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Articles 1831 - 1860 of 2632

Full-Text Articles in Nursing

"Evaluation Of Medication Adherence Through The Use Of Home Assisted Telemanagement", Kingsley Ezihe Ngameduru Jan 2019

"Evaluation Of Medication Adherence Through The Use Of Home Assisted Telemanagement", Kingsley Ezihe Ngameduru

Walden Dissertations and Doctoral Studies

Medication nonadherence can have serious consequences for patient outcomes. Home-automated telemanagement systems have supported increased levels of adherence among patients. This project explored whether the use of a home telemanagement program (HTM) would improve medication adherence in clinic patients diagnosed with hypertension (HTN). The health belief model, social learning theory, the self-regulation model and the theory of reasoned action guided this project. Providers in a primary care clinic completed the 4-question Morisky, Green, and Levine adherence scale with 50 HTN patients previously enrolled in a HTM. Survey results revealed that after 2 years in the program, patients were still forgetting …

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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 framework demonstrate how 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 case scenarios …

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Community Education Through A Stroke Champion Program, Michele Gribko Jan 2019

Community Education Through A Stroke Champion Program, Michele Gribko

Walden Dissertations and Doctoral Studies

Stroke is the fifth leading cause of death and primary cause of long-term disability in the United States. Public awareness of stroke symptoms and ability to activate the emergency medical system (EMS) quickly are essential for early treatment. At a large Joint Commission-certified Comprehensive Stroke Center with over 6,000 employees, a stroke champion program that included both clinical and nonclinical volunteers was initiated to determine whether stroke champion volunteers could learn and disseminate information about stroke symptoms and the importance of activating EMS within their community. Roger's diffusion-of- innovation framework was used to design and evaluate the outcome of the …

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Adhesive Transparent Chlorohexidine Gluconate Tegaderm™ Gel Dressing For Central Venous Catheter, Peter Kimiti Mwangi Jan 2019

Adhesive Transparent Chlorohexidine Gluconate Tegaderm™ Gel Dressing For Central Venous Catheter, Peter Kimiti Mwangi

Walden Dissertations and Doctoral Studies

Central-line-associated bloodstream infections (CLABSIs) occur during the insertion or change of the dressing of the central venous catheter (CVC) and are reportable healthcare-associated infections at the state and the national level. The purpose of this systematic review of the literature was to evaluate and synthesize available evidence to establish the effectiveness of using an adhesive transparent chlorohexidine gluconate (CHG) Tegaderm™ gel dressing for CVC in the prevention of CLABSIs. The logic model was used as a framework to guide the review of the literature to establish how an intervention that is not currently practiced can contribute to CVC prevention of …

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Reducing Compassion Fatigue In Hospice Nurses Through Education, Gregory Daniel Friesz Jan 2019

Reducing Compassion Fatigue In Hospice Nurses Through Education, Gregory Daniel Friesz

Walden Dissertations and Doctoral Studies

Compassion fatigue is a secondary stress reaction that results from providing care to those undergoing traumatic life events. Frequent exposure to dying patients with complex medical concerns has been identified as a contributing factor to compassion fatigue and resultant turnover among hospice nurses. The purpose of this project was to assess whether the provision of education to hospice nurses regarding compassion fatigue resulted in a demonstrable improvement in their levels of compassion fatigue. Watson's theory of human caring and Roy's adaptation model provided the theoretical foundation for this project. The practice-focused question for this project asked whether a reduction in …

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Strategies To Develop A New Nurse Residency Program, Casandra Allen Jan 2019

Strategies To Develop A New Nurse Residency Program, Casandra Allen

Walden Dissertations and Doctoral Studies

The ongoing shortage of registered nurses is a nationwide phenomenon. Many factors contribute to the dissatisfaction and stress of new graduate nurses during the initial transition phase of their career. The lack of peer and leadership support is among the many factors that lead to constant turnover. New nurses entering the workforce are caring for patients with more complex health problems. The Commission on Collegiate Nursing Education (CCNE) has developed standards for accreditation of entry-to-practice nurse residency programs (NRP). The purpose of this DNP project was to propose a formal evidenced-based nurse residency program to the stakeholders of an acute …

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Structured Education Using Scenario-Based Training In Cerner Electronic Medical Records, Ruby Aruldass Jan 2019

Structured Education Using Scenario-Based Training In Cerner Electronic Medical Records, Ruby Aruldass

Walden Dissertations and Doctoral Studies

Nurse practitioners are trained to use the electronic medical record (EMR) to document. Documentation in the EMR is often found to be incomplete, inaccurate, and unreliable, which affects the quality of care and patient safety outcomes. The purpose of the project was to improve the efficiency and effectiveness of nurse practitioners' documentation in the EMR. Malcolm Knowles' adult learning theory was used in this project to develop the education program. Kirkpatrick's training evaluation model was also used to analyze and evaluate the project. The study population included 5 primary care nurse practitioners in an ambulatory care setting using Cerner EMR. …

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Recruiting Strategies For A Nonprofit Health Care Facility, Jairo Borja Jan 2019

Recruiting Strategies For A Nonprofit Health Care Facility, Jairo Borja

Walden Dissertations and Doctoral Studies

Although predictions for the supply of registered nurses (RNs) is projected to increase to 3,849,000 by 2025, the demand for RNs is projected to grow to 3,509,000. The purpose of this single case study was to explore the strategies some recruiters in a nonprofit health care facility used to recruit RNs. The conceptual lens used for this study was general systems theory. Through a purposeful sample of 3 recruiters at a nonprofit health care facility located in New York, data collection occurred through semistructured interviews, reviewing job boards and the company website, and taking field notes the day of the …

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Increasing Uninsured Patients' Compliance With Return Primary Care Visits, Dorothy Clare Carleton Jan 2019

Increasing Uninsured Patients' Compliance With Return Primary Care Visits, Dorothy Clare Carleton

Walden Dissertations and Doctoral Studies

Patients who are unable to comply with their health care regimen are almost 3 times more likely to have an adverse health outcome and are more likely to suffer irreversible progression of a chronic disease process. Increasing patient return clinic visits is essential, not only to curtail rapidly rising costs of health care but also to improve patient outcomes. This project focused on an uninsured patient population of a clinic in a rural community in the southeastern United States. The purpose of the project was to conduct a systematic review of the literature and identify the barriers and motivating factors …

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Implementing Guidelines To Improve Hand Hygiene Compliance, Doreen Millicent Currie Jan 2019

Implementing Guidelines To Improve Hand Hygiene Compliance, Doreen Millicent Currie

Walden Dissertations and Doctoral Studies

Hand hygiene is the term for removing microorganisms with disinfecting agents, alcohol-based rub, or soap and water. Evidence supported the low rates of hand hygiene compliance among health care workers. This project addressed this gap in practice at a large acute care facility through an educational training program. Data from the facility on hand hygiene compliance revealed a compliance rate of 63%. The problem question explored whether an educational program on hand hygiene improve compliance. The focus of the program was to provide education on the World Health Organization's My 5 Moments for Hand Hygiene and the 7-step technique for …

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Improving Access To Cancer Care For The Rural Community With Telehealth, Cheryl Ann Fiscelli Jan 2019

Improving Access To Cancer Care For The Rural Community With Telehealth, Cheryl Ann Fiscelli

Walden Dissertations and Doctoral Studies

After a diagnosis of cancer, timely access to oncology care is a priority. For patients living in a rural community, there are many challenges such as proximity to cancer care, reduced access to state-of-the art therapies, lack of coordinated care, and limited access to clinical trials. A multidisciplinary consultation (MDC) via telehealth can improve access to care for rural oncology patients. The purpose of this project was to determine the effects of telehealth MDC on the time in days from diagnosis to the first treatment with the goal of persuading the project site to implement a telehealth MDC. The data …

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Enhancing Comfort Care Techniques In The Pediatric Inpatient Setting, Nicole Rae Mansky Jan 2019

Enhancing Comfort Care Techniques In The Pediatric Inpatient Setting, Nicole Rae Mansky

Walden Dissertations and Doctoral Studies

The benefits of pharmacological and nonpharmacological interventions for children undergoing painful medical procedures are well documented in extant nursing literature; however, such techniques continue to be underused in practice. Improving comfort during medical procedures is necessary to enhance the patient and family experience. The purpose of this project was to provide education to nursing staff about pediatric pain theories and evidence-based practice recommendations that support the use comfort interventions for pediatric patients of all ages. The practice-focused question addressed the development of an educational program designed to enhance staff knowledge of comfort intervention options and the benefits provided to patients. …

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Strategies For Reducing Medication Errors In An Outpatient Internal Medicine Clinic., Uche Gerard Obua Jan 2019

Strategies For Reducing Medication Errors In An Outpatient Internal Medicine Clinic., Uche Gerard Obua

Walden Dissertations and Doctoral Studies

Medication errors are among the most common causes of unintended harm to patients and have led to many deaths. Some categories of medication errors include; medications administered to the wrong person; medications administered at the wrong time, through the wrong route; administration of the wrong medication and/or dose; and the omission of medications. Guided by the logic model, the just culture model, and the Knowles theory of andragogy, the purpose of the project was to determine if providing information related to evidence-based strategies to reduce medication errors would result in safer medication administration practices and improved patient outcomes A survey …

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Wright's Competency Model And Quality And Safety Competencies, Staci Shanks Jan 2019

Wright's Competency Model And Quality And Safety Competencies, Staci Shanks

Walden Dissertations and Doctoral Studies

Competent nurses are instrumental in assuring that a patient receives safe patient care of the highest quality. Patient care that lacks quality places patients at risk of poor health outcomes and results in negative financial impacts for the organization. The purpose of this staff education project was to develop nurse competency education for a facility's competency program, which merged the Wright competency model with quality and safety education for nurses' competencies. The nurse competency staff education program was evaluated by the organization's stakeholders for inclusion in the competency program. The whole-part-whole model, Knowles's adult learning theory, and Lewin's change theory …

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Perceptions Of Well-Being And Coping Mechanisms From Caregivers Of Individuals With Autism, Barbara Simmons Jan 2019

Perceptions Of Well-Being And Coping Mechanisms From Caregivers Of Individuals With Autism, Barbara Simmons

Walden Dissertations and Doctoral Studies

Caregivers of individuals with autism often report increased levels of stress and a lack of social support to help them cope with various stressors as they provide care. Without coping mechanisms or social support, as individuals with autism present various behavioral and emotional challenges, caregivers can experience a decline in well-being. Thus, the purpose of this qualitative study was to explore the processes that caregivers of individuals between the ages of 9-18 diagnosed with autism use to cope with stress and social support in Southeast Georgia. Grounded theory was used to describe the perceived thoughts caregivers have about stress and …

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Leadership Strategies To Improve Nurse Retention, Floyd Jordan Colwell Jan 2019

Leadership Strategies To Improve Nurse Retention, Floyd Jordan Colwell

Walden Dissertations and Doctoral Studies

The nursing shortage and high turnover rates are a problem in the United States. The purpose of this multiple case study was to explore leadership strategies that hospital senior nurse managers in the Rocky Mountain states use to improve nurse retention. Participants were 6 hospital senior nurse managers including 3 chief nursing officers, 1 assistant chief nursing officer, and 2 directors who had demonstrated effective leadership strategies in retention of nurses. The leadership-motivated excellence theory was the conceptual framework. Semistructured interviews with open-ended interview questions were used to collect data; organization websites and documents were used to help corroborate evidence …

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Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata Jan 2019

Cultural Competence Of Public Health Nurses Who Care For Diverse Populations, Althea Michelle Otuata

Walden Dissertations and Doctoral Studies

Despite advances in health, science, and technology, U.S. healthcare lags in providing access to care and quality care to racial and ethnic minorities. Cultural competence has been noted as a strategy to improve access and quality. The purpose of this project was to assess public health nurses' cultural competence before and after participating in cultural competence informational modules. Two conceptual models were used in this project for theoretical guidance: Leininger's cultural care diversity and universality theory and Campinha-Bacote's process of cultural competence. To assess the nurses' cultural competence, the Cultural Competence Self-Assessment Checklist questionnaire was e-mailed to 57 public health …

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Faculty And Student Perspectives Of Nursing Student Completers In A Community College, Rachael Farrell Jan 2019

Faculty And Student Perspectives Of Nursing Student Completers In A Community College, Rachael Farrell

Walden Dissertations and Doctoral Studies

Research about retention of nursing students has focused on either specific student characteristics or on nursing students at the university level. A problem experienced by a community college nursing program in Maryland is low completion rates, which can affect the institution and the nursing profession. This qualitative case study explored faculty-related factors leading to success of students in the nursing program at this school, so the low completion rate can be addressed. The conceptual foundations for this study were Tinto's theory of student retention and Jeffreys' nursing undergraduate retention and success model. The research questions addressed how faculty-related factors affected …

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Effective Strategies For Recognition And Treatment Of In-Hospital Strokes, Maryika Ivanova Gibson Jan 2019

Effective Strategies For Recognition And Treatment Of In-Hospital Strokes, Maryika Ivanova Gibson

Walden Dissertations and Doctoral Studies

In-hospital onset strokes represent 4% to 20% of all reported strokes in the United States. The variability of treatment protocols and workflows as well as the complex etiology and multiple comorbidities of the in-hospital stroke subpopulation often result in unfavorable outcomes and higher mortality rates compared to those who experience strokes outside of the hospital setting. The purpose of this project was to conduct a systematic review to identify and summarize effective strategies and practices for prompt recognition and treatment of in-hospital strokes. The results of the literature review with leading-edge guidelines for stroke care were corelated to formulate recommendations …

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Nursing Education Workflows In Ehr Training, Liezel Granada Jan 2019

Nursing Education Workflows In Ehr Training, Liezel Granada

Walden Dissertations and Doctoral Studies

A need for improvement in nursing education regarding inpatient workflows and informatics skills was identified at this project site. Upon hire, nurses were required to complete a 4-hour basic class on the electronic health record (EHR) system, but this class did not include inpatient-nursing workflows needed to provide and facilitate care for patients. This project addressed the lack of EHR education on inpatient nursing workflows. The focus of this staff education project was an education class on inpatient nursing workflow provided to a nurse residency class. Sources of evidence were obtained through a literature search and pretest/post test data analysis. …

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Improving Early Mobilization In Acute Stroke Patients Through Best Practice Education, Angela Christine Middleton Jan 2019

Improving Early Mobilization In Acute Stroke Patients Through Best Practice Education, Angela Christine Middleton

Walden Dissertations and Doctoral Studies

Nonadherence to best practice guidelines in early mobilization in acute stroke increases the time from admission to mobilization and may increase residual long-term stroke effects. Early mobilization following an acute stroke is known to decrease long-term and secondary disability. The purpose of this project was to decrease the time from admission to mobilization in the acute stroke patient population by improving knowledge of best-practice guidelines in early mobility using an educational intervention for advanced practice nurse practitioners, physicians, and registered nurses. The practice-focused question for this project asked whether a staff educational program based on best-practice guidelines would decrease the …

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The Effect Of Self-Esteem, Bullying, And Harassment On Nurse Turnover Intention, Joyce Richelle Arand Jan 2019

The Effect Of Self-Esteem, Bullying, And Harassment On Nurse Turnover Intention, Joyce Richelle Arand

Walden Dissertations and Doctoral Studies

Currently there is a high rate of registered nurse (RN) turnover due in part to bullying and harassment among peers; which fosters lower quality nursing care, jeopardizes patient safety, and increases healthcare costs. The purpose of this quantitative nonexperimental study was to examine the relationship between inpatient nurses' individual self-esteem and reported bullying and harassment with their intent to leave their job. Two theories were used to provide structure to this work: cognitive experimental self theory and oppressed group theory. Data were collected using the Negative Acts Questionnaire, the Rosenberg Self-Esteem Scale, and the Turnover Intentions Measure. All RNs in …

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Adolescent Obesity Intervention In An Outpatient Primary Care Setting, Chinyere Susanna Awamba-Agu Jan 2019

Adolescent Obesity Intervention In An Outpatient Primary Care Setting, Chinyere Susanna Awamba-Agu

Walden Dissertations and Doctoral Studies

Lack of education in the outpatient setting related to causes, complications, and prevention of obesity is associated with high rates of obesity in adolescents 12 to 19 years of age. The gap in the adolescents' and family members' knowledge of obesity contributes to the adolescents' high calorie consumption and the development of obesity. The purpose of this project was to develop a staff education guideline for use by clinicians to educate adolescents and their families on how to develop nutritious food plans and decrease obesity. The project practice question asked whether educating the primary care providers in the primary care …

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Tobacco Treatment Education Module For Nurses Working In The Inpatient Psychiatric Setting, Marchell Rene Spielmann Jan 2019

Tobacco Treatment Education Module For Nurses Working In The Inpatient Psychiatric Setting, Marchell Rene Spielmann

Walden Dissertations and Doctoral Studies

Tobacco use among people with mental illness remain a significant problem in the western United States. At the project site, there is widespread tobacco use among patients with mental illness and lack of training for nurses to address the issue. The purpose of this project was to educate nurses working in the acute psychiatric setting about evidence-based tobacco treatment interventions. The practice-focused question addressed whether a tobacco education program would increase nurses' knowledge, confidence, and skills to provide tobacco treatment interventions to patients with a mental illness. Self-determination theory and the transtheoretical model of change provided the theoretical framework for …

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Preinfection Risk Perceptions Of Human Immunodeficiency Virus Positive Homosexual And Bisexual Men, Benjamin Singer Jan 2019

Preinfection Risk Perceptions Of Human Immunodeficiency Virus Positive Homosexual And Bisexual Men, Benjamin Singer

Walden Dissertations and Doctoral Studies

In 2017, there were 4,949 persons diagnosed with human immunodeficiency virus (HIV), 116,944 persons living with HIV, and 2,044 acquired immunodeficiency syndrome (AIDS) cases in Florida. Of the 4,972 new HIV diagnoses in Florida, 60% were related to male-to-male sexual contact, 4% from intravenous drug use, 2% from male-to-male sexual contact and intravenous drug use, 33% from heterosexual sexual contact, and 1% from other sources. Guided by the health belief model (HBM), this qualitative study sought to understand the lived experiences of HIV positive adult men who have sex with men (MSM) living in Florida, regarding their preinfection perceptions of …

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Developing Staff Education Regarding Colorectal Cancer Screening Practice Guidelines, Ruth Airiohuomo Aboiralor Jan 2019

Developing Staff Education Regarding Colorectal Cancer Screening Practice Guidelines, Ruth Airiohuomo Aboiralor

Walden Dissertations and Doctoral Studies

Colorectal rectal cancer (CRC) is the 3rd most common cancer in men, the 2nd most common cancer in women, and the 4th leading cause of cancer death. Lack of screening or delayed screening for CRC is the major cause of undiagnosed cancers that become malignant and eventually become fatal. Nurses at the project site are not in compliance with CRC screening guidelines due to inadequate knowledge of the screening guidelines recommended by the American Cancer Society, which creates a gap in practice. The purpose of this project was to develop staff education on CRC screening guidelines. The practice focused question …

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Increasing Nursing Staff Knowledge Of Palliative Care Criteria With A Decision Tree, Juliana Cotton Jan 2019

Increasing Nursing Staff Knowledge Of Palliative Care Criteria With A Decision Tree, Juliana Cotton

Walden Dissertations and Doctoral Studies

Palliative care is often not considered during care or is considered too late in the patient’s healthcare journey to provide much benefit. The underutilization of palliative care contributes to increased healthcare costs, poor patient outcomes, and decreased patient satisfaction. The practice-focused question guiding this evidence-based practice (EBP) project was whether an education program would increase nursing knowledge regarding palliative care criteria. The program was developed using Rogers’s diffusion of innovation model and a literature review to create educational tools and achieve a sustainable EBP change. An evidence-based decision tree was developed and used as a tool for teaching and learning. …

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Preterm Infant Incubator Humidity Levels: A Systematic Review, Laurie Glass Jan 2019

Preterm Infant Incubator Humidity Levels: A Systematic Review, Laurie Glass

Walden Dissertations and Doctoral Studies

Numerous scholars have reported that inconsistent incubator humidity in the neonatal intensive care unit (NICU) requires attention. Evidence synthesis was needed to assist the identification of optimal incubator humidity levels and duration to decrease transepidermal water loss (TEWL) and the potential for infection. The purpose of this doctoral project was to appraise and synthesize the evidence of preterm outcomes related to incubator humidity. The practice-focused question addressed what patient outcomes were impacted by incubator humidity level and duration in premature infants < 32 0/7 weeks cared for in the NICU. The foundation of this project was the Joanna Briggs Institute method for systematic reviews. Mefford’s theory of health promotion for the preterm infant was used to address the wholeness of the preterm infant’s body system. Evidence was classified using the Johns Hopkins evidence-based practice levels and quality of evidence. The search was conducted in 8 databases, and citation searching was used to identify 340 articles, 12 of which met the inclusion criteria. The evidence demonstrates that the practice of incubator humidity is warranted; however, it does not come without risks. Microbial growth was increased in high levels of incubator humidity. Unnecessary TEWL was prevented by lowering high levels of incubator humidity after the 1st week, improving skin barrier formation. Incubator humidity of 60%–70% in the 1st week was effective in preventing TEWL in infants born ≥ 26 weeks; however, future research is needed for infants < 26 weeks. When optimal levels and duration of incubator humidity are achieved, positive social change will occur from the improved outcomes of the smallest neonatal patients.

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Positive Deviance Behaviors And Definition In Nursing, Stacy L. January Jan 2019

Positive Deviance Behaviors And Definition In Nursing, Stacy L. January

Walden Dissertations and Doctoral Studies

The concept of positive deviance (PD) has not been studied in the context of nursing. Grounded in narrative inquiry and combined with vocabularies of motive and symbolic interactionism, the purpose of this study was to explore whether PD behaviors existed in nursing, and if so, to develop an operational definition of PD for nursing. The research question addressed what PD behaviors, if any, were present in nurses’ workplace stories. Using posted flyers, eight participants either self-selected or were selected by snowball method to participate. Interviews were conducted in locations decided on by each participant. Interview data were obtained, transcribed, then …

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A Staff Training Plan On Screening African Americans For Prediabetes, Valerie Kershaw-Berry Jan 2019

A Staff Training Plan On Screening African Americans For Prediabetes, Valerie Kershaw-Berry

Walden Dissertations and Doctoral Studies

African American adults have higher risks of undiagnosed Type 2 diabetes, uncontrolled Type 2 diabetes, and complications from Type 2 diabetes than members of other racial groups. Health care providers in rural Tennessee lack staff training plans for prediabetes screening of older African American adults. In addition, few rural Tennessee health care providers have programs in place to train staff in prediabetes screening, screening instrument use, and interventions for Type 2 diabetes prevention. The focus of this DNP project was on developing an evidence-based staff training program designed to improve knowledge regarding prediabetes screening in older African American adults. Concepts …

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