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Articles 1831 - 1860 of 2607
Full-Text Articles in Nursing
Evidence-Based Care In Urgent Care Centers, Kelly Wagner
Evidence-Based Care In Urgent Care Centers, Kelly Wagner
Walden Dissertations and Doctoral Studies
Concussions are brain injuries--also called mild traumatic brain injuries--that affect the function of the brain temporarily or permanently. The purpose of this doctoral project was to develop an education module for staff at an urgent care center to address the lack of knowledge and low level of comfort regarding the care for patients with a head trauma. This project introduced and educated the clinical staff on an evidence-based protocol for the treatment and management of a patient with a concussion. The Rosswurm and Larrabee model for evidence-based change was used as a foundation for refining the practice question, gathering evidence, …
A Magnet System Implementation Of The Hester Davis Fall Reduction Program, Debra Ann Bauer
A Magnet System Implementation Of The Hester Davis Fall Reduction Program, Debra Ann Bauer
Walden Dissertations and Doctoral Studies
A Magnet-recognized academic hospital system experienced an increase in patient falls and patient falls with injury after transitioning to a new electronic health record. The purpose of the project was to evaluate the effectiveness of a system-wide quality improvement practice change. The practice-focused question addressed a Magnet model implementation of a standardized, system-wide, evidence-based Hester Davis Scale (HDS) fall risk assessment and intervention tool and the impact on the nursing-sensitive indicators of patient fall rates and fall rates with injury. Successful implementation and sustained, correct use of the HDS fall risk assessment and targeted fall-prevention-intervention tools added to the evidence …
Strategies For Reducing Nurses' Turnover In Specialty Care Clinics, Lawrence Benjamin
Strategies For Reducing Nurses' Turnover In Specialty Care Clinics, Lawrence Benjamin
Walden Dissertations and Doctoral Studies
The nursing shortage and high turnover rates are a problem in Canada and the world over. The purpose of this single case study was to explore leadership strategies that nurse leaders in specialty care clinics in Canada use to reduce nurse turnover. The participants were 7 nurse leaders from a single organization with specialty care clinics across Canada who all had above average nurse retention rates when compared to the case organization's average nurse retention rate. The authentic leadership theory was the conceptual framework. Data sources for this study were company documents, participants' semistructured interview responses, member checking of the …
Educating Staff On The Family Caregiver Needs Of Brain Injury Patients, Carrie Maloney Robertshaw
Educating Staff On The Family Caregiver Needs Of Brain Injury Patients, Carrie Maloney Robertshaw
Walden Dissertations and Doctoral Studies
Acute rehabilitation hospitals assist brain injury patients and families who face a life- changing event to achieve greater independence and quality of life. During the acute rehabilitation phase of recovery, care is focused on the patient; however, there is a nationwide movement to implement patient- and family-centered care because caregivers experience grief and uncertainty about how to care for their loved one during hospitalization and upon discharge. The purpose of this staff education project was to educate rehabilitation staff on how to identify and to meet the needs of family members of brain injury patients in an acute rehabilitation center …
Educational Plan For Correctional Officers To Increase Awareness Of Diabetes Mellitus Among Inmates, Zaheerah Yasmeen Shareef
Educational Plan For Correctional Officers To Increase Awareness Of Diabetes Mellitus Among Inmates, Zaheerah Yasmeen Shareef
Walden Dissertations and Doctoral Studies
In the United States, approximately 30.3 million or 9.4% of the population have been diagnosed with diabetes mellitus. Of these, 8.3 million remain undiagnosed. There are approximately 2 million people incarcerated in detention centers, jails, and prisons across the United States with approximately 80,000 inmates living with diabetes. Correctional officers are not educated to identify and respond to inmates with evolving medical complications, such as low or high blood glucose, which can lead to preventable adverse events, including permanent injury or death. The purpose of this project was to develop an evidence-based education module to teach correctional officers how to …
Clinical Practice Guidelines For Home Management Of Intravenous Immunoglobulin Therapy, Rosemary Taylor
Clinical Practice Guidelines For Home Management Of Intravenous Immunoglobulin Therapy, Rosemary Taylor
Walden Dissertations and Doctoral Studies
The infusion of intravenous immunoglobulin therapy in the home setting requires a critical nursing assessment and interventions aimed at managing and preventing the escalation of adverse events. Some patients experience side effects that necessitate a rapid response by field nurses, requiring standing orders for nursing administration and the availability of essential medications to alleviate symptoms in the patient's home. The clinical practice issue was that the home health agency did not have a uniform clinical practice nursing guideline to assist field nurses in providing rapid responses for managing infusion-related reactions. The purpose of this project was to develop an evidence-based …
Educational Intervention On Metabolic Syndrome For Psychiatric Providers, Chika Emelda Okafor
Educational Intervention On Metabolic Syndrome For Psychiatric Providers, Chika Emelda Okafor
Walden Dissertations and Doctoral Studies
Statistics show a high prevalence of metabolic syndrome (MetS) in patients with mental illness receiving second-generation antipsychotic medications. MetS is associated with elevation of obesity, truncal obesity, blood pressure, cholesterol, and fasting glucose. The purpose of this project was to educate psychiatric providers about the importance of MetS screening, early detection, management, and referral for better treatment and management. The project was guided by Lewin's theory of change model. The project inquired if educational intervention on MetS improved providers' knowledge and intent to adopt MetS guidelines. A literature review and established guidelines of the American Psychiatric Association and American Diabetic …
A Clinical Practice Guideline To Improve Education In The Heart Failure Population, Mailey L. Wilks
A Clinical Practice Guideline To Improve Education In The Heart Failure Population, Mailey L. Wilks
Walden Dissertations and Doctoral Studies
Managing heart failure patients in the outpatient setting can pose a challenge for nurses and health care staff due to the need to educate patients on self-care skills and management of disease. Several factors, including health literacy and numeracy, need to be considered when developing an education program for heart failure patients to promote self-care management. The purpose of this project was to provide nursing staff with a clinical practice guideline (CPG) that incorporated health and numeracy literacy assessment into an individualized education program. The Johns Hopkins nursing evidence-based practice (EBP) model, the situation-specific theory of heart failure (HF) self-care, …
Nursing Education To Prevent Resident Falls In Long-Term Care, Henrietta Aguwa
Nursing Education To Prevent Resident Falls In Long-Term Care, Henrietta Aguwa
Walden Dissertations and Doctoral Studies
Residents in nursing facilities are more prone to falls than those living in the community. Injuries resulting from falls impact residents, their families, and healthcare costs. The gap in nursing practice was the lack of a comprehensive fall-prevention program in a long-term care facility that had experienced high fall rates among residents. This project addressed whether an educational program using the American Medical Directors Association's clinical practice guideline and the Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths, & Injuries) toolkit for fall- prevention improved the self-efficacy of direct-care staff in preventing falls among residents in a …
Educating Staff Nurses For Successful Patient Discharge, Julie First-Williams
Educating Staff Nurses For Successful Patient Discharge, Julie First-Williams
Walden Dissertations and Doctoral Studies
The definition of a successful discharge is a discharge that results in patients successfully managing a chronic disease for at least 30 days without requiring an acute inpatient hospitalization. Many chronic disease readmissions are preventable. Successful discharge planning takes a multidisciplinary team that includes nurses who assess the discharge plan and provide additional education where needed. The purpose of this project was to determine staff nurses' understanding of their role in discharge education. Dorothea Orem's self-care deficit theory guided the project and root cause analysis was used in the development of the problem statements. Staff nurses (n=12) from evening and …
Prescreening Recommendations For Patients On Medical Cannabis, Wen Chieh Hu
Prescreening Recommendations For Patients On Medical Cannabis, Wen Chieh Hu
Walden Dissertations and Doctoral Studies
Marijuana is the most frequently used illegal substance in the United States and is most widely used among young people aged 12 to 21 years. Accurate screening and monitored issuance of medical cannabis recommendations have been shown to decrease abuse rates of the substance, create fewer deaths from opiates, reduce crime rates, reduce marijuana use in youths, decrease car crash deaths, and lessen prevalence of suicide in young men. The purpose of this project was to explore whether multiple screening methods for depression and anxiety in patients who seek medical cannabis referrals for anxiety and depression would improve screening and …
Simulation As A Remediation Tool For Clinically At-Risk Associate Degree Nursing Students, Janna G. Lock
Simulation As A Remediation Tool For Clinically At-Risk Associate Degree Nursing Students, Janna G. Lock
Walden Dissertations and Doctoral Studies
Evidence-based remediation options are limited for nursing students who fail their clinical competency evaluations. Scholarly literature provides a paucity of studies related to the use of simulation-based technology to remediate nursing students. The research question focused on the difference in the initial competency demonstration evaluation scores of associate degree nursing students compared to the reevaluation scores after remediation with simulation-based technology. Benner's novice to expert and Kolb's experiential learning theories were used to explain how nurses acquire and develop skills. The researcher used a quantitative one-group pretest posttest design to examine archival data from 149 nursing students from a South-Central …
Pediatric Behavioral Health Best Practices In The Children's Emergency Department, Kristina Marie Pickering
Pediatric Behavioral Health Best Practices In The Children's Emergency Department, Kristina Marie Pickering
Walden Dissertations and Doctoral Studies
Emergency department (ED) use for behavioral-health-associated diagnoses has steadily increased in adult and pediatric populations, accounting for 1 out of every 8 ED visits. The increase in pediatric behavioral health ED visits, combined with limited resources for treatment, has created a challenge for EDs faced with extended boarding and constant observation of this population. The generalized behavioral health guidelines used at the practice site have not been adapted for the pediatric population. This project focused on providing age- and developmentally appropriate best practice guidelines for children under constant observation in the children's emergency department (CED) using Havelock's theory of planned …
Discharge Phone Call On Unplanned Readmission Due To Chemotherapy Among Cancer Patients, Denise Angelo Moreno Prudencio
Discharge Phone Call On Unplanned Readmission Due To Chemotherapy Among Cancer Patients, Denise Angelo Moreno Prudencio
Walden Dissertations and Doctoral Studies
The transition after hospitalization is a vulnerable period when adverse events like unplanned readmissions may occur. Unplanned readmissions with patients undergoing chemotherapy that are the result of gaps in communicating the discharge plan may be preventable. Several transitional care interventions have been explored, and one of these is the nurse discharge phone call. This project explored the effect of a nurse-led transitional discharge phone call within 30-days after hospital discharge on unplanned readmission due to chemotherapy among patients in the medical-oncology compared to patients without a nurse-led transitional discharge phone call. A nurse-led transitional discharge phone call was implemented within …
Staff Development Introducing Self-Care Within The Nurse Residency Curriculum, Lauren Elizabeth Rogers
Staff Development Introducing Self-Care Within The Nurse Residency Curriculum, Lauren Elizabeth Rogers
Walden Dissertations and Doctoral Studies
Caregiver burnout is an issue for health care organizations, negatively influencing cost, engagement, and workforce stability. Nurse residency programs are intended to address the gap in practice between academia and clinical practice and provide social support during this transitional time. Self-care education can positively affect novice acute care nurses' transition into their new professional role while building connections with the health care organization during the first year of employment. The purpose of this project was to develop a staff educational module to address the nursing practice problem of evidence-based self-care education within a nurse residency curriculum at the doctoral site. …
Improving Provider A1c Testing Frequency Adherence To Recommended Diabetes Guidelines, Susan Ann Simmons
Improving Provider A1c Testing Frequency Adherence To Recommended Diabetes Guidelines, Susan Ann Simmons
Walden Dissertations and Doctoral Studies
The Appalachian region of the United States has a high prevalence of diabetes, placing residents with diabetes at risk for physical, psychological, social, and financial burdens. To compound the issue, primary care providers often do not adhere to the guidelines established by the American Diabetes Association (ADA) regarding the recommended frequency of testing hemoglobin A1C in patients with diabetes. Lewin's planned change theory guided the project. The purpose of this project was to measure the knowledge of the primary care providers before and after an educational intervention covering the ADA guidelines for A1C monitoring and testing and to assess compliance …
Validation Of Communication Simulation Scenarios For Nurse Preceptors, Karie Thurston
Validation Of Communication Simulation Scenarios For Nurse Preceptors, Karie Thurston
Walden Dissertations and Doctoral Studies
An expectation of the nurse preceptor role includes the ability to evaluate, deliver feedback, and coach new graduate nurses. A gap in nurse preceptors' communication skills can affect the safety-related behaviors and quality of care provided by new graduate nurses, thus affecting patient outcomes. To bridge this gap, robust training on delivering feedback and coaching is needed for preceptors. The purpose of this staff education project was to develop and validate 5 communication simulation scenarios for preceptor training. Mezirow's transformative learning theory and the National League for Nurses-Jeffries simulation theory were used to guide the project. A panel of nurse …
Promoting Nurses Management Of Night Shift Sleepiness, Sunday Iken Okundolor
Promoting Nurses Management Of Night Shift Sleepiness, Sunday Iken Okundolor
Walden Dissertations and Doctoral Studies
Nurses are largely unaware of the problems of night-shift-nurse sleepiness and available strategies to manage night-shift sleepiness. The purpose of this project was to examine nurses' self-perception, awareness of sleepiness, and current strategies to manage this problem in the emergency medicine department of a major academic hospital in the western United States. The validated de-identified Karolinska Sleepiness Scale (KSS) was used to measure the prevalence and intensity of night shift nurses' sleepiness prior to the development of an educational program on strategies to manage sleepiness. Of the 164 registered nurses surveyed, 72 (43.9%) reported sleepiness greater than 7 on the …
Determinants Of Compassion Fatigue In Acute Care Nursing, Sherry Levering
Determinants Of Compassion Fatigue In Acute Care Nursing, Sherry Levering
Walden Dissertations and Doctoral Studies
Nurses experiencing compassion fatigue (CF) are emotionally exhausted, which contributes to decreased nurse retention and patient satisfaction. The focus of this project was to identify factors that contribute to CF. A systematic review was conducted to identify demographic factors that contribute to CF in the acute care setting, clarify the types of care situations that increase CF, and describe the social support networks of nursing units influencing CF. The review included peer-reviewed journal articles published between 2007 and 2018 that focused on registered nurses in the acute care setting. Using the grading of recommendation assessment development and evaluation format, 3 …
Helping Veterans Of Operation Enduring Freedom And Operation Iraqi Freedom, Dawn M. Robinson
Helping Veterans Of Operation Enduring Freedom And Operation Iraqi Freedom, Dawn M. Robinson
Walden Dissertations and Doctoral Studies
Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) created multiple challenges for the mental health of soldiers who served there. The local facility in this study determined there was a gap in providing OEF/OIF veterans assistance with mental health issues. The practice-focused question explored whether a training module for nurses would assist in the identification of signs and symptoms of mental health issues in OEF/OIF veterans, such as posttraumatic stress disorder, anxiety, depression, addictions, and suicidal/homicidal ideations, to help ensure timely referral for services. The project used Kolcaba's comfort theory as the basis for the training module. A pretest, …
U.S. Public Health Service Nurse Officers Working In Disaster Settings, Ingrid Stamand
U.S. Public Health Service Nurse Officers Working In Disaster Settings, Ingrid Stamand
Walden Dissertations and Doctoral Studies
The National Response Plan (NRP) was developed to provide support during national disasters. The U.S. Public Health Service (USPHS) Corps is 1 of the 7 uniform services and contributes to the mission of the (NRP). The USPHS Commissioned Corps (CC) Officers may be deployed for national disasters at any time and they must be ready to deploy. The purpose of this phenomenological qualitative study was to explore the lived experiences of USPHS CC Nurse Officers who have deployed in response to disasters in the United States. This study addressed the gap in literature related to the deployment perception of USPHS …
Adaptation Of Heart Failure Education Materials For The Middle Eastern Population, Nadine A. Williams
Adaptation Of Heart Failure Education Materials For The Middle Eastern Population, Nadine A. Williams
Walden Dissertations and Doctoral Studies
Cardiovascular disease, including heart failure, is the leading cause of death among male and female Middle Eastern Americans. In 2016, a medical center located in the northeastern region of the United States had an estimated 35% of heart failure patients readmitted within 30 days of discharge, 10% of these readmitted patients belonged to the local Middle Eastern community. The gap in nursing practice noted by nursing staff, patients, and their families was that the patient education materials on heart failure were not tailored to the cultural beliefs and customs of this high-risk population. The purpose of this project was to …
Achieving Improved Glycemic Control Among Hispanic Type 2 Diabetic Adults, Morenike Oyegbami
Achieving Improved Glycemic Control Among Hispanic Type 2 Diabetic Adults, Morenike Oyegbami
Walden Dissertations and Doctoral Studies
Type 2 diabetes is a major chronic health disease in the United States. A main concern of clinicians treating patients with Type 2 diabetes is poor glycemic control. The goal of this project was to improve glycemic control in Type 2 diabetic Hispanic adult patients in a private family practice clinic through the implementation of biweekly telephonic intervention focused on diabetes management by an advanced practice nurse/nurse practitioner. The project was guided by the chronic care model as a framework. The intervention was conducted over a 12-week period with 50 patients, ages 18 to 65. Data were collected from chart …
Improving Interdepartmental Care Collaboration For Pregnant Patients, Michelle Anne Ott
Improving Interdepartmental Care Collaboration For Pregnant Patients, Michelle Anne Ott
Walden Dissertations and Doctoral Studies
Communication is vital to improve patient care outcomes, especially with high acuity patients. Pregnant patients differ from other patient populations because their care involves 2 entities: the patient (mother-to-be) and her unborn fetus. There has been a noted gap in communication and care collaboration between the emergency department (ED) and obstetric (OB) teams at the project site, resulting in delays for patients and lack of appropriate maternal/fetal assessment and contributing negatively to patients' experiences. Using transitions theory and the Rosswurm and Larrabee model, a clinical practice guideline (CPG) inclusive of an obstetrically focused algorithm was developed and presented for use …
Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam
Addressing Human Papillomavirus Vaccination In Primary Care Pediatrics, Natasha Marie Subramaniam
Walden Dissertations and Doctoral Studies
Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Despite most common transmission, HPV immunization in adolescents remains below target rates of 80% as outlined by Healthy People 2020 Objectives. Nearly all individuals will contract HPV during their lifetime. The purpose of this project was to educate providers on successfully promoting HPV immunization in adolescents utilizing evidence-based methods. The health belief model (HBM) was the theoretical underpinning utilized to teach providers on discussions about 9vHPV immunization with parents of adolescents. The practice focused question explored whether an education program using concepts from the HBM would …
Improving Retention Strategies For Experienced Nurses, Kimberly M. Hollis
Improving Retention Strategies For Experienced Nurses, Kimberly M. Hollis
Walden Dissertations and Doctoral Studies
Experienced nurses depart the workforce in significant numbers; therefore, it is critical to understand how those departures affect patient care and safety. The focus of this systematic review included appraisal of recent research to provide an understanding of strategies used in acute care settings to retain experienced nurses. Guided by Benner's model of skill acquisition, the purpose of this systematic review was to identify factors that influence the decision of nurses with experience to leave or remain working in acute care work settings. The 19 articles selected for this review were limited to those pertaining to experienced registered nurses who …
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 …
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Walden Dissertations and Doctoral Studies
High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …
Promoting Nursing Communication Competence On A Spinal Cord Injury Unit, Tishon L. Creswell
Promoting Nursing Communication Competence On A Spinal Cord Injury Unit, Tishon L. Creswell
Walden Dissertations and Doctoral Studies
The power to communicate effectively and respectfully in the health care setting promotes job satisfaction, retention, and healthy relationships. Ineffective communication is one of the major causes of sentinel events, incivility, nurse turnover, and workplace hostility in the health care environment. This project examined a communication competence educational program on a spinal cord injury (SCI) nursing department and its potential to improve communication competence. The project question explored whether an educational series on incivility and creating healthy relationships would increase communication competence in nurses on the SCI unit. The project used the high reliability solutions for health care model communications …
Community Education Through A Stroke Champion Program, Michele Gribko
Community Education Through A Stroke Champion Program, Michele Gribko
Walden Dissertations and Doctoral Studies
Stroke is the fifth leading cause of death and primary cause of long-term disability in the United States. Public awareness of stroke symptoms and ability to activate the emergency medical system (EMS) quickly are essential for early treatment. At a large Joint Commission-certified Comprehensive Stroke Center with over 6,000 employees, a stroke champion program that included both clinical and nonclinical volunteers was initiated to determine whether stroke champion volunteers could learn and disseminate information about stroke symptoms and the importance of activating EMS within their community. Roger's diffusion-of- innovation framework was used to design and evaluate the outcome of the …