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Articles 1891 - 1920 of 2607
Full-Text Articles in Nursing
Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock
Educating Preoperative Staff On Operative Glycemic Control Guideline, Valerie Braddock
Walden Dissertations and Doctoral Studies
Glycemic control of the perioperative patient improves patient outcomes, specifically prevention of surgical-site infections. The prevention of surgical-site infections helps to reduce complications that can increase length of stay and readmissions, thereby increasing healthcare costs. The purpose of this project was to provide an educational module to the same-day surgery nurses on a clinical guideline to maintain glycemic control of the perioperative patient to prevent surgical-site infections. Lewin's change theory guided the development of a clinical practice guideline (CPG) for nurses to standardize the glycemic management of the perioperative patient. This project was conducted to determine whether educating nurses through …
Effectiveness Of Pressure Ulcer Protocols With The Braden Scale For Elderly Patients In The Intensive Care Unit: A Systematic Review, Natalie A. Floyd
Effectiveness Of Pressure Ulcer Protocols With The Braden Scale For Elderly Patients In The Intensive Care Unit: A Systematic Review, Natalie A. Floyd
Walden Dissertations and Doctoral Studies
Each year, approximately 3 million people in the United States develop a pressure ulcer. Although a preventable complication, pressure ulcers are among the top 5 adverse outcomes in the acute care setting with the prevalence as high as 42% in the intensive care unit (ICU). The purpose of this systematic review was to evaluate the inclusion of the Braden Scale as part of a multicomponent pressure ulcer intervention protocol, or care bundle, to identify geriatric patients hospitalized in the ICU who were at risk for pressure ulcers. The Cochrane protocol guided this review; findings were reported according to the Preferred …
Smoking Cessation Education For Acute Care Nurses, Dawn Garcia-Brinker
Smoking Cessation Education For Acute Care Nurses, Dawn Garcia-Brinker
Walden Dissertations and Doctoral Studies
Tobacco use among veterans is significantly higher than among members of the general population. The purpose of this quality-improvement project was to increase acute care staff members' knowledge and confidence in using tobacco cessation interventions to increase quit rates among the inpatients of a veterans' hospital in the midwestern region of the United States. An evidence-based, standardized Tobacco Tactics Toolkit was developed and implemented, and a 6 sigma method guided the quality improvement process to define, measure, analyze, improve, and control the tobacco-cessation education initiative. The reach, effectiveness, adoption, implementation, and maintenance framework was used to ensure that evidence-based interventions …
Educating Psychiatric Nurses To Improve Medication Adherence Among Schizophrenic Patients, Chandrika Mcqueen
Educating Psychiatric Nurses To Improve Medication Adherence Among Schizophrenic Patients, Chandrika Mcqueen
Walden Dissertations and Doctoral Studies
The purpose of this project was to implement an educational program that provided psychiatric nurses with the knowledge and skills to engage patients with a diagnosis of schizophrenia in self-care management regarding medication and treatment adherence. The theory employed in the project was the educational theory. Evidence of effectiveness came from a pre- and postintervention assessment of nurses' knowledge and confidence in teaching about medication, along with a pre- and postassessment of knowledge gained as a result of the educational intervention. Pre- and posteducational rates of patient rehospitalization for medication nonadherence were compared. The results indicated a 15% rate of …
Impact Of End-Of-Life Education On Nurses' Moral Distress, Jenniffer Lynn Mullen
Impact Of End-Of-Life Education On Nurses' Moral Distress, Jenniffer Lynn Mullen
Walden Dissertations and Doctoral Studies
Moral distress is a state of concern or anxiety that occurs when there is a correct action to take but an individual's ability to take that action is constrained in some way. Nurses, especially those who work in intensive care units (ICUs), may struggle with moral distress due to feelings of futility when caring for end-of-life patients. The purpose of this 1-group pretest-posttest quasi-experimental study, guided by Lazarus's theory of stress, coping, and adaptation, was to determine whether End-of-Life Nursing Education Consortium (ELNEC) education reduces moral distress in ICU nurses caring for end-of-life patients. A revised Moral Distress Survey (MDS-R …
Education Protocol For Type Ii Diabetes Mellitus, Raegan Elizabeth Quandt
Education Protocol For Type Ii Diabetes Mellitus, Raegan Elizabeth Quandt
Walden Dissertations and Doctoral Studies
Diabetes mellitus is one of the leading causes of death in the United States, contributing to rising health care costs and increased morbidity and mortality rates. Researchers demonstrated that aggressive heath measures involving ongoing diabetes self-management education are paramount in minimizing associated complications of diabetes. The management and prevention of diabetes is not standardized and providers within a health clinic in Illinois reported challenges in providing self-management education during scheduled patient appointments due to limited resources and time. The purpose of this DNP project was to develop a clinical practice guideline to be used by all providers within the health …
Dementia-Spcific Education In An Assisted Living Facility, Sharon Dianne Samarin
Dementia-Spcific Education In An Assisted Living Facility, Sharon Dianne Samarin
Walden Dissertations and Doctoral Studies
Providing competent, high-quality, and person-centered care is important in the healthcare environment, including the care for the aging and training of those who provide care. A knowledge gap in dementia-specific training was identified at an assisted living facility. The purpose of this project was to answer the question whether a dementia-specific educational staff training program would improve staff members' knowledge and application of dementia-specific competencies as well as caring behaviors. Watson's theory of human caring, the theory of planned behavior, and Leininger's framework of culture care were used to inform this project. The educational project evaluated the success of implementing …
Educational Outcomes Of Online Registered Nursing To Bachelor Of Science In Nursing Students, Shuba Samuel
Educational Outcomes Of Online Registered Nursing To Bachelor Of Science In Nursing Students, Shuba Samuel
Walden Dissertations and Doctoral Studies
The projected nurse workforce shortage and the need for nurses with bachelor's degree has increased the number of accelerated and online programs in nursing education. The evolving healthcare system demands registered nurses (RNs) to demonstrate critical thinking skills and evidence-based practice in varied healthcare settings. The purpose of this quantitative study was to analyze if academic variables, such as preadmission grade point average (GPA), predicted evidence-based skills and research utilization skills among students enrolled in the online RN to Bachelor of Science in nursing program. The theoretical foundations of this study was comprised of Knowles's adult learning theory, Benner's stages …
Nursing Students Experiences Of Career And Technical Education Health Science Programs, Precious Simmons
Nursing Students Experiences Of Career And Technical Education Health Science Programs, Precious Simmons
Walden Dissertations and Doctoral Studies
The state of education in the United States faces many challenges in preparing students for the workforce and postsecondary education. These challenges are heightened at the postsecondary level for schools of nursing. The current shortage of nurses will continue to rise if recruitment and retention strategies are not employed. The purpose of this qualitative hermeneutic phenomenological study was to understand and explore the experiences of former health science program students enrolled in nursing school. Research questions focused on the experience of career and technical education (CTE), motives and perceived benefits of CTE, nursing experience, career choice, and academic interests. The …
Reducing Home Health Copd-Related 30-Day Hospital Readmissions Using Telehealth Technology, Steven Eric Stammer
Reducing Home Health Copd-Related 30-Day Hospital Readmissions Using Telehealth Technology, Steven Eric Stammer
Walden Dissertations and Doctoral Studies
Chronic obstructive pulmonary disease (COPD) is a collection of chronic conditions that results in irreparable lung damage and stress to patients. COPD also has considerable financial impacts on health care entities due to frequent hospital readmissions of COPD patients. The Centers for Medicare and Medicaid Services penalize care entities for 30-day hospital readmissions. Many rehospitalizations attributed to COPD are due to exacerbations, often preceded by physiologic and emotional changes that can be monitored, allowing action to be taken to prevent readmissions. The practice problem for this quality improvement project explored whether the use of remote home monitoring of COPD patients …
Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson
Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson
Walden Dissertations and Doctoral Studies
Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also …
Educating Nurse Managers To Create A Culture Of Nurse Retention, Stacey Trotman
Educating Nurse Managers To Create A Culture Of Nurse Retention, Stacey Trotman
Walden Dissertations and Doctoral Studies
Nurse managers are stakeholders in creating a culture of nurse retention. The purpose of this staff education project was to identify evidence-based best practices that promote nurse retention and to educate nurse managers about these strategies. Knowles's theory of adult learning was the theoretical framework for the project. The practice-focused question addressed whether an education program for nurse managers would increase their understanding of evidence-based strategies to create a culture of nurse retention. The education program centered on 4 themes: professional development, communication and relationships, culture and work environment, and organizational structures and support. The concepts of 5 domains-- status, …
Teaching Heart Failure Patients A Low-Sodium Diet, Karen Faye Wright
Teaching Heart Failure Patients A Low-Sodium Diet, Karen Faye Wright
Walden Dissertations and Doctoral Studies
Congestive heart failure (CHF) is a progressive medical condition affecting more than 7 million people in the United States (US) with 700,000 new cases reported annually. More than half of those treated for CHF are readmitted at least once a year. The problem addressed by this quality improvement initiative was lack of adherence to low sodium diet (LSD) among CHF patients, knowledge and skill deficit, and excessive 30-day CHF readmissions. The health belief model and the self-care deficit theory guide nurses in acquiring the skills needed to teach LSD. Twelve months of data were selected from 93 CHF readmissions from …
Training For Advanced Practice Providers In A Heart Failure Unit, Merlyn Chua
Training For Advanced Practice Providers In A Heart Failure Unit, Merlyn Chua
Walden Dissertations and Doctoral Studies
Information from anecdotal interviews at a practicum site indicated a lack of training for advanced practice providers (APPs) in core competencies critical for effective practice in a heart failure (HF) unit. The goal of this project was to assess the APPs' verbal reports and develop HF unit-specific training for APPs. The practice-focused question examined whether unit-specific training for HF APPs improved knowledge and skills in HF management. The Johns Hopkins nursing evidence-based practice model and Knowles's adult learning theory were used to create a survey, a focus group, and a pre/posttest assessment of knowledge and skills gap. Descriptive and inferential …
Factors Influencing Emergency Registered Nurse Satisfaction And Engagement, Catherine Larock-Mcmahon
Factors Influencing Emergency Registered Nurse Satisfaction And Engagement, Catherine Larock-Mcmahon
Walden Dissertations and Doctoral Studies
Employee satisfaction and engagement have a direct impact on customer satisfaction. Dissatisfaction and disengagement lead to an increased intent to leave a job, poor patient outcomes, and decreased productivity. The retention and recruitment of qualified staff becomes an urgent priority to ensure safe and prudent patient care. The purpose of the qualitative research study was to better understand the beliefs, attitudes, perceptions, and reasons for emergency department registered nurses (ED RN) satisfaction and engagement in the workplace focusing on Herzberg's, Vroom's, Yetton's, Maslow's, Benner's, and Kahn's motivation and engagement theoretical frameworks. The qualitative case research study focused on satisfaction and …
Succession Planning And Development Of Nurse Leaders, Christina Martin
Succession Planning And Development Of Nurse Leaders, Christina Martin
Walden Dissertations and Doctoral Studies
Health care organizations can provide comprehensive, formal learning opportunities to develop nurse leaders for advanced leadership roles. The purpose of this doctoral project was to create an evidence-based nursing leadership academy focused on development of advanced leadership skills and competencies to cultivate frontline and midlevel nurse leaders for executive nursing and health care leadership positions. The practice-focused question addressed how an advanced nursing leadership education program would affect the knowledge level and competencies of nurse leader participants. The American Organization of Nurse Executives' (AONE) 5 nurse executive competency domains served as the framework for this project. Data were collected from …
Improving Hand Hygiene In An Intensive Care Unit, Charles Chukwuemeka Njenje
Improving Hand Hygiene In An Intensive Care Unit, Charles Chukwuemeka Njenje
Walden Dissertations and Doctoral Studies
Health-care-associated infections (HCAIs) affect hundreds of millions of people worldwide, causing morbidity and mortality among hospitalized patients. About 2 million patients suffer from HCAIs in the United States, and it is estimated that 99,000 of them die each year. Studies have indicated that transmission of health-care-associated microorganisms occurs through contaminated hands of health care workers. Hand hygiene (HH) is the single most effective way to prevent health-care-associated infections, yet health care workers' hand hygiene compliance remains low. One factor responsible for poor compliance with hand hygiene guide-lines are lack of knowledge of good hand hygiene and lack of hand hygiene …
Knowledge And Attitudes Of Emergency Room Nurses Regarding Palliative Care Patients, Pearl Alethea Harrison
Knowledge And Attitudes Of Emergency Room Nurses Regarding Palliative Care Patients, Pearl Alethea Harrison
Walden Dissertations and Doctoral Studies
Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura's social cognitive theory. The FATCOD was used to assess ED nurses' attitudes toward PC, and the PCQN was used to assess ED nurses' knowledge about PC prior to the …
Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies
Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies
Walden Dissertations and Doctoral Studies
Opioid drug misuse and dependence are a social and public health problem in the United States. Prescription opioid abuse and misuse have been associated with substantial morbidity and mortality rates as well as social and economic costs. The purpose of this project was to provide a systematic review of literature on the effectiveness of medication-assisted therapy interventions in addressing the problem of prescription opioid misuse in health care settings. The systematic review was completed through a literature search conducted across five electronic databases. The review was guided by the health belief model and eligible studies were rated using Johns Hopkins …
The Impact Of Shared Governance On Nursing Satisfaction And Retention, Melanie Wetmore
The Impact Of Shared Governance On Nursing Satisfaction And Retention, Melanie Wetmore
Walden Dissertations and Doctoral Studies
Shared governance is a practice model that supports shared decision making between direct care nurses and their leaders. Developed from Kanter's theory of structural empowerment, shared governance allows employees to influence decisions made in an organization. Shared governance has been shown to increase nursing satisfaction, positively impact outcomes, and reduce nursing turnover. The purpose of this project was to examine the relationship between implementation of a system-wide, multihospital shared governance structure and registered nurse (RN) satisfaction, turnover, and perceptions of shared governance. The 3 sources of evidence used in the study were 2016-2017 organizational RN engagement survey results, 2016-2017 organizational …
Medication Reconciliation In The Elderly, Munjanja Yvonne Litell
Medication Reconciliation In The Elderly, Munjanja Yvonne Litell
Walden Dissertations and Doctoral Studies
Medication therapy is the most prevalent and critical intervention of health delivery and the source of most errors in healthcare. Medication errors and associated adverse drug events (ADE) have serious health and economic ramifications, and in elderly patients ADE are the leading cause of morbidity and mortality. Medication reconciliation is the process of evaluating current medication treatment to manage the risk and optimize the outcomes of medication treatment by detecting, solving, and preventing ADEs. This education project answered the question whether education provided to long term care staff would improve knowledge of medication reconciliation and be retained over time. The …
A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan
A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan
Walden Dissertations and Doctoral Studies
Ineffective pain management in the post anesthesia care unit (PACU) increases patients' risk of adverse effects including decreased mobility, infection, chronic pain, depression, cardiopulmonary complications, increased length of stay, insomnia, fatigue, and overall decrease in quality of life. The PACU in a community hospital did not provide an evidence-based pain management guideline for nurses treating postoperative patients, resulting in nurses' concerns about providing pain management. The purpose of this project was to translate evidence on pain management into an evidence-based guideline for improved nursing practice in a PACU. Evidence was obtained from a detailed literature search using multiple databases and …
Evaluation Of Use Of Teach-Back For Patient Education, Tamara J. Orr
Evaluation Of Use Of Teach-Back For Patient Education, Tamara J. Orr
Walden Dissertations and Doctoral Studies
The focus of this quality improvement doctoral project was the evaluation of an organization's standardized use of the teach-back process for patient education implemented in February 2018. Teach-back is a process in which the patient restates the key concepts for self-management, so the nurse can assess the effectiveness of the teaching and learning process. The practice-focused question compared 4 questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey with literature and recommendations from major health care organizations. The Iowa Model was used to guide the project. The literature review was completed using the Cumulative Index to …
Perceptions Of An Ebp Module Mobile Application By New Graduate Nurses, Kristin Wilson Carlson
Perceptions Of An Ebp Module Mobile Application By New Graduate Nurses, Kristin Wilson Carlson
Walden Dissertations and Doctoral Studies
Evidence-based practice (EBP) is a key driver of care and advancements within nursing. It is essential to emphasize EBP early in a nurse's career to promote inquisitive minds and enthusiasm for seeking evidence. The purpose of this project was to implement an EBP mobile app into a nurse residency program (NRP) to improve the process of providing EBP information and resources to new graduate nurses. The intent of the project was to leverage mobile technology to engage new graduate nurses in evidence-based practice. Roger's diffusion of innovation framework guided the project. The target audience for the project was 16 new …
Development Of A Quality Improvement Program To Support Evidence-Based Nursing Practice, Heather Richards
Development Of A Quality Improvement Program To Support Evidence-Based Nursing Practice, Heather Richards
Walden Dissertations and Doctoral Studies
Nurses are expected to perform evidence-based practice (EBP) at the point of care (POC) to promote positive outcomes through the quality and safety of patient care. The struggle for nurses on the surgical digestive unit in a hospital to adopt EBP is the lack of access and knowledge to evidence-based research at the POC. The utilization of information technology is an innovated approach to providing access and knowledge for EBP at the POC to improve patient outcomes. The project was to develop a quality improvement program to improve nursing access and knowledge of EBP resources. The program was to identify …
Evaluation Of The N-O-T Program For Smoking Cessation Among High School Students, Whitney Jaye Erickson
Evaluation Of The N-O-T Program For Smoking Cessation Among High School Students, Whitney Jaye Erickson
Walden Dissertations and Doctoral Studies
Adolescents and young adults use more tobacco than all other adults, yet the percentage of this younger population eventually quitting the use of tobacco is lower. There is little evidence-based research to support adolescent smoking cessation programs. Using social learning theory (SLT) and the stages of change model, the purpose of this project was to evaluate the effectiveness of the Not-On-Tobacco (N-O-T) program, an evidence-based adolescent smoking cessation program, in reducing or preventing the number of cigarettes smoked by high school boarding students and to evaluate how best to individualize the program for this high school going forward. The DNP …
The Role Of Empathy In Nursing Assistant Retention, Garlina Finn
The Role Of Empathy In Nursing Assistant Retention, Garlina Finn
Walden Dissertations and Doctoral Studies
It is estimated that by 2020 there will be 2.8 million long-term care beds in residential facilities, staffed primarily with nursing assistants as the front-line care providers. The American Healthcare Association 2012 staffing survey showed that the median annual turnover rate for nursing assistants in the United States is 51.5%. High rates of turnover are associated not only with poorer quality of care but also with increased costs for facilities. The purpose of this project was to understand characteristics that are associated with long-term employment in the nursing assistant role by describing the personality characteristic of empathy in the nursing …
Comparing A General And Transitional Registered Nurse Orientation To Facilitate Quality Improvement, Kathryn R. Cortes
Comparing A General And Transitional Registered Nurse Orientation To Facilitate Quality Improvement, Kathryn R. Cortes
Walden Dissertations and Doctoral Studies
Most hospitals orient new graduate nurses and experienced nurses in the same generalized orientation programs. To address the cost of orientation to specialty units, a pediatric hospital developed a tailored transitional residency orientation program for experienced nurses. The purpose of this project was to describe, compare, and evaluate the existing generalized orientation program and the transitional orientation program to determine how the orientations differed in structure, process, and outcomes. Donabedian's model assessing quality of care services and Benner's novice-to-expert theoretical framework served as guides in evaluating the orientation outcomes. Qualitative data about residency classroom time, preceptor selection and time, mentor …
Developing Neonatal Gavage Tube Guidelines To Decrease Feeding Intolerance, Elizabeth Demeester Webster
Developing Neonatal Gavage Tube Guidelines To Decrease Feeding Intolerance, Elizabeth Demeester Webster
Walden Dissertations and Doctoral Studies
A nutritional method commonly used to deliver feedings to premature infants is the use of a gavage tube. To measure for any undigested breastmilk or formula, a gastric aspirate is checked prior to the next feeding. There is a gap in practice as to what to do if these aspirates signify feeding intolerance. The project question centered on identifying evidence-based guidelines in the literature that would help to define best practices related to feeding intolerance of gavage-fed infants. The Johns Hopkins Nursing Evidence-Based Practice model and the Appraisal of Guidelines Research and Evaluation provided the frameworks for gathering and evaluating …
Eliminating Or Decreasing Restraint Use And Seclusion For Adults In An Inpatient Psychiatric Facility, Charles Banks
Eliminating Or Decreasing Restraint Use And Seclusion For Adults In An Inpatient Psychiatric Facility, Charles Banks
Walden Dissertations and Doctoral Studies
Evidence from research around the world have indicated that the use of restraints and seclusion has become a controversial issue in mental health facilities relating to managing patients' aggressive behaviors. Evidence indicates that all other options should be used first and the use of restraints and seclusions should be used as a last resort when all other options have failed. The rationale is to bring about awareness of all of the options or alternative interventions that are available other than the use of restraints and seclusions, as research has indicated that restraints and seclusions provide no therapeutic value to the …