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Articles 1651 - 1680 of 2632

Full-Text Articles in Nursing

Perceptions Of Caregivers Following Diagnosis Of Primary Benign Brain Tumor, Lisa Ann Richards Homa Jan 2019

Perceptions Of Caregivers Following Diagnosis Of Primary Benign Brain Tumor, Lisa Ann Richards Homa

Walden Dissertations and Doctoral Studies

A brain tumor diagnosis is traumatic and has a devastating impact upon the caregiver and the family unit. The effects of the tumor growth and treatment often cause significant neurologic injury and dramatically affect the quality of life (QOL) for the patient and their entire family unit. Caregivers are constantly challenged to provide care, yet they feel untrained and underprepared as they struggle to adjust to new roles and responsibilities. The purpose of this study is to gain an understanding of the lived experiences of caregivers of individuals with primary benign brain tumor (PBBT). An interpretive phenomenological analysis approach was …

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Implementing Esi Education Project For Nurses In The Triage Process, Narissara L. Tran Jan 2019

Implementing Esi Education Project For Nurses In The Triage Process, Narissara L. Tran

Walden Dissertations and Doctoral Studies

Triage nursing assessment supports nursing professionals in delivering safe and effective patient care in emergency departments. This staff education project was driven by an observation of inconsistencies in triage among emergency department (ED) nursing staff. The purpose of the project was to improve the triage assessment knowledge of ED nurses. Specifically, the aim was to determine if educating ED nursing staff about using the Emergency Severity Index (ESI), a 5-level triage algorithm and a previously developed tool, would improve nurse knowledge in the triage process. Following discussion with the ED nursing manager at a hospital, a presentation on the ESI …

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Policy Knowledge Communication In Nursing, Curtiss John Vavra Jan 2019

Policy Knowledge Communication In Nursing, Curtiss John Vavra

Walden Dissertations and Doctoral Studies

Evidence-based practices in nursing improve patient outcomes, decrease healthcare costs, and can be implemented with policies and procedures. However, there is limited literature describing how nurses acquire policy knowledge, the dissemination of which may require a significant investment of resources by a hospital. The purpose of this study was to learn more about how nurses obtain policy knowledge. Rogers's diffusion of innovations theory guided the examination of communication channels and how they relate to the formation of policy knowledge. The research questions were designed to gather information on the relationship of policy communication channels, demographic factors, and the frequency of …

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Reducing Antipsychotic Medication Use In Long-Term Care Settings, Martha Ofeibea Agbeli Jan 2019

Reducing Antipsychotic Medication Use In Long-Term Care Settings, Martha Ofeibea Agbeli

Walden Dissertations and Doctoral Studies

The prescription rate of antipsychotics in patients with dementia varies between 20% and 50% for the common and troubling neuropsychiatric symptoms experienced by patients with dementia. The use of these antipsychotic medications has been linked with increased risk of morbidity and mortality due to associated Parkinsonism, over sedation, gait disturbances, cognitive decline, and cardiovascular adverse events. The purpose of this project was to assess whether development of an evidence-based clinical practice guideline (CPG) for a long-term care facility would increase awareness about issues that govern the safe use of antipsychotic medications. The conceptual framework for the project was Watson's model …

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Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena White Jones Jan 2019

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena White Jones

Walden Dissertations and Doctoral Studies

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …

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Using A Pediatric Early Warning Score Algorithm For Activating A Rapid Response Team, Ruthann Kosick Jan 2019

Using A Pediatric Early Warning Score Algorithm For Activating A Rapid Response Team, Ruthann Kosick

Walden Dissertations and Doctoral Studies

The nursing culture of an inpatient pediatric unit was resistant to activating pediatric rapid response team (PRRT) alerts despite guidelines for activation. Nurses routinely assessed patients and assigned a pediatric early warning score (PEWS); however, the level of illness severity was not interpreted consistently among nurses and a PEWS action algorithm did not exist to guide nurses' minimal actions based on the PEWS score. Guided by 3 adult learning theories (Knowles, Kolb, and Bandura) and 1 evaluation model (Kirkpatrick), this staff education project sought to educate pediatric nurses on a PEWS action algorithm and determine whether this project improved nurses' …

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Increased Patient Portal Usage Following An Educational Intervention, Renee Lynn Robinson Jan 2019

Increased Patient Portal Usage Following An Educational Intervention, Renee Lynn Robinson

Walden Dissertations and Doctoral Studies

The patient portal, a Health Information Technology (HIT) tool, was created to help patients become engaged with their health and health information to improve health outcomes. The practice problem was the low patient portal use and lack of nurses' knowledge of patient HIT tools at an urban ambulatory clinic in the northeastern United States. The practice-focused question explored whether an educational intervention with the care coordination team (CCT) would increase prescription refill requests and facilitate patient-provider communications via the patient portal. The 2 frameworks used for the project were Knowles's adult learning theory and Lewin's theory of change. The preintervention …

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An Evidence-Based Clinical Guideline To Improve Pediatric Asthma Outcomes, Andrew Wesolowski Jan 2019

An Evidence-Based Clinical Guideline To Improve Pediatric Asthma Outcomes, Andrew Wesolowski

Walden Dissertations and Doctoral Studies

Asthma is a disease that compromises the airways of the respiratory system, and is a prominent reason for hospitalization and emergency care needs. Over 6.1 million children are estimated to suffer from asthma. Asthmatic patients at an urban pediatric hospital emergency department (ED) were found to have higher revisit rates than the national average for large urban hospitals. The lack of a clinical guideline for educating families in patient care management at home could have contributed to readmission rates. The purpose of this project was to develop an evidence-based pediatric asthma education clinical guideline to aide healthcare providers with discharge …

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Undergraduate Nurse Educator Perceptions Of Preparation To Teach Interprofessional Collaboration, Tamara Powell Berghout Jan 2019

Undergraduate Nurse Educator Perceptions Of Preparation To Teach Interprofessional Collaboration, Tamara Powell Berghout

Walden Dissertations and Doctoral Studies

If nurse educators do not teach students to function in interprofessional teams, students may lack communication and teamwork skills, which can result in patient harm; however, nurse educators do not always understand the concept of interprofessional collaboration (IPC) and may, therefore, fail to teach it to students. The purpose of this multiple case study was to understand how undergraduate nurse educators prepared to teach IPC and how their preparation informed their teaching. The theory of transformative learning and the Interprofessional Education Collaborative core competencies of IPC framed this study. Data included semistructured interviews and associated documents from 9 nurse educators …

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Development Of A Bundle For Hemodialysis Infection Control, Lora Susan Lewis Jan 2019

Development Of A Bundle For Hemodialysis Infection Control, Lora Susan Lewis

Walden Dissertations and Doctoral Studies

Hemodialysis patients are at high risk of acquiring a blood stream infection (BSI), the second leading cause of death in this population. The purpose of this project was to create a clinical practice guideline (CPG) based on current evidence-based practice (EBP) that would bring a cohesiveness to the policies and provide an auditing tool to monitor infection control practices. Current literature supports the bundle approach, a small set of EBPs combined as a group of recommended interventions that apply to a specific patient population with the goal of improved delivery of care. The hemodialysis bundle project incorporated the theory of …

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Physical Activity And Dietary Interventions For Adolescent African Americans In Mississippi, Tanga Deson Hart Robinson Jan 2019

Physical Activity And Dietary Interventions For Adolescent African Americans In Mississippi, Tanga Deson Hart Robinson

Walden Dissertations and Doctoral Studies

African American (AA) adolescents have higher rates of obesity than many other ethnic groups, which increases their risk for obesity-related diseases. Culturally sensitive obesity preventive interventions have been unsuccessful, resulting in a steady increase of obesity among AA adolescents. AA adolescents in the southern region of the United States are at a higher risk for obesity and physical inactivity; knowledge and understanding of causative factors remains limited. To identify the impact of programs, a systematic review of the literature focused on structured physical activity and/or dietary education interventions in Mississippi. The ecological framework was used to guide this study. The …

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Nursing Knowledge On Pressure Injury Prevention In The Intensive Care Unit, Yanick Jacob Jan 2019

Nursing Knowledge On Pressure Injury Prevention In The Intensive Care Unit, Yanick Jacob

Walden Dissertations and Doctoral Studies

Over 60,000 hospital patients die each year from complications associated with hospital-acquired pressure injuries (HAPIs). Pressure-injury rates have increased by 2% within the past decade as life expectancy has also increased due to high cost in Medicare. Evidence shows that the incidence of pressure injuries (PIs) in healthcare facilities is increasing, with high rates of occurrence in intensive care units (ICUs). At the clinical site for which this project was developed, multiple in-services had been provided to staff regarding PIs, but uncertainty persisted about how knowledgeable the nurses were. This project, using the Academic Center for Evidence Star Model of …

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Basic Quality Care Blood Pressure Teaching Plan, Dorine A. Lynch Jan 2019

Basic Quality Care Blood Pressure Teaching Plan, Dorine A. Lynch

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is a leading risk factor for cardiovascular disease complications, disability, and mortality. Delayed detection of HTN increases the risk of the patient developing heart disease, renal failure, and stroke, which are among the leading causes of death in the US. Educating healthcare providers is, therefore, necessary to ensure accuracy when measuring blood pressure (BP) to improve the likelihood of early detection and commencement of treatment. The BP teaching project involved the development of an evidence-based teaching program to educate nurses at an East Coast Veterans' Administration Center on the guidelines of measuring BP. The practice-focused question addressed whether …

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A Staff Education Module For Depression Screening In Acute Care, Olufumilayo Sayo Onuoha Jan 2019

A Staff Education Module For Depression Screening In Acute Care, Olufumilayo Sayo Onuoha

Walden Dissertations and Doctoral Studies

Depression is one of the most common mental health disorders in the United States. Although it can be treated, it may go unidentified for a long period of time. The World Health Organization (WHO) anticipates that, by 2020, depression will become responsible for more disabilities than a combination of other conditions, excluding heart conditions. The prevalence of depression among the general population is higher in patients who seek emergency healthcare services. The purpose of this project is to develop an evidence-based educational module for nurses to screen for depression in an acute care setting using the PHQ-2 and PHQ-9 depression …

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Clinical Resource Practice Scenarios To Mitigate Bullying, Sabrina Renea Brown - Oliver Jan 2019

Clinical Resource Practice Scenarios To Mitigate Bullying, Sabrina Renea Brown - Oliver

Walden Dissertations and Doctoral Studies

Workplace bullying is repeated, aggressive action towards a victim, which especially affects new graduate nurses and can inhibit growth and lead to nursing burnout and staff turnover. The purpose of this Doctor of Nursing Practice project was to develop a clinical resource educational module. The case scenarios were developed using literature on workplace bullying and lateral violence. Clegg's circuits of power theory was applied to frame the organizational authoritative nursing power struggles that exist as a circular flow between different nursing group members, and the American Nurses Association (ANA) Practice Standards and Code of Ethics guided the assertive communication. The …

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Preventing Acute Myocardial Infarction Readmission Rates, Sherin Abraham Jan 2019

Preventing Acute Myocardial Infarction Readmission Rates, Sherin Abraham

Walden Dissertations and Doctoral Studies

Unplanned readmissions to the hospital are a problem faced by most health care organizations in the United States; hospitals are penalized for such readmissions. The project site identified high readmission rates for patients who were discharged after acute myocardial infarction (AMI), making careful transition home a necessity for post-AMI patients. The focus of this quality improvement (QI) project was implementation of an early follow-up appointment of AMI patients following discharge. The purpose of this project was to evaluate the effectiveness of changing follow-up appointments for patients with an AMI from 14-30 days to 7-14 days post discharge to reduce unplanned …

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Impact Of A Healthcare Workplace Violence Prevention Module On Staff Knowledge, Michelle Leigh Arroyo Jan 2019

Impact Of A Healthcare Workplace Violence Prevention Module On Staff Knowledge, Michelle Leigh Arroyo

Walden Dissertations and Doctoral Studies

The healthcare sector experiences violence 4 times as much as any other civilian domain, including law enforcement and corrections facilities. The clinical practice problem addressed in this project was the lack of adequate healthcare workplace violence (HWV) prevention in a not-for-profit community hospital. The purpose of this project increase awareness of HWV prevention through the use of an education module. Rogers’ diffusion of innovation model served as the foundation for analysis of scores from pre- and posteducation tests. The practice-focused question asked if a module on HWV prevention based on current clinical practice guidelines and peer-reviewed literature would improve staff …

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Multidisciplinary Simulation Training To Improve Nursing Knowledge Of Intraoperative Malignant Hyperthermia, Heather Burrell Jan 2019

Multidisciplinary Simulation Training To Improve Nursing Knowledge Of Intraoperative Malignant Hyperthermia, Heather Burrell

Walden Dissertations and Doctoral Studies

Malignant hyperthermia (MH) is a rare but severe reaction that can occur in the operating room. Due to the low volume of these reactions, nurses are often unprepared to handle the event; however, not recognizing the event and intervening can lead to the death of the patient. This is a practice problem that can be addressed through a nursing staff education simulation training program. The purpose for this doctoral project was to develop a multidisciplinary MH simulation program that could improve nursing knowledge when caring for patients experiencing an MH crisis in the operating room. The practice-focused question for this …

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Screening For Depression During The Early Perinatal Period, Loretta Ann Donnelly-Moreno Jan 2019

Screening For Depression During The Early Perinatal Period, Loretta Ann Donnelly-Moreno

Walden Dissertations and Doctoral Studies

The clinical practice guideline (CPG) is the implementation of a depression screening tool to be used in the early perinatal period. The practice change occurred in a rural Obstetrical and Gynecological (OBGYN) practice in the southern United States. The CPG change has been guided by recommendations from both the American Congress of Obstetrics and Gynecology and the American College of Nurse Midwives. Implementation of this CPG change addresses the gap in practice of not doing depression screening during the perinatal period, and only screening during the postpartum period, which was being done at the OBGYN office. Theorist Lewin’s ‘change theory’ …

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Development Of Nursing Staff Education For Central Line Maintenance, Doreen Lynn Farley Jan 2019

Development Of Nursing Staff Education For Central Line Maintenance, Doreen Lynn Farley

Walden Dissertations and Doctoral Studies

Patients with cancer who receive bone marrow transplants (BMT) are at increased risk for central line-associated blood stream infections (CLABSI), a serious complication leading to increased costs, length of stay, and even death. Recognition of an increased CLABSI rate at one BMT unit in the southwestern United States prompted development of an evidence-based staff development education program to improve nurses’ knowledge of central line maintenance and CLABSI prevention practices. Guided by Lewin change theory, the program was developed based on a nurse-led analysis and synthesis of the evidence, and a formative evaluation of the educational program conducted by a 3-member …

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A Urinary Catheter Insertion And Care Program For Reducing Catheter-Related Infections, Rodney R. Hauch Jan 2019

A Urinary Catheter Insertion And Care Program For Reducing Catheter-Related Infections, Rodney R. Hauch

Walden Dissertations and Doctoral Studies

Many inpatients in U.S. hospitals acquire an hospital-acquired infection (HAI), the majority of which can be attributed to an indwelling urinary catheter. The use of urinary catheters is a common practice within the acute care setting although the placement comes with risk. Improper catheter placement or a lack of care and maintenance can increase patient morbidity and mortality, as well as increase financial strain for the hospital. The purpose of this quality improvement (QI) evaluation was to determine if using a safety checklist and a 2-person urinary indwelling catheter-insertion team would reduce the rate of catheter-associated urinary tract infections (CAUTIs). …

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Reducing Falls In The Vulnerable Elderly: Implementing An Inpatient Fall Prevention Program, Bibi Farida Khan Jan 2019

Reducing Falls In The Vulnerable Elderly: Implementing An Inpatient Fall Prevention Program, Bibi Farida Khan

Walden Dissertations and Doctoral Studies

Inpatient falls are a leading cause of fatal and serious injuries among hospitalized elderly patients, often with devastating consequences. This quality improvement project was conducted on a geriatric unit in a large southeastern U. S. hospital, following recognition of an increase in the number of falls with several sustained injuries. After an analysis of the previous fall prevention strategies, a panel of stakeholders who formed a falls prevention committee determined that implementing an evidence-based fall risk assessment tool to help identify risk factors, as well as implementing interventions to address those risk factors, would make fall prevention more patient specific …

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Effects Of Teach-Back On Children’S Treatment In Parents With Low Health Literacy, Marion Ines Kopulos Jan 2019

Effects Of Teach-Back On Children’S Treatment In Parents With Low Health Literacy, Marion Ines Kopulos

Walden Dissertations and Doctoral Studies

Health literacy (HL) skills are necessary to understand the context of medical information provided to patients in all settings including the emergency room. People with low health literacy (LHL) have difficulty comprehending and implementing basic tasks such as understanding medication administration. The purpose of this quasi-experimental study guided by Orem’s self-care theory was to determine the effect of using the teach-back method for discharge instructions compared to standard written instructions based on parents’ learning style and HL skills assessed during their visit to the emergency room. The Newest Vital Sign (NVS) tool was reworded to assess the parents’ HL. A …

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Relationship Between Post-Resuscitation Debriefings And Perceptions Of Teamwork In Emergency Department Nurses, Kerri Lyman Jan 2019

Relationship Between Post-Resuscitation Debriefings And Perceptions Of Teamwork In Emergency Department Nurses, Kerri Lyman

Walden Dissertations and Doctoral Studies

Emergency department nurses are faced with traumatic patient events while functioning as members of multidisciplinary teams. Critical incident debriefing has been shown to benefit health care professionals and patient clinical outcomes. The purpose of this quantitative correlational study was to examine the relationship between the use of formal post-resuscitation debriefings and perceptions of teamwork in emergency department nurses. The study also addressed the type and timing of debriefing to determine whether these factors impacted perceptions of teamwork. The nurse as wounded healer theory served as the theoretical framework. Data from the Nursing Teamwork Survey were collected from 68 emergency department …

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Development Of A Tele-Healthcare Clinical Practice Guideline For Diabetic Patients, Kathy J. Montgomery Jan 2019

Development Of A Tele-Healthcare Clinical Practice Guideline For Diabetic Patients, Kathy J. Montgomery

Walden Dissertations and Doctoral Studies

Lack of access to healthcare in rural communities has resulted in increased morbidity and mortality rates among diabetic patients. The problem identified in this project was the lack of access to healthcare among diabetic patients living in rural southeast Ohio. Tele-healthcare is a strategy that provides healthcare remotely and has been introduced into the rural setting and offers an appropriate healthcare delivery mode for the rural community. The purpose of the project was to develop a tele-healthcare clinical practice guideline, including smart phone applications, for the management of diabetic patients. An expert panel consisting of 2 advanced practice nurses in …

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Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse Jan 2019

Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse

Walden Dissertations and Doctoral Studies

High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …

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Destination Arrival And Discharge Unit To Improve Patient Flow, Shelia Celeste Jeter Jan 2019

Destination Arrival And Discharge Unit To Improve Patient Flow, Shelia Celeste Jeter

Walden Dissertations and Doctoral Studies

The increase in patients presenting to the emergency department (ED) for primary care poses a serious safety issue in the care that can be provided. In a care area that is overcrowded, physicians, nurses, ancillary department staff, and other care team members may have a difficult time delivering care. Poorly managed flow in the ED leads to overcrowding, and patients with life-threatening illnesses are less likely to be transitioned to designated specialized areas in a safe and efficient manner. The practice-focused question was whether processes to improve the flow of patients entering the ED decreased the number of patients leaving …

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A Practice Guideline For Triaging Mental Health Patients In The Emergency Setting, Florence Nguh Jan 2019

A Practice Guideline For Triaging Mental Health Patients In The Emergency Setting, Florence Nguh

Walden Dissertations and Doctoral Studies

Today's emergency departments (EDs) are challenged with increasing numbers of patients with behavioral health (BH) issues and associated management problems. Patients presenting in the ED are increasingly in need of BH services due to a lack of available services in the community. The implication is that ED staff are faced with conducting a comprehensive review of their systems and processes for BH care delivery to ensure that the needs of this population are safely met. Specifically, this DNP project addressed the lack of evidence-based screening tools for the ED triage area for patients with BH issues. The purpose was to …

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A Systematic Review Of Nurse Staffing Models, Elizabeth Ndidi Ubochi Jan 2019

A Systematic Review Of Nurse Staffing Models, Elizabeth Ndidi Ubochi

Walden Dissertations and Doctoral Studies

Appropriate nurse staffing is essential to the delivery of high-quality patient care. Nursing leadership identifies nurse staffing model as an evidence-based staffing model following problems with nursing staff retention on 4 acute care units in a recently opened hospital. The linkage model guided the review of evidence on nurse staffing models and the relationship to nurse job satisfaction and nurse retention and to explore strategies that could lead to recommendations to nursing leadership. The 466 articles found were reduced to 7 articles, 2 at Level 1 (systematic review), 4 at Level VI (quantitative descriptive), and 1 at Level VII (expert …

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Direct Care Staffs’ Experiences And Perceptions Of Person-Centered Care Training, Jennifer Miranda Strollo Jan 2019

Direct Care Staffs’ Experiences And Perceptions Of Person-Centered Care Training, Jennifer Miranda Strollo

Walden Dissertations and Doctoral Studies

Many long-term care (LTC) facilities within the United States have replaced the institutional model of care with one that accepts person-centered care (PCC) as the guiding standard of practice. Quality training ensures that direct care staff have the skills and the knowledge in the delivery of quality PCC. However, many nurses and nursing assistants have expressed the desire for further training in PCC practices to effectively deliver quality care. The purpose of this study was to explore the types and length of training and education provided based on the perceptions and experiences of direct care staff related to their implementation …

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