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Articles 1891 - 1920 of 2632

Full-Text Articles in Nursing

Evidence-Based Pulmonary Rehabilitation Reduces Hospital Readmissions In Adults With Copd, Christiana Otuwa Jan 2018

Evidence-Based Pulmonary Rehabilitation Reduces Hospital Readmissions In Adults With Copd, Christiana Otuwa

Walden Dissertations and Doctoral Studies

Many patients are affected by chronic obstructive pulmonary disease (COPD), a progressive lung disease that obstructs air flow, resulting in dyspnea and inability to carry out daily activities. Despite optimal pharmacological management, COPD patients make frequent emergency room visits and are hospitalized due to exacerbations of COPD. Literature has suggested that pulmonary rehabilitation (PR), a nonpharmacological treatment, could help to decrease the symptoms that lead to illness exacerbation, hospital readmissions, and decreased quality of life in patients with COPD. The purpose of the project was to increase the quality of life and reduce admission rates for patients diagnosed with COPD …

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Weight Bias In Healthcare: An Investigation Of Impact On Obesity, Jennifer Scheffler, Fnp Jan 2018

Weight Bias In Healthcare: An Investigation Of Impact On Obesity, Jennifer Scheffler, Fnp

Walden Dissertations and Doctoral Studies

More than two-thirds of Americans are obese or overweight. Obesity rates have risen to an epidemic level, contributing to health inequalities and leading to reduced health-related quality of life. When obese and overweight persons face weight bias by health care providers, fragmented care may occur. Ensuring positive relationships with healthcare providers is important in helping those who are obese or overweight. The purpose of this project was to understand the factors that contribute to negative weight bias in the provider-patient relationship and to identify the most effective interventions that would reduce stigmatizing attitudes and support self-awareness, acceptance, and resolution for …

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Perinatal Residents' Perceptions Of Confidence Gained Through Their Preceptors, Veritta Henderson Jan 2018

Perinatal Residents' Perceptions Of Confidence Gained Through Their Preceptors, Veritta Henderson

Walden Dissertations and Doctoral Studies

The importance of preceptorships, as a mechanism to transfer knowledge of evidence-based nursing practices and developing confidence in nurses, is well-known. However, the effectiveness of preceptorships to develop confidence in perinatal nurses who provide safe care to childbearing women is unknown. Guided by Kolb's model of experiential learning and using a narrative analysis approach, this study examined perinatal nurse residents' perceptions of experiences that enhanced learning and developed confidence during preceptorship. Twenty nurses who completed a perinatal nurse residency of 18 weeks or more in the past 12 months participated in audiotaped, structured interviews. Their answers were transcribed and data …

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Nurse Practitioners' Experiences With Role Transition: Supporting The Learning Curve Through Preceptorship, Viktoriya Y. Pleshkan Jan 2018

Nurse Practitioners' Experiences With Role Transition: Supporting The Learning Curve Through Preceptorship, Viktoriya Y. Pleshkan

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role transition is difficult and ill-supported before and after graduation. Although preceptorships are essential in supporting a NP's role transition, there is a paucity of data on student and novice NPs' experiences with their role transition and how it is supported through preceptorships. The purpose of this hermeneutic phenomenological study was to understand and describe the meaning of NPs' role transition experiences while in a preceptorship before and after graduation. Schlossberg's transition theory and the cognitive apprenticeship models were used to guide the exploration of concepts of role transition and preceptorship. One face-to-face, 3 Skype, and …

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Preoperative Nurses' Teaching For Open Heart Surgery Patients, Sofya Alshvang Jan 2018

Preoperative Nurses' Teaching For Open Heart Surgery Patients, Sofya Alshvang

Walden Dissertations and Doctoral Studies

Every year thousands of patients in the United States undergo cardiothoracic surgery. These patients have high levels of anxiety because they do not know what to expect. At the same time, many nurses on the cardiac telemetry/surgical floor are not aware that effective preoperative teaching can make a significant difference in patients' outcomes; thus, nurses had focused on postoperative teaching. The purpose of this project was to develop a preoperative teaching program through which nurses could help patients undergoing open heart surgery. The mentioned above practice initiative used Neuman's systems model as a framework. The project used a before-and-after design: …

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Minimizing Home Health Care-Acquired Pressure Injuries Through Effective Nursing Teamwork, Juliana Baah Jan 2018

Minimizing Home Health Care-Acquired Pressure Injuries Through Effective Nursing Teamwork, Juliana Baah

Walden Dissertations and Doctoral Studies

Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain …

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Improving Nursing Knowledge, Satisfaction, And Retention In Long Term Care, Ghislaine Barry Jan 2018

Improving Nursing Knowledge, Satisfaction, And Retention In Long Term Care, Ghislaine Barry

Walden Dissertations and Doctoral Studies

Through advancements in modern medicine, human beings worldwide are living longer. The increase in life expectancy creates a need for a more qualified and knowledgeable nursing workforce for the delivery of quality geriatric health care. Although nurses are the primary care providers for vulnerable older adults, they are generally not well trained or prepared in geriatric care. Therefore, the purpose of the project was to develop an education program aimed at improving nursing knowledge of geriatric care in the long-term care (LTC) setting. The goal of the project was to answer the research question: What impact would attendance in the …

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Development Of Patient-Centered Team-Based Care Certification, Stephanie Lynn Stewart Jan 2018

Development Of Patient-Centered Team-Based Care Certification, Stephanie Lynn Stewart

Walden Dissertations and Doctoral Studies

Accountable care units (ACU-?¢) provide a new model for integrated patient care. The ACU-?¢ promotes patient centeredness in nursing units as team members work collaboratively with physicians to improve patient outcomes and reduce unwarranted variations. A health system in the southeastern United States incorporated the ACU-?¢ as part of their care model. These units were held accountable for their clinical, service, and cost outcomes but lacked a validation process to demonstrate the effective utilization of their data. The purpose of this DNP project was to create a patient centered care (PCC) certification process, guided by the Donabedian model, that would …

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Meeting The Nutritional Needs Of Very Low Income Diabetic Patients, Mary Hossley Jan 2018

Meeting The Nutritional Needs Of Very Low Income Diabetic Patients, Mary Hossley

Walden Dissertations and Doctoral Studies

Adult Type II diabetes is an increasing public health problem, particularly among very low-income minority populations. The purpose of this study was to create a nutritional guide for a diabetic specific meal plan with an accompanying food pantry nutrition packet for very low-income Type II diabetic patients at a rural Mississippi Free Clinic. The practice-focused question is: Will a nurse-prepared nutritional guide with supplemental food packets improve the glucose control in low income diabetic patients? The gap in practice is that there has been no structured nutrition education guide and no food pantry support plan for Type II adult diabetics. …

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A Staff Educational Initiative To Improve The Use Of Childhood Obesity Guideline Recommendations, Kris Kuhlmann Louque Jan 2018

A Staff Educational Initiative To Improve The Use Of Childhood Obesity Guideline Recommendations, Kris Kuhlmann Louque

Walden Dissertations and Doctoral Studies

Obesity affects one out every six children in the United States, which places them at risk for other chronic conditions such as cardiovascular disease, diabetes, and continued obesity into adulthood. Considering military children are more likely to enter the Armed Forces than their civilian counterparts, an increase in obesity among military families decreases the number of potential future military recruits who are physically eligible to serve. Despite this growing epidemic, providers report a lack of education and a low self-efficacy in the treatment of this condition. This doctorate of nursing practice study addresses this educational gap by attempting to improve …

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Evaluating A Discharge Bundle For Chronic Obstructive Pulmonary Disease, Sharon Scardina Jones Jan 2018

Evaluating A Discharge Bundle For Chronic Obstructive Pulmonary Disease, Sharon Scardina Jones

Walden Dissertations and Doctoral Studies

Acute exacerbation of chronic obstructive pulmonary disease (COPD) is one of the leading causes of hospital readmissions within 30 days. Frequent readmissions negatively affect hospital reimbursements and patient outcomes. Creative strategies, such as COPD care bundles, have been shown to reduce readmission rates according to existing studies. A COPD discharge bundle was developed and implemented at 1 community hospital in response to an identified problem with COPD readmissions. Evaluation of this quality improvement initiative was the purpose of this project study. The practice-focused question was: Have 30-day readmission rates changed following the implementation of a COPD discharge bundle prior to …

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Trauma-Informed Education Toolkit For Screening Pediatric Victims Of Sexual Abuse And Maltreatment, Analena Michelle Lunde Jan 2018

Trauma-Informed Education Toolkit For Screening Pediatric Victims Of Sexual Abuse And Maltreatment, Analena Michelle Lunde

Walden Dissertations and Doctoral Studies

The complex challenges facing the sexual assault nurse examiners program in a midwest state are underreporting, late reporting, and poor coordination of care for pediatric victims of child maltreatment with sexual abuse. The main objective of this quality improvement project was the identification of necessary practice-related approaches to care to decrease barriers associated with reporting suspicions of abuse or neglect. An evidence-based, multidisciplinary assessment clinical toolkit that followed clinical components of trauma-sensitive, child-centered screenings triggering a coordinated response to conduct a forensic medical exam within 96 hours of the alleged incident was evaluated. During 3 rounds of surveys following the …

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Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes Jan 2018

Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes

Walden Dissertations and Doctoral Studies

Chronic pain affects approximately 100 million adults in the United States annually, and costs exceeding $635 billion. Pain is the most common complaint in primary care, and chronic pain accounts for up to 16% of emergency room visits. Additionally, chronic pain accounts for 25% of missed workdays annually. Veterans are particularly vulnerable to chronic pain and have an increased incidence of chronic non-cancer pain. Chronic pain for veterans cost the Veterans Administration (VA) about $385 billion each year. This project evaluated the Patient Aligned Care Team (PACT) model to manage chronic lower back pain (CLBP) at a VA primary care …

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Management Of Chronic Kidney Disease By Advanced Practice Nurses, Anthony C. Amagwu Jan 2018

Management Of Chronic Kidney Disease By Advanced Practice Nurses, Anthony C. Amagwu

Walden Dissertations and Doctoral Studies

Despite best available care, uncontrolled chronic kidney disease (CKD) - a complex disease that impacts millions in the United States, will eventually progress to end stage renal disease which is associated with high morbidity and mortality. New evidence suggests management of earlier stages of CKD is effective in delaying disease progression. This project evaluated the impact of a CKD class, led by a nephrology nurse practitioner, on preventing disease progression in advanced CKD patients with diabetes and hypertension. The purpose of the class was to validate the need for the advanced practice nurse (APN) in the care continuum of CKD. …

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Increasing Knowledge About Food Allergy Management In The Preschool Setting, Katherine Mizell Crow Jan 2018

Increasing Knowledge About Food Allergy Management In The Preschool Setting, Katherine Mizell Crow

Walden Dissertations and Doctoral Studies

The prevalence of food allergies is a growing concern in the United States. Approximately 8% of the pediatric population has some form of food allergy. Many of these children are either in the preschool and primary school setting, which is where the majority of allergic reactions occur. If the symptoms of a food allergy reaction are not treated within minutes of exposure, the results can be damaging or fatal. Evidence continues to demonstrate that preschool and school personnel do not feel trained or prepared should a severe reaction arise. The purpose of this evidence-based project was to determine if the …

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Nursing Leadership And Employee Satisfaction Perception In A Virtual Work Environment, Angelique Duffy Jan 2018

Nursing Leadership And Employee Satisfaction Perception In A Virtual Work Environment, Angelique Duffy

Walden Dissertations and Doctoral Studies

Virtual team leaders in health care must have the right resources available to help them effectively perform their jobs. Better performance from the leader may lead to greater employee satisfaction. The problem addressed by this study was the impact of leadership style on employee satisfaction of virtual nurses. The purpose of this quantitative correlational study was to investigate the relationship between the leadership styles of virtual nursing environment leaders as perceived by virtual employee nurses and the nurses' satisfaction as measured by the Multifactor Leadership Questionnaire-short form. Building on the theoretical foundation of Bass's 1990 work, this study examined the …

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Creation Of A Diabetic Health Literacy Program For Staff Of A Rural Federally Qualified Healthcare Center, Cathy Jones Jan 2018

Creation Of A Diabetic Health Literacy Program For Staff Of A Rural Federally Qualified Healthcare Center, Cathy Jones

Walden Dissertations and Doctoral Studies

Adult residents in rural communities have a higher incidence of chronic diseases. This fact coupled with low health literacy and a lack of primary and specialty care services makes the management of diseases such as diabetes difficult. The purpose of this doctoral project was to develop a diabetic health literacy program for staff of a rural federally qualified health care center (FQHC) that is the largest primary care center within a 5-county area in a rural mid-Atlantic region of the United States. Most residents have difficulty understanding diabetic information as it is presented to them, which leads to an increase …

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Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth Jan 2018

Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth

Walden Dissertations and Doctoral Studies

Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …

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Clinical Practice Guideline For Differentiating Risk Factors For Avoidable And Unavoidable Pressure Ulcers., Vivian Suarez-Irizarry Jan 2018

Clinical Practice Guideline For Differentiating Risk Factors For Avoidable And Unavoidable Pressure Ulcers., Vivian Suarez-Irizarry

Walden Dissertations and Doctoral Studies

Pressure ulcers (PUs) present intrinsic risk factors that are not consistently identified by clinical assessments. The objective of this project was to develop a clinical practice guideline (CPG) to provide nurses with guidance in identifying and differentiating how intrinsic and extrinsic risk factors are associated with populations at risk for developing avoidable and unavoidable PUs. CPG development followed a systematic method to search the literature, organize findings, and assess the strength of the resulting evidence and its applicability to the CPG. Quality of the CPG was assessed by a panel of 8 health care professionals using the Appraisal of Guidelines …

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Baby's Skin, Deborah Weatherspoon, Debra Henline Sullivan Jan 2018

Baby's Skin, Deborah Weatherspoon, Debra Henline Sullivan

Walden Faculty and Staff Publications

A neonate's skin serves many important roles, is fragile, and requires special care. The childbirth educator may be called on to give sound, evidence based advice to caregivers who have concerns about their baby's skin. This article reviews the basics in newborn skin care with qualified recommendations on skin imperfections. Neonatal skin alterations are reviewed and include erythema toxicum neonatorum, milia, sebaceous glands, baby acne, and cradle cap. Babies are also affected by too much moisture which can result in drool rashes, heat rashes, and diaper rashes. These rashes are common and treatable with proficient guidance. Other skin concerns are …

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A Nursing In-Service For Diabetes Education, Heidi Steiner Jan 2018

A Nursing In-Service For Diabetes Education, Heidi Steiner

Walden Dissertations and Doctoral Studies

Nurses play a central role in preparing patients for discharge. Diabetes affects one-third of all hospitalized patients, with readmission rates 20% higher for patients with diabetes. Low health literacy affects patients' ability to understand education provided during a hospitalization, especially in diabetic patients who are required to perform complex self-care activities. The rehabilitation nurses within the practicum site struggled to provide adequate diabetes education, leading to patients' readmissions and frequent calls to the nursing unit post discharge. The purpose of this project was to educate nurses on an inpatient unit about survival skills and teach-back approaches to improve inpatient diabetes …

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Direct Supervisor Influence On Nurse Engagement, Kelly Elaine Tapp Jan 2018

Direct Supervisor Influence On Nurse Engagement, Kelly Elaine Tapp

Walden Dissertations and Doctoral Studies

Nurse engagement is essential for organizational success. If organizations can engage nurses, they may be able to improve organization and patient outcomes. The purpose of the evidence-based practice project was to use current evidence of direct supervisor influence on nurse engagement to create an educational program for clinical leads to use in their interactions with direct reports. The relationship-based care model was used as a framework for the project, and concepts included work engagement, nurse engagement, recognition versus meaningful recognition, professional development, communication, transformational leadership, and authentic leadership. Before and after attending the education program, clinical leads were given a …

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Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner Jan 2018

Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner

Walden Dissertations and Doctoral Studies

The Medicare Annual Wellness Visit (AWV) has been available to Medicare beneficiaries since 2005; however, most eligible individuals have not taken advantage of this benefit. The literature supports that patients are willing to schedule and complete an AWV if urged to do so by their primary care provider; however, providers are reluctant to advise patients to pursue the AWV due to the lack of perceived value and overall health benefit. The integrative theory of health behavior change was used as the theoretical framework for the project. By increasing patient self-management skills through education, engagement, and support, the project was designed …

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Effect Of Augmented Reality On Anxiety In Prelicensure Nursing Students, Sarah Ball Jan 2018

Effect Of Augmented Reality On Anxiety In Prelicensure Nursing Students, Sarah Ball

Walden Dissertations and Doctoral Studies

Prelicensure nursing students experience high anxiety as they enter the clinical setting, which can have a negative impact on learning care performance and critical thinking. Nursing faculty are faced with the challenges of limited time for clinical experiences, meeting the needs of learners who are technologically astute, and engaging students in the clinical environment to meet learning outcomes. The purpose of this pretest posttest quasi-experimental study, guided by the discovery learning theory, was to determine the effect of augmented reality (AR) 360 photosphere on prelicensure nursing students' level of anxiety as they entered a new clinical environment as compared to …

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A Nursing Education Program To Decrease Use Of Psychotropics Among Dementia Patients, Tami Felicia Blackmon Jan 2018

A Nursing Education Program To Decrease Use Of Psychotropics Among Dementia Patients, Tami Felicia Blackmon

Walden Dissertations and Doctoral Studies

Dementia, a clinical condition that affects the psychological ability of patients, is distinguished by a significant overall decline in cognitive function that results in distorted perception. Guiding nursing practice in the long-term care (LTC) setting to decrease the unnecessary use of psychotropics is critical because doing so relates to the patients' quality of life and safety. In the LTC facility that served as the practicum site for this study, there was an observed overuse of psychotropic medications in the care of patients with dementia. The practice-focused question guiding this project asked whether a nursing staff development program would decrease the …

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Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock Jan 2018

Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock

Walden Dissertations and Doctoral Studies

Glycemic control of the perioperative patient improves patient outcomes, specifically prevention of surgical-site infections. The prevention of surgical-site infections helps to reduce complications that can increase length of stay and readmissions, thereby increasing healthcare costs. The purpose of this project was to provide an educational module to the same-day surgery nurses on a clinical guideline to maintain glycemic control of the perioperative patient to prevent surgical-site infections. Lewin's change theory guided the development of a clinical practice guideline (CPG) for nurses to standardize the glycemic management of the perioperative patient. This project was conducted to determine whether educating nurses through …

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Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha Jan 2018

Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha

Walden Dissertations and Doctoral Studies

Minority immigrant women are more likely to be diagnosed with and suffer from cervical cancer compared to other minority women in the United States. The purpose of this qualitative ethnographic study was to explore cultural health perceptions, behaviors, and barriers to cervical cancer prevention among Korean immigrant women (KIW) in Hawaii. The health belief model and the social-ecological model were used to guide the study. Data were collected using individual structured interviews with 20 KIW ages 21 to 65 who are first-generation KIW immigrant to Hawaii. Data were coded and analyzed to identify themes. Findings revealed that participants (a) prefer …

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Effectiveness Of Pressure Ulcer Protocols With The Braden Scale For Elderly Patients In The Intensive Care Unit: A Systematic Review, Natalie A. Floyd Jan 2018

Effectiveness Of Pressure Ulcer Protocols With The Braden Scale For Elderly Patients In The Intensive Care Unit: A Systematic Review, Natalie A. Floyd

Walden Dissertations and Doctoral Studies

Each year, approximately 3 million people in the United States develop a pressure ulcer. Although a preventable complication, pressure ulcers are among the top 5 adverse outcomes in the acute care setting with the prevalence as high as 42% in the intensive care unit (ICU). The purpose of this systematic review was to evaluate the inclusion of the Braden Scale as part of a multicomponent pressure ulcer intervention protocol, or care bundle, to identify geriatric patients hospitalized in the ICU who were at risk for pressure ulcers. The Cochrane protocol guided this review; findings were reported according to the Preferred …

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Smoking Cessation Education For Acute Care Nurses, Dawn Garcia-Brinker Jan 2018

Smoking Cessation Education For Acute Care Nurses, Dawn Garcia-Brinker

Walden Dissertations and Doctoral Studies

Tobacco use among veterans is significantly higher than among members of the general population. The purpose of this quality-improvement project was to increase acute care staff members' knowledge and confidence in using tobacco cessation interventions to increase quit rates among the inpatients of a veterans' hospital in the midwestern region of the United States. An evidence-based, standardized Tobacco Tactics Toolkit was developed and implemented, and a 6 sigma method guided the quality improvement process to define, measure, analyze, improve, and control the tobacco-cessation education initiative. The reach, effectiveness, adoption, implementation, and maintenance framework was used to ensure that evidence-based interventions …

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Preparing Novice Nurses For Early Recognition Acute Deterioration, Norma Patricia Harris Jan 2018

Preparing Novice Nurses For Early Recognition Acute Deterioration, Norma Patricia Harris

Walden Dissertations and Doctoral Studies

Hospitalized patients increasingly present with complex health issues that place them at risk for acute patient deterioration (APD). Novice nurses are ill-equipped with the critical clinical skills to function competently in recognizing APD, placing patients at risk for negative health outcomes. This project addressed the need to educate novice nurses to recognize APD and answered the project focused questions that asked if an educational intervention with high-fidelity simulation (HFS) would improve nurse knowledge and clinical confidence in recognizing APD. Benner's novice-to-expert and the constructivism theory were used to guide the project. Based upon a review of the literature, the HFS …

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