Nursing Commons^™

Fall Prevention On The In-Patient Neurological Stroke Unit, Syvol Letwan Middleton

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quality improvement (QI) evaluation project was to decrease patient falls on a neurological stroke unit. This unit had the most falls throughout the hospital system. The unit averaged 50-60 falls per year with an average of 4.75 falls per month. Guided by Neumann’s system model, the project targeted those patients at the highest risk for falling related to deficits post-stroke and post-neurological disease process. Staff were informed about Last fall, Express needs, Awareness of safety, and Frequency of bowel and bladder (LEAF) to determine if this tool could decrease falls in the neurological stroke population patients. …

Implementation Of Night Shift Rounding To Improve Nursing Communication And Reduce Days Of Intubation In The Intensive Care Setting, Lisa Wilkinson

Walden Dissertations and Doctoral Studies

Multidisciplinary rounds are the gathering of various health care providers who have a shared interest in a patient’s well-being to discuss the plan of care and the patient’s progress through their hospital stay. This multidisciplinary group of staff can be the providers, the nurse, charge nurse, social worker, pharmacist, dietician, respiratory, chaplaincy, and occupational and physical therapists. On night shift at the project site, this rounding process did not occur, leaving the staff feeling they were not involved in the plan of care. The purpose of this quality improvement evidenced-based project was to create a process change, introduced to the …

Educating Nurses On Failure To Rescue Due To Treatment Delay, Ganiyu Olasheni Adewale

Walden Dissertations and Doctoral Studies

Studies have found a shortfall in nurses' skills in caring for patients with a significant risk of failure to rescue in an acute care setting. The practice gap the healthcare facility was experiencing today was a gap in relation to failure to rescue with an increased rate of sentinel cases. There was a knowledge deficit among critical care nurses. The importance of educating nursing staff is to increase their knowledge and help decrease the occurrence of failure to rescue in an acute care setting. The practice-focused question for this education project asked if educating nursing staff with a medical-surgical competency …

Implementation Of A Staff Education Project On Human Trafficking For Emergency Department Staff, Monica Rena Hunt

Walden Dissertations and Doctoral Studies

Evidence demonstrates that people who are being trafficked will seek medical attention, especially in emergency departments, which presents a rare opportunity to identify and support them. This Doctor of Nursing Project (DNP) was designed to evaluate if educating emergency department nurses on using an adult screening tool for human trafficking improves knowledge in a local emergency department in Texas. The participants were 11 registered nurses. The Maslow hierarchy of needs theory and the adult learning theory were used as a framework, and the models used to construct the educational project were Gagne’s nine levels of learning and the use of …

Preventing Nosocomial Infections In West Central Africa Through Nurse Education, Frida Ashu

Walden Dissertations and Doctoral Studies

AbstractNosocomial infections are acquired after being hospitalized. Lack of nurses’ education pertaining to nosocomial infections increase the risk of infections. Nurses working in the target facility in West Central Africa were not knowledgeable about current evidence-based infection control practices. The purpose of this project was to educate nurses on how to reduce the rate of nosocomial infections. The analysis, design, develop, implement, and evaluate model was used to guide the development of this project. Three experts evaluated the education program for content validity and usability. The program was presented as a PowerPoint to 40 health care workers via Zoom. The …

Reducing Opioid Prescribing By Using The Center For Disease Control Guidelines, Christina Marie Peters

Walden Dissertations and Doctoral Studies

Opioid abuse is a serious national health crisis resulting in overdose and increased mortality in chronic pain patients. The purpose of this evidenced-based, quality improvement (QI) project was to improve primary care provider’s (PCP) awareness of The Center for Disease Control and Prevention’s (CDC) opioid prescribing guidelines to reduce opioid prescribing at this project site. The Donabedian model of structure, process, and outcome was used as the framework for this QI project. Lewin’s change management model of unfreezing and freezing was used as a guide to implement organization change by creating problem awareness, seeking alternative methods, and integrating the new …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Factors Contributing To High Rates Of Pre-Eclampsia Among African American Women, Tinisia Jordan Boyd

Walden Dissertations and Doctoral Studies

Maternal and neonatal deaths remain a significant healthcare concern globally. For instance, 4% of pregnancies in the United States are affected by pre-eclampsia, which is the second leading cause of maternal mortality globally. However, evidence shows that African American women are at higher risk of developing pre-eclampsia during pregnancy, and the population experiences severe maternal outcomes compared to other communities. Therefore, the goal of the project was to assess nurses' level of knowledge working in maternal units on pre-eclampsia and eclampsia and assess the effectiveness of simulation-based training on pre-eclampsia on improving nurse knowledge and self-efficacy. Several models were used …

Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney

Walden Dissertations and Doctoral Studies

Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …

Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder

Walden Dissertations and Doctoral Studies

Newly licensed nurse turnover can be costly, causing a mismatch between supply and demand for nurse staffing needs, lowering quality outcomes, and decreasing patient satisfaction. This quantitative study was conducted to identify the relationship between why newly licensed nurses selected their first position and their retention in that initial position. Other factors examined in relation to retention were unit most worked, age, race, sex, and education level. Irvine and Evans’s theory of job satisfaction and Maslow’s hierarchy of needs guided the analysis of the data. Secondary data used were the Newly Licensed Registered Nurse New Cohort 3 Survey from 2016 …

Family Perceptions Of Mental Health Service Use Among Mexican Americans, Vickie Gayle Nethercott

Walden Dissertations and Doctoral Studies

AbstractMexican immigrants are less likely to use psychiatric services compared to people from other race or ethnic groups in the United States, yet little is known about the reasons why the Mexican American population are less likely to seek mental health services. A qualitative descriptive study, guided by Leininger's culture care diversity and universality care theory, was used to explore the perceptions of mental health service use and barriers to psychiatric services for Mexican American immigrants living in the United States. After institutional review board approval was obtained, flyers were placed in five churches in a northwestern U.S state where …

Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa

Walden Dissertations and Doctoral Studies

AbstractMany patients whose primary or secondary chronic condition is hypertension present to their first follow-up appointment in a primary care facility in the north of Puerto Rico with uncontrolled high blood pressure. Nurses’ knowledge of hypertension is vital to addressing a gap in practice for this patient population and patient quality of life and the prevention of cardiovascular diseases. The practice-focused question guiding this project focused on a nurse educational session for increasing hypertension management knowledge as well as a follow-up phone call protocol that aimed to improve patient care. The theoretical framework guiding this project was Pender’s health promotion …

Clinical Vaccination Education Guideline For The African American Community, Margaret Chinedum Nwoji

Walden Dissertations and Doctoral Studies

AbstractVaccination hesitancy is high among African Americans and other people of color. The practice gap addressed in this project was the lack of a culturally sensitive clinical guideline for vaccination education relevant to the African American community. The practice-focused question was answered by developing an evidence-based Clinical Vaccination Education Guideline for the African American Community (CVEGAAC) that was validated by a group of four content experts using the Appraisal of Guidelines, Research, and Evaluation tool. The content experts scored each of the domains above 90%, implying that the CVEGAAC is of high quality and ready for implementation. The end users …

Self Care Education For Nurses Following An Assault, Barbara Lynn Schwarz

Walden Dissertations and Doctoral Studies

AbstractSelf-Care Education for Nurses Following an Assault by Barbara Lynn Schwarz MS, Nebraska Wesleyan University, 2008 BS, Nebraska Wesleyan University, 2004

Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2023 Abstract Every day, 1 in 4 nurses experience physical and/or verbal assault, surpassing the rates among police officers and prison guards. This issue is particularly widespread among nurses working in mental health settings. The local practice problem for this project was the absence of self-care education for nurses following workplace assaults. The literature revealed that such assaults have traumatic …

Stress And Coping Among Sud Certified Peer Recovery Specialists, Cynthia June Thomas

Walden Dissertations and Doctoral Studies

Certified Peer Recovery Specialists (CPRSs) are individuals with lived experience in the successful recovery of substance use or mental health disorders. CPRSs provide services for individuals seeking or enrolled in substance use disorder (SUD) recovery, provide mentoring and coaching, service and resource connections and lead recovery groups but, the job of a CPRS can have beneficial and detrimental impacts on the CPRS’s personal recovery. The purpose of this quantitative study, guided by Lazarus’s theory of coping and stress, was to determine whether there is (a) a relationship in stress and coping effectiveness among CPRSs, (b) a difference in the level …

A Clinical Practice Guideline For Managing Behavioral Problems In Persons With Dementia, Ken J. Brinker

Walden Dissertations and Doctoral Studies

AbstractAs the baby boom generation ages, the demand for effective nursing care for patients diagnosed with dementia has greatly increased. The challenges associated with dementia include a patient’s inability to focus, pay attention, and follow conversations. Patients often become forgetful, angry, frustrated, and aggressive with family members and caregivers. The medical providers and administrators at a long-term care facility needed assistance in developing a clinical practice guideline for managing behaviors demonstrated by patients with dementia. The project question centered on the identification of current evidence supporting a clinical practice guideline for nursing practice for unpredictable behaviors demonstrated by residents diagnosed …

Comparison Of Rural Associate Degree Nursing Students’ Clinical Judgment After Curriculum Change, Karen Bowen

Walden Dissertations and Doctoral Studies

New graduate nurses often lack adequate clinical judgment skills to practice competent nursing care, which may result in increased risk of committing practice errors that threaten patient safety. To mitigate errors in patient safety, industry leaders have called for nursing program improvements in preparation of nursing students’ clinical judgement as they transition to professional practice. Guided by Tanner’s clinical judgment theory, the rural state nursing programs in this study implemented a concept-based curriculum to promote clinical judgment which includes thinking skills, priority setting, and management of care. The purpose of this three-part, quantitative, nonexperimental study was to compare the development …

Improving Veteran’S Care Outcomes With The Implementation Of Care Coordination, Katrina Ann Canady

Walden Dissertations and Doctoral Studies

AbstractAstute care coordination is essential to eliminating fragmented care, duplication of services, medication errors, and unnecessary emergency rooms visits. This Doctor of Nursing practice project was a quality improvement (QI) initiative that addressed the gap in practice regarding RN care managers who were not consistently performing care coordination as outlined by the office of community care at the project site. The purpose of the project was to evaluate the effectiveness that an educational intervention had on the RN care managers’ abilities to perform care coordination. The care coordination model (CCM) served as the project framework because it provides a systematic …

Educating Nurses On Mental Fatigue, Tawanna Ann Canty

Walden Dissertations and Doctoral Studies

Education correlates with nurse performance and avoiding mental fatigue. This project attempted to answer the question, “Educating nurses on mental fatigue will increase knowledge” focusing on educating rehabilitative nurses regarding mental fatigue. The project was guided by the Analysis, Design, Develop, Implement, and Evaluate model. Twenty rehabilitative nurses were administered a pretest consisting of 10 multiple-choice test questions. They received education on mental fatigue through PowerPoint presentations and handouts. After completing the education, participants were administered a posttest with the same 10 questions. An evaluation tool consisting of six questions was completed measuring an increase in knowledge after the posttest. …

Teach-Back As An Evidence-Based Tool In Patient Education, Andrea Clyne

Walden Dissertations and Doctoral Studies

AbstractDischarge instructions are a valuable component of patient education as they can influence outcomes post-discharge, leading to positive social change through improved morbidity and mortality. The use of teach-back education by registered nurses is a best practice that assures understanding of discharge instructions. However, consistent use of this method relies on the staff’s conviction and confidence in this manner of education. The purpose of this project was to develop, deliver, and evaluate a program to educate staff on the best practice of teach-back to effectively deliver patient education. The logic model helped guide and develop the stages of the project …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Staff Education To Promote Probiotic Breastfeeding Therapy, José Diaz

Walden Dissertations and Doctoral Studies

Preterm birth is the leading cause of death in children under 5. In addition, there are 22 million babies born underweight each year which also contributes to the infant mortality rate. Some reasons for the inability to thrive and survive are the infants' immature system, allostatic load inadaptability, and undiversified and underdeveloped microbiota. Human breast milk (HBM) provides lifesaving nutrients, which prevents necrotizing enterocolitis and mortality. In addition, probiotic supplementation helps reduce late-onset sepsis, morbidities, and mortality. A literature review provided substantial evidence that HBM and probiotics can improve an infant's microbiota, thus improving thrivability and survivability. Probiotics offset the …

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

A Nursing Staff Education Module On Survivorship Care Plans In Primary Care, Janette Francis

Walden Dissertations and Doctoral Studies

Survivorship care plans (SCPs) bridge the gap in the transition of care from oncology to primary care providers (PCPs) for breast cancer survivors. Despite strong recommendations for SCPs, their use remains limited. Guided by Knowles’ adult learning theory, the project focused on, first, determining whether a predeveloped staff education activity was valid using the Lynn model criteria for validation. Second, if in a rural clinic where SCP were not consistently used providers, nurses, and staff knowledge regarding the importance of SCP would increase following an educational program. An expert panel of 5 educational experts validated the educational module for appropriateness …

Improving Advanced Practice Registered Nursing Knowledge Of Shingles Management, Kyla Gilbert

Walden Dissertations and Doctoral Studies

AbstractShingles is a viral infection that can adversely impact patients if not promptly treated. In the project facility, a gap in practice was identified when a 6-month facility chart review noted a delay in shingles diagnosis 60% of the time. It is important for the Advanced Practice Registered Nursing (APRN) to be knowledgeable regarding diagnoses and best practices for treatment of shingles. However, the local facility had no available education on shingles. The practice-focused question asked whether APRN knowledge of shingles could be improved through staff education. The doctoral project provided shingles education to address the identified knowledge gap. The …

Nurse Perceptions Of Nonacademic Factors That Influence Undergraduate Nursing Student Retention And Persistence To Graduation, Marianne Gray

Walden Dissertations and Doctoral Studies

Having an adequate supply of nurses is critical to maintaining the health care system. The problem for this study was that undergraduate nursing students were leaving a local Midwest community college’s nursing program before obtaining a degree. The purpose of this qualitative study was to explore the perceptions of the program’s recent graduates, regarding nonacademic factors that they believe helped to facilitate their success. Jeffreys’s nursing universal retention and success model served as the conceptual framework. The research question was focused on identifying nurse graduate perceptions of nonacademic factors that contributed to their success. A basic qualitative research design was …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

Exploration Of Nurses' Knowledge About Healthcare For Transgender Patients, Elizabeth Kempt

Walden Dissertations and Doctoral Studies

AbstractThe transgender population is growing, and along with the population growth, the healthcare needs for gender transitioning of both medical and surgical procedures. Registered nurses (RNs) who care for hospitalized transgender patients are required to be knowledgeable about their care, yet little is known about what nurses know about the healthcare of the transgender patient. The purpose of this basic qualitative study, guided by Benner’s novice to expert theory, was to explore the knowledge and perceptions of RNs regarding healthcare of transgender persons undergoing transition to the opposite gender. Social media and snowball sampling were used to recruit 10 RNs …

Registered Nurses’ Perceptions Regarding Postoperative Pain Management And Opioids For Adolescents, Susan Miller

Walden Dissertations and Doctoral Studies

More than 2.4 million children undergo surgery annually in the United States and many experience postoperative pain. Poor pain management causes negative outcomes to both the individual and society. Increased rates of prescription drug misuse and rising death rates for adolescents from drug overdoses underscore the need for improvements in pain management. However, there is a lack of research, limited guidelines, and significant provider variability in managing adolescents’ acute postoperative pain. The purpose of this qualitative study was to explore the topic of acute postoperative pain management for adolescents through the lens of registered nurses (RNs). Nurses play an essential …

Staff Education On Diabetes Self-Management For Patients, Happiness Ifeoma Oguariri

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus, a disease in which the body does not metabolize, store, and excrete. glucose appropriately, presents an economic and health burden in the United States. Summary of recent evidence shows that nurses lack adequate education in providing. diabetes self-management education to patients. Research also shows that providing. nurses with education increases their knowledge of the disease and empowers them to teach their patients self-care. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this Doctor of Nursing Practice program was to plan, implement, and evaluate a staff education. program on diabetes self-management. …