Nursing Commons^™

Let My People Go:Improving Nurses’ Knowledge To Decrease Physical Restraint Use, Trisha Marie Zehrung

Walden Dissertations and Doctoral Studies

Despite extensive research revealing the dangers of physical restraint use, it remains a common practice in critical care settings across the globe. Nurses stand at the forefront of clinical decision-making regarding the use of physical restraints but are doing so with a lack of education and evidence-based practices. The project addresses whether an evidence-based educational program regarding the use of physical restraints and alternative measures is an acceptable method for intensive care unit (ICU) nurse education according to six local subject matter experts (SMEs). The project’s purpose was to create an educational program outlining physical restraint evidence and alternative measures …

Increasing Nurse Managers’ Knowledge And Self-Confidence Levels In The Use Of Two Alternative Staffing Models, Latonia Yvette Cushingberry

Walden Dissertations and Doctoral Studies

AbstractThe practice problem for this DNP project was the lack of confidence of eight nurse managers at the project site in implementing alternative staffing models to meet increased inpatient care demands during times of patient surges. The purpose of this DNP project was to provide an education module to nurse managers at the project site to enhance their self-confidence levels for alternative staffing during cases of patient surges. Framed by Knowle’s adult learning theory, the practice-focused question for this project addressed whether an educational program on two alternative staffing models increased acute care nurse managers’ self-reported knowledge and confidence levels …

Bullying Experienced By Newly Graduated Registered Nurses In Long Term Care, Valeria Linetski

Walden Dissertations and Doctoral Studies

Bullying toward newly graduated registered nurses (NGRNs) is a global concern that impacts various health care settings. Long term care (LTC) setting received minimal attention related to bullying experienced by registered nurses. NGRN’s face difficulty integrating into practice due to bullying experiences which causes them to quit, change jobs and even leave the profession, which further contributes to the nursing shortage and high turnover rates. The purpose of this transcendental phenomenological study was to address the knowledge gap in the literature by exploring NGRNs lived experiences of bullying as they transition into practice in LTC. Exploring bullying experienced by NGRN’s …

Relationship Between Emotional Intelligence, Mentorship, And Burnout In Nursing Faculty, Jasmine Louis

Walden Dissertations and Doctoral Studies

Nursing faculty early in their careers face challenges involving transitioning into new roles, high workloads, and lack of support, making them vulnerable to burnout. Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. The purposes of this study, guided by Maslach’s burnout theory, were to determine if there is a relationship between emotional intelligence and mentorship in terms of burnout among nursing faculty who are in their early careers, if there are differences in terms of burnout among these nursing faculty who have received mentorship compared to those who did not receive, and if there is …

Lifestyle Modifications To Reduce Hypertension In Obese Patients: A Clinical Practice Guideline, Tiffany Lynn Oates

Walden Dissertations and Doctoral Studies

In the United States, obesity affects almost 50% of the population with estimates of 60–70% of hypertension in adults attributable to adiposity. The practice gap addressed in this project is a lack of standardized patient education on lifestyle modifications aimed at reducing hypertension in the obese patient, which is the recommended first line of treatment for these patients. The practice focused questions were answered when evidence from the literature supported the implementation of a clinical practice guideline developed from evidence-based literature focused on patient education about lifestyle modification as the initial treatment for the reduction of hypertension in the obese …

Evaluation Of An Orientation Program For Graduate Nurses Transitioning Into Professional Practice, Kristy Patrick-Lewis

Walden Dissertations and Doctoral Studies

The transition from student nurse to practicing professional is extremely challenging. The local organization experienced increases in turnover among new graduate hires and determined that adjustments to their orientation program to better meet the needs of new graduates were warranted. The problem that this doctoral project addressed is the lack of evaluation of the effectiveness of the new orientation program. The practice-focused question examined the effectiveness of the new orientation program at reducing turnover and improving satisfaction with the quality of the orientation program among new graduate nurses. The framework used to guide this study was Patricia Benner’s novice to …

Influences Of 12-Hour Shifts On Unhealthy Eating Habits Of Acute Care Nurses, Ruth Sawdy

Walden Dissertations and Doctoral Studies

Shift work is a necessary part of a nurses’ work schedule to patients who need 24 hours of continuous care. Eating habits of nurses are influenced by working long hours, not having adequate time to take a meal break, and not having access to healthy food choices which can cause stress and exhaustion and results in weight gain and obesity. The purpose of this quantitative logistic regression analysis, guided by the health belief model and the theory of planned behavior, was to determine if there was a relationship between shift work and the unhealthy eating habits/obesity rates of acute care …

Nursing Staff Education On The Use Of The American Diabetes Association Guidelines, Terrie Hattie Allen

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus is a complex chronic condition that requires continuous care and management. Approximately 34 million Americans are diagnosed with diabetes and around 90%–95% suffer from Type 2 diabetes. The problem identified in this project was the need to follow the American Diabetes Association guidelines in place at the study site clinic but are not adhered to by the staff. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to plan, implement, and evaluate a nursing staff education program on the use of the American Diabetes Association Guidelines for diabetes. …

Effect Of Covid-19 On Comprehensive Predictor Exam Scores And Nursing Program Scores And First Generation College Students, Heather Marie Austin

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic forced nursing education programs to change traditional face-to-face teaching to virtual education and simulated experiences. Therefore, research is needed to determine how this change affected nursing students’ academic performance and their performance on standardized exams. The purpose of this three-part study, guided by Knowles’s adult learning theory, was to determine if there was a difference in Associate of Science in Nursing (ASN) students’ performance on: (a) Assessment Technology Institute (ATI) Comprehensive Predictor (CP) scores, (b) end of program scores, and for (c) CP scores for first generation students before the COVID-19 pandemic compared with nursing students’ scores …

Increasing Knowledge Of A Weekend Staffing Policy Among Nurses Working Weekends, Fatima Bah

Walden Dissertations and Doctoral Studies

Abstract

The relationship between adequate nurse staffing and patient outcomes is well documented. The local organization identified a concern with appropriate weekend staffing due to repeated callouts by nurses. The purpose of this DNP project was to determine whether an educational intervention on the relationship between adequate staffing and positive patient outcomes, coupled with a review of the organization’s policy regarding weekend staffing, increases knowledge and awareness among nurses working weekends. Benner’s novice to expert theory and systems theory were used to ground this project. Following an invitational email, 20 individuals participated in the educational intervention. Most participants (n = …

The Lived Experience Of Expectant Mothers During The Covid-19 Pandemic, Bridgette Schulman

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic has resulted in many changes to obstetric care practices. While the changes aimed to decrease transmission and protect mothers and infants, the study revealed unintended consequences of the changes put in place during COVID-19. Currently, there is a gap in knowledge and understanding of how the changes in obstetric care practices affect women’s perceptions of the birth experience. The purpose of the study was to explore the lived experience of mothers who gave birth in the health care setting during the COVID-19 pandemic through the eyes of those who experienced it. The research question was: What is …

American College Of Obstetricians And Gynecologists Postpartum Hemorrhage Protocol, Rasheedat Romoke Adewumi

Walden Dissertations and Doctoral Studies

Postpartum hemorrhage (PPH) is the most significant cause of maternal deaths during or after childbirth. Due to a high PPH rate, a tertiary care facility in the Southwest United States implemented the Association of Obstetricians and Gynecologist (ACOG) protocol anticipating decreasing PPH rates. This quality improvement project was designed to evaluate whether implementation of the ACOG PPH protocol reduced the incidence of PPH. The practice-focused question was “What is the effect of the implementation of the ACOG PPH protocol on the incidence of PPH?” The Iowa model was selected to guide the project toward accomplishing its goals. The incidence of …

Perceptions Of Hypertensive Adults With Low Health Literacy About Self-Management Of Hypertension, Ngozi Scholar Chukwuemeka

Walden Dissertations and Doctoral Studies

AbstractHypertension (HTN) is one of the most significant risk factors for morbidity and mortality worldwide and is responsible for the annual deaths of approximately 9 million people globally. A major problem with HTN self-management (SM) is low health literacy (HL), which is associated with poor health outcomes and self-care. The purpose of this explanatory sequential, mixed method study, guided by Pender’s health promotion model, was to explore the perceptions of adults with HTN and low HL about the SM of their HTN. A total of 32 adults with HTN were screened using the Newest Vital Sign health literacy screening tool. …

Nonpharmacological Pain Control Following Hip And Knee Replacements In Older Adults, Adraine Cox

Walden Dissertations and Doctoral Studies

Abstract Over prescribing opioids after hip and knee replacements in older adults is closely linked to the opioid epidemic. Despite being a public health concern associated with increased mortality rates, opioids are the most frequently used method for controlling postoperative pain. Therefore is important to know whether nonpharmacological pain control methods may effectively reduce the burden of opioid addiction, thus reducing the risk of opioid-related fatalities. The purpose of this study was to determine whether a systematic review of the literature provided evidence supporting nonpharmacological methods of pain control following hip and knee replacements in older adults compared to use …

Clinical Practice Guideline For Post Discharge Primary Care Follow-Up Program For Copd, Stephanie Frimpong-Badu

Walden Dissertations and Doctoral Studies

AbstractApproximately 15.7 million individuals throughout the United States have been diagnosed with chronic obstructive lung disease (COPD), with 700,000 individuals hospitalized annually in the United States. An estimated one in five patients are readmitted within 30 days, raising the costs above $15 billion annually. The gap in practice was a lack of adequate clinical practice guidelines associated with discharge to primary care in this acute care facility. The purpose of this project was to use the expertise of the multidisciplinary team of pulmonologists, acute care nurse practitioners, respiratory therapists, and pharmacists to develop a clinical practice guideline using evidence-based literature …

Staff Education To Improve Safe Use Of Antipsychotic Medication In An Outpatient Clinic, Marinette Nyangono Garrison

Walden Dissertations and Doctoral Studies

AbstractThe use of antipsychotic medications is growing in an outpatient clinic despite the increased risk of mortality and morbidity such as falls, fractures, stroke in adults, neurological adverse effects, weight gain, and cardio-metabolic abnormalities in pediatric populations. The purpose of this project was to develop an educational program to enhance clinic staff knowledge about pharmacologic and nonpharmacologic means to manage patients’ care and improve outcomes. The conceptual framework for the project was Knowles’s adult learning theory supported by the Kirkpatrick model of training evaluation. The practice-focused question asked whether an educational program would increase staff knowledge related to the safe …

Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall

Walden Dissertations and Doctoral Studies

The Veteran’s Health Administration (VHA) is the largest employer of registered nurses in the United States. The American Association of Colleges of Nursing predicts there will be a nursing shortage through the year 2030 and replacing and training each nurse is expensive and negatively impacts patient care. A review of the literature showed organizations with high levels of organizational citizenship behavior (OCB) had high levels of job satisfaction, which reduces turnover, but there was no research on the existence and impact of OCB in a federal health care facility, specifically the VHA. The purpose of this quantitative, correlational research was …

Educating Staff Nurses On E-Cigarette And Vaping Associated Lung Injury, Dana Janette Imaoka

Walden Dissertations and Doctoral Studies

AbstractVaping product use has gained popularity since the first device was marketed in the early 2000s. Use among the adolescent and teen populations has grown steadily to the point of becoming an epidemic. As the largest group of healthcare professionals, nurses have the most contact with patients in healthcare settings and are in the position of providing care and education to them. The purpose of this doctoral project was to increase knowledge of vaping product use as well as the growing number of e-cigarette- and vaping-associated lung injuries (EVALI) in the United States. A gap was identified in nurses’ knowledge …

Experiences Of Bsn Graduates Integrating Cultural Competence When Caring For Multicultural Patients, Judith A. Daniels

Walden Dissertations and Doctoral Studies

Registered nurses entering the workforce with baccalaureate of science degrees in nursing (BSN) are expected to be knowledgeable and skilled in planning and caring for multicultural patients, but there is little information on what experiences new nurses have in implementing culturally competent care. The purpose of this descriptive phenomenological study, guided by the Campinha-Bacote process of cultural competence in the delivery of health care services model, was to understand the lived experiences of BSN graduates with one year or less experience in implementing cultural competence in planning care for their multicultural patients. The research question directly addressed this purpose. Ten …

Development Of An Insomnia Assessment Guideline For Bipolar Disorder, Daniel Oyewusi Oyewole

Walden Dissertations and Doctoral Studies

AbstractBipolar disorder (BD) affects more than 1% of the world’s population regardless of race, sex, ethnicity, or socioeconomic status. BD is a severe and chronic mental illness characterized by insomnia, depressed and elevated mood, racing thoughts, mood swings, anxiety and depression, and suicide. Insomnia is prevalent in BD and occurs across all stages of BD, yet no guidelines exist. The clinical practice guideline entitled the Insomnia Assessment Guideline for Bipolar Disorder (IAGBD) was developed using best-practice evidence from the published literature. The IAGBD is a step-by-step process for assessing insomnia in bipolar patients. Clinicians follow a series of questions in …

Self-Management Support Program For Dialysis Patients, Elmer Sadiang-Abay

Walden Dissertations and Doctoral Studies

AbstractChronic kidney disease (CKD) prevalence rates have been on the rise in recent years, and currently, about 37 million Americans are living with the disease. Most patients with CKD progress to end-stage renal disease (ESRD), resulting in additional treatments, including kidney transplants and hemodialysis (HD). HD treatments depend on patients’ adherence to self-management practices. The practice gap was the lack of guidelines for staff to use with ESRD patients to teach self-management strategies. This project aimed to develop an evidence-based clinical practice guideline (CPG) on a self-management support program for dialysis patients for use by health care providers at the …

Health Belief Effects On Preventive Health Among Hispanic Migrant And Seasonal Farmworkers, Angela M. Trawick

Walden Dissertations and Doctoral Studies

Migrant and seasonal farmworkers (MSFWs) are the unhealthiest workers in the United States and experience barriers to preventive healthcare. While faced with numerous health risks, many Hispanic MSFWs may not seek preventive health services or have access to them when they need them. The purpose of this study, guided by the rural nursing theory, was to understand the beliefs/health seeking behaviors of MSFWs and how they described usage of preventive health services. Fourteen Hispanic farmworkers volunteered to do telephone or in person interviews. The codes and categories were reviewed to identify patterns and make connections between the data using Saldana’s …

End-Of-Life Education For Long-Term Care Nurses, Naquita Altidor Jacques

Walden Dissertations and Doctoral Studies

Long-term care (LTC) nurses play a crucial role in preserving the quality of life of terminally ill patients. However, many identify deficits in skills, education, and training for end-of-life (EOL) care. The objective of this project was to educate LTC nurses caring for individuals reaching the end of their lives on EOL care. The practice-oriented question concerned whether an evidence-based educational program improved nurses’ knowledge related to EOL care and confidence in caring for EOL patients and families. The End-of-Life Nursing Education Consortium's evidence-based educational module was used to provide the content. Rosswurm and Larrabee’s model for change to evidence-based …

Enhancing Parental Compliance In Managing Attention Deficit Hyperactivity Disorder, Claudia E. K-Ackah

Walden Dissertations and Doctoral Studies

Medication adherence in children is essential in ensuring that treatment approaches are successful and lead to positive health outcomes for the patient. However, with the young child largely dependent on the abilities and drive of parents and caregivers, adherence to the treatment regimen for children diagnosed with attention-deficit/hyperactivity disorder (ADHD) can be challenging. A systematic literature review using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) model was used to locate, analyze, and synthesize sources to identify current evidence-based strategies used by health care providers for enhancing parental compliance in managing the child with ADHD. Reported in themes, …

A Phenomenological Exploration Of How Nursing Experience Shapes The Transitional Performance Of Primary Care Nurse Practitioners, Helen Okeke

Walden Dissertations and Doctoral Studies

AbstractPoor access to healthcare and a shortage of primary care providers in underserved communities paved the way for reliance on advanced practice registered nurses (APRNs). This increased reliance on APRNs as primary care providers necessitates expanded public policy on APRN practice; however, information on APRN transitional experiences remains inadequate to inform policymakers effectively. Illinois’ Nurse Practice Act requires APRNs to incorporate the scope of practice of registered nurses into their practice but does not describe what that experience should be. Using Kanter’s theory of organizational structural empowerment and Benner’s novice to expert nursing model as theoretical lenses to ground the …

Evaluation Of A Cardiac Surgery Nurse Navigator Quality Improvement Program, Eileen Joy Watkins

Walden Dissertations and Doctoral Studies

AbstractPatients who have had cardiac surgery may experience longer hospital stays and increased readmission rates when there is poor care coordination between patients, families, and the healthcare team. Poor care coordination leads to unclear expectations of each phase of care, decreased compliance with postoperative care regimen resulting in increased length of stay, patient and family dissatisfaction, and increased rates of readmission. This project evaluated a Cardiac Surgery Nurse Navigator (CSNN) Quality Improvement program to address care coordination and improve length of stay and readmission rates for cardiac surgery patients. The goal was to determine whether the CSNN program was effective …

Motivational Interviewing: A Strategy To Improve Health Professional's Communication, Lanita James

Walden Dissertations and Doctoral Studies

Miscommunication between patients and healthcare professionals is common in U.S. hospitals and is considered one of the chief factors in reduced patient satisfaction with care. Collaboration with the nurse researcher who reviewed the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) data for a local hospital noted that negative ratings were directly related to the miscommunication between the patient and care providers. Further identified that the nursing staff was not knowledgeable about evidenced-based strategies needed to communicate effectively with the patients. The purpose of this DNP project was to develop an education program to increase nurses' knowledge about …

Educating Clinicians In A Nursing Facility To Proactively Manage Urinary Tract Infections, Setha Joseph

Walden Dissertations and Doctoral Studies

AbstractUrinary tract infections (UTIs) have been identified as the most common reason for hospital visits among adults. The Centers for Disease Control and Prevention indicates that the prevalence of UTIs in long-term care facilities ranges from 20%-50%. The purpose of this staff education project was to implement an educational program to increase staff knowledge of proactive management of urinary tract health with the ultimate goal of reducing acute illnesses at the skilled nursing facility (SNF). Knowles theory of adult learning informed curriculum development and Kirkpatrick's levels of training evaluation guided program evaluation. The project team planned, developed, implemented, and evaluated …

Impact Of A Standardized Situation, Background, Assessment, And Recommendation Tool On Satisfaction And Communication In The Perioperative Area, Salomy Abraham

Walden Dissertations and Doctoral Studies

AbstractEffective communication among health care providers is critical to maintain patient safety during the handoff of care. Communication breakdown during handoff can lead to medical errors and sentinel events. The perioperative area is a vulnerable area that is prone to communication errors due to the involvement of providers from various disciplines and the nature of the quick patient turnovers within the perioperative area. To ensure proper communication during the handoff in the perioperative area, a unit-specific handoff tool is required. The focus of the project was to implement a standardized situation, background, assessment, and recommendation (SBAR) communication tool in the …

Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …