Nursing Commons^™

Novice Nurses’ Perceptions Of Caring With Empathy In An Acute Care Hospital In The Northeastern United States: A Transcendental Phenomenological Study, Haley Zurcher

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the essence of the experience of empathy among novice nurses in an acute care facility in the Northeast United States. The Central Research Question (CRQ) for this study was: What was the perceived experience/understanding of empathy by novice nurses working in acute care settings in northeastern Pennsylvania, United States? The study was guided by Bandura’s (1977) self-efficacy theory to examine how confidence, environmental influences, and personal beliefs shaped the development and expression of empathy in early nursing practice. The study was conducted at a large acute care hospital. The sample …

A Phenomenological Hermeneutic Study Of The Lived Experiences Of Pre-Licensure Nursing Students’ First Semester Clinical Rotations Following Simulation Learning, Ogochukwu Vera Nnakwe

Doctoral Dissertations and Projects

This phenomenological hermeneutic study aims to understand the lived experiences of pre-licensure nursing students during their clinical rotation semester following simulation learning at Southeastern University. The guiding theory for this study is Kolb’s experiential learning theory (Kolb, 1984). Simulation learning in nursing education is a teaching approach that lets learners practice practical nursing skills in a safe environment without risking patient safety, thus bridging the gap between theory and practice (Mishra et al., 2023). It offers students opportunities to improve their knowledge of clinical skills and enhance their abilities (Koukourikos et al., 2021). The study involved a sample of 12 …

The Relationship Between Resiliency Scores And Nurse Educators Intent To Stay In Academia: A Predictive Correlational Study, Michele Lee Blash

Doctoral Dissertations and Projects

A shortage of both clinical nurses and nursing educators exists. These shortages have a multitude of impacts on the field of nursing, both at the bedside and in academia. The shortage of clinical nurses impacts the number of nurses available to provide quality patient care. The shortage of nursing educators can impact the number of students accepted into nursing programs and, in turn, the number of new nurses available to provide direct care to patients. The purpose of this quantitative non-experimental predictive correlational design study was to examine how the resiliency of nursing educators impacts their intent to stay in …

Re-Education On Chlorhexidine (Chg) Bathing Protocol Affects Patient Chg Bathing Compliance And Surgical Site Infection (Ssi) Rates, Mary Samantha Ross

Doctoral Dissertations and Projects

Surgical site infections (SSI) are considered a hospital-acquired infection, leading to increased hospital length of stay (LOS), readmission rates, increased cost, morbidity, mortality rates, and poor postoperative outcomes. The literature review demonstrated the benefits of preoperative Chlorhexidine (CHG) bathing, but called for standardized protocols, improved education, and patient compliance. Research and clinical experience supported the need for improved patient compliance with CHG bathing. Consistent SSI rates even after protocol changes called for re-education of nursing staff in addition to addressing patient compliance issues. Therefore, providing re-education on the updated protocol, which addresses patient compliance issues, can lead to a reduction …

Comparing The Difference In Nurses’ Knowledge And Attitudes Toward Near-Death Experiences (Ndes) Before And After Receiving Nde Education, Renata B. Mcallister

Doctoral Dissertations and Projects

Near-death experiences (NDEs) have been reported in approximately 6.3% to 39.3% of patients who survived death or critical illness. Research indicated that health care professionals, of whom nurses are the largest group, received little education or training on NDEs. Nurses' responses to a disclosure could help the patient integrate the experience or contribute to stress and isolation. National nursing standards do not address education or competencies specific to NDEs, and few studies have examined educational programs on the topic. This quasi-experimental study examined changes in nurses' knowledge and attitudes before and after a three-part asynchronous training on NDEs, measured with …

Implementation Of Staff Education To Reduce Or Prevent Pressure Injury, Beverley A. Moses

Doctoral Dissertations and Projects

Pressure injuries (PIs) present a significant clinical challenge in healthcare settings, particularly among patients with limited mobility, comorbidities, and complex musculoskeletal injuries. These injuries lead to adverse patient outcomes, such as increased morbidity, prolonged hospital stays, and an increase in healthcare costs. Despite advancements in clinical practice, PI prevention remains a critical area for quality improvement, necessitating a standardized, patient-centered approach to care. This Doctor of Nursing Practice (DNP) project aimed to improve patient outcomes by implementing a standardized educational initiative for nursing staff in a bone and joint unit at a private hospital in Upstate New York. The project …

Exploring Nursing Students' Experiences Of Simulation-Based Learning In Developing Critical Thinking, Clinical Reasoning And Clinical Judgment In The Management Of Mental Health Patients: A Qualitative Case Study, Irene Bellew

Doctoral Dissertations and Projects

The purpose of this case study was to explore how simulation-based learning experiences shape the development of critical thinking, clinical reasoning, and clinical judgment for associate degree nursing students when caring for patients with mental health needs. It addressed the need to narrow the gap between theoretical knowledge and practical application in clinical settings, enhancing the preparedness of novice nurses. By positioning nurse educators as facilitators of innovative strategies, this study advocates for the integration of simulation-based learning within nursing curricula. Roy’s adaptation model guided the study, and data were collected through observation of simulation sessions, semi-structured interviews, and reflective …

Exploring The Motivations And Educational Needs For Undergraduate Nursing Students To Enter Into Critical Care: A Qualitative Study., Christina S. Pradhan

Doctoral Dissertations and Projects

Critical care nursing is a specialty that demands a high level of skill and dedication. In this high-stress, fast-paced environment, nurses must think fast and act decisively with sound clinical judgment and knowledge. The purpose of this hermeneutic phenomenological qualitative study was to understand the motivating factors that cause nurses to enter the field of critical care, as well as to explore the ways in which undergraduate nursing studies may be improved to better prepare future critical care nurses. Knowles’ adult learning theory was well suited for nursing students bound for a critical care path. Students at two different baccalaureate …

Pedagogy Challenged: A Phenomenological Examination Of Teaching Through A Prolonged Technological Disruption, Jerry Cervantes

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to examine the lived experiences of nursing faculty in a pre-licensure Bachelor of Science in Nursing program who taught during a prolonged technological disruption caused by a ransomware attack at a private college in Ohio. The theories guiding this study were transformative learning theory and resilience theory as they relate to how educators make meaning of disorienting events and sustain professional functioning when established systems fail. Data were collected through semi-structured interviews, a focus group, and reflective journals from purposively selected nursing faculty participants and were analyzed according to the phenomenological procedures …

The Effect Of Structured Prebriefing On Pre-Simulation Anxiety In Baccalaureate Nursing Students Participating In High-Fidelity Simulation: A Quantitative Quasi-Experimental Nonequivalent Pretest-Posttest Control Group Study, Laura D. Wade

Doctoral Dissertations and Projects

The purpose of this quantitative quasi-experimental nonequivalent pretest-posttest control group study was to examine the effect of structured prebriefing on pre-simulation state anxiety among baccalaureate nursing students participating in high-fidelity simulation (HFS) at a private faith-based university in the South-Central United States (U.S.). Simulation is widely used in nursing education; however, nursing students frequently experience elevated anxiety prior to simulation that may negatively influence learning and performance. Despite recognition of prebriefing as best practice in simulation-based education, limited quantitative research has examined the effect of structured prebriefing on pre-simulation anxiety. A convenience sample of 73 baccalaureate nursing students enrolled in …

Exploring The Role Of Self-Efficacy In Undergraduate Nursing Students: A Transcendental Phenomenological Study, Dorothy Elaine Rolling

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the role of self-efficacy for nursing students whose primary language was not English and who were enrolled in higher education in the northeastern area of the United States. The theory guiding this study was Bandura’s theory on self-efficacy. The major tenets of the self-efficacy theory aligned with the metaparadigm of nursing (person, health, environment, nursing) and with the study’s focus, which was to explore how English as a second language (ESL) nursing students could successfully complete the registered nursing program at an institution of higher learning. The central research question was: …

Associate Degree Program Administrator Perceptions Of Clinical Dishonesty, Cynthia Moore Swineford

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to explore the perceptions of associate degree nursing program administrators regarding faculty reporting of dishonest clinical behaviors by pre-licensure nursing students. Aristotle’s theory of virtue ethics guided this examination of how administrators interpret ethical responsibility, leadership influence, and professional accountability related to clinical dishonesty. The central research question asked, “What are the perceptions of associate degree program administrators regarding faculty reporting of dishonest student behaviors in clinical settings?” The sample included 11 associate degree nursing program administrators from programmatically accredited nursing programs in three mid-Atlantic states. Data were collected through semi-structured interviews, …

The Effect Of A Mass Casualty Incident Adult Hyper-Realistic Simulation On Nurse Confidence Levels And Satisfaction Of Nurses: A Quasi-Experimental Study, Melodie Ann Nutter

Doctoral Dissertations and Projects

The purpose of this quantitative quasi-experimental study was to examine registered nurses (RNs) satisfaction and confidence levels after experiencing hyper-realistic simulations using a mass casualty incident (MCI) simulation method. With the world seeing a rise in MCI events, nurses often become one of the first professional medical providers to interact with the affected individuals. To fill this gap in education, the introduction of intensive hyper-realistic simulation training plays a vital role and provides an advanced perspective on the ever-increasing MCIs in today’s healthcare environment. This quasi-experimental study, using the Wilcoxon rank test and paired, assessed the satisfaction and confidence levels …

Use Of The Casper Test As An Admissions Test For Predicting Academic And Clinical Performance In Student Registered Nurse Anesthetists: A Predictive Correlational Study, Barbara A. Acord

Doctoral Dissertations and Projects

This quantitative, non-experimental, predictive correlational study examined the extent to which CASPer test scores predict academic and clinical performance among student registered nurse anesthetists (SRNAs). Certified registered nurse anesthetists (CRNAs) provide over 80% of anesthesia services in the United States, showing the importance of effective admissions processes to identify candidates most likely to succeed academically and clinically. Traditional admissions criteria in nurse anesthesia programs largely prioritize grades and may underrepresent non-cognitive attributes associated with student success. A convenience sample used a medium effect size, power of .8, and alpha level of .05, with G*Power calculated to be 85 participants 2nd …

Exploring The Lived Experiences Of Operating Room Nurse Interns Transitioning To Practice: A Qualitative Study, Christina C. Baker

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to describe the essence of the lived experiences of new graduate nurse interns transitioning to the operating room (OR) specialty at a southeastern U.S. university hospital system. Many hospitals have nurse residency programs designed to support and facilitate new nursing graduates’ transition to practice areas. The OR is a highly specialized nursing area requiring training in addition to what is offered in nurse residency programs. The central research question was, what is the lived experience of new graduate OR nurses as they complete their transition to practice programs? The theory guiding this …

Associate Degree Nursing Students’ Lived Experiences With Simulation: A Qualitative Phenomenological Study, Jamie O'Connor Florez

Doctoral Dissertations and Projects

This qualitative phenomenological study examined the lived experiences of prelicensure associate degree nursing (ADN) students related to skills acquisition and workplace readiness through simulation-based learning at community colleges in California. Skills acquisition and workplace readiness were defined as students’ perceptions of their ability to competently perform nursing skills and prepare for entry into the healthcare workforce. Guided by Kolb’s experiential learning theory, data were collected from 13 ADN students through questionnaires, semi-structured interviews, and reflective journaling and analyzed using Braun and Clarke’s six-phase thematic analysis.

Three themes emerged: varying emotions from excitement to feeling overwhelmed; experiences of collaboration and unprofessionalism …

Investigating Nursing Instructors’ Perceptions Of Students’ Critical Thinking And Clinical Judgment After Attending A Flipped Pathophysiology Course, Ashley L. Harmon

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to understand an instructor’s ability to develop critical thinking and clinical judgment for pathophysiology nursing students at a state university in the southeastern United States while using the flipped pedagogical approach. The theory guiding this study was Piaget’s constructivist theory, which aligned with the active role of learners in constructing knowledge, and supported the exploration of how flipped classrooms influenced the development of critical thinking and clinical judgment. The central research question for this study was: What are nursing instructors’ perceptions of students' development of critical thinking and clinical judgment when applying pathophysiology …

The Relationship Between The Health Science Reasoning Test And Successful Completion Of An Associate Degree Nursing Program: A Retrospective Predictive Study, Joyce A.Ajkuce Kucerovy

Doctoral Dissertations and Projects

The purpose of this study was to retrospectively identify whether the addition of an entrance exam such as the Health Science Reasoning Test (HSRT) to the current admission criteria of an associate degree nursing (ADN) education program would aid in selecting students with the highest chance of successfully completing the program and entering the workforce. A nonexperimental, retrospective, quantitative, predictive correlational study design was used. A retrospective convenience sample of 320 first-year nursing students in an ADN education program was obtained. The G* power analysis showed a minimum sample size of 107 students was needed. Statistical analysis involved a multiple …

Nursing Faculty Attitudes Toward Artificial Intelligence: A Quantitative Causal-Comparative Cross-Sectional Study, Micaela Mcspadden

Doctoral Dissertations and Projects

The rapid growth of artificial intelligence (AI) in healthcare has highlighted the importance of understanding how nursing faculty perceive this technology. Although prior studies have explored public views, nurses’ perceptions, and faculty attitudes toward technology and curriculum change, limited research has focused on nursing faculty perspectives toward AI. Through the lens of the Theory of Reasoned Action (TRA) and the Technology Acceptance Model (TAM), this study examined factors that influence nursing faculty attitudes toward AI in nursing education. This study used a quantitative, causal-comparative, cross-sectional design with 263 nursing faculty participants from undergraduate pre-licensure programs in the United States. Participants …

Workplace Violence: A Paradigm Shift, Ann Marie Hutchens

Doctoral Dissertations and Projects

Workplace violence (WPV) has reached epidemic proportions. WPV poses devastating results on the healthcare industry: affecting quality of care and patient outcomes, contribute to the development of physical and psychological conditions for nurses, and reduce the healthcare teams’ level of job satisfaction and organizational commitment. The United States is already facing a nursing shortage due to baby boomers retiring and an increase chronic disease and the elder population. Although strongly prevalent, WPV is significantly underreported. It is believed that the low rate of reporting is a consequence of apathy that violence is an occupational hazard, and that nothing will change. …

Bridging The Gap: Optimizing Outpatient Care Delivery In Rural Kenya Through A Telemedicine Workflow Training Initiative, Elizabeth K. Bennett

Doctoral Dissertations and Projects

Access to timely, high-quality outpatient care in rural Kenya is constrained by workforce shortages, geographic barriers, and inefficiencies in care delivery. This Doctor of Nursing Practice project evaluated the impact of implementing a structured telemedicine workflow and training program for a regional mission hospital in the highlands of Western Kenya and its satellite outpatient clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's Change Theory, and the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework, the project employed a quasi-experimental, pre-post design, with eight medical providers participating in structured workshops, interactive telemedicine simulations, and workflow integration exercises. Impacts were …

The Effect Of Community-Based Exercise For Individuals With Pre-Existing Health Conditions, Amy M. Stahl

Doctoral Dissertations and Projects

Physical inactivity is a growing problem for the health and wellbeing of the world’s population. Increases in physical activity may help to improve health outcomes for the general population of the United States. This study is two-fold and seeks to determine if community-based exercise groups are successful in improving the health of people with preexisting conditions and encouraging community members to adhere to an exercise program. A quasi-experimental 12-week comparison study consists of a control group of standard care and an intervention group that participates in a three-day a week community walking group. The purpose of the group is to …

Implementation Of Enhanced Recovery After Surgery Protocols To Improved Maternal Pain Management, Stefanie Sherman

Doctoral Dissertations and Projects

Cesarean sections remain the most common surgical procedures in the United States, but they come with significant risks, including increased pain, infection, longer recovery, and higher health care costs. Enhanced Recovery After Surgery (ERAS) guidelines outline an evidence- based, multidisciplinary approach that optimizes surgical recovery and improves outcomes. The primary goal of this project was to evaluate the impact of the implementation of ERAS guidelines in a community hospital with women undergoing scheduled cesarean sections on postoperative pain management as measured by aggregate pain scores. The Iowa Model of Evidence-Based Practice was used to guide this quasi-experimental pre-post project, which …

Exploring The Relationship Between Maternal-Fetal Training And Maternal Desert Workers’ Compassion Fatigue: A Predictive Correlational Study, Marissa Lemley Brown

Doctoral Dissertations and Projects

The purpose of this quantitative, predictive correlational study was to explore the relationship between maternal-fetal training and maternal desert workers’ compassion satisfaction, burnout, and secondary traumatic stress in the southeastern region of the United States. Maternal deserts are defined as areas without dedicated obstetric services and impact more than 28 million childbearing-age women. These areas are becoming more prevalent, leaving healthcare workers to face caring for maternal-fetal health concerns in generalist areas. The study utilized a predictive correlational design to analyze relationships where multiple variables could influence the study. Stamm’s Professional Quality of Life V-5 (ProQOL) scale was used to …

The Effects Of Escape Room Simulations On Stress Levels Of Sophomore Baccalaureate Nursing Students: An Experimental Study, Bethany L. Mcfann

Doctoral Dissertations and Projects

The purpose of this quantitative experimental pretest -posttest design using an experimental and control group was to determine if gaming escape room simulation will decrease BSN nursing students' stress in high fidelity simulation (HFS). The sample size of 64 students had 32 students randomly assigned to each group, the control and the experimental group. The first-year sophomore Bachelor of Science in nursing (BSN) students at a state university were randomly assigned to either traditional or escape room simulation scenarios. Stress levels of each group were measured using the State-Trait Anxiety Inventory (STAI) tool before and after the simulations with statistical …

Bridging The Gap: Improving Medication Communication Through The Teach-Back Method At Discharge, Sangeeta Biju Varghese

Doctoral Dissertations and Projects

Patient experience and hospital readmission rates are both key performance indicators in value-based reimbursement, as defined by the Centers for Medicare & Medicaid Services. Both these indicators have a negative impact not only on patients but also on hospital profitability, and they are closely tied to discharge education. Lack of proper discharge instructions, especially about medication regimen, can result in adverse effects in patients post-discharge, which could have been prevented had they gotten adequate discharge instructions. Research has shown that almost 20% of patients leaving the hospital have an adverse drug event after discharge. Nurses have a key role in …

The Lived Psychosocial Experiences Of Nursing Students Transitioning From In-Person Learning To Virtual Learning: A Transcendental Phenomenological Study, Lesley I. Gerald-Koram

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore and understand the lived psychosocial experiences of nursing students who transitioned from in-person learning to virtual learning at the onset of the COVID-19 pandemic in the northeast region. The study comprised of 15 participants who were enrolled in accredited nursing programs across New York, who experienced the abrupt shift in learning platforms during a global crisis. The abrupt shift significantly affected the emotional, academic, and professional development of the nursing students. This research was rooted in the growing concern of nursing student mental health, academic engagement, and preparation for clinical …

Nurse Confidence In Mental Health Communication: Examining The Effect Of An Educational Intervention In Outpatient Specialty Departments, Joy-Ruth Mathews

Doctoral Dissertations and Projects

The global prevalence of mental health illnesses has prompted a growing need for healthcare professionals to be prepared to identify and address these concerns. Many nurses in outpatient specialty departments report feeling underprepared and lacking confidence when communicating with patients about mental health concerns. This scholarly project utilized an educational intervention to improve nurse confidence in mental health communication, the application of therapeutic communication techniques, and resource identification. A quasi-experimental, one-group pretest/posttest design was implemented, with nurses from outpatient specialty departments at Duke Health’s Kernodle Clinic completing pre- and post-Likert scale surveys to assess changes in their self-reported confidence. The …

Nurse-To-Nurse Change-Of-Shift Handoff Communication: The Experience Among Senior Nursing Students In A Hospital Setting—A Transcendental Phenomenological Study, Karen Bryson

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the lived experiences of senior nursing students with nurse-to-nurse change-of-shift handoff communication during their clinical practicum at a major healthcare system in the United States. The guiding research question was: What are the lived experiences of senior nursing students when communicating shift-to-shift handoff reports to incoming nurses during senior clinical practicum in an acute care hospital setting? Bandura's social cognitive theory and Kolb's experiential learning theory are the two theories that support the conceptual framework of this study. Ten nursing students were purposefully recruited from local two-year and four-year nursing …

Experiences Of A Simulated Medical Malpractice Lawsuit On Nursing Students' Documentation Practices: A Transcendental Phenomenological Approach, Heide Thorne

Doctoral Dissertations and Projects

The purpose of this qualitative, transcendental phenomenological study is to understand the perspectives of first semester nursing students participating in a simulated medical malpractice lawsuit and documentation practices. The theory guiding this study is Kolb’s experiential learning theory (ELT), as it explains the relationship of learning and knowledge transfer through a simulation-based learning activity (SBL). Data collection approaches included observations, anonymous reflective journals, and individual interviews or questionnaire capturing students’ personal experiences and emerging themes. Bracketing enhanced reflexivity, reduced bias, and strengthened the study’s credibility and dependability. Results of the study support the efficacy of a specific, powerful SBL activity …