Nursing Commons^™

Guideline Development For An Adjunct Faculty Orientation In Prelicensure Nursing Programs, Pamela Ann Nehring

Walden Dissertations and Doctoral Studies

A research study conducted by the National Council of State Boards of Nursing noted adjunct faculty educators have significant learning requirements and that nursing education throughout the United States has not met the basic needs of novice adjunct faculty educators. Adjunct faculty at a local community college noted a deficit in the orientation process for new clinical faculty. The purpose of this quality improvement project was to develop a guideline for new clinical faculty orientation. The sources of evidence were a literature review and a survey using the Delphi process with an expert panel comprising a group of 7 interested …

Impact Of A Formal Mentorship Program On Frontline Nurse Managers, Tonya Ranee Roth

Walden Dissertations and Doctoral Studies

There are numerous factors that influence a nurse manager's job satisfaction and intention to remain in a job. The purpose of this project was to evaluate whether a formal mentorship program for nurse managers impacted job satisfaction and intention to remain in a job. A pilot program was developed and 15 nurse managers from 2 hospitals in the Pacific Northwest participated in a 6-month mentorship program. The program was guided by mentorship enactment theory and Kouzes and Posner's exemplary leadership framework. Using the Leadership Profile Inventory (LPI) and the Nurse Manager Practice Environment Scale (NMPES), job satisfaction, intention to stay …

Work Engagement, Job Satisfaction, And Nurse Turnover Intention, Yolanda Marie Edwards-Dandridge

Walden Dissertations and Doctoral Studies

In the United States, the high turnover rate of registered nurses and indications of a future shortage of registered nurses is detrimental to healthcare organizations. The purpose of this correlational study was to examine whether, in hospitals, work engagement and job satisfaction predicted registered nurse turnover intention. The theoretical framework was Fishbein and Ajzen's theory of reasoned action. Probability sampling was used to identify 155 participants, all full-time registered nurses with 2 or more years of employment in New York hospitals. Data, obtained from surveys, were analyzed via multiple linear regression. The results revealed that only job satisfaction predicted turnover …

Barriers To Timely Activation Of Rapid Response Teams, Lajuanah Jean Herdrich

Walden Dissertations and Doctoral Studies

Timely activation of the rapid response team (RRT) depends on the nurse's willingness

and ability to make a rapid decision. The practice-focused questions for this DNP project

sought to identify barriers that contribute to delays in activating the RRT when needed in

medical-surgical patients. The self-efficacy theory was the guiding theory and was used

to examine self-confidence and performance along with Donabedian's health care model.

Qualitative data were obtained through focus groups and identified 2 prominent thematic

barriers among nurses with less than 3 years' experience: a lack of self-confidence and

the of lack of knowledge and experience. Results of …

Accelerated Online And Hybrid Rn-To-Bsn Programs: A Predictive Retention Algorithm, Melissa Knight

Walden Dissertations and Doctoral Studies

Predicting retention and time to graduation within accelerated online and a hybrid RN-to-BSN programs are significant elements in leveraging the pipeline of qualified RNs with BSN degrees, but the literature lacks significant accounts of retention and time to graduation outcomes within these programs and predictive algorithm developments to offset high attrition rates. The purpose of this study was to quantitatively examine the relationships between pre-entry attributes, academic integration, and institutional characteristics on retention and time to graduation within accelerated online RN-to-BSN programs in order to begin developing a global predictive retention algorithm. This study was guided by Tinto's theories of …

Clinical Nursing Faculty Competency, Christine Lee Kalt

Walden Dissertations and Doctoral Studies

Nursing faculty are responsible for graduating competent students and being competent themselves; however, the required competencies of clinical nursing faculty who instruct students in the clinical area are unidentified. The practice problem addressed in this project was the lack of a structured, organized process for identifying initial and ongoing competencies of a clinical nursing facility. The purpose of this project was to explore nursing faculty clinical competency and provide a multimethod, multispecialty approach for implementing clinical nursing faculty competency. The target population was clinical nursing faculty (n= 30) in an academic setting. This project explored the impact of a multimethod, …

Effects Of High-Fidelity Simulation On The Critical Thinking Skills Of Baccalaureate Nursing Students, Janine Roth Blakeslee

Walden Dissertations and Doctoral Studies

This project study addressed the decline in successful passing rates for the National Licensure Exam for Registered Nurses (NCLEX-RN) in a nursing program at a private university in the Midwestern United States. There is support from the literature for a connection between critical thinking skills of nursing students and successful passing of the NCLEX-RN. The purpose of this quantitative study was to examine whether significant differences existed in mean critical thinking skill scores across time within groups (pretest to posttest) and between groups (simulation versus written case studies), as measured by the Health Science Reasoning Test. Cognitive learning theory as …

A Systematic Review Of The Effectiveness Of The Nln Jeffries Simulation Framework, Angela Feeler

Walden Dissertations and Doctoral Studies

Simulation theoretical frameworks serve as guidelines for the development, planning, implementation, and evaluation phases during nursing simulation activities. Simulation frameworks provide a substantive foundation for research, education, and practices that contribute to the science of nursing education. The purpose of this systematic literature review was to evaluate and synthesize evidence-based research that can be used to recommend the National League for Nursing (NLN) simulation education framework for simulation activities. The Academic Center for Evidence-Based Practice star model of knowledge transformation and descriptive theory were used as frameworks to guide this systematic literature review. The practice question for this systematic literature …

Incorporation Of The Caring Moment In Scripting, Anita E. Barker

Walden Dissertations and Doctoral Studies

A large healthcare system in Texas mandated scripting as way to improve patient satisfaction. The purpose of this project was to incorporate a caring moment into scripting by the nursing staff to improve patient satisfaction. The project was guided by Watson's caring theory, the adult learning theory, and Lewin's planned change theory. All 35 nurses from the primary care and specialty care outpatient clinics of the Texas healthcare system participated in a staff development training to learn how to incorporate a caring moment into their script. Of these 35 nurses, 13 (37%) chose to complete the pre-education and postproject surveys. …

Staff Education Project Using The Stop Elderly Accidents Deaths And Injuries (Steadi) Toolkit, Carla Fisher

Walden Dissertations and Doctoral Studies

Falls are a major public health concern and contribute significantly to mortality and morbidity in the older adult population. Each year, approximately 3 million older adults are treated in emergency departments for fall-related injuries and at least 300,000 older people are hospitalized for hip fractures. The purpose of this project was to improve the participants' knowledge and highlight interventions to reduce the incidence of falls and injuries as a result of falls. The project was developed using the Stop Accidents, Deaths and Injuries (STEADI) toolkit, the Iowa model of evidence-based practice to promote quality of care, and the Lewin's change …

Evaluating An Educational Initiative For Postsurgical Vascular Patients, Cynthia Ann Gillespie

Walden Dissertations and Doctoral Studies

The educational medium GetWellNetWork (GWNW) in a large magnet teaching facility offered few educational videos specific to vascular patients with a focus on leg elevation after lower extremity bypass surgery. Supplying patient-specific education has the potential for providing cost-effective nursing care to vascular patients and improving hospital reimbursement. Guided by the interactive care model, a storyboard was developed using best-practice evidence for vascular postoperative patients that could lead to the development of a video to address the educational needs of vascular patients upon discharge. The practice focused question asked if a video addressing the importance of leg elevation would improve …

Exploring Education Needs For Heart Failure Patients' Transition Of Care To Home, Michelle D. Williams

Walden Dissertations and Doctoral Studies

Transitions of care is a model designed to ensure that patients have resources needed to assist them to care for themselves at home after hospital discharge, which helps to decrease preventable adverse events. For people with heart failure (HF) to transition home from the hospital successfully, specific education is needed that is individualized to the disease process, but most patients' educational needs after discharge are unmet. The purpose of this qualitative study, guided by the Meleis middle range theory of transition, was to explore the perspectives of people with HF about their educational needs in order to gather data that …

An Educational Program For Primary Nursing, Marsha-Gail Mcdonald

Walden Dissertations and Doctoral Studies

To increase continuity of care and reduce clinical errors, management in an inpatient rehabilitation unit of a private, nonprofit hospital chose to change the care delivery model to primary nursing; unit nurses had inadequate understanding of primary nursing, creating a gap in practice. The purpose of this project was to develop an educational program on primary nursing to address the question of how education on primary nursing would impact the understanding of the model among the nurses in the patient rehabilitation unit of the project site. Rogers's diffusion of innovation model provided a framework for developing the educational program. The …

Nursing Staff Education For Heart Failure Disease Management, Kerri Murphy

Walden Dissertations and Doctoral Studies

Heart failure (HF) has a global significance for the older population and is the most common reason for hospitalization. Patients with HF can reduce their risk for hospital readmissions and adverse outcomes through self-management of their disease. Nurses are responsible for educating patients about HF self-management; however, nurses at the project site lacked sufficient understanding and confidence to perform adequate HF patient education, creating a gap in practice. This project was guided by Pender's health promotion model and adult learning theory with the goal to increase nurses' knowledge and confidence with the self-management principles of HF. The purpose of this …

Reducing Central Line-Associated Bloodstream Infections, Alexis Genarrian Whitfield

Walden Dissertations and Doctoral Studies

Central line-associated bloodstream infection (CLABSI) at the local healthcare setting exceeded the benchmark of 0 CLABSI. The Infection Prevention and Control (IPC) department determined that a role as CLABSI nurse champion would address the problem; however, no comprehensive education on CLABSI prevention and maintenance was available at the site. The purpose of this project was to develop a CLABSI prevention and maintenance education module using Knowles's adult learning theory and the chain of infection model. The practice-focused question asked whether a CLABSI educational module would provide the necessary information to educate nurse champions on CLABSI prevention and maintenance. The education …

Predicting Risk For Opioid-Induced Sedation And Respiratory Depression In Hospitalized Patients, Alison Partridge

Walden Dissertations and Doctoral Studies

Pain assessment and management is a fundamental part of nursing care. Opioids are 1 of the interventions utilized to manage pain within the hospital setting and have a known adverse effect called opioid-induced sedation and respiratory depression (OSRD). The purpose of this quantitative study was to create a prediction model with the known risk factors present on admission, to determine how well they predict OSRD. This served as a first step in the creation of a risk screen tool, supported by the cognitive continuum theory, in understanding the judgment and decision-making process to provide safe care. The combination of factors …

Instructional Methods And Attitudes Among Nursing Faculty Related To Students With Disabilities, Melissa Anne Radecki

Walden Dissertations and Doctoral Studies

Nurse educators are tasked with preparing safe, competent nurses but are faced with unique challenges in helping students with disabilities. Students with learning disabilities require accommodations which are alterations or adjustments within the learning environment and are developed by the instructor. The purpose of this 3-manuscript dissertation, guided by the universal design for instruction (UDI), was to explore the attitudes and instructional methods used among nursing faculty related to teaching students with learning disabilities. Three research questions were framed as parallel studies to address the gap in understanding how faculty view nursing students with disabilities, how clinical specialty influences faculty's …

Improving Nurse Well-Being Through A Mindfulness-Based Education Strategy, Sandra Dearholt

Walden Dissertations and Doctoral Studies

Abstract

An estimated 33% to 54% of hospital nurses exhibit signs of emotional stress and

decreased well-being, which is associated with a negative impact on nurses’ health, job

performance, patient care outcomes, and healthcare cost. This project sought to improve

nurse well-being by providing nurses with education on mindfulness-based practices.

The practice question addressed whether implementing a mindfulness-based education

strategy for nurses improved nurse well-being. Three models informed this project: the

health promotion model, the andragogical model, and Kirkpatrick’s 4 levels of training

evaluation. Sources of evidence included the Maslach Burnout Inventory (MBI) and a

knowledge assessment administered to 10 …

Civility Promotion Actions And Decisions Of Prelicensure Baccalaureate Nurse Faculty, Brooke Stelle Russo

Walden Dissertations and Doctoral Studies

Acts of incivility in nursing education and practice settings are a growing concern. Previous research has indicated that uncivil behaviors, especially among nurses in the healthcare workplace, create toxic work environments and pose risks to patient safety. Uncivil behaviors among nurse educators and students were found to erode the learning environment and lead to poor program outcomes. Researchers provided evidence to show varied levels of incivility in academic and workplace environments and recommended solutions to improve civility, yet little evidence exists to show how nurse faculty approach civility promotion in their practices. This qualitative, descriptive study was designed to explore …

Developing A Preceptor Training Program For Registered Nurses In A Teaching Hospital, Persephone Annis Munnings

Walden Dissertations and Doctoral Studies

In a report on the nursing shortage, the American Association of Colleges of Nursing cited insufficient preceptors as one of the factors influencing the decreased intake of nursing students to registered nurse (RN) programs, thus compounding the shortage issue. The site selected for this project was a teaching hospital that annually facilitates hundreds of nursing students for clinical practice. Graduate nurses rotating through the hospital are assigned to work with RNs within their assigned units. The purpose of this doctoral project was to develop a preceptor training program for RNs in a teaching hospital. The practice-focused question examined whether RNs …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey

Walden Dissertations and Doctoral Studies

A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of …

Hospital-Acquired Pressure Ulcer Prevention, Druscilla Willis Jones

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure ulcers (HAPUs) represent a significant challenge in the care provided for hospitalized patients. HAPUs impact morbidity, mortality, and quality of life. At the local practice site, the incidence of HAPUs increased in the perioperative setting. The practice-focused question for this project asked if an education program for staff nurses working in a perioperative care setting with high HAPU incidence can advance nurse knowledge regarding prevention, early assessment, symptoms, and treatment of HAPUs. The purpose of this educational project was to develop a pretest and posttest designed education program on HAPU prevention and care for perioperative nurses. The Iowa …

Education Program For Critical Care Nurses On Preventing Catheter-Associated Urinary Tract Infections, Olatunde Olatunji

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) are the most frequently reported hospital-acquired condition, affecting more than 560,000 patients each year. CAUTIs prolong hospital stays and increase health care costs, and they can result in patient morbidity and mortality. Nurses can be empowered by receiving education and knowledge to manage and identify urinary catheters that are not clinically indicated. The purpose of this project was to develop an education program on CAUTI prevention for critical care nurses using the teach-back method. The conceptual framework that guided this project was Knowles's adult learning theory. The theoretical model was based on 4 fundamental assumptions …

Improving Care For Transgender Veterans Through Staff Education, Stephanie C. Henrickson

Walden Dissertations and Doctoral Studies

The VHA Directive 1341 (2018a): Providing Health Care for Transgender and Intersex Veterans, outlines care for transgender patients. Staff members at the project site lacked knowledge of the directive and available resources, making their care of transgender veterans inefficient. The purpose of the project was to implement staff education about the directive and resources to increase transgender patient visits and access to care. The practice-€focused question asked whether the development and implementation of staff education about the national directive and transgender services would affect the number of transgender patient visits in a 2-€month period. The Iowa and Community Readiness Models …

Staff Education On Metabolic Syndrome In Patients Taking Antipsychotic Medications, Juliana Ifeoma Omile

Walden Dissertations and Doctoral Studies

Second-generation antipsychotics (SGAs) are prescribed for treatment of psychosis. A major side effect of SGAs is an increased risk of metabolic syndrome (MetS) with symptoms of hypertension, hyperlipidemia, hyperglycemia, and truncal obesity. A clinic in the northeastern United States was not screening patients for MetS when being treated with SGAs. The purpose of this project was to educate staff on MetS risk factors, signs, symptoms, and patient management with a goal to improve their knowledge of MetS. Lewin's change theory provided a conceptual framework for the project. The project question explored the development and evaluation of an educational module on …

Impact Of The Prophecy Job Fit Predictor On New Graduate Nurse Satisfaction, Joi Alesha Johnson

Walden Dissertations and Doctoral Studies

Research has shown that job satisfaction influences retention of nurses, and policies focused on nursing satisfaction are more beneficial for retaining new nurses than adjusting work hours and wages. The prophecy job fit predictor is a quality improvement initiative designed to identify where a nurse should be assigned based on behavior, clinical capabilities, and personality assessment. The practice-focused question for this project focused on whether satisfaction rates of recently graduated registered nurses were influenced by their unit placement. The conceptual frameworks that guided this project were the plan, do, study, and act method and Herzberg's 2-factor theory. Data were obtained …

Evaluation Of Shared Governance Implementation At A Community Hospital, Teresa Nardontonia

Walden Dissertations and Doctoral Studies

Shared governance is a model in which staff collaborate through a decentralized decision-making structure, sharing ownership and accountability and partnering to make decisions about clinical practice, professional development, patient experience, quality improvement, and research. The hospital shared governance project team aligned its shared governance model with the American Nurses Credentialing Center Pathway to Excellence standards. The purposes of this project were to do a process evaluation of shared governance implementation at one 64-bed community hospital in central Florida and make recommendations for continuous quality improvement. The project followed the plan-do-study-act methodology developed by Deming. Through the collection of meeting minutes …

Improving Compassion Fatigue And Vicarious Trauma Knowledge For Psychiatric Nurses, Natalie P. Rebelo

Walden Dissertations and Doctoral Studies

Nurses are exposed to traumatic patients and high stress regularly; this repeated exposure can increase rates of compassion fatigue and vicarious trauma. When nurses are not properly educated about compassion fatigue and vicarious trauma, it can impact their ability to provide effective patient care and result in harmful effects including insecurity, altered cognitive functioning, loss of empathy and diminished self-esteem. This project focused on educating psychiatric nurses regarding compassion fatigue and vicarious trauma. The theory guiding the project was the Neuman's system model. Fifty-six psychiatric nurses were administered a pretest consisting of 10 multiple choice test questions. They were educated …

Quality Improvement Initiative To Improve Patient Attendance In Diabetes Self-Management Education Classes, Charon Denise Randel

Walden Dissertations and Doctoral Studies

Diabetes self-management education (DSME) is a key resource in the battle against diabetes and its secondary effects. This quality improvement project was conducted to address the decreased attendance rates of DSME classes in a community health center in the southern United States. The practice question for this project explored process-related strategies to increase patient attendance in DSME classes. Based on review of patient reports of reasons for nonattendance and an evaluation of peer reviewed literature on improving attendance in DSME, the following strategies were implemented: (a) alternative solutions such as providing patients with the dates for a year of initial …