Nursing Commons^™

The Impact Of Human Resources On Nurses' Turnover Intention, Anita Estell Jackson

Walden Dissertations and Doctoral Studies

Nurse retention is of great concern to healthcare organizations including hospitals. With so many countries reporting a shortage in nursing personnel, healthcare organizations are now seeking ways to reduce this shortage. It is known that job satisfaction and turnover intention impact nurses' continued employment. However, the role of human resources (HR) impact on nurses' job satisfaction and turnover intention is unknown. The theoretical basis of this study came from the work of Bowen and Ostroff who argued the strength of HRM system regulates employee perceptions and outcomes within an organization. Therefore, the purpose of this study was to evaluate the …

Enhancing The Resilience Of Acute Care Psychiatric Nurses Through A Brief Gratitude Intervention, Patricia D. Sullivan

Walden Dissertations and Doctoral Studies

Stressors affecting healthcare providers have accelerated in recent years, causing increasing rates of burnout and emotional exhaustion. Evidence suggests that improving general mental well-being of nurses could enhance their resilience and ability to cope in stressful situations. Psychiatric nurses are at risk by caring for involuntary and manipulative patients who can be violent and abusive. The purpose of this project was to improve psychiatric nurses' mental well-being through the implementation of a gratitude practice and examined the effect of this brief gratitude intervention on their mental well-being. Models informing this project were human caring theory, resilience theory, and positive psychology …

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

Coping And Support Strategies Portrayed In Rheumatoid Arthritis Illness Blogs, Folasade Bolanle Alagbada

Walden Dissertations and Doctoral Studies

The symptoms of rheumatoid arthritis (RA), such as pain, fatigue, stiffness, and inflammation, limit individuals’ abilities to care for themselves, participate in social events, and complete tasks associated with gender norms. RA is a chronic and debilitating disease that people struggle to cope with physically, mentally, emotionally, socially, and financially, but many have not established effective coping and support strategies. The purpose of this hermeneutic phenomenological qualitative study guided by a combination of Orem’s theory of self-care and Watson’s theory of the human caring was to explore the coping mechanisms and support strategies of women and men with RA as …

Development Of A Clinical Practice Guideline For The Care Of Transgender Patients, Wayne Zeh Wellington

Walden Dissertations and Doctoral Studies

AbstractTransgender persons face stigma and discrimination while receiving health care services. The gap in nursing practice at a clinic serving transgender patients in the Southeastern United States was a lack of understanding by providers of evidence-based practices for the provision to patient-centered care. The purpose of this project was to develop a clinical practice guideline (CPG) for the care of transgender patients. The project question asked, based on current evidence, what CPG for patient-centered care should be recommended to providers in the clinic. The patient-centered care model developed around the Donabedian model of quality improvement was used to guide the …

Qualitative Evaluation Of A Hospital-Based Preceptor-Guided Clinical Orientation Program, Brian Eigelbach Martin

Walden Dissertations and Doctoral Studies

Effective preceptor-guided clinical orientation programs (PGCOP) help new graduate nurses (NGNs) across the theory-practice gap to provide safe, effective, and efficient patient care. This constructivist-designed qualitative program evaluation study explored NGNs’ and preceptors’ perceptions of a local hospital’s PGCOP as an effective transition vehicle. The conceptual framework combined Knowles’ andragogical process model for learning with the new world Kirkpatrick model evaluation model. The sample included 7 NGNs who graduated in the past year and had no prior orientation experience and 5 preceptors employed by the study site for at least 1 year. A goal-free approach guided data collection with face-to-face …

Use Of Simulations To Improve Clinical Judgment In New Graduate Nurses, Aaliyah Sabreen Franks

Walden Dissertations and Doctoral Studies

The goal of healthcare organizations across the world is to provide safe, efficient healthcare for patients and their families. The practice problem for this DNP Project, a staff education project, addressed simulation as a strategy to improve clinical judgment in new graduate nurses. Recent studies have shown that 23% of new nurses do not demonstrate entry-level competency and are not as effective as more experienced nurses when making clinical judgment decisions. This lack of efficacy poses a threat to patient safety. This was based on nurse’s progression through Benner’s five levels of competency and was designed to enhance new graduate …

Clinical Practice Guideline: Early Screening For Dementia In Diabetes Mellitus, Angelyn Levell-Smith

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus (DM) is a recognized cognitive impairment risk factor. Even with hyperglycemia being a modifiable risk factor in dementia, primary care is without an evidence-based screening tool to screen patients with diabetes for cognitive abilities. Current literature supports developing an evidence-based standardized guideline for early screening for cognitive impairment in elderly patients with DM. The purpose of this doctor of nursing practice (DNP) clinical practice guideline (CPG) project was to develop an evidence-based CPG for early screening of dementia in patients with DM, providing a means for early recognition of cognitive decline in these patients, making early intervention more …

Staff Education On American Diabetes Association Standards Of Medical Care For Diabetes, Christine Nsubuga

Walden Dissertations and Doctoral Studies

Diabetes is a commonly encountered chronic illness that leads to other lifelong comorbidities if left uncontrolled. Ranked as the seventh leading cause of death in the United States, diabetes affects over 29 million Americans. Although 90%-95% of all diabetes cases are preventable with proper planning and management, clinicians continue to be challenged as they strive to achieve the desired patient care goals. This Doctor of Nursing Practice (DNP) staff education project addressed the lack of standard evidence-based care for diabetic patients in the federally qualified health center look-alike practice for which this project was developed. Guided by the practice-focused questions …

Guiding Nurses To A Healthier Lifestyle, Margaret Yvonne Garcia

Walden Dissertations and Doctoral Studies

AbstractNurses provide continuous patient care around the clock. Nurses who work outside of the 9:00 a.m. to 5:00 p.m. hours are susceptible to fatigue and sleep deprivation that impair their attention to detail, ability to remain focused, information processing, and problem solving. This is especially prevalent among those who work the night shift. Nurses also find that their memory, reaction time, motivation, communication, mood, and empathy are affected with fewer hours of sleep. This project explored the sleepiness that night shift nurses experience and provides nurses with strategies to improve these symptoms. Nurses were provided with a PowerPoint presentation to …

Non-Pharmacological Interventions For Residents With Dementia, Jared Bielanski

Walden Dissertations and Doctoral Studies

The use of antipsychotic medications in persons with dementia has been shown to increase mortality in long-term care (LTC) patients. National guidelines recommend the use of nonpharmacological interventions when possible for LTC residents with dementia. Nurses who work in a local LTC facility are not regularly trained in effective nonpharmacological interventions and lack the knowledge to provide care for patients with dementia. To provide safe and effective alternative interventions to antipsychotic medication use, nurses and direct care staff must have current, evidence-based education available to them about alternative practices. The purpose of this staff education project, guided by Calista Roy’s …

Decreasing Thirty-Day Readmissions For Heart Failure Patients, Willybroad Che

Walden Dissertations and Doctoral Studies

Heart failure (HF) patients have a 20-25% hospital readmission rate within the first month of discharge. Patients experiencing HF often have a decline in health resulting in frequent hospitalizations and encumbering symptoms including dyspnea, fluid retention, and orthopnea. HF is a common condition in nursing homes and accounts for a significant proportion of resident transfers to emergency departments. HF is considered one of the costliest diagnoses in the United States, estimated to cost the healthcare system billions of dollars annually. The purpose of this systematic review was to provide a synthesis of evidence-based literature on the current recommendations and strategies …

Barriers To Reporting Workplace Violence In Emergency Departments: A Systematic Review, Kari Gaston

Walden Dissertations and Doctoral Studies

Underreporting of workplace violence by emergency department (ED) nurses is a global practice concern. When workplace violence is not reported, the breadth of the issue is not reflected in the data, which is necessary to support legislative action, regulatory requirements, and organizational changes to prevent violence. The purpose of this systematic review of literature was to appraise and synthesize evidence regarding ED nurses’ barriers to reporting workplace violence. The practice-focused question addressed the barriers to reporting workplace violence according to emergency nurses. The theory of planned behavior was the theoretical framework for this project. Melnyk and Fineout-Overholt’s critical appraisal of …

Increasing Culturally Competent Care Of Lgbtq Patients By Providing Staff Education, Victoria Jacoby

Walden Dissertations and Doctoral Studies

The majority of health care professionals do not feel confident or competent to adequately care for a lesbian, gay, bisexual, transgender, and queer (LGBTQ) patient. Research has identified a link between poor preparedness of the provider/staff and poor patient outcomes. The purpose of this study was to evaluate the effectiveness of an in-person staff education module about providing culturally competent care to LGBTQ patients. The study focused on providers’ attitudes, preparedness, and confidence in caring for a LGBTQ patient. The Iowa and Kirkpatrick models were utilized to ground and evaluate the study. This study was a one-group pre- and posttest …

Development Of Practice Guidelines Based On Need-Driven Dementia-Compromised Behavior Model, Amy Marie Nolan

Walden Dissertations and Doctoral Studies

People with dementia, who experience cognitive decline, memory loss, and reasoning difficulties, often exhibit compromised behaviors such as agitation or aggressive behavior that impact negatively upon the person’s quality of life and increase safety risks. The purpose of this project was to develop an evidence-based clinical practice guideline (CPG) to improve the use of effective evidence-based interventions by staff in a skilled long-term care nursing facility to manage the compromised behavior of residents with dementia. The Need-Driven Behavioral Model, which suggests that compromised behaviors occur when patient attempts to accomplish a goal or express a need, provided the framework CPG …

Reducing Readmissions For Patients Hospitalized With Congestive Heart Failure, Morgan B. Morgan

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is the leading cause for readmission in hospitals and has a

high mortality and morbidity rate, with implications for hospitals and third-party payers.

Readmissions of patients with CHF are related to inadequate patient knowledge at

discharge, inadequate follow-up with a health care provider, and treatment regimen

nonadherence. Patients report feeling ill prepared to provide appropriate self-care during

the transition from inpatient hospital stay to the home setting. One strategy to assess the

patient's understanding following discharge education is through a process known as

teach-back. The purpose of this quality improvement initiative guided by Knowles's

theory was …

Nursing Faculties’ Perceptions Of Teaching Students Who Speak English As Second Language, Natalia S. Ruiz Muniz

Walden Dissertations and Doctoral Studies

Nursing students who speak English as a second language (ESL) often struggle due to language barriers, the complexity of the medical vocabulary, and the knowledge base that they must develop in a short time. These struggles may be due in part to the preparation of nursing educators to meet the specific needs of the ESL student population. The purpose of this qualitative research study was to develop a greater understanding of nurse educators' perceptions when teaching ESL nursing students. The conceptual framework used was Cummins' framework for the development of language proficiency. Four research questions guided this basic qualitative research …

Relationship Between Burnout And Academic Teaching Level Among Nursing Faculty, Erica Lynn Sciarra

Walden Dissertations and Doctoral Studies

Nursing faculty function as healthcare providers, educators, mentors, advisors, and researchers, which contributes to the development of emotional exhaustion or burnout due to role overload. Symptoms of burnout may vary among nursing faculty depending on academic teaching level, tenure status, and educational preparation and may influence the physical and psychological health of nursing faculty, potentially affecting work productivity, career longevity, and the number of future nurses educated. The purposes of this study, guided by Maslach’s multidimensional burnout theory and the job demands resources model, were to determine (a) if there was a difference in level of burnout between graduate and …

Associate Degree Nursing Graduates’ Experiences Of The Transition From Student To Nurse, Katherine Margaret Slusser

Walden Dissertations and Doctoral Studies

Attrition among newly graduated nurses remains a top concern among nursing leaders in the United States. Many published studies about new graduate nurses focus on bachelors-prepared nurses or on mixed populations of nurses that include both associate and baccalaureate degree graduates. No published studies were located that focused specifically on the Associate Degree Nursing (ADN) graduate. The purpose of this qualitative, interpretive phenomenological study was to understand the experiences of transition after graduation and into professional nursing of newly employed nurses who graduated from an ADN program. The theoretical basis for this study was Meleis’s transition theory. The research question …

Newly Licensed Registered Nurse Generation Cohorts And Retention In First Registered Nurse Positions, Elizabeth S. Gizenski

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to evaluate the association between newly licensed registered nurses (NLRN) generational cohorts and NLRN who plan to leave or have left their first nursing position. The research problem focused on the generational cohorts of NLRN and retention. The research questions addressed different generations of NLRN, their intent to stay in their first job, and whether poor orientation was a factor for those who already left their first nursing position. The theoretical foundation was Strauss–Howe’s generational theory explaining how each generation views the world based on what they experienced in their lifetime. Data retrieved …

Relationship Of Complementary Modes Of Agency In The Self-Management Of Diabetes, Andrew Romo

Walden Dissertations and Doctoral Studies

Effective control of type-2 diabetes mellitus (DM2) is essential for minimizing the likelihood of developing comorbidities that result from poor glycemic control. Extensive self-management considerations are required of people with DM because they must actively participate in their own care and engage with other socially-based sources of self-management support. The purposes of this quantitative study were to determine if there is an association between (a) the extent that the individual mode of human agency is employed and quality of diabetes control among adults who have been diagnosed with DM2 for at least one year and (b) the extent that the …

Exploring The Lived Experiences Of The Prelicensure Hispanic Nursing Student, Mary Valerie Santos

Walden Dissertations and Doctoral Studies

AbstractNursing constitutes the largest group of healthcare professionals in the United States. Despite decades of discussion about the need to diversify the nursing profession, there continues to be a significant lack of diversity, particularly in the number of Hispanic nurses. The purpose of this qualitative study was to explore the lived experiences of Hispanic nursing students who have enrolled in a pre-licensure nursing program using Leininger’s culture care theory as the theoretical framework for this phenomenological study. This study sought to explore the lived experiences of the prelicensure Hispanic nursing student attempting to complete nursing school successfully and what factors …

A Systematic Review Of Culturally Sensitive Strategies To Address Obesity Among Hispanic-American Pediatric Patients In The Primary Care Setting, Rachel Vurbeff

Walden Dissertations and Doctoral Studies

Obesity significantly increases morbidity and mortality, and its incidence amongHispanic-American children and adolescents exceeds that of any other ethnic group in the United States. Without proper intervention, these children and adolescents will experience the burden of costly comorbidities across the lifespan. Guided by Leininger’s theory of culture care diversity and universality, the purpose of this project was to identify evidence-based, culturally sensitive strategies to prevent and treat obesity among Hispanic-American pediatric patients in the primary care setting through a systematic review of the literature utilizing the Joanna Briggs Institute method. The practice-focused question that guided this review focused on finding …

Review Of A Remediation Program In An Associate Degree Nursing Program, Christopher Thomas Young

Walden Dissertations and Doctoral Studies

New nurse graduates must pass the National Council Licensure Examination (NCLEX) in order to achieve nursing licensure. In Northern New Mexico associate degree nursing program with a large disadvantaged student population, the average pass rate for the licensure exam often falls below the state board of nursing mandated 80% pass rate. This study's purpose was to evaluate the effect of an NCLEX remediation program on students' ability to pass the NCLEX, using Knowles adult learning theory to guide this work. The research questions investigated the relation between the remedial instruction and the 2 dependent variables KAPLAN predictor scores and NCLEX …

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 …

Review Of A Remediation Program In An Associate Degree Nursing Program, Christopher Thomas Young

Walden Dissertations and Doctoral Studies

New nurse graduates must pass the National Council Licensure Examination (NCLEX) in order to achieve nursing licensure. In Northern New Mexico associate degree nursing program with a large disadvantaged student population, the average pass rate for the licensure exam often falls below the state board of nursing mandated 80% pass rate. This study's purpose was to evaluate the effect of an NCLEX remediation program on students' ability to pass the NCLEX, using Knowles adult learning theory to guide this work. The research questions investigated the relation between the remedial instruction and the 2 dependent variables KAPLAN predictor scores and NCLEX …

Nurse Practitioner-Led Education Program For Heart Failure Patients, Shay Felecia Clarke

Walden Dissertations and Doctoral Studies

Heart failure (HF) affects 5.7 million Americans and continues to be a leading cause of hospitalizations and deaths in the United States, posing an enormous burden on patients, families, and the health care system. Readmission rates for HF within 30 days post hospital discharge at small rural acute care facility in the southeast are consistently higher than the national average. The gap in nursing practice was the lack of up to date patient education postdischarge guidelines on HF for the socioeconomically disadvantaged, culturally diverse patient population located in this small rural town. The purpose of this project was to use …

A Provider Education Program Addressing Barriers To Diabetic Patients’ Self-Care, Henrietta O. Emokidi

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among American Indian/Alaskan Natives and the 7th leading cause of death in the United States. Type 2 diabetes (T2DM) affects 9% of the U.S. population and costs the United States an estimated $245 billion annually. The purpose of this project was to identify patients’ concerns related to their disease and to develop an education program for providers to address these concerns. The project was framed using Orem’s theory of self-care and the middle-range theory of self-care of chronic illness. Five providers in an underserved clinic in Alaska conducted assessments during a primary care …

Decreasing Hiv Stigmatization For Care Of Young Men Of Color Who Have Sex With Men, Alethea Arnett Miller

Walden Dissertations and Doctoral Studies

HIV-related stigma from healthcare provider attitudes, beliefs, perceptions, or misconceptions has been a barrier to healthcare delivery. This project was conducted to examine whether an HIV-related stigma education provided to healthcare clinic staff with a focus on advance practice registered nurses can improve knowledge and empathy toward young men of color who have sex with men (MSM), which can lead to improved overall quality of healthcare through increased health behaviors and retention in care. An educational intervention was conducted utilizing a blended-learning environment focused on social cognitive theory to influence social behavior change among healthcare professionals, increasing their exposure, knowledge, …

Effect Of Bundled Interventions By Patient Type To Reduce Falls, Celia Nurse

Walden Dissertations and Doctoral Studies

Despite consistent efforts in the healthcare field, 700,000 to 1 million patients fall in hospitals each year. There is a gap in the literature regarding identification of optimal bundles of fall prevention interventions (FPIs) for patients by type, and though patients of all ages fall in hospitals, older adults fall more, which may mean that the influence of FPIs may differ for patients by age. The purpose of this descriptive, retrospective, quantitative secondary data analysis study, guided by Virginia Henderson’s need theory, was to examine the differences in the influence of bundled FPIs in reducing the number of falls (NOF) …