Nursing Commons^™

Moving Teamwork Into Teaming: Evaluating A Team-Based Model Of Nursing Care, Katie Lynn Maloney

Walden Dissertations and Doctoral Studies

Nursing practice faces staffing shortages, complex patient care, and a need to develop creative ways to fill staffing holes within the acute care clinical setting (Beckett et al., 2021). A hospital in New Hampshire, United States implemented a team-based nursing care model on a geriatric psychiatric unit in January 2023. The model has been in place for 18 months. The focus of this Doctor of Nursing Practice (DNP) quality improvement (QI) evaluation project was to determine if implementing the team-based nursing model of care improved patient outcomes such as falls, restraint use, and hospital-acquired pressure injuries and reduced the number …

Executive Summary: Clinical Practice Guideline Obstetrics Diabetes Management, Carole N. Louis

Walden Dissertations and Doctoral Studies

Summary A clinical practice guideline (CPG) was developed because the perinatal department lacked standardized management of pregestational and gestational diabetes. The practice issue is relevant since managing maternal glucose ranges during pregnancy mitigates adverse maternal and neonatal outcomes. The practice-focused question asks, “What are the best practices to manage diabetes in the intrapartum and postpartum settings?” The project was designed to develop an evidence-based protocol to provide standardized management for nurses and providers. Most studies in the literature search were quantitative sources with either A or B overall quality ratings. Based on the evidence, the intrapartum target maternal glucose range …

Staff Education To Use The Mental Health Risk Assessment Tool, Nkeiruka Okwuoma Okonkwo

Walden Dissertations and Doctoral Studies

Suicide/self-harm continues to be one of the most common sentinel events that could result in significant harm or death especially among mental health patients (Mills et al., 2020). Environmental hazards seem to be the primary contributing factor in patient suicide and self-harm cases. Thus, patient suicide remains a safety concern, especially in mental health facilities. It is important that nurses have the knowledge to prevent, identify, assess, and respond appropriately whenever they encounter patients at risk for suicide/self-harm. This Doctor of Nursing Practice (DNP) staff education project focused on educating staff on how to use the Mental Health Environmental Risk …

The Application Of Therapeutic Communication Between Staff And Patients, Aloysius Mokom Tamufor

Walden Dissertations and Doctoral Studies

The practice problem identified was the limited use of therapeutic communication among staff at the project site facility, which was attributed to low knowledge. The purpose of the project was to improve nurses’ knowledge of and intent to use therapeutic communication when interacting with patients with mental health disorders. The question that guided the project was: Does staff education about therapeutic communication improve nurses’ knowledge of and intent to use it when interacting with patients? A sample of 20 healthcare staff, which included advanced practice registered nurses and registered nurses who practiced in a mental health facility completed the education …

Universal Suicide Screening In Outpatient Primary Care And Specialty Care, Tamaria Featherlin

Walden Dissertations and Doctoral Studies

Native Americans are disproportionately affected by suicide, with mortality rates that are 2.5 higher than White and non-Hispanic Americans. Nursing staff in an Indian Health Service (IHS) outpatient and specialty care clinic inconsistently assess for suicide risk before outpatient and specialty clinic appointments due to sporadic use of screening tools and lack of confidence to ask patients suicide risk screening questions. The purpose of this staff education project was to determine if interactive education of outpatient nursing providers regarding universal screening for suicide risk using the Ask Suicide Screening Questions (ASQ) for patients who are 8 to 11. Patient Safety …

Inclusiveness Of English As A Second Language Nursing Students In The Academic Setting, Bahgat Youwakeem

Walden Dissertations and Doctoral Studies

This study explored the perceptions of English as a Second Language (ESL) nursing students regarding inclusiveness in nursing programs in the southern United States. The problem addressed is the limited research on how ESL nursing students perceive inclusiveness in academic environments, particularly in the Southern States, where diversity is increasing. Previous studies have focused on the general challenges faced by ESL students, but few have examined their specific perceptions of inclusivity in nursing programs. The purpose of this qualitative phenomenological study, guided by Whannell and Whannell’s identity theory, was to gain insights into ESL nursing students' lived experiences of inclusiveness. …

Staff Education Project For Adult Icu Nurses, Hani Ayyad

Walden Dissertations and Doctoral Studies

This staff education project is a crucial initiative designed to enhance nursing knowledge and skills in the care of central lines. Its overarching goal is to reduce the incidence of central line-associated bloodstream infections (CLABSI) in a teaching hospital. Given that CLABSIs are a major concern in Intensive Care Units (ICUs), due to higher morbidity, mortality, and healthcare expenditures, this project is very important. My goal was to fill these gaps by providing a comprehensive staff education program addressing this critical issue. The evidence-based practice question (EBP) guiding this Doctor of Nursing Project (DNP) project was: Does the Staff Education …

Pneumonia Pathway’S Effectiveness In Decreasing Length Of Stay In An Acute Care, Marie Carline Hollant

Walden Dissertations and Doctoral Studies

Community-acquired pneumonia (CAP) can be detrimental to patient outcomes. One major challenge affecting care for CAP is hospital length of stay (HLOS), which is associated with multiple factors, mainly comorbid conditions. One way to improve the efficiency of CAP hospital care is the implementation of pneumonia clinical pathways to ensure effectiveness in application of pneumonia treatment and care. This project evaluated the effectiveness of using pneumonia pathways by evaluating HLOS before and after the health care staff in the project site implemented pneumonia pathways. Use of the pneumonia pathways in the project site started in 2021, but there had not …

Abstract Education On Agency For Healthcare Research And Quality Ideal For Health Ministry, Francesse Charles-Cherelus

Walden Dissertations and Doctoral Studies

Education on Agency for Healthcare Research and Quality IDEAL for Health Ministry by Francesse Charles-Cherelus MS, Walden University, 2020 BS, Clayton State University, 2018 Project in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2024 The problem addressed in this project was lack of access to community resources for care of patients with behavioral or mental health conditions. Without adequate resources, patients are at risk for rehospitalization. The purpose of the doctoral project was to develop a staff education program for health ministry staff and evaluate effectiveness to increase staff confidence in …

Staff Education To Improve Medication Compliance In Older Patients In Home Settings, Chika Ugoala Okwonna

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project was a staff education intervention intended to improve medication adherence at a long-term care facility. The practice gap identified was that staff lacked current evidence-based knowledge in medication compliance. The project addressed whether educating staff on medication compliance would increase knowledge. The purpose of this project was to increase knowledge with the overall goal to improve patient outcomes. Planning strategies included undertaking a strengths, weaknesses, opportunities, and threats (SWOT) assessment of the organization’s readiness. The project involved creating and implementing an in-person 60-minute presentation. Eighteen nursing staff voluntarily participated in the education intervention, …

Evaluation Of An Educational Intervention Focused On Intake And Output Documentation, Ingrid Lea Bloomfield

Walden Dissertations and Doctoral Studies

Heart failure (HF) is the primary reason for hospital admissions in the United States, accounting for almost 6.5 million hospital days per year and for 8.5% of cardiovascular deaths. As part of care delivery and supported by the evidence, providers use intake and output (I&O) to guide a HF patient’s overall treatment plan. Following several reviews in the local organization, it was determined that I&O documentation sheets were incomplete or not completed at all. Thus, organizational leadership determined that an educational intervention focused on I&O monitoring and documentation as part of the HF patient treatment plan would address this gap-in-practice. …

Executive Summary: Clinical Practice Guideline, Bona Eze

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a gap in practice in an outpatient clinic in the Northeastern United States. The gap in practice was a lack of standardized patient education on self-care management strategies for adult patients with diabetes, leading to increased rates of noncompliance, readmission, and poor health outcomes. The guiding question asked whether an expert panel could evaluate and validate a clinical practice (CPG) developed from current, evidence-based literature and recommendations from the American Association of Clinical Endocrinologists and the American Diabetes Association on self-care management strategies for the adult patient with diabetes. The project followed …

Relationship Between Opioid Treatment And Nonpharmacological Chronic Pain Management Interventions And Perceived Effectiveness Of Managing Chronic Pain In African American Adults, Bona Eze

Walden Dissertations and Doctoral Studies

Chronic pain impacts all areas of life for most Americans, but the issue is particularly salient among African Americans (AAs) as they face adverse pain outcomes. There is little understanding of pain management strategies used by AAs to inform pain management recommendations. The purpose of this study, guided by the COM-B model and biopsychosocial theory, was to determine if there were a relationships between opioid treatment and perceived effectiveness of managing chronic pain in AA adults who are 18 years and older as well as between nonpharmacological interventions (physical therapy, chiropractic care, talk therapy, self-management program, yoga, massage) and perceived …

Effectiveness Of Simulation In The Education Of Rns Transitioning Into The Operating Room, Cortney Ann Lupo

Walden Dissertations and Doctoral Studies

RNs who are new to the operating room (OR) must gain confidence and clinical reasoning skills to care for individuals undergoing surgery. Training in the OR is stressful but using simulation for training RNs new to the OR may improve clinical reasoning and confidence. The purposes of this two group, repeated measures study, guided by National League of Nursing/ Jefferies simulation theory and Benner’s novice to expert theory, were to determine if there was a difference in (a) clinical reasoning levels of RNs new to the OR who received simulation compared to clinical reasoning levels of RNs new to the …

Nurse Educators’ Experiences In Implementing Concept-Based Teaching, Ma Camlaria Felismino

Walden Dissertations and Doctoral Studies

The National League for Nursing called for implementing innovative teaching strategies in nursing education. Concept-based teaching (CBT) is a method that encourages learners to interpret, analyze, and integrate knowledge. Despite reports that CBT improves student outcomes and enhances critical thinking, the adoption of CBT is slow. This qualitative descriptive study, guided by Rogers’s diffusion of innovations theory, explored how nurse educators have experienced implementing CBT. Secondary data were analyzed from interviews conducted with 13 participants. Using constant comparative analysis, seven key themes emerged and were linked to the successful adoption and implementation of CBT: communication, learning from established programs, curriculum …

Staff Education Program To Enhance Patient Handover Communication, Olufemi Olawale

Walden Dissertations and Doctoral Studies

Patient handover communication is the process that occurs when nurses transfer responsibility for patient care and give status reports to nurses who are assuming care of the patient. The practice problem at the project site was the gap in quality, accuracy, and completeness of information that was shared during the handover process. The purpose of this project was to develop, implement, and evaluate a staff education program on effective communication handover between nurses and care providers. The practice-focused question for this project was: Will a staff education project increase nurses’ and clinicians’ knowledge and competency with using the situation, background, …

Improving Nursing Communication Through Handoff Tool Education: A Staff Education Project, Linda Holt Anderson

Walden Dissertations and Doctoral Studies

The common practice of handoff of care communication is an integral part of patient care. However, ineffective handoff communication is associated with significant risks to patient outcomes. The issue of ineffective handoff of care is a local practice problem as well as a national issue. Strategies including standardized verbal, written, and electronic clinical handoff tools are emerging. However, many nurses are not knowledgeable regarding use of these standardized handoff of care tools. Therefore, the practice-focused question for this doctoral project asked whether an educational program on use of a standardized handoff tool could increase nursing knowledge as compared pre- and …

Effects Of Nursing Faculty Incivility On Nursing Student Attrition, Amber Solheim

Walden Dissertations and Doctoral Studies

Incivility in nursing academia can occur with various people in the role of the perpetrator or victim, including students, faculty, and healthcare professionals in clinical settings. Nursing faculty incivility towards students may lead to nursing student attrition in practical nursing or associate degree programs. The purposes of this study, guided by Bandura’s social learning theory and Tajfel’s social identity theory, were to determine if there is a (a) difference in perceived faculty incivility in nursing students who withdraw from nursing school and nursing students who do not withdraw and (b) the difference in the levels of perceived faculty incivility between …

Clinical Practice Guideline On Evaluating The Effectiveness Of Venipuncture Arm Simulation, Drena D. Belland

Walden Dissertations and Doctoral Studies

Venipuncture is an integral process in clinical care, and it has an indispensable role in diagnostics and determining therapeutic interventions. The process of phlebotomy has faced several challenges that have compromised patients’ safety. The risk of incorrect venipuncture, or preanalytical errors, leading to severe patient complications of hematoma and thrombosis calls for training using current, evidence-based practices. The goal of this project was to develop a clinical practice guideline (CPG) to determine the efficacy of venipuncture simulation training using an arm task trainer to enhance the phlebotomy skills of nurses. Based on the outcome, present, state, test model and Nightingale’s …

A Staff Education Program On Managing Covid-19 In A Correctional Setting, Mary Catherine Knight

Walden Dissertations and Doctoral Studies

The medical departments of many correctional facilities were unprepared to manage the COVID-19 pandemic. The practice problem identified for this doctorate of nursing practice (DNP) project was the lack of knowledge of health staff on managing incarcerated individuals' care during a pandemic. The primary purpose of the project was to develop, implement, and evaluate a staff education program on evidence-based interventions for preventing and managing a pandemic in a correctional facility. This project was guided by David Kolb's experiential learning theory and the analysis, design, development, implementation, and evaluation (ADDIE) model. The practice setting was a local detention center in …

Educating Nurses On How To Mentor Newly Hired Licensed Practical Nurses, Tamika Tamara Johnson

Walden Dissertations and Doctoral Studies

The lack of mentorship for licensed practical nurses (LPN) in long-term care facilities can be stressful and challenging for a new hire nurse. Recognizing that mentoring is essential to achieve employee satisfaction, higher retention rates and the well-being of residents, the objective of this doctorate in nursing practice project was to create a staff education program and mentorship manual. Knowles’s adult learning theory; Benner’s novice to expert model; and the analysis, design, development, implementation, and evaluation model served as the framework for developing the DNP project. The project was guided by the following question: Does a mentorship-focused educational intervention increase …

Evaluating The Communication And Accountability Of Nurses In The Clinic Setting, Emily Baarz

Walden Dissertations and Doctoral Studies

Research has demonstrated the importance of effective communication and its relationship to positive patient, provider, and organizational outcomes. In the local organization, nursing staff verbalized concerns regarding lack of professional communication that may contribute to a hostile work environment and affect the quality of patient care delivered. To address this concern, the organization implemented a staff education program focused on effective communication practices and level of accountability. The purpose of this quality improvement project was to determine if the educational intervention focused on effective communication practices and level of accountability increased the participants’ perceptions of communication and accountability among nursing …

Education For Nursing And Primary Care Providers On Nonpharmacological Management Of Chronic Pain, Ma Teresita Gonzales De Jesus

Walden Dissertations and Doctoral Studies

Chronic pain is one of the leading causes of disability worldwide, with a significant financial burden on those individuals affected, the communities, the healthcare systems, and the government. Chronic pain also interferes with individuals’ daily activities and alters the quality of life. The treatment for chronic pain includes a variety of medications, including prescription opioids and nonprescription such as NSAIDS, acetaminophen, and muscle relaxants. Pharmacological treatments can result in untoward effects. The CDC has recommended nonpharmacological alternative treatment modalities that promote self-management but are not emphasized or utilized in the primary care setting. The staff education program was framed within …

Staff Education To Enhance Healthcare Providers' Use Of The Phq-9 Assessment Tool, Priscilia Nguh

Walden Dissertations and Doctoral Studies

Depression is a common mental health issue that has a substantial impact on people’s well-being and healthcare results. While there is ample evidence of depression’s harmful impact, the difficulty of accurate diagnosis remains. Inadequate screening of depression in primary health clinics results in treatment delays. The PHQ-9 is a tool to diagnose depression, however many clinicians are unfamiliar with its use. As a result, individuals susceptible to depression may not receive timely appropriate management, leading to poor health outcomes and higher healthcare utilization. This practice focused project aimed to understand if staff education would improve healthcare providers’ knowledge regarding use …

Educating Nursing Staff On Urinary Tract Infections, Eldarada Rosamay Searcy

Walden Dissertations and Doctoral Studies

The primary objective of this doctor of nursing practice (DNP) project was to educate staff on urinary tract infection (UTI) prevention. A gap in practice was identified among nursing staff at an assisted-living facility who lacked current, evidence-based knowledge. This project was conducted to determine whether educating staff on UTI prevention increased their knowledge. Knowles’s adult learning theory and the analysis, design, development, implementation, and evaluation model were used as the theoretical framework that guided this project. Eighty-eight healthcare workers at the project site voluntarily participated in this project. Before the education session, a 10-question, multiple-choice pretest was administered to …

Nurse Leaders Promoting Well-Being Through Mindfulness, Laura G. Cockrell

Walden Dissertations and Doctoral Studies

Becoming a nurse is not just a career but a calling. With this calling comes an ethical duty to the patient, but the duty remains to provide care for oneself. During the COVID-19 pandemic, a strained nursing profession felt the effects of a self-care deficiency. Mindfulness is one self-care tool that can allow nurses to maintain a state of well-being. This project followed Orem’s self-care deficit theory, in which people can use self-care to maintain wellness. The purpose of this project was to develop, deliver, and evaluate an education program for registered nurse leaders on mindfulness activities to address whether …

Student Nurse Experiences Of Retention Strategies And The Perceived Contribution To Academic Progress, Jessica Dugas

Walden Dissertations and Doctoral Studies

There is a worldwide nursing shortage that has been heightened by the COVID-19 pandemic. Several factors have contributed to the worsening shortage, including high attrition rates in nursing programs. Retention strategies have been suggested to support nursing students during their education to have success and graduate. The purpose of this descriptive qualitative study was to explore how nursing students experience retention strategies and their perceived contributions to academic progress. Bandura’s social cognitive theory was the theoretical framework used to guide the study. Data were collected from one-on-one interviews with 12 nursing students recruited using purposeful and snowball sampling. Data were …

Transformative Learning: Changing Nurses’ Perceptions About People In Poverty, Jacqueline Debrew

Journal of Social, Behavioral, and Health Sciences

Background: Meaningful learning experiences with clients in poverty may help nursing students change their perceptions towards those experiencing poverty and, thus, provide unbiased, nonjudgmental care when they become nurses.

Purpose: The purpose of this research was to understand what learning activities and experiences nursing students found meaningful and led to a change in prior perceptions of people in poverty.

Methods: Guided by Mezirow’s Theory of Transformative Learning, accelerated BSN students enrolled in a mental health nursing course (n = 14) were assigned reflective journals throughout the semester on their assigned clinical experiences, which were analyzed for emergent themes.

Results: …

The Experiences Of Icu Nurses Caring For Covid-19 Patients In Zambia, Mable Kasonde Mwila

Walden Dissertations and Doctoral Studies

The purpose of this research was to explore the experiences of ICU nurses caring for COVID-19 patients in Zambia. The problem was lack of knowledge on what intensive care unit nurses experienced while caring for COVID patients then to investigate the experiences of ICU nurses taking care of COVID patients in Lusaka, Zambia. Using Sister Callista Roy’s nursing adaptation model as a conceptual framework, the qualitative interpretative phenomenology approach was used to interview 14 participants in two hospitals in Zambia. MAXQDA software was used to organize data to develop codes and derive six themes, which were education, emotional and psychological …

Experiences Of Black Males With Generalized Anxiety Disorder During The Covid-19 Pandemic, Cynthia Lynn Williams

Walden Dissertations and Doctoral Studies

This qualitative research dissertation involved exploring the intersection of race, gender, and mental health via lived experiences of Black males who were diagnosed with generalized anxiety disorder during the COVID-19 pandemic to provide a comprehensive understanding of how the unique sociocultural context of the pandemic influenced their experiences with anxiety. Using a qualitative Interpretive Phenomenological Analysis research design and semi-structured interviews with a diverse sample of seven Black males living in various regions of the United States the interviews involved their personal experiences, coping mechanisms, and perceptions of societal and systemic factors that affected their mental health during the pandemic. …