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Articles 1771 - 1800 of 2607
Full-Text Articles in Nursing
Nurses' Lived Experiences Of Comfort Care Among Residents At The End Of Life, Ezekiel Olufemi Osundina
Nurses' Lived Experiences Of Comfort Care Among Residents At The End Of Life, Ezekiel Olufemi Osundina
Walden Dissertations and Doctoral Studies
Nurses provide comfort care for individuals who are at the end of life and reside in the long-term care environment. However, how nurses provide comfort care to those who are dying and nurses' perceptions about providing comfort care are not known. The purpose of this phenomenological study, guided by Kolcaba's theory of comfort, was to examine nurses' lived experiences of comfort care among residents at the end of life in long-term care facilities. The research questions were designed to elicit rich data about the lived experiences of nurses in providing comfort care to dying residents to find out factors that …
Telehealth And Type 2 Diabetes Management, Blessing Nneoma Ikpeama
Telehealth And Type 2 Diabetes Management, Blessing Nneoma Ikpeama
Walden Dissertations and Doctoral Studies
The use of telehealth in healthcare has grown in recent years; however, little is known about the effectiveness of this delivery method in the management of Type 2 diabetes mellitus (T2DM). Guided by the chronic care model and telehealth in chronic disease model, the purpose of this systematic literature review was to explore evidence related to lowering hemoglobin A1c levels and managing T2DM using telehealth in the outpatient setting. The practice-focused questions explored telehealth interventions used in T2DM management and their effectiveness. The Joanna Briggs Institute (JBI) method for conducting systematic literature reviews was the process, and data were compiled …
Nurse Faculty Perceptions Of Role Stress And Faculty-To-Faculty Incivility, Anne Kraft Kleinhesselink
Nurse Faculty Perceptions Of Role Stress And Faculty-To-Faculty Incivility, Anne Kraft Kleinhesselink
Walden Dissertations and Doctoral Studies
The purpose of this study was to determine the relationship between nurse faculty perceptions of role stress and faculty-to-faculty incivility using the stressor-emotion model of counterproductive work behaviors. A convenience sample of 79 nurse faculty from 39 undergraduate nursing programs in Iowa responded to an online survey. The survey consisted of two instruments: Workplace Incivility Civility Scale and Role Strain Scale. Findings revealed 76 participants perceived incivility as a problem and identified stress (n = 64) and demanding workloads (n = 54) as contributing factors. Pearson correlation results revealed a positive relationship between experienced incivility and nurse faculty perceptions of …
Fostering Self-Care And Nurse Resilience, Cheryl Jean Mcnamara
Fostering Self-Care And Nurse Resilience, Cheryl Jean Mcnamara
Walden Dissertations and Doctoral Studies
Role expectations and stressful work environments place nurses at high risk for burnout. Nurses at an urban hospital were experiencing unhealthy work environments and not engaging in self-care to promote health and wellbeing. The purpose of this project was to evaluate the effectiveness of an existing quality improvement (QI) initiative developed to encourage nurses to engage in self-care. Pender's health promotion model supported the premise that despite barriers, nurses will engage in self-care. A survey elicited responses from 1,248 participating registered nurses on the extent of their engagement with self-care and perceived effect on their health, health knowledge, stress level, …
Decreasing Hospital Admission Rates In Long-Term Care, Melanie R. Meissner
Decreasing Hospital Admission Rates In Long-Term Care, Melanie R. Meissner
Walden Dissertations and Doctoral Studies
Each year, hospitalizations from long-term care (LTC) settings occur, in part, due to underdeveloped nursing assessment skills, ineffective communication with primary care providers (PCPs), and delayed intervention. Through staff development nursing education, the quality and timeliness of care can be improved. The practice question that guided this doctoral project focused on whether evidence-based research information would assist in decreasing LTC-to-hospital admission rates through improved nursing assessment skills and better communication with PCPs. Using the logic model, the effectiveness of a program was evaluated and the impact of interventions on a predicted outcome was determined. Sources of evidence included obtaining best …
Addressing Bullying Behavior In Pediatric Patients Using A Clinical Practice Guideline, Barnitta Latricia Moses
Addressing Bullying Behavior In Pediatric Patients Using A Clinical Practice Guideline, Barnitta Latricia Moses
Walden Dissertations and Doctoral Studies
Childhood bullying can lead to adverse physical and mental health outcomes for both the victim and the bully. Risk factors for bullying can be related to gender, race, sexual preference, and having any type of disability. A pediatric primary care clinic in a large, metropolitan area, the focus for this project, did not have an evidenced-based clinical practice guideline (CPG) for providers to facilitate the management of children who presented with reported bullying. The project, guided by the Tanner's integrated model of clinical judgement, addressed the question whether a CPG would facilitate the early recognition and treatment of bullying in …
Developing An Educational Program For Tracheostomy Care, Joy Onuoha
Developing An Educational Program For Tracheostomy Care, Joy Onuoha
Walden Dissertations and Doctoral Studies
Medical-surgical nurses at the project site demonstrated a knowledge deficit regarding the care of adult patients with a tracheostomy. Such knowledge deficits could expose patients to higher risks for infection, bedsores, prolonged hospital stays, increased costs, increased caregiver burden, and death. The purpose of this project was to develop an educational program to improve nurses' knowledge and confidence in the provision of evidence-based tracheostomy care to answer the question if the content of an evidence-based educational program developed to improve nurses' knowledge and confidence in managing adult patients with tracheostomy on a medical-surgical floor would meet the expectations of a …
Noise Pollution/Reduction Education For Frontline Staff In The Acute Care Setting, Lopa Patel
Noise Pollution/Reduction Education For Frontline Staff In The Acute Care Setting, Lopa Patel
Walden Dissertations and Doctoral Studies
Noise levels in hospital settings have risen beyond the recommended range of 35-40 decibels, resulting in poor patient healing outcomes and other health conditions ranging from sleep deprivation, anxiety, agitation, delirium, depression, and high heart rate and blood pressure. These negative patient health experiences are evidenced by poor scores for the Hospital Consumer Assessment of Healthcare Providers and Systems, which are indicators of patients' perceptions of care. This project explored whether an educational activity for 48 direct care staff, who include registered nurses and nursing assistants, in a cardiac unit on the impact of noise pollution on patient healing would …
Reducing Door-To-Provider Times By Using Nurse Practitioners In Triage, Megan Lynnell Anderson
Reducing Door-To-Provider Times By Using Nurse Practitioners In Triage, Megan Lynnell Anderson
Walden Dissertations and Doctoral Studies
Increased patient wait times it the emergency department (ED) have been linked to poor patient outcomes and adverse health care events. The purpose of this quality improvement project was to determine if placing a nurse practitioner (NP) in the triage area would reduce door-to-provider times and improve patient throughput within the ED. The primary question for this quality improvement project was whether the use of NPs in the triage area would improve patient throughput and decrease wait times in the ED. A secondary question identified was if implementing an NP in the triage area would decrease patient length of stay …
Strategies For Nursing Staff Working In A Correctional Facility., Ima James
Strategies For Nursing Staff Working In A Correctional Facility., Ima James
Walden Dissertations and Doctoral Studies
As primary care providers in correctional facilities, correctional nurses are expected to balance inmates' healthcare needs with the security demands of the facility. This project explored whether an evidence-based education program could provide strategies for promoting health, a healthy work environment, and a sense of well-being to improve the knowledge, coping skills, and well-being of nurses working in a correctional occupational setting. Twenty nurses participated in an educational intervention project that was guided by the transactional theory of stress. Using a pretest/posttest design, data were collected over a 2-week period and calculated using means and percentages. The descriptive statistics using …
Effectiveness Of Physiological Alarm Management Strategies To Prevent Alarm Fatigue, Amy Clemens
Effectiveness Of Physiological Alarm Management Strategies To Prevent Alarm Fatigue, Amy Clemens
Walden Dissertations and Doctoral Studies
There is limited clinical research on the effectiveness of alarm management strategies and nursing behaviors related to alarms in clinical settings. As many as 76% of physiological monitor alarms are overlooked as clinically insignificant by nursing staff. Excessive alarms may impact patient outcomes and cause cognitive overload for nurses that can result in medical errors and missed patient resuscitations. The purpose of this systematic review was to rate alarm management studies on level of evidence for interventions, nursing responses to alarms, and impact on alarm fatigue behavior. The nursing role effectiveness model guided this project. Twenty-seven studies were reviewed to …
Building A Compassion Fatigue Toolkit, Stephanie C. Correa
Building A Compassion Fatigue Toolkit, Stephanie C. Correa
Walden Dissertations and Doctoral Studies
Compassion is an important tenet of nursing care delivery. When compassion is compromised, such as with compassion fatigue (CF), not only is patient care compromised, but also caregivers can be physically and psychologically affected, resulting in stress and burnout. The purpose of this project was to create a web-based educational toolkit focused on prevention of CF, establish the content validity of the elements in this toolkit, and make recommendations regarding its implementation and sustainability. Watson's theory of human caring guided this project. Ten experts with at least 10 years of experience and CF knowledge, a bachelor's degree in nursing, and …
Reducing 30-Day Readmissions For Patients With Stroke, Faith Omomen Ighile
Reducing 30-Day Readmissions For Patients With Stroke, Faith Omomen Ighile
Walden Dissertations and Doctoral Studies
In a stroke-certified 500-bed acute care hospital, the 30-day readmission rates for patients discharged to rehabilitation centers or skilled nursing facilities were higher than the rates for patients discharged to home. A review of data by the stroke team showed 44 patients readmitted within 30 days of initial stroke discharge between October 2016 and January 2017. The rate of re-admission for those discharged home was 41% (18 patients), whereas the rate for those discharged to acute inpatient rehabilitation, long-term acute care, or skilled nursing facilities was 59% (26 patients). The practice-focused question for this project assessed whether using a re-admission …
Evidenced-Based Staff Education Program For Novice Perioperative Nurses, Marjorie Jasinski
Evidenced-Based Staff Education Program For Novice Perioperative Nurses, Marjorie Jasinski
Walden Dissertations and Doctoral Studies
Knowledge of surgical procedures, instruments, and supplies is essential to the perioperative nurse working in the operating room (OR). Nursing school curricula do not specifically educate surgical nurses; therefore, it is difficult to fill open OR positions with experienced perioperative nurses. The purpose of this doctoral project was to develop a perioperative educational program for RNs newly hired in the OR. The practice-focused question asked whether an evidence-based staff education program for the novice perioperative nurse would increase the nurse's knowledge of OR procedures and protocols for patient management. The novice-to-expert framework was used to explore how adult learners acquire …
Acuity-Based Nurse Staffing And The Impact On Patient Outcomes, Sara Kollman
Acuity-Based Nurse Staffing And The Impact On Patient Outcomes, Sara Kollman
Walden Dissertations and Doctoral Studies
The costs of healthcare in the United States are of national concern. The systematic review of the literature (SRL) explored the practice-focused nursing question regarding the relationship between the use of acuity-based staffing (ABS) models and positive patient outcomes. Analyzing the impact of ABS models on patient quality outcomes and the potential economic value could provide evidence essential for the healthcare executives responsible for fiscally prudent labor management and for creating an evidence-based business case for adequate, patient-centric nurse staffing. The synergy model for patient care and Covell's nursing intellectual capital theory guided the doctoral project. The Preferred Reporting Items …
Contributors To The Development Of Intercultural Competence In Nursing Students, Esther Zazzi
Contributors To The Development Of Intercultural Competence In Nursing Students, Esther Zazzi
Walden Dissertations and Doctoral Studies
Nurses deal more effectively with cultural diversity when they have an ethnorelative orientation toward cultural difference and commonality on the Intercultural Development Continuum, which was the theoretical framework of this study. Scholarly literature shows limited knowledge on what fosters nurses' intercultural development. Thus, this quantitative, retrospective study was the first investigation in health care in Switzerland conducted on nursing students' orientation on the Intercultural Development Inventory (IDI) and the relationship to student demographic variables. The sample for this secondary data analysis consisted of the IDI results from nursing students enrolled between 2010 and 2016 at the largest nursing college in …
Education Program For Critical Care Nurses On Preventing Catheter-Associated Urinary Tract Infections, Olatunde Olatunji
Education Program For Critical Care Nurses On Preventing Catheter-Associated Urinary Tract Infections, Olatunde Olatunji
Walden Dissertations and Doctoral Studies
Catheter-associated urinary tract infections (CAUTIs) are the most frequently reported hospital-acquired condition, affecting more than 560,000 patients each year. CAUTIs prolong hospital stays and increase health care costs, and they can result in patient morbidity and mortality. Nurses can be empowered by receiving education and knowledge to manage and identify urinary catheters that are not clinically indicated. The purpose of this project was to develop an education program on CAUTI prevention for critical care nurses using the teach-back method. The conceptual framework that guided this project was Knowles's adult learning theory. The theoretical model was based on 4 fundamental assumptions …
Development And Evaluation Of A Long-Term Care Skills Simulation Program, Tina Marie Gerovac
Development And Evaluation Of A Long-Term Care Skills Simulation Program, Tina Marie Gerovac
Walden Dissertations and Doctoral Studies
New graduate nurses often lack clinical skill competency. In a single year, a long-term care facility located in the midwestern region of the United States reported 25 clinical errors, each costing the facility approximately $10,000. Root-cause analysis revealed 85% of those errors were made by nurses in their 1st year of practice. The increase in clinical errors were attributed to insufficient clinical preparation prior to independent practice. A review of the current scholarly literature suggested simulation had demonstrated efficacy in the development and maintenance of clinical nursing skills and answered the practice-focused question: Development of a skills simulation program for …
Reducing Child Maltreatment Through Prevention, Chantel Marie Eckert
Reducing Child Maltreatment Through Prevention, Chantel Marie Eckert
Walden Dissertations and Doctoral Studies
Child maltreatment is a public health problem directly linked to poor outcomes across the lifespan, including chronic health conditions and even death. The local population served by the agency in which the project took place experienced an increase in reports of child maltreatment. Agency leadership identified deficiencies in parental knowledge about positive parenting practices as a contributing factor to the problem. To address the problem, the agency implemented a quality improvement evidence-based home visiting pilot initiative. The evaluation of that initiative was the purpose of this project. Bandura's social cognitive learning theory provided the theoretical framework for the project, and …
Education Of Clinic Providers To Promote Improved Diabetes Management, Olubunmi Roseline Awe
Education Of Clinic Providers To Promote Improved Diabetes Management, Olubunmi Roseline Awe
Walden Dissertations and Doctoral Studies
Diabetes is one of the most common major illnesses in the United States population and can lead to severe complications if not properly managed. Research has shown that over the past 2 decades there has been an increase in the prevalence of prediabetes, Type 2 diabetes, and associated complications and chronic diseases. Diabetes management is an ongoing challenge faced by providers nationally and it is the focus of this staff education development project at the outpatient clinic site. The purpose of this project was to ensure that clinic staff used an evidence-based approach to identify patients with diabetes, manage patients …
Impact Of Smoking Cessation Education On Workplace Wellness, Monica Coles
Impact Of Smoking Cessation Education On Workplace Wellness, Monica Coles
Walden Dissertations and Doctoral Studies
Guidelines and laws prohibit smoking in public places, and evidence supports the safety and effectiveness of workplace wellness programs in promoting healthy environments. A long-term care (LTC) facility selected as the focus for this project does not offer wellness programs and does not restrict on-site smoking by employees. The purpose of this project was to construct an evidence-based smoking cessation education program for delivery to employees at the LTC facility. The practice-focused question addressed whether a workplace wellness smoking cessation education program would increase employees' knowledge of the harmful effects of smoking and promote engagement in smoking cessation strategies. A …
Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes
Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes
Walden Dissertations and Doctoral Studies
A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for …
Compassion Fatigue In Emergency Department Nurses, Michelle Candice Lawrence
Compassion Fatigue In Emergency Department Nurses, Michelle Candice Lawrence
Walden Dissertations and Doctoral Studies
Compassion fatigue (CF) is defined as a sudden onset of the inability to experience feelings or compassion for others that is triggered by a nurse's inability to separate his/her feelings of stress and anxiety associated with caring for patients who have suffered from a traumatic event. The practice problem addressed in this doctoral project was the lack of knowledge of emergency department nurses (EDNs) related to CF in the work setting, resulting in a negative impact on a nurse's ability to provide quality care to patients. The purpose of the project was to present an educational program on how to …
Ambidexterity And Innovation In Chief Nursing Officers In The Healthcare Setting, Jennifer Wasilewski
Ambidexterity And Innovation In Chief Nursing Officers In The Healthcare Setting, Jennifer Wasilewski
Walden Dissertations and Doctoral Studies
Leaders in the healthcare setting are challenged with competing responsibilities as they seek to provide high-quality services, ensure the implementation of safety measures, and engage in workforce maintenance. Many researchers have described innovation as a strategic approach to organizational concerns and have noted a failure to implement innovative measures in healthcare. This study was an investigation of the impact of ambidexterity in healthcare leaders on innovation. The purpose of this quantitative study, guided by the ambidexterity theory of leadership for innovation, was to analyze the extent to which ambidextrous leadership characteristics of healthcare executives and chief nursing officers (CNOs) influence …
Staff Education For Providers In An Outpatient Hemodialysis Center, Ibijoke Owolabi
Staff Education For Providers In An Outpatient Hemodialysis Center, Ibijoke Owolabi
Walden Dissertations and Doctoral Studies
The impact of end-stage renal disease (ESRD) on healthcare costs is significant. In 2013, the cost of providing care for the ESRD patient population was 7.1% of total Medicare expenses. ESRD patients' non-adherence with the medical plan is a reason for the high cost of care and poor patient outcomes. Staff education can have a positive impact on patient adherence in terms of the management of chronic illnesses, such as ESRD. This DNP project was an education program for hemodialysis (HD) staff regarding empowering patients to learn about self-care strategies aimed at improving ESRD patients' adherence to fluid restriction and …
Root Cause Of Medication Errors In A Pediatric Intensive Care Unit, Louis Gilbert Tingling
Root Cause Of Medication Errors In A Pediatric Intensive Care Unit, Louis Gilbert Tingling
Walden Dissertations and Doctoral Studies
Five to 27% of all pediatric medication orders lead to errors and play a significant role in the morbidity and mortality of the pediatric patients admitted to hospitals. The practice problem explored the high rate of medication errors in the pediatric intensive care unit (PICU) of the project site, where the population is particularly vulnerable due to their acute illnesses. The purpose of this project was to analyze the root causes of all cases of medication error in this hospital's PICU during the last 2 years. The literature review was used to categorize secondary data extracted from the hospital's quality …
Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale
Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale
Walden Dissertations and Doctoral Studies
Although licensed registered nurses (RNs) comprise a significant percentage of the U.S. health care workforce, there is a lack of qualified nurses to meet patient needs. This shortage is expected to intensify as practicing nurses leave the profession. The problem that prompted this study was that an attrition-reduction program implemented in the nursing program at a U.S. midwestern community college did not show a reduction in the average attrition rate. The academic integration construct of Tinto's theory of student departure was used to examine archival academic performance records of 145 students enrolled in the local program from 2010 to 2012. …
Prevention And Management Of Aggression And Violence In Mental Health Settings, Margaret Arotimi
Prevention And Management Of Aggression And Violence In Mental Health Settings, Margaret Arotimi
Walden Dissertations and Doctoral Studies
Aggression and violence in healthcare settings can lead to severe psychological, physical, and economic consequences for the victims, institutions, and society in general. Empirical evidence indicated that patient-initiated physical and verbal aggression is a longstanding problem affecting nurses working in psychiatric hospital settings. At the project site, approximately 88% of the staff members reported having been assaulted by mental health patients in the admission units at some point in the provision of care between 2015 and 2017. The purpose of this project was to develop an educational program for nurses at the site to use as preventive strategies in managing …
Targeted Education For The Prevention Of Vaccine Refusal, Catina Lashawn Davis
Targeted Education For The Prevention Of Vaccine Refusal, Catina Lashawn Davis
Walden Dissertations and Doctoral Studies
Vaccinations are important factors in the eradication of most communicable diseases. Tetanus, diphtheria, and pertussis (Tdap) vaccine has been found to decrease the incidence and further spread of pertussis, and even nullify its existence, yet many postpartum mothers opt not to receive the vaccination even if eligible to do so. It was unknown whether clinical nursing staff at the project site had sufficient knowledge about Tdap vaccine to educate postpartum mothers to accept the vaccine. The practice-focused question explored whether an educational program and a toolkit implemented for nursing staff members on the postpartum nursing unit would improve Tdap vaccination …
The Benefit Of Leadership Using First Choice For New Graduate Nurse Retention, Jodie Marie Lyons
The Benefit Of Leadership Using First Choice For New Graduate Nurse Retention, Jodie Marie Lyons
Walden Dissertations and Doctoral Studies
The United States has a nursing shortage that is projected to grow to over 500,000 by the year 2030. This is an issue for leaders because the nursing shortage affects health care organizations sustainability. The purpose of this qualitative descriptive phenomenological study was to identify and report the lived experiences of new graduate nurses (NGNs) in oncology and whether unit of first choice (UFC) effected their intention to remain after 2 years of practice. The research question considered the lived experiences of NGNs in oncology units who either had oncology as their UFC or were placed on an oncology unit …