Nursing Commons^™

Determining The Effectiveness Of A Nurse-Led Heart Failure Education Program In Reducing 30-Day Hospital Heart Failure Readmissions, Amy Suzanne Cosby

Doctoral Dissertations and Projects

The purpose of this project was to determine if a nurse-led heart failure (HF) education program would reduce overall 30-day hospital readmissions related to. Affecting millions of adults in the United States, HF is a growing health epidemic as well as an economic burden to healthcare systems. The population for this project included patients admitted with a diagnosis of acute or chronic HF based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. An electronic health record intervention indicated that when a healthcare provider diagnosed a patient with any HF ICD-10 code, the nurse-led HF education …

Leveraging Simulation For Excellence, Alecia Kimberly Liburd

Doctoral Dissertations and Projects

This project aims to identify and address the factors hindering the effective utilization of the simulation lab at Grady Memorial Hospital. Despite the simulation lab’s potential to enhance clinical skills and decision-making abilities through realistic medical scenarios, it remains underutilized. This evaluation project was a pretest and posttest design to assess the impact of educational interventions. Educational workshops, email communications, and awareness campaigns were the primary methods used to increase the understanding and utilization of the simulation lab.

Data analysis involved descriptive and thematic analyses of lab usage metrics and pre- and posttest responses. The findings indicate that simulation-based learning …

Theory Informed Audit And Feedback To Decrease Medication Administration Errors, Victoria Martin

Doctoral Dissertations and Projects

Medication administration errors remain a serious and preventable cause of morbidity and mortality in health care. Technology at the point of care is often bypassed in the medication administration process despite the intention to prevent adverse drug events through the addition of a layer of cross-checks and alerts. The purpose of this project was to understand if human behavior could be influenced using effective audit and feedback, data transparency, and communication tactics to decrease administration-related errors, such as wrong patient, wrong medication, wrong dose, and adverse drug events, with the use of barcode medication administration (BCMA) in the emergency department. …

Improving Nursing Retention Through Mentorship In A Long-Term Care Facility: An Educational Toolkit, Adriane Nichole Anthony-Cupil

Doctoral Dissertations and Projects

A major nursing shortage in the healthcare industry is made worse by high turnover rates. Healthcare organizations have used mentoring programs that have been found to enhance job satisfaction, thus improving nurse retention. To address this challenge, this study examined the use of a mentorship program supplemented by an educational toolkit that is specially made to improve nurse retention in long-term care facilities. By offering an organized learning path with resources that address support, effective communication, and cultural competency, the educational toolkit has the potential to enhance mentorship. The objective of this initiative was to equip registered nurses with the …

Nursing Faculty Exposure To Student Incivility And Interventions In Place To Address: A Case Study, Kimberly Lowe

Doctoral Dissertations and Projects

The purpose of this qualitative case study was to explore nursing faculty exposure to nursing student incivility at a nursing college in the Mid-Atlantic region. Bandura's social learning theory provided this study’s theoretical framework. The continuum of workplace aggression and conceptual model fostering incivility in nursing education also guided this study. This study answered the following central research question: How have nursing faculty been exposed to incivility by nursing students? Data were collected for this study through one-on-one interviews with nursing faculty exposed to nursing student incivility and a focus group with the same nursing faculty to discuss the current …

Standardizing Critical Skills And Competency Validation To Promote Self-Efficacy Among Rapid Response Nurses, Kelli Dail Baker

Doctoral Dissertations and Projects

Competency validation is a key component of supporting nurses with necessary skills to provide care for their patients. However, many healthcare organizations do not have a standardized process for determining which skills are evaluated and the method by which evaluation occurs. To address competency validation among rapid response nurses (RRNs), this evidence-based practice project was proposed to increase self-efficacy. This project involved a thorough data review of all rapid response skills, categorizing all interventions based on quantity and acuity, and holding a hands-on educational fair for a set of standardized skills. A quasi-experimental design was used to collect data pre- …

Optimizing Care Delivery: Determining The Impact Of A Mobile Interpreter App On Patient Satisfaction, Leslie M. Bright

Doctoral Dissertations and Projects

Introduction: Patients with limited English proficiency (LEP) experience increased health disparities including poorer health outcomes, lack of access to quality healthcare services, and decreased patient satisfaction related to cultural and language barriers.

Purpose/Significance: The purpose of this project was to determine the impact of a technology-based mobile app used for medical interpreter services on patient satisfaction in patients with LEP during urgent care visits.

Methods: The project design consisted of a mobile interpreter app used for medical translation services during urgent care visits. Pretest and posttest patient satisfaction questionnaires were administered before and after the mobile app use to determine …

Pediatric Respiratory Assessment Measurement Tool And The Benefits Of Utilizing It: An Integrated Review, Amy Michelle Randolph

Doctoral Dissertations and Projects

Asthma is a leading cause of hospitalizations of pediatric patients. The absence of comprehensive screening in the emergency department setting can impact the care of the patient who presents in respiratory distress. This integrated review focused on the benefits of the utilization of the Pediatric Respiratory Assessment Measurement tool. The methods utilized to collect evidence included a web-based search that led to a review of multiple articles. The results were analyzed using MeInky’s Hierarchical Levels of Evidence and organized into a literature matrix. The review ultimately supported the hypothesis that the PRAM tool is an effective instrument compared to other …

An Integrative Review: Improving Copd Patient Outcomes Using The Teach-Back Method, Bichundo Lambert

Doctoral Dissertations and Projects

Chronic obstructive pulmonary disease (COPD) is a common clinical health concern that causes airflow resistance to the lungs and persistent respiratory symptoms, which can impact quality of life for the COPD patient. The condition is common to adults over 40 years of age. It is estimated that 210 million people worldwide suffer from the disease, and its incidence is on the rise. In United States, COPD affects 16 million people and costs the government $24 billion annually. The researchers predicts that COPD will be the third-leading course of mortality by 2030 worldwide. The objective of this integrative review was to …

Exploring Prelicensure Bsn Students' Knowledge Of Mindfulness Meditation Using A Smartphone App To Manage Stress And Promote Resilience: A Qualitative Single Case Study, Beth A. Kelley

Doctoral Dissertations and Projects

The purpose of this qualitative single case study was to explore pre-licensure Bachelor of Science in Nursing (BSN) students' knowledge of mindfulness meditation (MM) using a smartphone app (SMA) to manage stress and promote resilience. Guiding this study was the transactional model of stress, adaptation, and coping by Lazarus and Folkman (1984) and the zone of proximal development (ZPD) educational theory by Vygotsky. The study asked the following questions: What was pre-licensure Bachelor of Science of Nursing (BSN) students’ knowledge of mindfulness meditation (MM) using a smartphone app (SMA) to manage stress and promote resilience? What had the prelicensure BSN …

Educating Nurses On The Components Of A Healthy Work Environment, Kathryn L. Scott

Doctoral Dissertations and Projects

It is essential to look at the entire picture to ensure patient care is offered in the highest quality manner possible. One must look at patient satisfaction, quality outcomes, and job satisfaction experienced by the nursing staff providing care to accomplish this goal. Research has shown that nurse burnout has increased exponentially as of late. Some blame the COVID-19 pandemic; others look at the generation of nurses graduating from nursing school and starting in the field, comparing the baby boomer nurse to the Gen Z nurse. Many factors are involved, and with the recent addition of paying particular attention to …

The Effects Of An Emotional Intelligence And Empathy Interactive Education Program With Prelicensure Nursing Students, Karen Browne

Doctoral Dissertations and Projects

A dissertation is presented on a teaching program for emotional intelligence (EI) and empathy with a cohort of nursing students enrolled in a traditional, undergraduate nursing college in the Northeast region of the United States (US). An interactive teaching program was used with various media to present new material and learning activities during the spring semester. The importance of teaching nursing students the aspects of EI was to prepare them for the rigors of the profession by allowing them to delve into their own self-awareness and emotional regulation, which in turn helps to connect with patients in a more robust …

Improving Use Of Water Immersion And Birth Satisfaction During The First Stage Of Labor Through An Educational Handout, Dana E. Taylor

Doctoral Dissertations and Projects

Although using the birthing tub for hydrotherapy during the first stage of labor has been proven to be a safe and effective method of low-intervention pain management, as well as research that indicates potential other benefits such as a reduction in the use of an epidural, improvement in breastfeeding rates, and promotion of physiologic birth, its use is often limited. Chief reasons for the lack of its use include difficulty and time constraints with tub set-up and lack of knowledge about its benefits, especially the length of time used. A quasi-experimental evidence-based project at a suburban magnet-designated hospital using a …

The Price We Pay: An Integrative Review Exploring The Effects Of Wellness Culture On Nurse Burnout Rates, Rebekah Lillian Vance

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify cultural factors contributing to nurse burnout and to explore the strategies and effectiveness of wellness culture and cultural changes on nurse burnout rates. Nurse burnout has been attributed to a myriad of factors and has been identified in nursing since the 1970s. While other professions with similar burnout issues have investigated and implemented culture-wide changes to address burnout, nursing has remained stagnant in the field of burnout research, often applying single interventions that fall short of creating significant, lasting change. An integrative review of nursing, peer-reviewed literature was conducted in an …

Provider Implementation Of Probiotics As An Adjuvant Treatment Modality For Patients With Anxiety And Or Depression In A Primary Care Setting, Sarah Dedmon

Doctoral Dissertations and Projects

The prevalence of anxiety and depression among Americans is growing rapidly. Patients are seeking out traditional treatments as offered by their primary care providers, but also frequently look toward integrative or complementary methods of managing their symptoms. The use of dietary supplements is at an all-time high, yet the U.S. Food and Drug Administration does not regulate these substances for potency and purity or evaluate them using quality standards as it does pharmaceuticals. Most providers lack education regarding the physiological interaction their patients may experience when using these substances and are naïve to their place in primary care medicine. The …

Examining The Effects Of An Isbarr Educational Intervention On Self-Efficacy Of Senior-Level Nursing Students Within A Transition To Practice Course: A Quasi-Experimental Study, Stacy Nicole Taylor

Doctoral Dissertations and Projects

The purpose of this study was to examine the effects of an introduction, situation, background, assessment, requests/recommendations, and repeatback/readback (ISBARR) educational intervention on self-efficacy of senior-level nursing students' within a Transition to Practice course at one Christian university in the southeast United States. The theoretical framework utilized in this study was Bandura's theory of self-efficacy. This study was a quasi-experimental design with a control and intervention group. The control group was in the Fall 2023 semester, and the intervention group was in the Spring 2024 semester. Each participant completed a pre-test and post-test, which was the New Generalized Self-Efficacy Scale. …

Anticoagulation Stewardship Initiative For The Outpatient Management Of Atrial Fibrillation, Ryleigh Hawker

Doctoral Dissertations and Projects

Anticoagulation prescribing for patients with atrial fibrillation at a local primary care and urgent care office has largely been conservative and unstandardized, leaving patients at risk for cardioembolic strokes. As more and more patients are diagnosed with this condition, the greater the need becomes for appropriate management within these settings. This includes preventing strokes with anticoagulation and utilizing an integrative or collaborative approach between specialty and non-specialty centers. The Anticoagulation Stewardship Initiative is the first step in promoting effective and safe anticoagulation practices in primary and urgent care centers, while simultaneously streamlining care for newly diagnosed patients. Some of the …

Closing The Sepsis Communication Gap In The Ed: An Integrative Review, Rebecca Caldwell Hamlett

Doctoral Dissertations and Projects

Many patients experiencing sepsis seek care in the Emergency Department (ED), making the ED their first interaction with the healthcare system. Unfortunately, these individuals often face significant delays in receiving life-saving treatment interventions. In 2021, the Surviving Sepsis Campaign revised their sepsis guidelines to recommend implementing standard operating procedures for managing septic patients. The purpose of this integrative review was to examine the impact of an ED sepsis huddle on enhancing communication among all ED personnel regarding potential septic patients. Ultimately, the goal is to activate a multidisciplinary or intercollaborative team, expedite treatment, and fulfill sepsis communication gaps. This integrative …

Impact Of Preceptorship And Mentoring On New Nurse Resilience, Dianna Marie Lundrigan Garza

Doctoral Dissertations and Projects

Healthcare organizations continue to have difficulties retaining healthcare staff. Administrations spend significant amounts of time and money to incentivize new nurses to join their organizations with mixed results for both acute and long-term care units. Preceptorship or mentorship has been identified as having an impact on increasing positivity and resilience in new nurses. This paper examined prior research to identify trends and patterns in findings regarding this topic. Research of databases was conducted to identify common topics regarding resilience and retention of new nurses. Data supported having preceptors who receive training in teaching methods, communication, and support of new nurses. …

Lean Implementation Difference Between Lean Maturity, Psychological Well-Being, And Employee Engagement Of Nurses In A Hospital Setting, Kevin E. Smith

Doctoral Dissertations and Projects

This quantitative study examined the differences of Lean implementation in three settings; (a hospital in a health system where Lean is implemented throughout the system, a hospital that has implemented Lean in a health system that has not implemented Lean, a hospital that has not implemented Lean in a health system that has not implemented Lean) between LM, PWB, and EE among nurses in a hospital setting. The theoretical construct of the job demands-resources model is used to base the study. Three survey instruments (Psychological Well-Being Scale, Utrecht Work Engagement Scale, Lean Healthcare Implementation Self-Assessment Instrument) were self-administered by registered …

Experiences Of Community Hospital Nurses In Blended Learning In Singapore: A Transcendental Phenomenological Study, Anqi Su

Doctoral Dissertations and Projects

The COVID-19 pandemic has led to many changes in the landscape of nursing care and nursing teaching and learning. One such change is the transition from traditional face-to-face learning to blended learning. While blended learning has many benefits and offers excellent opportunities for learning beyond the conventional methodologies and within the safety parameters of the COVID-19 pandemic, there is varied effectiveness from the literature review, and much is still being determined about community nurses' experiences in Singapore. Therefore, a qualitative transcendental phenomenological study on blended learning experiences among nurses in a community hospital in Singapore during the COVID-19 pandemic was …

The Pause: Impacting Moral Distress In Our Caregivers, An Integrative Review, Bethany Corinne Furman

Doctoral Dissertations and Projects

Moral distress is endemic to healthcare in the emerging post-covid era. Moral distress is defined as the knowledge of the correct or ethical action but the repeated inability to act in that manner. First studied in nursing, it has been found in nearly every facet of healthcare and is strongly associated with clinician burnout, intent to leave position, and behaviors that can in turn compromise patient safety. Intensive care unit (ICU) nurses experience moral distress at higher rates than other subspecialties. Prevention of and recovery from moral distress is complex, but various forms of debriefing have long been suggested to …

Implementation Of A Nursing Care Bundle For Hospitalized Patients Receiving End-Of-Life Care, Klaire Thomason

Doctoral Dissertations and Projects

A significant number of patients die in the hospital. Family-centered nursing care interventions are critically important to help ease the physical, social, spiritual, and emotional symptoms that patients may experience at the end of life. Despite the importance of the nurse’s role in delivering comprehensive end-of-life care, many nurses lack the knowledge and confidence necessary to implement evidence-based interventions. The purpose of this project was to evaluate the effectiveness of a nursing care bundle on increasing nurses’ self-perceived ability to deliver high-quality end-of-life care to patients in the inpatient setting. For this pilot study, an evidence-based Comfort Care Nursing Bundle …

Facilitator Ethnicity And Clinical Judgement Among Senior Minority Students Using Unfolding Case Studies, Rachael King

Doctoral Dissertations and Projects

Unfolding case studies are a technique used in advancing critical thinking in order for nursing students to enhance their clinical judgement. The format at which they are delivered can influence the degree of learning, understanding, applying, analyzing, and evaluating for students, especially senior minority nursing students. This quasi-experimental posttest survey between-groups study involved implementing unfolding case studies with a randomly selected minority or non-minority facilitator video recording for senior minority nursing students. After completing the case study, all participants were given a posttest survey, the Clinical Decision Making in Nursing Scale (Jenkins, 1983). The survey evaluates students’ self-perceived clinical judgement. …

Adapting To Change: Adn Faculty Perspectives About The Future Of Adn Education: A Qualitative Case Study, Linda D. John

Doctoral Dissertations and Projects

The purpose of this qualitative, single case study was to offer more insight into how the adoption of the BSN as the entry-level for nursing practice affects the future ADN education and what the change means for ADN faculty at multiple programs throughout regions of the United States. Eleven ADN faculty were sampled to acquire their perspective about this phenomenon. Semi-structured, open-ended interviews enabled data collection. Rogers’ diffusion of innovation theory (DIT) facilitated an understanding about how ADN faculty are responding and adapting to the anticipated educational change. The central research question asked, “What is the perspective of ADN faculty …

The Impact Of Reporting Patient Safety Events: An Integrative Review, Catherine M. Amitrano

Doctoral Dissertations and Projects

Since the 1999 Institute of Medicine landmark report, To Err is Human, leading organizations such as the Agency for Healthcare Research and Quality have been working with healthcare leaders to reduce patient harm. A problem in healthcare is errors continue to occur at alarming rates. The COVID-19 pandemic impacted patient safety efforts and organizations are trying to get to pre-pandemic patient safety progress. The purpose of this integrative review was to review and evaluate individual research studies on patient safety event reporting and summarize what is known about the topic in terms of how patient safety event reporting impacts patient …

Improving The Socio-Emotional Competence Of Academic Nurse Educators: An Experimental Study, Helen Freeman

Doctoral Dissertations and Projects

An academic nurse educator with a high level of socio-emotional competence (SEC) can create an inviting learning environment that promotes the highest level of achievement from students. The purpose of this two-group pretest-posttest experimental study was to determine the extent of effectiveness of socio-emotional intelligence education and a reflection-guided professional development plan in improving the socio-emotional competence of academic nurse educators. The Bar-On emotional social intelligence (ESI) conceptual model and the Purkey invitational theory were frameworks used to guide the study. The Emotional Quotient Inventory (EQ-i 2.0) was used as the data collection instrument to measure the pretest and posttest …

The Experience Of Nursing Faculty In Uganda Integrating Technology In The Classroom: A Phenomenology Study, Catherine Nankanja

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand the lived experiences of nursing faculty in integrating digital technology in the classroom in Uganda. Technology penetration in Uganda, a developing country, is still minimal and as a result little is known about impact of digital technology integration in the nursing education. This study was guided by this central research question: What is the experience of nursing faculty in Uganda in integrating digital technology in the classroom? There were four other sub-questions. The study was founded on the connectivism learning theory, which emphasizes leveraging digital technology in education. However, to …

Do More Than Train New Nurses...Retain Them! A Qualitative Research Study, Kerrin L. Hampton

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study is to understand the orientation experiences of new graduate nurses and identify retention practices that are relevant and beneficial to the population of interest. Study participants were new graduate nurses employed at a five-hospital healthcare system. Using social constructivism as the theoretical framework, the study sought to answer the research question of what are the lived experiences of new graduate nurses during orientation? Ten new graduate nurses participated in individual interviews to discuss their personal orientation experiences. The interviews informed the researcher regarding the meaning and value new graduates place on their orientation …

Faith-Based Intervention To Prevent Adolescent Self-Injury: An Integrative Review, Adekemi O. Akinyemi

Doctoral Dissertations and Projects

This integrative review explores the efficacy of incorporating faith-based (Christian/spiritual) interventions within the framework of Dialectical Behavior Therapy (DBT) to prevent non-suicidal self-injury (NSSI) among adolescents aged 11-19. As the prevalence of NSSI among this demographic group continues to rise, understanding the potential benefits and challenges of integrating faith-based components into evidence-based therapeutic approaches is crucial. The review synthesizes existing literature, drawing on empirical studies, theoretical frameworks, and clinical evidence to assess the impact of faith-based integration in DBT. Through a comprehensive analysis of diverse sources (e.g. CINAHL, PubMed, PsycINFO, NIH) this review was able to shed light on the …