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Articles 1351 - 1380 of 2607
Full-Text Articles in Nursing
Exploring Cultural Experiences Of African American Recipients Of Healthcare, Christopher Steven Hairfield
Exploring Cultural Experiences Of African American Recipients Of Healthcare, Christopher Steven Hairfield
Walden Dissertations and Doctoral Studies
Culturally competent care is widely accepted as a strategy to address healthcare disparities based on the perceptions of the individual provider, yet this approach lacks the voice of the African American (AA) communities intended to benefit from the strategy. Individuals in AA communities have been shown to suffer higher incidence of disease, disproportionately poorer health outcomes, and inequitable healthcare treatment. Framed by Leininger’s culture care theory, the purpose of this interpretive phenomenological study was to explore the lived cultural experiences of AA recipients of care when interacting with the healthcare system in an effort to contribute evidence to improve the …
Developing Nurse Managers Through An Evidence-Based Education Program, Theresa Ann Hannu
Developing Nurse Managers Through An Evidence-Based Education Program, Theresa Ann Hannu
Walden Dissertations and Doctoral Studies
AbstractThis study explored the lack of formalized managerial education and training for nurses new to leadership. This quantitative study specifically explored the knowledge gap of beginner nurse managers based on a lack of formalized education, a universal approach is supported by the research. Currently, there is no standard or formal nurse manager education program through the Department of Nursing or the Department of Learning and Development. The focus of the evidence-based project was to evaluate pre- and post-data assessing the impact of instituting a formal education program for beginner level nurse managers in collaboration with the human resources department of …
Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas
Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas
Walden Dissertations and Doctoral Studies
AbstractHeart failure (HF) is a progressive and life -threatening disease that places a large burden on the health care systems worldwide with increased rates of re-hospitalization, readmissions, and outpatient visits. With the use of telehealth monitoring and support from nursing case managers, HF patients are able to manage this disease at home. The focus of this project was to evaluate a home health agency (HHA) telehealth program, exploring if there was an improvement in 30-day readmission rates, and patient satisfaction scores for the HHA telehealth program one year after revising the program incorporating nursing virtual case managers. This project used …
Clinical Practice Guideline On Childhood Obesity, Catherine Nanyongo Manga
Clinical Practice Guideline On Childhood Obesity, Catherine Nanyongo Manga
Walden Dissertations and Doctoral Studies
AbstractFamily care practitioners (FCPs) are important players in the treatment of childhood obesity. However, the evidence-based literature shows that practitioners lack both knowledge of how to diagnose the condition as well as the confidence and education to care for patients with obesity. The primary care setting for this project has a 77% obesity rate among the clinic pediatric population compared to a national average of 19%; the FCPs at the target clinic lacked sufficient knowledge on the diagnosis and treatment of obesity, limiting their ability and confidence to counsel families on weight control measures. Following the Walden University Clinical Practice …
Use Of Evidence-Based Clinical Practice Guidelines In Obesity Management In Women, Chizimako Margaret Eze
Use Of Evidence-Based Clinical Practice Guidelines In Obesity Management In Women, Chizimako Margaret Eze
Walden Dissertations and Doctoral Studies
Obesity is one of the Healthy People 2020 high-priority public health issue. Obesity is of importance due to the troubling higher prevalence in women because of the close link that exists between body weight and reproductive health in females from menarche to menopause and beyond. The identification of guidelines to improve or manage the care of female patients can alleviate the burden and complications from being overweight or obese. This project guided by the ADDIE (analyze, design, develop, implement, and evaluate) model was conducted in a family primary care clinic to address a gap in practice, the lack of knowledge …
Alarm Fatigue On Medical-Surgical Units, Jody S. Destigter
Alarm Fatigue On Medical-Surgical Units, Jody S. Destigter
Walden Dissertations and Doctoral Studies
Technology use in the medical-surgical acute care setting has increased and leads to alarm, alert, and notification overload, also known as alarm fatigue, which is one of the top 10 health technology hazards leading to patient harm. Alarm fatigue is a new phenomenon within the acute care health care setting and impacts patients, families, staff, leadership, organizations, and the profession of nursing. The purpose of this descriptive, comparative, quantitative study was to examine the difference in the level of alarm fatigue and its impact on performance for nurses who work on a technology-dedicated, inpatient, medical-surgical unit versus a traditional inpatient …
Influence Of Questioning On Development Of Clinical Reasoning In Prelicensure Nursing, Teresa Maria Brown
Influence Of Questioning On Development Of Clinical Reasoning In Prelicensure Nursing, Teresa Maria Brown
Walden Dissertations and Doctoral Studies
Clinical reasoning is the basis for every clinical decision a nurse makes; however, only 23% of newly graduated nurses are safely able to recognize urgent clinical patient problems and demonstrate appropriate management of those problems. Furthermore, new nurses make 50% of medical errors. This leaves nurse educators looking for evidenced-based teaching/learning strategies to help their students develop clinical reasoning skills. The purpose of this study was to investigate the influence of questioning as a problem-based teaching/learning strategy on clinical reasoning in undergraduate nursing students. The theoretical framework used to guide this study was Tanner’s clinical judgment model. Using Lasater’s clinical …
The Patient Dignity Project, Jennifer Kepler Flick
The Patient Dignity Project, Jennifer Kepler Flick
Walden Dissertations and Doctoral Studies
The delivery of patient-centered care is central to many healthcare initiatives. However, the national nursing shortage and the task-oriented nature of the nursing process can make the delivery of this type of care difficult. Nursing as a caring science requires nurses to have an in-depth understanding of how the care they provide impacts patient dignity. Although the Patient Dignity Question is effective as a dignity-preserving intervention, the project facility offered no orientation or educational opportunities that specifically related to patient dignity. This project was a multimodal educational intervention on protecting patient dignity with pre- and posteducation survey assessments. The practice-focused …
Surgical Site Infection Rates After Implementation Of The Surgical Care Improvement Project Initiative, Victor Lao De Guzman Jr
Surgical Site Infection Rates After Implementation Of The Surgical Care Improvement Project Initiative, Victor Lao De Guzman Jr
Walden Dissertations and Doctoral Studies
Surgical site infections (SSIs) reflect a serious complication in modern healthcare and are a substantial burden to healthcare systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. The Surgical Care Improvement Project (SCIP), introduced in 2006, was developed by the Centers for Medicare and Medicaid Services to reduce SSI rates by 25%. However, SCIP was retired in 2015. Given the considerable financial burden of SSIs and because SSIs may be prevented using evidence-based measures, it was worth revisiting and re-evaluating the quality improvement efforts brought about by the success of the evidence-based SCIP initiative. This …
Staff Education: Nonpharmacological Interventions For Pain In Older Adults With Osteoarthritis, Rachel 'Seunayo Ilesanmi
Staff Education: Nonpharmacological Interventions For Pain In Older Adults With Osteoarthritis, Rachel 'Seunayo Ilesanmi
Walden Dissertations and Doctoral Studies
Osteoarthritis (OA) pain is a major social problem for older adults and has psychological and physical implications. In the clinic where the project was implemented, the family nurse practitioners (FNPs) are not addressing the OA pain of the older adult patients according to the evidence-based practice (EBP) guidelines. The purpose of this project was to educate FNPs on EBP guidelines regarding nonpharmacological intervention for chronic pain in OA patients. Knowles’ adult learning theory guided the development of the education program specific to the unique learning style of the FNPs. Fourteen FNPs who treat patients with OA in 3 clinic settings …
The Experience Of Women With Opioid Use Disorder Accessing Methadone Treatment, Lizette Cristine Keenan
The Experience Of Women With Opioid Use Disorder Accessing Methadone Treatment, Lizette Cristine Keenan
Walden Dissertations and Doctoral Studies
The number of women experiencing opioid use disorder (OUD) in Canada has increased exponentially. In Canada, healthcare is socialized and free for all citizens and often medications like methadone are free as well, yet few individuals with OUD access treatment services. The purpose of this study was to describe the lived experiences of Canadian women with OUD who were receiving methadone treatment. Interpretive phenomenology was used to investigate the treatment experiences of seven women with OUD. The conceptual framework of self-care of chronic illness was used examine this phenomenon. Data was analyzed using a seven step process of interpretive phenomenological …
Preparing Staff Nurses For Timely Management Of Hypertension In Acute Ischemic Stroke, Nneoma Oguguo
Preparing Staff Nurses For Timely Management Of Hypertension In Acute Ischemic Stroke, Nneoma Oguguo
Walden Dissertations and Doctoral Studies
When a blood clot obstructs the flow of blood and oxygen to the brain, it can cause an ischemic stroke. Hypertension is the most important risk factor for ischemic stroke because it causes damage to the arteries, making them easy to burst or clog and subsequently increases the risk of stroke. Advanced treatments have been developed to dissolve clots and restore blood flow to the brain. Tissue plasminogen activator (tPA) has been clinically beneficial in acute ischemic stroke if it is given early and under the right conditions. Nurses can improve patient care through application of evidenced-based management. The purpose …
Benefits Of Using An Electronic-Medical-Record In The Emergency Department: A Systematic Review, Eduardo Paguntalan Monroy
Benefits Of Using An Electronic-Medical-Record In The Emergency Department: A Systematic Review, Eduardo Paguntalan Monroy
Walden Dissertations and Doctoral Studies
AbstractLow quality of care is a problem for many United States (U.S.) emergency departments (E.D.). The use of electronic medical records (EMR) with quick embedded tools, treatment plans, and protocols decrease E.D. overcrowding, reduce boarding time, to approximate the 4- hour recommendation by the Joint Commission on Accreditation of Healthcare Organizations, and improve quality of care. The project question asked whether a systematic review of EMRs with quick embedded tools, treatment plans, and protocols decreased overcrowding and boarding time, and improved E.D. quality care. This systematic review used the Johns Hopkins Model to answer the project question by guiding selection, …
Associations Between Nurse Manager Engagement And Nursing Quality Indicators, Justin Travis Morris
Associations Between Nurse Manager Engagement And Nursing Quality Indicators, Justin Travis Morris
Walden Dissertations and Doctoral Studies
Individuals serving in the nurse manager role are critical stakeholders supporting frontline nurses delivering quality care within acute care settings. Despite evidence supporting nurse managers’ contributions to improved quality outcomes for patients by proxy, there is scant evidence supporting direct relationships between the role and outcomes. This study intended to provide quantitative evidence of relationships between nurse managers’ engagement, nurse managers’ tenure, and patient outcomes. The leadership complexity theory classified the nurse manager as a meso-level leader, requiring support from the macro- and microlevels of the organization. Acting as a liaison, meso-level leaders’ function in the space between executive leadership …
Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson
Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson
Walden Dissertations and Doctoral Studies
Healthcare acquired pressure injuries (HAPIs) are a serious and debilitating condition in the elderly, and it is therefore critical to reduce the incidence of HAPIs. Mitigation strategies are often implemented for patients who score in the highest risk categories on the Braden Scale for Predicting Pressure Sore Risk©. Yet, the evidence suggests vulnerable older adults who score in the midrange of the Braden Scale, and specifically, the mobility subscale, develop HAPI more frequently. The review question centered on the evaluation of the current evidence for early mitigation strategies in response to Braden Scale midrange mobility subscale scores. The gap addressed …
Reducing Fall Rates At A Long-Term-Care Facility, Francis Ortego
Reducing Fall Rates At A Long-Term-Care Facility, Francis Ortego
Walden Dissertations and Doctoral Studies
In the United States, older adults often experience fall events that may result in physical, mental, and financial hardship. Since the project site was experiencing a significant number of patient falls, a fall-prevention quality improvement (QI) program was implemented. Guided by the diffusion of innovation theory and the plan-do-study-act (PDSA) model, the purpose of this doctoral project was to evaluate the effectiveness of that program to determine if the monthly fall rate in the facility would decrease during the next 6 months. The project site provided deidentified data in the form of monthly fall-rate totals as collected from the long-term-care …
Beliefs About Evidence-Based Practice Among New Graduate Nurses, Julie Bane
Beliefs About Evidence-Based Practice Among New Graduate Nurses, Julie Bane
Walden Dissertations and Doctoral Studies
It is an expectation that new graduate nurses (NGNs) use evidence-based practices (EBP) in patient care; however, studies indicated that NGNs lack confidence in, belief in, and a full understanding of EBP processes and implementation. The doctoral project practice-focused question addressed whether immersion in EBP education and completion of an EBP project through a quality-improvement pilot program would enhance NGNs’ beliefs about the benefits and processes of EBP as well as increase confidence in their ability to implement EBP in the clinical setting. Knowles’ adult learning theory and Rogers’ diffusion of innovation theory guided the project’s motivation and examination of …
Prevention And Self-Care Education For Osteoporosis In A Rural Orthopedic Clinic, Jean Sanford
Prevention And Self-Care Education For Osteoporosis In A Rural Orthopedic Clinic, Jean Sanford
Walden Dissertations and Doctoral Studies
Abstract Osteoporosis affects 25 million people in the United States causing over 1.5 million fractures every year. The gap in practice at a rural southeast orthopedic clinic was a lack of patient education on prevention and self-care management of osteoporosis and osteopenia. The purpose of the project was to develop a program to educate clinic providers on prevention and self-care management for osteoporosis and osteopenia. The Knowles theory of adult learning framed the project components. A 10-question pretest/posttest assessing knowledge was administered to 10 registered nurse participants. For the presurvey, five participants demonstrated a lack of knowledge of medication administration …
Nursing Majors’ Attitudes Toward Suicide And Mental Health Training, Beverly Arleen Burton
Nursing Majors’ Attitudes Toward Suicide And Mental Health Training, Beverly Arleen Burton
Walden Dissertations and Doctoral Studies
AbstractThe mental health training of nursing majors may play a role in their levels of confidence in attending to suicide patients as working professionals. The purpose of this quantitative study was to explore what impact, if any, attitudes toward suicide had on nursing majors’ levels of confidence in their mental health training. Pender’s health promotion theory was the theoretical framework. A descriptive correlational survey was used to explore individuals majoring in nursing confidence and perceived skills in mental health training. The 4 research questions asked the relationship between the level of confidence in helping someone with a mental health problem …
Clinical Practice Guideline For Palliative Care Referral, Samantha Jones
Clinical Practice Guideline For Palliative Care Referral, Samantha Jones
Walden Dissertations and Doctoral Studies
Palliative care is a type of specialty care that focuses on the improvement of the quality of life and prevention of suffering of those with progressive serious illnesses by addressing the physical, emotional, and spiritual needs of patients and families. There are many misperceptions about palliative care by providers, patients, and their families. Inconsistent interventions and a lack of palliative care education for providers results in delayed palliative care involvement. Delayed involvement results in patients with unmet palliative care needs. The purpose of this project was to develop clinical practice guidelines to ensure appropriate care based on the best available …
Reducing Infection Rates Through Handwashing Education, Maureen N. Osegbe
Reducing Infection Rates Through Handwashing Education, Maureen N. Osegbe
Walden Dissertations and Doctoral Studies
AbstractHealth care-associated infections (HCAIs) affect millions of people worldwide, causing morbidity and mortality among hospitalized patients. Hand hygiene is the single most effective way to prevent HCAIs. This project addressed a gap in practice regarding nurses’ knowledge on the effective use of hand hygiene in a medical/surgical unit in a hospital located in northeastern Maryland. This project addressed the question of whether an educational program on handwashing for nurses reduced HCAI rates. A literature review was conducted to support the development of the educational program; relevant sources included peer-reviewed journal articles, systematic reviews, and guidelines that supported the practice-focused question, …
The Impact Of Staff Education On Nurses And Medical Assistants' Knowledge Of Hiv Prevention And Screening, Eurekia Denise Samuel
The Impact Of Staff Education On Nurses And Medical Assistants' Knowledge Of Hiv Prevention And Screening, Eurekia Denise Samuel
Walden Dissertations and Doctoral Studies
AbstractIn some U.S. ambulatory clinics, limited time is available for patient education during primary care, which is a barrier to increasing the recommended annual screening for HIV of persons with risk factors between the ages of 13 and 64. One solution to removing this barrier is the expansion of the role of frontline staff so that patient education, particularly in the areas of secondary prevention and routine testing, can occur at the beginning of the visit during initial checking in and assessments. At the project site, a rural ambulatory clinic in the southern United States, however, the frontline staff lacked …
Professional Values Of Corporate Nurses, Kasey Jeanne Sands
Professional Values Of Corporate Nurses, Kasey Jeanne Sands
Walden Dissertations and Doctoral Studies
Healthcare is comprised of providers, who offer patient services, and payors, who manage the financial reimbursement of providers. Not much is known about registered nurses (RNs) in the corporate payor industry due to a lack of research. Strong professional values (PVs) are expected of all RNs, but research has shown this to vary across the field, meaning that RNs may require support in this area. As little is known about RNs in the payor industry, how these nurses sustain their PVs within the industry has not been evaluated, recognized, or supported. Therefore, the aims of this quantitative, descriptive, and correlational …
Emotional Intelligence And Compassion Fatigue In Emergency Nurses, Kylie Yearwood
Emotional Intelligence And Compassion Fatigue In Emergency Nurses, Kylie Yearwood
Walden Dissertations and Doctoral Studies
Compassion fatigue (CF) is mental and emotional exhaustion that occurs over time in nurses who provide care to traumatized individuals and includes both secondary traumatic stress syndrome (STS) as well as burnout (BO), which results from being overwhelmed in the workplace. Emotional intelligence (EI) has shown to be helpful in nurses who work in a fast-paced, high-stakes environment, such as the emergency department. The purpose of this quantitative, cross-sectional, descriptive study, guided by Orem’s self-care deficit nursing theory, was to determine whether there were relationships (a) between EI and CF in emergency nurses, (b) between EI and STS in emergency …
Transition Of Care To Decrease Hospital Readmission After Acute Mi, Patricia Yoon
Transition Of Care To Decrease Hospital Readmission After Acute Mi, Patricia Yoon
Walden Dissertations and Doctoral Studies
The time period after an acute myocardial infarction (AMI) can be overwhelming for patients; while glad to be discharged from the hospital, they may not have the knowledge nor resources to properly manage secondary prevention measures and treatment of residual coronary artery disease (CAD). The gap in nursing practice this project addressed is the lack of follow up of care leading to increased rates of readmission. The goal of this quality improvement (QI) initiative was to evaluate pre/post data and synthesize results to make recommendations for possible practice change whether a 30-day transition of care program could decrease readmission rates …
Nursing Faculty Experiences With Mobile Technology Use In The Classroom, Sue Ellen Clark
Nursing Faculty Experiences With Mobile Technology Use In The Classroom, Sue Ellen Clark
Walden Dissertations and Doctoral Studies
Research to date on faculty use of technology in the classroom has largely focused on student perceptions of technology, technology use in higher education, and benefits of technology use in teaching and learning. A critical factor in integrating technology relates to nursing faculty members’ mobile technology (MT) experience. The aim of this descriptive phenomenological study was to explore the experiences of nursing faculty when integrating MT in the face-to-face classroom. More precisely, this study was designed to explore the reasons for inconsistencies among faculty in the integration of MT in the face-to-face classroom in baccalaureate nursing education programs. Experiences of …
Poststroke Depression And The Lived Experiences Of The Family Caregiver And Care Recipient Dyad, Tiffany Chere' Gurley-Nettles
Poststroke Depression And The Lived Experiences Of The Family Caregiver And Care Recipient Dyad, Tiffany Chere' Gurley-Nettles
Walden Dissertations and Doctoral Studies
AbstractPoststroke depression in stroke survivors is a more common occurrence than once believed as the survivor of stroke must contend with the loss of their former self and with residual physical, communicative, cognitive, and/or psychological changes. Family members who become informal caregivers, with minimal to no training in some cases, may experience stress from having to adjust to new family roles and responsibilities. Limited information is available on the lived experiences of the family caregiver and the survivor of stroke. The objective of this study was to explore the lived experiences of the survivor or stroke with poststroke depression and …
Relationship Between Nurses’ Perception Of Empowerment, Job Satisfaction, And Intent To Stay, Ma Leilani Hall
Relationship Between Nurses’ Perception Of Empowerment, Job Satisfaction, And Intent To Stay, Ma Leilani Hall
Walden Dissertations and Doctoral Studies
Retention of perioperative nurses who work in the operating room is critical to an organization's effectiveness and financial wellness. Factors that retain perioperative nurses are empowerment and job satisfaction. The purposes of this quantitative study, guided by Kanter's theory of structural empowerment, were to determine (a) the level of empowerment and job satisfaction among perioperative nurses and their intent to stay in the organization and (b) if age, gender, education, perioperative experience, and national nursing certification predict empowerment among perioperative nurses. Fifty-five perioperative nurses responded to the Conditions for Work Effectiveness Questionnaire-II, Nursing Workplace Satisfaction Questionnaire, and Intent to Stay …
Nursing Staff Education Fall Prevention Program At A Skilled Nursing Facility, Solomon Lomo
Nursing Staff Education Fall Prevention Program At A Skilled Nursing Facility, Solomon Lomo
Walden Dissertations and Doctoral Studies
Falls have negative effects on the confidence, function, and quality of life in older adults and are major cause of injury and death among this population. The quality assurance report in a long-term care facility identified an average of 10 falls per week in the last quarter of 2017. The facility has a person-centered policy, which creates fall prevention challenges when usual fall protective practices are prohibited. The purpose of this education program was to educate staff nurses working with patients in a long-term care facility on additional evidenced based practices to prevent falls and injuries without compromising the person-centered …
Antibiotic Stewardship: Decreasing Antibiotic Use For Viral Upper Respiratory Infections, Merkessie Taresa Redix
Antibiotic Stewardship: Decreasing Antibiotic Use For Viral Upper Respiratory Infections, Merkessie Taresa Redix
Walden Dissertations and Doctoral Studies
AbstractOverprescribing antibiotics for viral upper respiratory infections is a common practice in the United States. This overprescribing of antibiotics can cause several health issues and increase health care costs. Despite the current guidelines recommended by the Centers for Disease Control and Prevention (CDC) the overprescribing of antibiotics by providers remains an issue. The purpose of this project was to educate providers on antibiotic stewardship for viral upper respiratory infections. The practice question was used to explore whether an educational program using concepts from Lewin’s change theory and Kolb’s learning theory would increase provider’s knowledge about the current evidence- based prescriptive …