Nursing Commons^™

The Political Astuteness Of The New Mexico Registered Nurse, Gloria Sue Doherty

Walden Dissertations and Doctoral Studies

The United States spends the most per capita of all the developed countries on healthcare but demonstrates the worst healthcare outcomes. National agencies have turned to Registered Nurses (RNs) to improve healthcare outcomes through participation in healthcare policy development. Although the recommendation for participation in policy development exists, RNs, including those in the U.S. state of New Mexico have not participated at high levels. The purpose of this quantitative cross-sectional study was to measure the political astuteness of RNs in New Mexico and to determine to what extent nursing leaders have been successful in diffusing Institute of Medicine recommendations. Rogers’s …

Staff Education On Medication Screening Tool For Nursing Home Residents, Jinkee Sarah Beltran

Walden Dissertations and Doctoral Studies

The prevalence of potentially inappropriate medications (PIMs) among nursing home residents continues to be high. Researchers have demonstrated that the use of a medication screening tool identifying PIMs can improve medication safety among older adults. Screening tools, such as the Beers criteria and the Screening Tool for Older Persons’ Prescriptions (STOPP), are evidence-based guidelines that use several validated criteria to identify PIMs in older adults’ medication regimens. While the use of these tools is standard in the acute care setting, limited studies have been conducted regarding their use in the nursing home setting. The purpose of this project was to …

Systematic Review Of The Barriers To Breastfeeding For Non-Hispanic Black Women, Ketty N. Floyd

Walden Dissertations and Doctoral Studies

Breastmilk provides the optimal food for newborns and contributes to improved lifelong health. A community hospital in the Eastern United States serving non-Hispanic Black (NHB) women has a breastfeeding exclusivity rate of only 8%, which is low compared to the state’s exclusivity rate of 40%. A systematic review of the literature was conducted to identify the breastfeeding barriers for NHB mothers and to identify strategies to address them. Guided by Fishbein and Yzer’s integrative model and the SQUIRE 2.0 knowledge reporting framework, 30 articles were appraised using Melnyk and Fineout-Overholt’s hierarchy of research and the Caldwell, Henshaw, and Taylor qualitative …

Implementation Of A Fall Prevention Program For The Elderly In A Long-Term Care Facility, Maureen Orobosa Igharosa

Walden Dissertations and Doctoral Studies

One out of 4 older people fall each year. By the year 2030, it is estimated that 49 million older adults will fall and that 12 million will incur injuries as a result. A rise in the trend in falls among older adults represents a growing burden; the cost for falls billed to Medicare in the year 2015 was an aggregate of over $31 billion. The purpose of this quality improvement evaluation project was to assess the effectiveness of a fall preventative pilot program to reduce the number of falls among the residents of a rehabilitation and long-term care facility …

Teaching Guidelines For Screening Prostate Cancer In African American Men, Joain Sophie Silvera

Walden Dissertations and Doctoral Studies

AbstractAfrican American (AA) men have the highest incidence of prostate cancer (PCa) compared to their White and Hispanic counterparts and a higher mortality rate than any other ethnicity. While biological and socioeconomic factors are to be blamed, many AA men are not aware of the opportunities for screening or the prognoses for the condition. There is an obvious need for increased awareness in AA men concerning preventative screening for PCa. Following the Walden University Clinical Practice Guideline Manual and guided by the Appraisal of Guidelines for Research & Evaluation (AGREE II) model to guide and validate the newly developed clinical …

Educating Nurses To Help Promote Diabetes Self-Care Management In Primary Care, Delphine E. Ikpasaja

Walden Dissertations and Doctoral Studies

Diabetes is a chronic disease that has a genetic and lifestyle component, and it affects individuals in various parts of the world. A lack of understanding of the nature of the disease has contributed to the complications experienced by patients with diabetes 2 (DM2), such as an elevated glycosylated hemoglobin (A1C) and hyperglycemia. At the clinic where this project took place, patients received an initial teaching but did not get any further support or resources to manage their disease. A four sections of a 30 minutes each was the educational presentation used with staff at the clinic to help them …

Lived Experiences Of Lassa Fever Survivors In Southsouth Nigeria, Albert Oamen Oyeribhor

Walden Dissertations and Doctoral Studies

AbstractLassa fever, a viral disease, was first isolated in the late 1960s and affects 300,000 to 500,000 people, causing 5,000 to 10,000 fatalities annually across West Africa. Although there are studies on the causes and prevalence of Lassa fever, there is a paucity of studies regarding the quality of life (QoL) and lived experiences of survivors. The purpose of this qualitative study, guided by Leininger’s culture care theory, was to describe the QoL and meanings of the lived experiences of Lassa fever survivors in the Southsouth region of Nigeria. Fifteen survivors of Lassa disease were interviewed. Data were analyzed using …

Type 2 Diabetes Prevention And Management Educational Toolkit, Theresa O. Orjiakor

Walden Dissertations and Doctoral Studies

AbstractDiabetes is one of the chronic diseases that are challenging to prevent and manage. Approximately 8.3% of the United States' population has type 2 diabetes. One of the primary challenges in managing the disease entails reducing the associated financial and human costs by preventing new cases and enacting social change. Prevention and management education programs using enhanced toolkit may have positive effects on type 2 diabetes patients, who start enjoying a good quality of life, as well as positive social change in their communities and families. The purpose of this project was to develop and evaluate a type 2 diabetes …

Nursing Clinical Practice Guideline Development For The Care Of Sexual Assault Survivors, Elssy J. Bingham

Walden Dissertations and Doctoral Studies

Sexual assault, a form of sexual violence, is an egregious crime that continues to be a serious and significant public health problem which affects millions of people each year in the United States and globally. Sexual assault may have lasting and devastating negative physical and emotional consequences. Knowledgeable nurses can have a positive impact on a survivor’s safety and recovery. The purpose of this project was to develop a Clinical Practice Guideline (CPG) for nurses who provide the initial care when patients present in the emergency room following sexual assault. The conceptual framework used for this project included Knowle’s Theory …

Program Evaluation Of A Home-Based Primary Care Practice And Patients With Heart Failure, Anne Rose Walsh

Walden Dissertations and Doctoral Studies

Heart failure (HF) affects over 5.5 million adults in the United States with a prevalence of 10%'€“20% in older adults and accounts for 3% of all hospital admissions with a readmission rate as high as 25% within 1 month of discharge. Patients with HF account for approximately 42% of the doctor of nursing practice project site's patient population, and the health system has a 30-day readmission rate of 35% for patients with HF in 2 large hospitals. Thus, the health system loses almost $13 million per year in Medicare penalties. This retrospective quality improvement project reviewed the effectiveness of care …

Pressure Injury Prevention In An Urban Surgical Intensive Care Unit, Kayma P. Ricks

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure injuries (HAPIs) affect approximately 2.5 million patients in the

United States, annually. Prevention requires surgical intensive care unit (SICU) nursing staff to

effectively use evidence-based risk assessment measures to appropriately identify patients at risk

for developing HAPIs and to prevent poor patient outcomes. The Braden Scale risk assessment

tool has demonstrated reliability and validity in the prediction and assessment of patients at risk

for the development of HAPIs. The purpose of this Doctor of Nursing Practice (DNP) project

was to improve nurses’ knowledge of the appropriate use of the Braden Scale risk assessment

tool in the SICU of …

Managing Disruptive Patient Behaviors In A Mental Health Clinic: A Staff Education Program, Mary Odusanya

Walden Dissertations and Doctoral Studies

Disruptive patient behavior is a significant issue in healthcare. Staff education programs are beneficial in managing disruptive patient behaviors. There has been an increase in the occurrence of disruptive patient behaviors at the clinical site, which is an outpatient mental health clinic, and staff members are not well equipped to deal with these situations. The purpose of this project was to develop, implement, and evaluate a staff education program on how to manage disruptive patient behaviors in an outpatient mental health clinic. Using a pre- and posttest design, the project aimed to answer the question of whether a staff education …

Rural Practical Nursing Students' And Faculty Members' Perceptions Of Supports And Barriers To Success, Amy J. Randall-Mcsorley

Walden Dissertations and Doctoral Studies

Practical nursing program students at a rural vocational school (RCC) in the midwestern United States were graduating at a low rate that was putting the school at risk to not meet accreditation standards set by the Council on Occupational Education. The purpose of this study was to explore the perceptions of practical nursing program students and faculty at RCC about institutional, situational, and dispositional supports and barriers students faced toward graduation. The conceptual framework, Cross’s model of barriers to adult learning, was used to identify institutional, situational, and dispositional supports and barriers. A bounded case study design was employed to …

Effectiveness Of Education On Modified Early Warning System For Nurses, Shanmugavalli Janakaraj

Walden Dissertations and Doctoral Studies

The research problem at the practicum site was a delay in recognizing patient’s deterioration due to lack of nurses’ knowledge with early warning signs. It is important to address the problem as the Quality Department noted the delay in identification of patient decline and treatment from mortality case reviews, rapid response team and Code Blue debriefing analysis and missed sepsis identification. A further gap analysis revealed an inadequacy of staff knowledge with warning signs. The purpose of this project was to educate nurses on the Modified Early Warning System (MEWS), a patient assessment scoring system based on six physiological parameters. …

Accelerated Baccalaureate Nursing Student And Faculty Perceptions Of Blended Learning, Emily Elliott

Walden Dissertations and Doctoral Studies

In response to the demand for baccalaureate-educated nurses, nursing schools offer an accelerated baccalaureate of science in nursing (BSN). The problem is nursing programs have used blended learning approaches, but it is unclear whether and in what ways accelerated BSN students benefit from this learning design. The purpose of this qualitative case study was to explore how faculty and students perceived the benefits and challenges of an accelerated BSN program utilizing a blended learning format. Knowles’s adult learning theory served as the conceptual framework through which interview data were analyzed. Participants included 6 faculty and 7 students from 1 school …

Congestive Heart Failure And Strategies To Improve Quality Of Life, Esther Akunna Okorie

Walden Dissertations and Doctoral Studies

Congestive heart failure is a global, chronic, progressive, and debilitating disease affecting mostly older adults. The multiple complications associated with the health issue led to readmissions and markedly reduced ability of heart failure (HF) patients to perform the self-care management of the problem. Nurses are responsible for providing a standardized quality education for patients; however, nurses at the project site lacked adequate skills and knowledge to bridge the gap in HF self-care management education. The project was guided by health belief model and self-care deficit with the goal of boosting the staff knowledge and confidence with providing patient HF self-care …

New Graduate Residency Programs, Shareen Estelle Taylor

Walden Dissertations and Doctoral Studies

Nurses are the largest group of healthcare providers in most acute care hospitals, and the demand for registered nurses is expected to grow by 15% by 2026. The new graduate registered nurse (NGRN) is the supply that will fill the shortage; however, NGRNs are reportedly lacking in the ability to connect the lessons learned in the classroom with real patient care, unprepared for necessary skills, emotionally stressed, and have a high first-year turnover rate. Strategies such as nurse residency programs are needed to support NGRNs as these new nurses’ transition from academics to clinical practice. The purpose of this project, …

Assisting Psychiatric Nurses In Managing Work Stress And Decreasing Callouts And Absenteeism, Prisca Njume

Walden Dissertations and Doctoral Studies

Management and reduction of work stress is important in promoting nurses' well'€being. Understanding how to decrease stress levels may allow nurses to provide better care, improve patient outcomes, and experience increased job satisfaction. The focus of this project was to empower psychiatric nurses to manage work-related stress and decrease callouts and absenteeism. Person-environment fit theory, job demand-control (support) theory, the job demands-resources model, and the effort-reward imbalance model were used to inform the project. Pretest and posttest data were collected from 61 nurses using the Perceived Stress Scale. Deidentified retrospective and prospective data of the number of callouts were also …

Practice Improvement: Intimate Partner Violence Screening Implementation, Enitan Salawu

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) is a significant public health problem in the United States and worldwide. A recent U.S. crime report indicated that close to half of all homicides involve women victims of current or former intimate partners. The purpose of this doctoral project was to develop a training program to educate clinicians in the primary care setting on IPV screening. Participants received education on the Hurt, Insult, Threaten, Scream (HITS) screening tool to identify IPV survivors with available referral resources. The practice-focused question involved clinicians' level of knowledge regarding using the HITS tool kit to screen for IPV in …

Educating Nurses About Poststroke Depression And Using The Phq-2/9, Mary Mcmullen

Walden Dissertations and Doctoral Studies

Stroke has affected more than 7 million people and up to 33% of those patients reporting depression. The lack of screening for depression for patients post stroke can delay treatment for depression and hinder or lengthen recovery. The purpose of this project was to develop a nursing staff education program on using the Patient Health Questionnaire (PHQ) tools (PHQ-2 and PHQ-9) at the bedside to detect signs and symptoms of depression and identify nurse-driven interventions. Using the Johns Hopkins nursing evidence-based practice model and Orem's self-care model for guidance, an interdisciplinary team was assembled to collaborate on the development. A …

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test …

Lived Experiences Of African American Nursing Students In An Associate Degree Nursing Program, Monique Renee Merritt

Walden Dissertations and Doctoral Studies

Despite recognition of the barriers that African American nursing students encounter while pursuing nursing education, leaders of U.S. nursing programs continue to struggle to retain these students and promote their degree completion. Poor retention and lack of completion contributes to the unequal representation of African American nurses in the U.S. healthcare workforce compared to the overall population. The purpose of this qualitative study was to examine the experiences that helped to promote African American nursing students’ success or served as barriers to successful completion of an Associate Degree Nursing program. Tinto’s integration model was used as the theoretical framework. Semistructured …

An Educational Program For Providers On Asthma Management For Pediatric Clients, Ngozi Anyatonwu

Walden Dissertations and Doctoral Studies

Asthma, a chronic inflammatory respiratory disease, is the third-ranking cause of hospitalization among children under the age of 15. Of the 25 million Americans living with asthma, 6.2 million are children under the age of 18. In 2018, more than 11.4 million people with asthma, including more than 3 million children reported having one or more asthma exacerbations. The burden of pediatric asthma accounts for more than 13.8 million missed school days among children ages 5 to 17 years, $3 billion in losses due to missed work, $29 billion due to asthma-related mortality and $50.3 billion in medical costs. Asthma …

Impact Of Mentoring On First Year Nursing Student Anxiety, Heather Ann Clesi

Walden Dissertations and Doctoral Studies

First-year nursing students (FYNS) experience anxiety that can decrease academic achievement and result in attrition from the nursing program (NP). Research has not evaluated the impact of faculty mentoring (FM) offered by the NP on FYNS anxiety level and academic achievement in didactic courses. This study, guided by Neuman’s system model, used a descriptive cross-sectional design. An online survey link was distributed to FYNS in a southwestern state via NP directors and social media. FYNS were asked if their NP offered FM and were sorted into groups based on their response. Responses were received from 321 participants with 75 meeting …

Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens

Walden Dissertations and Doctoral Studies

Adolescent obesity is a worldwide multifaceted epidemic. This disease affects the medical, physical, psychosocial, and family aspects of adolescent life. Identification, diagnosis, and referrals to providers that can initiate early interventions that improve weight status have been recommended as critical steps in curtailing childhood obesity. This evidence-based clinical practice guideline (CPG) was developed for the healthcare providers at a rural clinic in Southwest Arkansas to provide consistency in the identification, diagnosis, and referral of adolescents. The health belief model (HBM) and the trans-theoretical model (TTM) were used to consider adolescents’ individual characteristics and beliefs as well as their readiness to …

Medication Reconciliation In An Outpatient Clinical Setting, Tilena Martin

Walden Dissertations and Doctoral Studies

Medication reconciliation is a fundamental step in the delivery of safe care, because if it is not done correctly, it can set the stage for medication errors. Medication reconciliation has been shown to alleviate safety issues that lead to mortality, falls, and adverse drug reactions. The project question examined how in-service training can improve the knowledge of nurse practitioners and medical assistants about medication reconciliation. The project was guided by Knowles’ theory of adult learning and Rosswurm and Larrabee’s health belief model. A 1-hour educational module was prepared, and all participants completed the training prior to a discussion period. Sources …

The Hospital Consumer Assessment Of Healthcare Providers And Systems And Readmissions, Sheri Matson

Walden Dissertations and Doctoral Studies

Patient perception of care has become a main priority in the delivery of high-quality health care. The creation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provided a nationally standardized method of evaluating patient perception to be incorporated in the reimbursement process defined by the Centers for Medicare and Medicaid Services (CMS). The purpose of this study was to examine the relationship between HCAHPS scores and readmission rates in 2 states in the South Atlantic region of the United States. Using social construction theory, this quantitative study utilized multiple regression analysis to analyze HCAHPS scores (independent …

Learned Helplessness Among Acute Care Nurses And Its Influence On Inpatient Fall Incidence, Jennifer Glendening

Walden Dissertations and Doctoral Studies

Over one million inpatient falls with injury are reported across the United States annually resulting in harm which are consistently linked to the quality of nursing care delivery in acute inpatient settings. Learned helplessness (LH) emerges as a behavioral concept to consider among acute care nurses, specifically medical-surgical nurses, because the effects of LH may include an overall decrease in efforts, persistence, and learning due to the repeated exposure to the challenges of balancing complex patients and working environments. The purpose of this study, guided by Donabedian’s model, was to determine if there was a relationship between acute care nurses’ …

English As A Second Language Students' Experiences In Associate Degree Nursing Programs, Angie Lundgren

Walden Dissertations and Doctoral Studies

The general nursing shortage experienced in the U.S. leads students who speak English as a second language (ESL) to enter into nursing school programs. Although these students may enter the nursing programs, they may not successfully complete the nursing programs due to various barriers they face during their enrollment. The purpose of this phenomenological study, guided by the NURS model, was to understand the perceptions and experiences of ESL nursing students related to learning and the barriers to learning and success while enrolled in an associate degree nursing program. Semi structured, face-to-face interviews were conducted with 10 associate degree ESL …

Barcode Medication Administration In The Emergency Department To Mitigate Medication Errors, Holly Gauthier-Wetzel

Walden Dissertations and Doctoral Studies

Electronic health record systems (EHRs) have been adopted in healthcare facilities to unify the workflow process of healthcare professionals. Studies have demonstrated the addition of barcode medication administration (BCMA) software technology within the EHR has decreased medication errors within hospitals and long-term care facilities. However, limited research has been conducted to establish whether using BCMA in outpatient areas has had an influence on medication error rates. Literature reveals that many facilities have not adopted BCMA in outpatient areas. The purpose of this study was to investigate whether medication errors were mitigated after BCMA was implemented in the emergency department (ED). …