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Articles 1321 - 1350 of 2607
Full-Text Articles in Nursing
A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes
A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes
Walden Dissertations and Doctoral Studies
Critical access hospitals (CAHs) encounter unique challenges in terms of providingquality resources to their community, often lacking quality measures and continuity comparable to larger regional and tertiary hospitals. One CAH in rural Minnesota implemented an overnight hospitalist telemedicine service to address concerns with provider resources and quality practice. An evaluation of quality improvement implementation was completed to address data regarding ER transfers and inpatient length of stay (LOS). Following the triple aim framework to improve patient care, population health, and decrease costs, Donabedian’s model of quality improvement was utilized. Three months of pre and postimplementation data were collected one year …
An Educational Program For Nurses To Improve Culturally-Appropriate Mental Health Assessment For Nigerian Immigrant Youth In Central Florida, Blessing Anyaiwe Onyekachi
An Educational Program For Nurses To Improve Culturally-Appropriate Mental Health Assessment For Nigerian Immigrant Youth In Central Florida, Blessing Anyaiwe Onyekachi
Walden Dissertations and Doctoral Studies
AbstractNigerians, like other immigrants, face many health issues with rising waves of conflict and political instability that contribute to high migration rates. As a result, when they arrive in other countries, these immigrants not only have to deal with the trauma they left behind but face issues such as cultural stereotypes, stigma, lack of insurance, cultural and language barriers, poor communication, social discrimination, and low socioeconomic status. The question that this project addressed was whether an educational program for nurses would improve knowledge on culturally-appropriate mental health assessment for Nigerian immigrant youth in Central Florida. This was a nursing staff …
The Use Of The Qsen Framework In Nrp For Graduate Nurses: A Systematic Review, Debra Friedl
The Use Of The Qsen Framework In Nrp For Graduate Nurses: A Systematic Review, Debra Friedl
Walden Dissertations and Doctoral Studies
In hospitals offering a nurse residency programs (NRP) for new graduates, the framework used can impact retention and job satisfaction rates. To meet the nursing needs of the hospitalized population, it is critical to understand which NRP framework results in higher retention and job satisfaction rates as compared to national rates. The purpose of this systematic review was to examine the evidence on those NRP using the quality and safety for education of nurses’ framework (QSEN) to compare rates of job satisfaction and job retention with published national rates. A comprehensive search outlined in the PRISMA (Preferred Reporting Items for …
Staff Education Program: Increasing Nursing Knowledge Of Exclusive Breastfeeding, Leigh Anne Panek
Staff Education Program: Increasing Nursing Knowledge Of Exclusive Breastfeeding, Leigh Anne Panek
Walden Dissertations and Doctoral Studies
In the initial postpartum period, exclusive breastfeeding (EBF) improves women's and children's health status and outcomes. Gaps in nursing practice that decrease the rate of EBF during hospitalization at this site were identified by the lactation consultant using a standard chart audit during the last two years. The purpose of this Doctor of Nursing Practice education project was to provide a comprehensive education program that included the purpose, philosophy, nursing practice, and evaluation tools for increasing the EBF rates to meet the Joint Commission’s standard of improvement for perinatal care core measures. A formal educational program that included didactic and …
Smoothing Patient Flow By Improving Bed Turnover Time, Carrie Lanasha Percell
Smoothing Patient Flow By Improving Bed Turnover Time, Carrie Lanasha Percell
Walden Dissertations and Doctoral Studies
Bed Management Solutions (BMS) is a bed tracking system that provides real-time data into hospital activities, including admissions, transfers, discharges, bed turnover rates, and processing time frames. When BMS is used appropriately, it has the potential to improve bed turnover rates, reduce stress of clinical staff, improve patient satisfaction, and improve patients’ well-being. Delays in bed turnover times can create overcrowding, extended wait times, bottlenecking, delays in patient care, and significant patient flow problems. The purpose of this DNP project was to develop a staff education program to answer the question if the implementation of an educational training program could …
Staff Development Project For Fall Prevention In Long-Term Care, Afua Ofosuhene
Staff Development Project For Fall Prevention In Long-Term Care, Afua Ofosuhene
Walden Dissertations and Doctoral Studies
AbstractFalls pose major healthcare problems in long-term care (LTC) facilities. Falls significantly impede quality of life for the elderly and their caregivers. The purpose of the project was to determine if the fall prevention program Stopping Elderly Accidents Deaths & Injuries (STEADI) increased staff knowledge regarding fall prevention and reduced fall rates at the LTC setting. The project addressed whether educating LTC staff regarding a fall prevention program could increase their knowledge of fall prevention and decrease the rate of falls. The gap identified was that nurses lacked education regarding fall prevention strategies. The Plan-Do-Study-Act (PDSA) model was the evidence-based …
Strategies To Reduce Costs Caused By Medication Errors In Us Hospitals, Janice Leah Chobanuk
Strategies To Reduce Costs Caused By Medication Errors In Us Hospitals, Janice Leah Chobanuk
Walden Dissertations and Doctoral Studies
Medication errors result in patient harm, including deaths, costing American hospitals over $20 billion annually. The financial impact and reduced public confidence in safe patient care create a business problem for hospital leaders trying to contain costs, maintain a competitive edge, and sustain patient satisfaction. Grounded in the sociotechnical conceptual framework, the purpose of this generic qualitative study was to identify strategies hospital leaders use to reduce costs caused by medication errors in hospitals. Data collection involved semistructured interviews with 10 hospital leaders from various high-reliability hospitals across the United States and a review of documents related to medication management …
Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi
Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi
Walden Dissertations and Doctoral Studies
AbstractPersons with intellectual and developmental disabilities (IDD) have significant health disparity in terms of high numbers of hospitalizations compared to the general population. The purpose of the project was to improve staff ability to recognize and respond to the changes in the health status of intellectually and developmentally disabled individuals living in a group home. The project utilized Knowles’s theory of adult learning to develop a curriculum suitable for adult learners and the Kirkpatrick model to guide the assessment of the training. Pre- and post-perception of learning and satisfaction surveys were provided to the participants online. A paired t test …
The Lived Experience Of African American Young Adult Men With Hiv And Self-Care Collaborative Management, Barbara A. Moore
The Lived Experience Of African American Young Adult Men With Hiv And Self-Care Collaborative Management, Barbara A. Moore
Walden Dissertations and Doctoral Studies
AbstractAfrican American young adult (AAYA) men living with HIV often lack interventions that address the influence that HIV has on their quality of life, especially their relationships. Self-care collaborative management (SCCM) concerns related to disclosure and stigmatization complicate social, psychological, and SCCM behaviors. Intervention programs addressing these concerns should be based on relevant, accurate information, but this information is lacking for AAYAs. The purpose of this research was to explore and describe the lived experiences of male AAYAs with HIV and their use of SCCM. The study method was qualitative; Husserl’s transcendental phenomenology was the design. The individual family self-management …
Improving Nurses’ Knowledge To Provide Diabetes Self-Management Education For African Americans, Jakeyla Reed
Improving Nurses’ Knowledge To Provide Diabetes Self-Management Education For African Americans, Jakeyla Reed
Walden Dissertations and Doctoral Studies
African Americans are at high risk for type II diabetes compared to other ethnic groups due to biological, socioeconomic, and psychosocial risks. Specifically, African American adults are nearly two times more likely than White individuals to develop type II diabetes. The meaningful gap-in-practice addressed by this doctoral project was nurses’ lack of diabetes knowledge affecting their ability to provide diabetes care and diabetes self-management education (DSME) to their patients with diabetes. The clinical practice-focused question asked whether an education intervention for outpatient clinic nurses could improve their knowledge of DSME. Orem’s self-care model, Bandura’s self-efficacy theory, and Lewin’s change theory …
Medical Spas: Ensuring Compliance And Patient Safety, Mike Chammout
Medical Spas: Ensuring Compliance And Patient Safety, Mike Chammout
Walden Dissertations and Doctoral Studies
Nonsurgical aesthetic procedures continue to grow in popularity; however, evidence-based clinical practice guidelines that can assist providers when performing aesthetic treatments are lacking. This gap in practice can result in the increased prevalence of side effects from treatments that can compromise patient safety and result in increased litigation. The goal of this project was the development of a clinical practice guideline (CPG) that can be used by aesthetic providers to standardize care when performing nonsurgical aesthetic procedures that can ultimately improve provider knowledge, which would improve patient safety. This CPG sought to answer the practice-focused question involving whether the development …
Lived Experiences Of Newly Graduated Registered Nurses, Tonya Lyn Chancey
Lived Experiences Of Newly Graduated Registered Nurses, Tonya Lyn Chancey
Walden Dissertations and Doctoral Studies
Attrition rates for first year newly graduated registered nurses (NGRNs) are between 30% to 60%; high level of attrition negatively affects hospital organizations, other nurses, and patient outcomes. Transitioning from student nurse to clinical nurse poses challenges for NGRNs which includes assuming responsibilities for a full patient load, communicating with physicians, and adjusting to shift work. The purpose of this phenomenological study, guided by Kramer’s reality shock theory and Duffy’s quality caring model, was to examine the lived experiences of a first-year cohort of NGRNs working in the acute care setting of a Florida hospital. Thirteen NGRNs were interviewed using …
Improving Fall Risk Knowledge Through Staff Education In An Assisted Living Facility, Assumpta Egowure Ike
Improving Fall Risk Knowledge Through Staff Education In An Assisted Living Facility, Assumpta Egowure Ike
Walden Dissertations and Doctoral Studies
AbstractPatient safety and fall prevention are crucial for nurses and healthcare workers especially in assisted living facilities considering the age and health status of the patients. Low staff knowledge of fall risk measures in an assisted living facility may have contributed to an increase in the number of falls recorded in the facility by 20% in the last 2 years. This project addressed the questions of whether an education project could increase staff’s level of knowledge on fall risk measures, and whether any improved knowledge would coincide with the number of falls per patient day in the assisted living facility? …
Reducing The Readmissions Through Multidisciplinary Rounds In Older Adults, Fatima Rajapathy Tisseverasinghe
Reducing The Readmissions Through Multidisciplinary Rounds In Older Adults, Fatima Rajapathy Tisseverasinghe
Walden Dissertations and Doctoral Studies
Hospital readmissions are a reflection of poor quality of care. The readmission rate in an acute care for the elderly (ACE) unit was above the national benchmark in 2017. The specific problem includes lack of communication, collaboration, and coordination among the interdisciplinary team. Further, in older adults, the problem is accentuated by health illiteracy, comorbidities, cognitive impairment, polypharmacy, and unclear discharge and follow-up care instructions. Poor care transition costs Medicare 17.4 billion dollars a year. Multidisciplinary rounds (MDRs) have been adopted by many hospitals as evidence-based interventions to reduce readmissions within 30 days. This Doctor of Nursing Practice (DNP) project …
A Delphi Study On The Use Of Simulation In Undergraduate Nursing Education, Diana L. Bailey
A Delphi Study On The Use Of Simulation In Undergraduate Nursing Education, Diana L. Bailey
Walden Dissertations and Doctoral Studies
AbstractThe lack of traditional clinical sites for nursing students has prompted a surge in simulation as an innovative teaching strategy in undergraduate nursing education. The International Nursing Association for Clinical Simulation and Learning (INASCL) developed the INACSL Standards of Best Practice: SimulationSM to direct schools of nursing in implementing high-quality simulations. As simulated experiences replace traditional clinical experiences, it is imperative that simulated experiences replicate real-life patient scenarios. The purpose of this Delphi study was to establish consensus on the use of the INACSL Standards of Best Practice: Simulation in undergraduate nursing education. The conceptual frameworks guiding this study were …
Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer
Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer
Walden Dissertations and Doctoral Studies
AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used …
Experience Of The Obese Population With Weight Bias/Stigma, Gary Mathew Brown
Experience Of The Obese Population With Weight Bias/Stigma, Gary Mathew Brown
Walden Dissertations and Doctoral Studies
Obesity management has been identified as an important issue in health promotion, and some researchers have also reported that people who are obese often do not seek health care. Yet, current research is lacking on the complexities of weight stigma from the perspective of people who are obese. The purpose of this qualitive descriptive study was to understand the perceptions of weight bias/stigma of obese individuals. Guided by Goffman’s Theory of Social Stigma and the Health Belief Model, purposive sampling was used to recruit 10 participants who had a body mass index greater than 30 and who lived in West …
Increasing Fall Awareness Through Nursing Staff Education, Evelyn Ahiante Dennis
Increasing Fall Awareness Through Nursing Staff Education, Evelyn Ahiante Dennis
Walden Dissertations and Doctoral Studies
Patient falls are a significant healthcare concern, with the highest risk being among older adults aged 65 and older. A lack of nursing knowledge can contribute to patient falls. This DNP project was conducted in the medical-surgical trauma unit of a 137-bed local rehabilitation center in Northern Georgia. The intention of the project was to understand if a nursing staff education program would increase knowledge regarding falls prevention. Kurt Lewin’s change theory provided the framework for the project. The project participants were nine medical surgical nurses. Using the analysis, design, development, implementation (ADDIE) model, a falls prevention education program was …
Diabetes Education For Nursing Staff In Primary Health Care, Artemio Pontejos
Diabetes Education For Nursing Staff In Primary Health Care, Artemio Pontejos
Walden Dissertations and Doctoral Studies
The nature of the DNP project was a staff education program for staff nurses and other clinic personnel on diabetes self-care management in a primary health care setting. The goal of this educational program was to improve and update the knowledge on self-care management of primary health care nurses. This education program followed the Walden University DNP Project Manual for Staff Education guidelines. The purpose of this continuing education of professional nurses was to improve nurses’ patient education on self-care management. After a 3-day face-to-face 90-minute lecture, improvement of knowledge was measured with a comparison of a pretest and a …
A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas
A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas
Walden Dissertations and Doctoral Studies
High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and …
Clinical Practice Guidelines For Nursing Orientation At A Small Clinic, Elizabeth Bemah
Clinical Practice Guidelines For Nursing Orientation At A Small Clinic, Elizabeth Bemah
Walden Dissertations and Doctoral Studies
In the United States, the registered nurse turnover rate was 17.2% in 2018, a 0.4% increase from 2017. The nursing turnover rate at a small out-patient clinic in the northeast United States was 19.1% in 2019 and has not improved to date. The administrator at the out-patient clinic further indicated that the turnover rate has been approximately two nurses per month for the last 6 months and that the facility did not have a formalized nurse orientation program. Nursing orientation is one of the strategies for increasing the confidence levels and retention of newly hired nurses. The purpose of this …
Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead
Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead
Walden Dissertations and Doctoral Studies
In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives …
An Orientation Program For Neonatal Nurse Practitioners In A Level Iii Nicu, Lu-Ann Campagnola
An Orientation Program For Neonatal Nurse Practitioners In A Level Iii Nicu, Lu-Ann Campagnola
Walden Dissertations and Doctoral Studies
Due to a nationwide shortage of neonatal nurse practitioners (NNPs), chronic short staffing shifted priority away from hiring novice and newly graduated NNPs in favor of recruiting experienced NNPs and contracting temporary locum tenens to expeditiously fill gaps in NNP staffing. Provision of formal orientation and an infrastructure that supported successful role transition became devalued and inconsistency in clinical approach and decision-making amongst providers raised concerns for patient safety. The goal of this Doctor of Nursing Practice (DNP) project was to develop a formal orientation program for NNPs in a Level III Neonatal Intensive Care Unit. The purpose was to …
Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo
Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo
Walden Dissertations and Doctoral Studies
Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …
Increasing Nurse Manager Knowledge Of Authentic Leadership, Patricia Ann Stone
Increasing Nurse Manager Knowledge Of Authentic Leadership, Patricia Ann Stone
Walden Dissertations and Doctoral Studies
AbstractResearch has demonstrated a positive correlation between authentic leadership and positive patient and organizational outcomes. Given that nurses can be educated in authentic leadership, providing nurse leaders with training opportunities will help them develop authentic leadership skills which will benefit patients and the organization. At the project site, there is little opportunity for leadership development among nurse leaders. Thus, the purpose of this DNP project was to determine if an educational intervention focused on authentic leadership increase knowledge and awareness among nurse managers. Authentic leadership theory grounded the DNP project. Twenty-three nurse managers were invited to participate in an educational …
Staff Education Program For Chlamydia And Gonorrhea Self-Collected Vaginal Swabbing, Cheryl Marie Tugman
Staff Education Program For Chlamydia And Gonorrhea Self-Collected Vaginal Swabbing, Cheryl Marie Tugman
Walden Dissertations and Doctoral Studies
Girls and women carry the burden of negative consequences of untreated sexually transmitted diseases (STDs), such as chlamydia and gonorrhea. Screening for chlamydia and gonorrhea by increasing self-collected vaginal swabbing (SCVS) can improve access of care and prevent delayed treatment. Nurses may support their patients if they receive training in how to teach screening for sexual self-healthcare. The purpose of this project was to develop and conduct a staff education program in an urban primary care clinic. The project addressed whether the education program would increase nurses’ knowledge of SCVS. The goal is to ultimately increase female patients’ access to …
Nurse Perspectives Of Trauma-Informed Care, Lee Ann Blazejewski
Nurse Perspectives Of Trauma-Informed Care, Lee Ann Blazejewski
Walden Dissertations and Doctoral Studies
There is growing interest in trauma-informed nursing methods to better respond to the needs of patients with histories of adverse childhood experiences and other traumatic events. Recent advances in the understanding of how trauma can negatively affect long-term health outcomes have fostered a shift towards trauma-informed care as a method to decrease patient retraumatization in nursing practice. With the implementation of trauma-informed care in many areas of healthcare and public health, several challenges have been exposed. The purpose of this study was to examine nurses’ lived experience of implementing trauma-informed care into nursing practice for the care of patients with …
Staff Education And Depression Screening In Pulmonology And Sleep Medicine, Christina Boyle
Staff Education And Depression Screening In Pulmonology And Sleep Medicine, Christina Boyle
Walden Dissertations and Doctoral Studies
AbstractDespite recommendations that all adults be screened for depression, providers at the project site struggled to consistently assess for depression. Identification of depression is an essential step in depression management, which is a concern for patients with sleep disorders and other pulmonary disease served at the site. The purpose of this project was to develop an education training program for clinicians regarding depression screening. The theory of cognitive development using the Iowa model of evidence-based practice (EBP) guided the project, which sought to determine if an EBP education program regarding depression screening would be an effective means for staff education, …
The Impact Of Self-Esteem And Body Dissatisfaction On Internalized Stigma In Obese, Hispanic Women, Dorothy M. Burns
The Impact Of Self-Esteem And Body Dissatisfaction On Internalized Stigma In Obese, Hispanic Women, Dorothy M. Burns
Walden Dissertations and Doctoral Studies
AbstractThe current literature on self-esteem (SE), body dissatisfaction (BD) and internalized weight stigma (IWS) was limited, albeit evolving. The variables were well established across multiple domains of study: IWS was consistently noted to be a contributing factor for the development of obesity, but no studies explored the relationship between SE and BD on IWS. Therefore, the purpose of this correlational study was to explore the relationship between SE and BD and their effect on IWS in 30–44-year-old, obese, Hispanic women who are 20% more likely to be overweight or obese than non-Hispanic women. The study was guided by symbolic interactionism …
Leadership Empowerment Behavior And Psychiatric Nurses Intent To Leave, Temitope Kikelomo Gold
Leadership Empowerment Behavior And Psychiatric Nurses Intent To Leave, Temitope Kikelomo Gold
Walden Dissertations and Doctoral Studies
There is a shortage of registered nurses (RNs) who work in the specialty of psychiatric nursing. Attrition among psychiatric RNs is partly due to lack of leadership empowerment which includes autonomy and access to professional development opportunities. The purposes of this study, guided by Kanter’s theory of structural empowerment, were to determine (a) if there was a relationship between leadership empowerment behavior and psychiatric RNs’ intent to leave within the first 2 years of practice in inpatient psychiatric settings and (b) if there was a relationship between leadership empowerment behavior and intent to leave among psychiatric registered nurses who are …