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Articles 1981 - 2010 of 2632

Full-Text Articles in Nursing

Discharge Calls And Avoiding Hospital Readmissions, Wanda Lee Cassavettes Jan 2018

Discharge Calls And Avoiding Hospital Readmissions, Wanda Lee Cassavettes

Walden Dissertations and Doctoral Studies

Hospital readmissions are disruptive and costly for patients and hospitals. As hospital discharge instructions are a key nursing responsibility, this project implemented a nurse follow-up phone call intervention within 12-48 hours of patient discharge from an indigent care facility in the Great Lakes region of the United States. The project was designed to understand whether follow-up phone calls from nurses that clarified discharge instructions, symptom management, and medications would be associated with decreased readmission rates within 30 days post-discharge among chronic care patients. The theoretical framework was the health belief model, which proposes that the patient's knowledge of illness severity, …

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Antibiotic Prescribing Habits Of Urgent Care Providers, Mellisa Thompson Jan 2018

Antibiotic Prescribing Habits Of Urgent Care Providers, Mellisa Thompson

Walden Dissertations and Doctoral Studies

Antibiotics are commonly prescribed and requested for viral illnesses despite evidence-based research studies and societal guidelines that advise against this practice. Literature has indicated that antibiotic decision-making comes from a provider's experience or exposure to illness, uncertainty of illness, or from being pressured by the patient. Nurses and advanced practice nurses are important participants in the antibiotic stewardship initiative. The purpose of this project was to examine potential knowledge deficits responsible for inappropriate antibiotic prescribing at a rural urgent care clinic in the southeastern United States, which when addressed could promote an educational in-service to decrease the number of antibiotics …

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Improving The Care Of Patients With Urinary Catheters Through A Quality Improvement, Ashley Nicole Holmstrom Jan 2018

Improving The Care Of Patients With Urinary Catheters Through A Quality Improvement, Ashley Nicole Holmstrom

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTI) significantly increases patient morbidity and mortality, length of stay, and organizational cost. In the 2 years prior to project implementation, the incidence of CAUTI increased by 15% in the local acute care, inpatient facility that served as the project site. Nursing leaders at the project site linked the increase in CAUTIs to a nursing knowledge deficit related to CAUTI prevention principles. The clinical question focused on the impact of CAUTI prevention staff training on the incidence of CAUTI, length of stay, and cost to the local acute care organization. After a review and critical appraisal …

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Validating A Home Health Care Staff Educational Module For Wound Treatment And Documentation, Kimberly Sanders Hebert Jan 2018

Validating A Home Health Care Staff Educational Module For Wound Treatment And Documentation, Kimberly Sanders Hebert

Walden Dissertations and Doctoral Studies

Although guidelines and minimal standards for the care and documentation of wounds in home health care settings in the United States are available, there is a lack of compliance among many home health care agencies (HHAs) with regard to the accuracy of wound documentation and care of wounds. Failure to follow guidelines for wound care according to Centers for Medicare and Medicaid Services and Home Health Outcome and Assessment Information System standards could result in loss of revenue for HHAs, improper treatment of wounds, and legal ramifications. The purpose of this doctoral project was to develop and validate a staff …

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Empowering Cultural Competency In Healthcare Providers, Betty Antoinette Dement Jan 2018

Empowering Cultural Competency In Healthcare Providers, Betty Antoinette Dement

Walden Dissertations and Doctoral Studies

Racial and ethnic health disparities are highest in communities of color; providing culturally competent care could address these disparities. Culturally competent communication between the healthcare provider and the patient is an essential behavior that may improve health in racially and ethnically diverse women. A quality improvement project was completed with guidance from the 5 constructs of the Campinha-Bacote model as the conceptual framework, and the method used was the Consumer Assessment of Healthcare Providers and Systems survey. The perspective of 20 Mexican American and 20 African American women in El Paso, Texas between ages 45 and 72 with menopausal symptoms …

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Assessment Of Evidence-Based Practice Readiness And Plan For Implementation Of Clinical Practice Guidelines In A Tertiary Hospital, Linda Keller Jan 2018

Assessment Of Evidence-Based Practice Readiness And Plan For Implementation Of Clinical Practice Guidelines In A Tertiary Hospital, Linda Keller

Walden Dissertations and Doctoral Studies

Using evidence-based practice (EBP) to deliver patient care in a hospital setting improves patients' care and their outcomes. The use of clinical practice guidelines (CPG) enables nurses and other healthcare professionals to translate current evidence into bedside care. However, there continue to be barriers for hospitals in adopting and implementing evidence-based care using CPGs, including a lack of understanding about EBP by nursing staff. The purpose of this project was to explore readiness of registered nurses in a tertiary hospital to use EBP and provide recommendations for a plan to implement CPGs successfully. Melnyk's research identified EBP as an approach …

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The Relationship Between Nurse Staffing And Quality Outcomes In Georgia Nursing Homes, Tamara Kathleen Stephens Jan 2018

The Relationship Between Nurse Staffing And Quality Outcomes In Georgia Nursing Homes, Tamara Kathleen Stephens

Walden Dissertations and Doctoral Studies

The quality of care in United States' nursing homes has been of concern to consumers, government agencies, and researchers for several decades. Nurse staffing has been identified as a key factor influencing the quality of care in nursing homes. The purpose of this quantitative, correlational research was to determine if relationships existed between nurse staffing levels and three quality care outcomes in the state of Georgia. Donabedian's quality conceptual framework guided the study. The framework encompasses three interrelated dimensions of quality including structure, process, and outcomes. Nurse staffing levels and facility bed size represented the structure of nursing homes and …

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Predicting The Nclex-Rn Pass Rate At An Associate Degree Nursing Program, Dawne Devoe Olbrych Jan 2018

Predicting The Nclex-Rn Pass Rate At An Associate Degree Nursing Program, Dawne Devoe Olbrych

Walden Dissertations and Doctoral Studies

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) first-time pass rate for an associate degree in nursing (ADN) program was below the national mean, presenting a problem for graduates who failed the NCLEX-RN and could not enter the workforce as registered nurses. Knowles's assumptions of adult learning, Ebbinghaus's forgetting curve, and Zull's neuroscience research served as the theoretical frameworks for this study. The purpose of this study was to identify which academic and time-lapse variables predict the graduate's first-time passage for the NCLEX-RN. Archived academic records and NCLEX-RN results for all 786 graduates from one ADN program who took …

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Experiences Of Interpersonal Interaction Between Nurse Educators And Minority Nursing Students, Debra Boldan Jan 2018

Experiences Of Interpersonal Interaction Between Nurse Educators And Minority Nursing Students, Debra Boldan

Walden Dissertations and Doctoral Studies

Changes in the cultural composition of the United States population are not reflected in the nursing workforce. The lack of diversity in nursing may be due to the unique interpersonal needs of minority nursing students remaining unmet in traditional nursing education programs, which might unintentionally lead to alienation, isolation, and lower graduation rates for minority students. The purpose of this phenomenological study was to explore interpersonal interaction experiences nursing educators have in teaching minority nursing students. Critical social theory provided the theoretical framework to explore the ways social inquiries may hinder learning and keep marginal groups from reaching their full …

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Non-Nursing Courses' Impact On Nclex-Rn Pass-Rates In Associate Degree Nursing Programs, Nicole A. Garner Jan 2018

Non-Nursing Courses' Impact On Nclex-Rn Pass-Rates In Associate Degree Nursing Programs, Nicole A. Garner

Walden Dissertations and Doctoral Studies

Nurse educators make decisions regarding the inclusion or exclusion of non-nursing courses in a curriculum. The current literature lacks research regarding which courses have the most impact on first-time nursing licensing examination pass-rates. The purpose of this quasi-experimental study was to investigate if there is a specific combination of courses that enhance first-time licensing examination pass-rates, using 161 randomly selected accredited associate degree nursing programs. General systems theory applied to nursing education was the framework for the study. ANOVA and independent t-tests were used to address the questions of non-nursing courses or discipline-specific set of non-nursing courses' impact on first-time …

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Scenario-Based Communication Simulation Curriculum And Plan, Sandra Imperial Jan 2018

Scenario-Based Communication Simulation Curriculum And Plan, Sandra Imperial

Walden Dissertations and Doctoral Studies

The Joint Commission reported that communication failures in United States hospitals contribute to 30% of all malpractice claims, and in 2008, The Joint Commission listed the improvement of effective communication among healthcare providers as a National Patient Safety Goal. The purpose of this practice-focused project was to develop a scenario-based communication simulation for implementation approval by a panel of experts. The approved curriculum was designed to integrate a communication-based simulation scenario into the nurse residency program of a large, urban medical center to improve new graduate nurse communication skills, increase nurse communication competency and self-efficacy, and decrease communication errors. Kolb's …

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Improving Advanced Practice Nurses' Knowledge Of Cerebral Hemorrhage Assessment And Management, Kimberly Marie Lombardo Jan 2018

Improving Advanced Practice Nurses' Knowledge Of Cerebral Hemorrhage Assessment And Management, Kimberly Marie Lombardo

Walden Dissertations and Doctoral Studies

Cerebral hemorrhages are a type of stroke causing bleeding in the brain from a ruptured brain vessel or an aneurysm. In the emergency department (ED), advanced practice nurses (APNs') play a pivotal role in identifying cerebral hemorrhages. Many APNs' lack the skills necessary to assess, diagnose, and manage this type of stroke. A delay in diagnosis of cerebral hemorrhages carries a high risk of morbidity and mortality and can lead to lifelong disability or death. The framework of this project is the Patricia Benner theory of novice-to-expert, which is a 5-step approach designed to strengthen nursing skills with the goal …

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Compassion Fatigue And Burnout: Awareness And Prevention For The Novice Nurse Population, Jamie B. Lopez Jan 2018

Compassion Fatigue And Burnout: Awareness And Prevention For The Novice Nurse Population, Jamie B. Lopez

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) and burnout (BO) in the novice nurse population can negatively affect the organization, patient safety, patient satisfaction, and the individual. Novice nurses are susceptible to the development of CF and BO due to a lack of knowledge about the causes and the stress experienced as the novice nurse transitions to practice. The purpose of this staff education project was to fill the gap in practice by creating awareness about CF and BO during the nurse orientation process and by providing prevention strategies. The relationship-based care model and the theory of planned behavior were used to guide the …

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Reducing Congestive Heart Failure Hospital Readmissions Through Discharge Planning, Lacy Rebaka Thomas Jan 2018

Reducing Congestive Heart Failure Hospital Readmissions Through Discharge Planning, Lacy Rebaka Thomas

Walden Dissertations and Doctoral Studies

Every year, thousands of congestive heart failure (CHF) patients are readmitted to the hospital within 30 days of discharge. There is a gap in practice in the care continuum of patients with CHF within the transition from hospital to home. One of the factors known to increase a patient's risk for readmission is the lack of patient engagement and self-efficacy regarding the treatment plan. The purpose of this project was to implement a transition of care practice guideline that consisted of the use of a risk identification tool, a customized care plan for patients at high risk for readmission, and …

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Intensive Care Unit Nurse Education To Reduce Sepsis Mortality Rates, Corina Meade Jan 2018

Intensive Care Unit Nurse Education To Reduce Sepsis Mortality Rates, Corina Meade

Walden Dissertations and Doctoral Studies

Sepsis causes major health care problems in the United States, resulting in long hospitalizations, complications, and even patient death. Lack of nursing knowledge regarding sepsis signs and symptoms is a significant problem at a hospital in the northeast. Local hospital data showed a high patient mortality rate for patients diagnosed with sepsis. The purpose of this project was to develop an educational module on sepsis for intensive care nurses. The educational module was developed using current sepsis evidence-based guidelines. The practice-focused question for the project asked whether an educational module on sepsis would increase the intensive care nurse's knowledge on …

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Nurse Navigator Role Description And Processes For Best Outcomes Among At-Risk Patients, Judean Leroy Jan 2018

Nurse Navigator Role Description And Processes For Best Outcomes Among At-Risk Patients, Judean Leroy

Walden Dissertations and Doctoral Studies

The nurse navigator role developed in the 1990s to support African American female oncology patients' access to services. Successful in oncology, the role has expanded to support patients with diabetes, heart failure, and chronic obstructive pulmonary disease. A unique cost-effective opportunity exists for nurse navigators to fill the gap in transitional care, between the acute care setting and home, for chronically ill and other at-risk patients who are often readmitted within 30 days for treatment of the same disease. The purpose of the project was to refine the job description of the nurse navigators in a Midwestern acute care hospital. …

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Enhancing The Nurse Aide Student's Knowledge Of Evidence-Based Geriatric Care Practices, Vivienne Mcdaniel Jan 2018

Enhancing The Nurse Aide Student's Knowledge Of Evidence-Based Geriatric Care Practices, Vivienne Mcdaniel

Walden Dissertations and Doctoral Studies

Certified nurse aides provide approximately 65% of care to more than 1.4 million older adults residing in nursing homes who have been diagnosed with 1 or more chronic illnesses or debilitating conditions. Licensed nurses rely on nurse aides to report potentially harmful status changes in geriatric residents. Nurse aides often receive limited education and do not have a structured care process to guide them in their practice in the geriatric population. The purpose of this educational quality improvement project was to develop a geriatric-specific nurse aide care process to increase the knowledge of student nurse aides regarding processes to identify …

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Developing An Impella Education Program For The Critical Care Registered Nurse, Sara Jackson Jan 2018

Developing An Impella Education Program For The Critical Care Registered Nurse, Sara Jackson

Walden Dissertations and Doctoral Studies

Every year, hundreds of thousands of patients have coronary angiograms performed in the United States. The Impella is a percutaneous ventricular support device that provides hemodynamic support for patients if hemodynamic instability occurs during the procedure. The critical care nurse is responsible for the recovery and management of the patient with the Impella device in place. The purpose of this scholarly project is to provide registered nurses (RN) who have not previously managed the Impella device with the appropriate education in order to demonstrate competency. The program demonstrated improved RN knowledge about the Impella and increased confidence when managing the …

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Pilot Texas Red Cross Virtual Disaster Health Services Model-Case Study, Kathryn Elaine Weseman Jan 2018

Pilot Texas Red Cross Virtual Disaster Health Services Model-Case Study, Kathryn Elaine Weseman

Walden Dissertations and Doctoral Studies

The Red Cross traditional method of Disaster Health System (DHS) response is ' boots on the ground.' Texas, the 2nd largest state by population and land mass, has only 15 DHS volunteer nurses who were not able to meet the needs of disaster victims in Texas with the traditional response method. The Texas Red Cross DHS volunteer nurses began piloting a virtual DHS model in 2014. The research question was how Texas Red Cross nurses designed, developed, implemented, and evaluated the Texas Red Cross virtual DHS Model. The purpose of this case study was to provide this information in a …

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Educating Oncology Nurses On The Benefits Of Patient Exercise, Roberta Anderson Jan 2018

Educating Oncology Nurses On The Benefits Of Patient Exercise, Roberta Anderson

Walden Dissertations and Doctoral Studies

Exercise benefits patients with cancer during and after treatments. A formalized educational program is lacking at the project's site for oncology nurses on the benefits of exercise for their patients during and after treatment. The purpose of the project was to address the identified gap in practice at the project's site by providing education to oncology nurses on the benefits of exercise for their patients during and after treatment. The ARCS model of motivational design was used as a theoretical foundation to develop and guide the educational program presented to the oncology nurses. The question addressed in the project was: …

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Enhancing Urinary Catheter Skills Among Clinically Practicing Nurses, Arvella Derisa Battick Jan 2018

Enhancing Urinary Catheter Skills Among Clinically Practicing Nurses, Arvella Derisa Battick

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) contribute to increased patient length of stay and health care costs. The literature has shown that one plausible cause of CAUTIs is improper Foley catheter insertion techniques among nurses. The purpose of this project was to answer the project-focused question that asked if there was a difference in nurses' practice skills following an educational intervention involving aseptic Foley insertion. Benner's novice-to-expert theory was the conceptual model for the study. Nurses from a college nursing program were asked to demonstrate Foley catheter insertion on a simulation model, and their technique was evaluated using a standardized checklist. …

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Health Literacy As A Measure To Reduce Cost, Improve Health And Access, Vivian Dee Jan 2018

Health Literacy As A Measure To Reduce Cost, Improve Health And Access, Vivian Dee

Walden Dissertations and Doctoral Studies

The United States dedicates greater than 17% of its gross national product to healthcare. This percentage is expected to go up to 20% by 2018. Despite the high cost of care, the health care system remains inefficient and ineffective. Barriers include reduced access to care related to low health literacy. Complicating low health literacy is the high readability score of patient education materials. The high readability score is in part due to tools that are not standardized and measure different aspects of education materials creating varying readability scores. The purpose of this quality improvement project was to adopt a tool, …

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Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan Jan 2018

Use Of Simulation For Tracheostomy Care, A Low Volume, High Risk Nursing Procedure, Vijaya Ramakrishnan

Walden Dissertations and Doctoral Studies

Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of …

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Educational Training Of Staff Nurses For Evidence-Based Practice, Tina June Theriaque Jan 2018

Educational Training Of Staff Nurses For Evidence-Based Practice, Tina June Theriaque

Walden Dissertations and Doctoral Studies

Translating research into practice takes 10 to 20 years or more. Evidence-based practice (EBP) integration remains at 10% to 20%, despite recommendations requiring EBP-guided decisions. Up to 30% decreases in health care system spending, improved quality outcomes, and increased staff satisfaction result from EBP integration. Nurse leaders, who rate quality and safety as the highest priority but EBP as the lowest, are accountable for EBP enculturation; a desire to support bedside registered nurses in EBP exists, yet this EBP use knowledge gap supersedes this goal. The purpose of this project was to provide an EBP education program introducing the use …

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The Effects Of Hourly Rounding On Patient Safety And Satisfaction, Renee Allatzas Jan 2018

The Effects Of Hourly Rounding On Patient Safety And Satisfaction, Renee Allatzas

Walden Dissertations and Doctoral Studies

The clinical practice problems addressed by the DNP project were the low patient satisfaction scores and the high number of falls on a hospital neurological step-down unit. The purpose of this project was to improve the Hospital Consumer Assessment of Healthcare Providers and Systems score on one patient satisfaction question and decrease the number of patient falls by implementing hourly rounding, using a script related to patient comfort and toileting needs. The scripted questions were expected to increase the satisfaction of patients and decrease unassisted falls due to increased attention to patient pain and positioning and timely help with toileting …

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Improved Rehabilitation By Improving Discharge Processes To Decrease Readmissions, Deborah A. Walton Jan 2018

Improved Rehabilitation By Improving Discharge Processes To Decrease Readmissions, Deborah A. Walton

Walden Dissertations and Doctoral Studies

Inadequate discharge planning for individuals with chronic illnesses or injuries is associated with increased readmissions to the hospital or rehabilitation facility where the original treatments were administered. To help ensure the recovery of discharged patients and avoid readmissions, discharge planners guide medication and care processes. The rate of readmissions was high in a stand-alone rehabilitation center due to ineffective discharge plans. Patients, family members, and caregivers lacked knowledge about medications, treatments, and self-care guidelines after the patient left the facility. The purpose of this project was to ascertain the impact of improved discharge processes using the (a) IDEAL Discharge Planning …

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Coping With Sickle Cell Disease Using Cognitive Behavior Therapy, Helen Alexander Jan 2018

Coping With Sickle Cell Disease Using Cognitive Behavior Therapy, Helen Alexander

Walden Dissertations and Doctoral Studies

This project focused on identifying the best evidence available on the use of cognitive behavior therapy (CBT) for pediatric patients and families with sickle cell disease (SCD) to improve their coping skills with pain management. This resulted from an identified gap in nursing practice regarding psychosocial support for this subset of hospitalized pediatric patients. The practice-focused question was whether there was evidence in the literature on the use of CBT techniques to improve parental coping skills with children who have chronic and life-threatening illness that could be utilized with sickle cell disease. The theory of stress and coping guided the …

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Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan, Leslie C. Hussey, Kathleen Brewer Jan 2018

Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan, Leslie C. Hussey, Kathleen Brewer

Journal of Social, Behavioral, and Health Sciences

Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, no studies were located about hypertension in the Armenian American population, despite evidence of health disparities in this population. The purpose of the present study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. A quantitative approach was used to examine the relationship between hypertensive status and health promotion behavior. With a sample size of n = 204, this …

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Perceptions Of Nursing As A Career By African American College Students Attending Historically Black Colleges And Universities, Brenda Marie Owens Jan 2018

Perceptions Of Nursing As A Career By African American College Students Attending Historically Black Colleges And Universities, Brenda Marie Owens

Walden Dissertations and Doctoral Studies

Previous studies and official organizations have indicated that African Americans are underrepresented in the healthcare workforce and that patients belonging to minority groups feel they are treated slightly differently in healthcare settings. Limited research examines perceptions of the nursing profession among a variety of demographic groups, and exploratory investigations into the perceptions of nursing as a career by African Americans are limited. The purpose of this quantitative descriptive study was to explore perceptions of nursing as a career by African American students who attend an undergraduate program at a historically black college or university (HBCU) in an attempt to further …

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Evaluating Nursing Pain Assessment Documentation With The Pediatric Client, Aziza Alexander Jan 2018

Evaluating Nursing Pain Assessment Documentation With The Pediatric Client, Aziza Alexander

Walden Dissertations and Doctoral Studies

Pain is often seen as a primary complaint in the pediatric emergency department (ED). Assessment and documentation of pain are integral to effective pain management, and nurses are responsible for documenting pain assessment. Nursing documentation is essential for ensuring continuous, safe, high-quality care. Evidence shows nurses are inadequately documenting pain assessment and reassessment and not always using appropriate pain scales in a busy, cosmopolitan children's hospital ED. The practice-focused question that guided this project was: How does an educational module and change in electronic health record pain assessment flowsheet increase the nurses' compliance with initial documentation of pain? An educational …

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