emily Elliott

Walden Dissertations and Doctoral Studies

In response to the demand for baccalaureate-educated nurses, nursing schools offer an accelerated baccalaureate of science in nursing (BSN). The problem is nursing programs have used blended learning approaches, but it is unclear whether and in what ways accelerated BSN students benefit from this learning design. The purpose of this qualitative case study was to explore how faculty and students perceived the benefits and challenges of an accelerated BSN program utilizing a blended learning format. Knowles’s adult learning theory served as the conceptual framework through which interview data were analyzed. Participants included 6 faculty and 7 students from 1 school …

Congestive Heart Failure And Strategies To Improve Quality Of Life, Esther Akunna Okorie

Walden Dissertations and Doctoral Studies

Congestive heart failure is a global, chronic, progressive, and debilitating disease affecting mostly older adults. The multiple complications associated with the health issue led to readmissions and markedly reduced ability of heart failure (HF) patients to perform the self-care management of the problem. Nurses are responsible for providing a standardized quality education for patients; however, nurses at the project site lacked adequate skills and knowledge to bridge the gap in HF self-care management education. The project was guided by health belief model and self-care deficit with the goal of boosting the staff knowledge and confidence with providing patient HF self-care …

New Graduate Residency Programs, Shareen Estelle Taylor

Walden Dissertations and Doctoral Studies

Nurses are the largest group of healthcare providers in most acute care hospitals, and the demand for registered nurses is expected to grow by 15% by 2026. The new graduate registered nurse (NGRN) is the supply that will fill the shortage; however, NGRNs are reportedly lacking in the ability to connect the lessons learned in the classroom with real patient care, unprepared for necessary skills, emotionally stressed, and have a high first-year turnover rate. Strategies such as nurse residency programs are needed to support NGRNs as these new nurses’ transition from academics to clinical practice. The purpose of this project, …

Assisting Psychiatric Nurses In Managing Work Stress And Decreasing Callouts And Absenteeism, Prisca Njume

Walden Dissertations and Doctoral Studies

Management and reduction of work stress is important in promoting nurses' well'€being. Understanding how to decrease stress levels may allow nurses to provide better care, improve patient outcomes, and experience increased job satisfaction. The focus of this project was to empower psychiatric nurses to manage work-related stress and decrease callouts and absenteeism. Person-environment fit theory, job demand-control (support) theory, the job demands-resources model, and the effort-reward imbalance model were used to inform the project. Pretest and posttest data were collected from 61 nurses using the Perceived Stress Scale. Deidentified retrospective and prospective data of the number of callouts were also …

Practice Improvement: Intimate Partner Violence Screening Implementation, Enitan Salawu

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) is a significant public health problem in the United States and worldwide. A recent U.S. crime report indicated that close to half of all homicides involve women victims of current or former intimate partners. The purpose of this doctoral project was to develop a training program to educate clinicians in the primary care setting on IPV screening. Participants received education on the Hurt, Insult, Threaten, Scream (HITS) screening tool to identify IPV survivors with available referral resources. The practice-focused question involved clinicians' level of knowledge regarding using the HITS tool kit to screen for IPV in …

Improving The Patient Experience With Communication, Pauline Adora Salmon

Walden Dissertations and Doctoral Studies

A quality patient experience is one of the highest priorities for hospitals as patients and families are looking to healthcare providers to meet their demands for quality service. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures the extent to which providers effectively communicate pertinent information such as communication about medications. On a 20-bed intermediate care unit, the HCAHPS item scores relating to nurse communication and communication about medicine were inconsistent and, on most occasions, were below the comparison benchmark of the 50th percentile when compared to other like hospitals. The purpose of this quality improvement project …

Quality Initiative To Reduce Falls In An Acute Care Setting, Janet Maxine Belcher

Walden Dissertations and Doctoral Studies

Falls are the most frequently reported incidents among hospitalized patients in the United States with at least 4 falls per 1,000 patient days occurring annually. Falls are related to high rates of mortality and morbidity and high hospital costs. The purpose of this project was to evaluate a fall prevention quality initiative to reduce falls in an acute care facility by educating staff on an evidence-based fall prevention protocol. The project sought to explore whether implementation of an evidence-based fall prevention initiative in educating nurses would affect the nurses’ professional knowledge and the number of patient fall incidences in the …

Adolescent Substance Abuse Screening, Wesley W. Lynch

Walden Dissertations and Doctoral Studies

Adolescent substance use is a key public health problem in rural Ohio. Primary care nurses lack substance use screening knowledge and skills. Early screening and detection of possible substance use issues aids in directing patients to appropriate health services. This project involved the implementation of an educational intervention on the CRAFFT screening tool for primary care nurses in rural Ohio. Guided by Kurt Lewin's 3-step model to emphasize prevalence of substance use and need for screening among adolescents, the purpose of this project was to provide training on the CRAFFT screening approach and share guidelines to implement routine substance abuse …

Systematic Literature Review On Fall Prevention In An Acute Care Hospital Setting, Sonia A. Hudson

Walden Dissertations and Doctoral Studies

Falls, with and without injury, in acute care hospitals are quite common but can be prevented if appropriate interventions are in place to address this issue. It is imperative that nurses assess fall risks of all patients admitted to the hospital and advocate for appropriate interventions to prevent falls in those who are found to be at risk. The purpose of this project was to recommend changes to the current fall prevention protocol in the project facility, an acute care hospital, based on best practices identified in a systematic review of the literature. At the time of the project, the …

Impact Of Nursing Education On Dysphagia Screening Knowledge, Jeanette Doreen Brumm

Walden Dissertations and Doctoral Studies

Dysphagia is a common, life-threatening complication potentially experienced by patients with acute stroke. Complications related to dysphagia can lead to aspiration pneumonia, morbidity, and mortality. Thus, early identification of dysphagia is necessary for improving patient outcomes and avoiding adverse health consequences. Nurses have the unique opportunity to impact patient care by increasing knowledge of evidenced-based treatment of dysphagia in acute ischemic stroke patients. Therefore, the project question asked whether Registered Nurse (RN) dysphagia education could improve nursing knowledge of dysphagia screening. The purpose of this project was to increase RN knowledge regarding dysphagia screening using the Yale Swallow Protocol (YSP). …

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …