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Articles 2041 - 2070 of 2607
Full-Text Articles in Nursing
Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell
Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell
Walden Dissertations and Doctoral Studies
Tobacco use is the leading cause of premature and preventable death in the United States, yet millions of Americans continue to use tobacco. Nursing professionals comprise the largest health care provider group and can help improve tobacco cessation among their patients. The purpose of this doctoral project was to increase nursing staff and advanced practice providers knowledge, skills, and confidence related to tobacco cessation interventions. The project took place in a family medicine clinic in Central Texas. The nursing staff (which included 1 registered nurse and 3 licensed vocational nurses) and advanced practice providers (which included 3 nurse practitioners and …
Strategies To Reduce Hospital Readmission Rates After Bariatric Surgery, Catherine Scarlett
Strategies To Reduce Hospital Readmission Rates After Bariatric Surgery, Catherine Scarlett
Walden Dissertations and Doctoral Studies
Bariatric surgery is a major surgery that has become a frequent procedure in North America; growth in the number of bariatric surgery procedures has resulted in an increase in readmissions after the procedure. A systematic review of the literature using the shifting processes model as a guide was used to answer the practice-focused questions regarding reasons for hospital readmissions for postoperative bariatric surgery patients and strategies that reduce complications of the procedure. Providing Innovative Service Models and Assessment chart (PRISMA) was used to quantify 17 studies that met the inclusion criteria. Results demonstrated that the reasons for readmissions after bariatric …
Reducing Clabsi Rate Among Icu Patients, Rita L. Walker
Reducing Clabsi Rate Among Icu Patients, Rita L. Walker
Walden Dissertations and Doctoral Studies
Approximately 55% of intensive care unit (ICU) patients require the use of a central venous catheter (CVC). CVCs are often an essential component of care; however, CVCs can create avenues for pathogens to enter the bloodstream and cause a central line-associated bloodstream infections (CLABSI), which can lead to increased mortality and morbidity, prolonged length of stay, increased cost of care, decreased patient satisfaction, and increased workload. In 2017, the CLABSI rate at the project site was 4.3 per 1,000 catheter days as compared to the national rate of 0.8 per 1,000 catheter days. Based on Piaget's theory of constructivism, a …
Preoperative Nurses' Teaching For Open Heart Surgery Patients, Sofya Alshvang
Preoperative Nurses' Teaching For Open Heart Surgery Patients, Sofya Alshvang
Walden Dissertations and Doctoral Studies
Every year thousands of patients in the United States undergo cardiothoracic surgery. These patients have high levels of anxiety because they do not know what to expect. At the same time, many nurses on the cardiac telemetry/surgical floor are not aware that effective preoperative teaching can make a significant difference in patients' outcomes; thus, nurses had focused on postoperative teaching. The purpose of this project was to develop a preoperative teaching program through which nurses could help patients undergoing open heart surgery. The mentioned above practice initiative used Neuman's systems model as a framework. The project used a before-and-after design: …
Improving Nursing Knowledge, Satisfaction, And Retention In Long Term Care, Ghislaine Barry
Improving Nursing Knowledge, Satisfaction, And Retention In Long Term Care, Ghislaine Barry
Walden Dissertations and Doctoral Studies
Through advancements in modern medicine, human beings worldwide are living longer. The increase in life expectancy creates a need for a more qualified and knowledgeable nursing workforce for the delivery of quality geriatric health care. Although nurses are the primary care providers for vulnerable older adults, they are generally not well trained or prepared in geriatric care. Therefore, the purpose of the project was to develop an education program aimed at improving nursing knowledge of geriatric care in the long-term care (LTC) setting. The goal of the project was to answer the research question: What impact would attendance in the …
Mindfulness Meditation: A Self-Awareness Approach To Weight Management, Michelle Brown
Mindfulness Meditation: A Self-Awareness Approach To Weight Management, Michelle Brown
Walden Dissertations and Doctoral Studies
Obesity is a crucial health care issue that has a global effect on the health care industry. Not only does obesity decrease the patients' quality of life, it also places an astronomical burden on health care delivery systems. The purpose of this quality improvement project was to establish a weight management program derived from evidence-based research. The research question is can the utilization of mindfulness meditations and practices with traditional weight loss methodologies produce sustainable weight loss? Pender's health belief model was the conceptual framework utilized to guide and provides structure for this project. The health belief model has been …
Staff Education Module For Bar Code Medication Administration, Francoise Juste
Staff Education Module For Bar Code Medication Administration, Francoise Juste
Walden Dissertations and Doctoral Studies
Bar Code Medication Administration (BCMA) is a technology-supported nursing tool that has become the standard of practice for medication administration. When used effectively and efficiently, this tool has the potential to reduce medication errors in acute care settings. In a pediatric unit at a major urban hospital in the northeast region of the United States, the absence of a BCMA nursing staff educational module affected the use of this safety tool leading to an increase of medication errors. The purpose of this DNP project was to develop a comprehensive educational module to promote BCMA in the pediatric unit of the …
Trauma-Informed Education Toolkit For Screening Pediatric Victims Of Sexual Abuse And Maltreatment, Analena Michelle Lunde
Trauma-Informed Education Toolkit For Screening Pediatric Victims Of Sexual Abuse And Maltreatment, Analena Michelle Lunde
Walden Dissertations and Doctoral Studies
The complex challenges facing the sexual assault nurse examiners program in a midwest state are underreporting, late reporting, and poor coordination of care for pediatric victims of child maltreatment with sexual abuse. The main objective of this quality improvement project was the identification of necessary practice-related approaches to care to decrease barriers associated with reporting suspicions of abuse or neglect. An evidence-based, multidisciplinary assessment clinical toolkit that followed clinical components of trauma-sensitive, child-centered screenings triggering a coordinated response to conduct a forensic medical exam within 96 hours of the alleged incident was evaluated. During 3 rounds of surveys following the …
Systematic Review Of Nurse Residency Programs, Abiola Olatokunbo Ajanaku
Systematic Review Of Nurse Residency Programs, Abiola Olatokunbo Ajanaku
Walden Dissertations and Doctoral Studies
The first 2 years of a new graduate nurses career can be stressful and traumatic. Many new graduates leave the profession within their first 2 years of employment. Organizations have sought to implement programs that will promote new graduate job retention. Nurse residency programs (NRPs) are programs geared toward fostering and nurturing new graduates once they begin their nursing careers. Residency programs can last anywhere from 3 months to 1year, depending on the nursing specialty. A key component in retaining new graduates is to facilitate a successful transition into nursing practice. This project served as a systematic review regarding the …
Evaluating The Impact Of An Early Warning Scoring System In A Community Hospital Setting, Christine Conner
Evaluating The Impact Of An Early Warning Scoring System In A Community Hospital Setting, Christine Conner
Walden Dissertations and Doctoral Studies
Failure to recognize and respond to early signs of deterioration in hospitalized patients can have significant implications associated with delays in treatment. This lack of recognition was the impetus for rapid response teams in the United States and the recommendation by the Institute of Healthcare Improvement for use of early warning scores. This project was designed to evaluate the pilot implementation of an early warning score on 2 units in a community hospital in the Northeast. The practice-focused question was used to explore how patient outcomes changed following implementation of an early warning score (EWS) compared to patient outcomes associated …
Evidence-Based Education Program To Reduce Nurse Manager Burnout, David Howe
Evidence-Based Education Program To Reduce Nurse Manager Burnout, David Howe
Walden Dissertations and Doctoral Studies
Nurse managers face numerous challenges and stressors in their daily practice. The support services offered to managers to facilitate coping in stressful situations vary among employers and may be ineffective depending on the stressors faced. Implementation of evidence-based best practices may positively impact nurse managers' ability to manage stress. The purpose of this project was to develop an evidence-based stress reduction education program to empower nurse managers to handle work-related stressors and reduce burnout. The primary theory used to inform this project was the job demands-resource model, which explains how job demands and resources have multiple effects on job stress, …
Collaborative Treatment Plan Development, Sally Kangas
Collaborative Treatment Plan Development, Sally Kangas
Walden Dissertations and Doctoral Studies
The practice problem for this quality improvement project was the lack of engagement of chronic back pain patients at a Midwest clinic in evidence-based risk/benefit discussions regarding treatment options. The project was designed to explore whether practice guidelines increase patient engagement as measured by the Patient Activation Measure (PAM). Practice guidelines for interactive patient/nurse practitioner discussions regarding treatment options were developed, implemented, and evaluated. The concepts of chronic pain, chronic pain treatment options, and patient engagement were researched, and the evidence was evaluated using the Grades of Recommendation Assessment, Development, and Evaluation system. The clinical practice guideline was developed following …
Evidence-Based Pulmonary Rehabilitation Reduces Hospital Readmissions In Adults With Copd, Christiana Otuwa
Evidence-Based Pulmonary Rehabilitation Reduces Hospital Readmissions In Adults With Copd, Christiana Otuwa
Walden Dissertations and Doctoral Studies
Many patients are affected by chronic obstructive pulmonary disease (COPD), a progressive lung disease that obstructs air flow, resulting in dyspnea and inability to carry out daily activities. Despite optimal pharmacological management, COPD patients make frequent emergency room visits and are hospitalized due to exacerbations of COPD. Literature has suggested that pulmonary rehabilitation (PR), a nonpharmacological treatment, could help to decrease the symptoms that lead to illness exacerbation, hospital readmissions, and decreased quality of life in patients with COPD. The purpose of the project was to increase the quality of life and reduce admission rates for patients diagnosed with COPD …
Improved Rehabilitation By Improving Discharge Processes To Decrease Readmissions, Deborah A. Walton
Improved Rehabilitation By Improving Discharge Processes To Decrease Readmissions, Deborah A. Walton
Walden Dissertations and Doctoral Studies
Inadequate discharge planning for individuals with chronic illnesses or injuries is associated with increased readmissions to the hospital or rehabilitation facility where the original treatments were administered. To help ensure the recovery of discharged patients and avoid readmissions, discharge planners guide medication and care processes. The rate of readmissions was high in a stand-alone rehabilitation center due to ineffective discharge plans. Patients, family members, and caregivers lacked knowledge about medications, treatments, and self-care guidelines after the patient left the facility. The purpose of this project was to ascertain the impact of improved discharge processes using the (a) IDEAL Discharge Planning …
Integration Of Learning Activities For Improved Performance On The Nclex-Rn Exam, Erika Wilkinson
Integration Of Learning Activities For Improved Performance On The Nclex-Rn Exam, Erika Wilkinson
Walden Dissertations and Doctoral Studies
An institute of higher education located in the United States was unable to maintain the required first-time pass rate, on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam, by nursing graduates, as defined by their State Board of Nursing and accreditation body. Failure to meet these requirements resulted in a corrective action plan and fewer licensed nurses able to enter practice. The purpose of this study was to identify curricular changes to the associate nursing program to improve the first time pass rate by their nursing graduates. Benner's theory of skill acquisition was used as the conceptual framework …
Perceptions Of Collaboration And Mutual Respect Among Members Of Interprofessional Teams, Brenda Lankhof
Perceptions Of Collaboration And Mutual Respect Among Members Of Interprofessional Teams, Brenda Lankhof
Walden Dissertations and Doctoral Studies
Government agencies are encouraging healthcare practitioners to work in interprofessional teams to address the complex needs of an aging population, to improve client outcomes, and to increase the cost-effectiveness of health care. However, a clearer understanding of the elements required for an effective interprofessional collaborative practice is needed. The purpose of this online, descriptive study was to focus on one component, mutual respect, and determine its relationship to collaboration among members of interprofessional teams working in family health teams (FHTs) and community health centers (CHCs) across Ontario. D'Amour's four-dimensional model of collaboration was used as the theoretical basis. This model …
Early Detection Of Neonatal Abstinence Syndrome By Neonatal Intensive Care Unit Nurses, Ebele Oraka
Early Detection Of Neonatal Abstinence Syndrome By Neonatal Intensive Care Unit Nurses, Ebele Oraka
Walden Dissertations and Doctoral Studies
Neonatal abstinence syndrome (NAS) is a public health concern that is increasing in the United States due to the use of illicit drugs by pregnant women, which exposes the fetus to these substances. NAS results in increased infant morbidity and prolonged stay in the hospital, which can lead to increased cost of care. The inability of the nurses to care for at-risk infants can lead to inconsistent NAS scores, which can affect the infant's care treatment. The project examined the effectiveness of educating the neonatal intensive care unit (NICU) nurses on the correct use of the modified Finnegan Neonatal Abstinence …
Nurse Supervisors And Certified Nursing Assistants: Leadership Characteristics And Job Satisfaction, Jennifer Patterson
Nurse Supervisors And Certified Nursing Assistants: Leadership Characteristics And Job Satisfaction, Jennifer Patterson
Walden Dissertations and Doctoral Studies
Significant costs are associated with the turnover rate of certified nursing assistants (CNAs) in skilled nursing facilities (SNFs), and turnover impacts the quality of care for residents of the SNFs through disruption of care. The purpose of this quantitative cross-sectional study was to identify the leadership characteristics of supervisors most associated with the job satisfaction (JS) of CNAs in SNFs. Herzberg's dual factor theory was used as the theoretical framework to explain the relationship between the leadership characteristics and the associated JS. The research question was used to examine the independent variables of trust, teamwork, supportive supervision, leader-follower relationships, and …
Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist
Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist
Walden Dissertations and Doctoral Studies
Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …
Experiences Of Interpersonal Interaction Between Nurse Educators And Minority Nursing Students, Debra Boldan
Experiences Of Interpersonal Interaction Between Nurse Educators And Minority Nursing Students, Debra Boldan
Walden Dissertations and Doctoral Studies
Changes in the cultural composition of the United States population are not reflected in the nursing workforce. The lack of diversity in nursing may be due to the unique interpersonal needs of minority nursing students remaining unmet in traditional nursing education programs, which might unintentionally lead to alienation, isolation, and lower graduation rates for minority students. The purpose of this phenomenological study was to explore interpersonal interaction experiences nursing educators have in teaching minority nursing students. Critical social theory provided the theoretical framework to explore the ways social inquiries may hinder learning and keep marginal groups from reaching their full …
Non-Nursing Courses' Impact On Nclex-Rn Pass-Rates In Associate Degree Nursing Programs, Nicole A. Garner
Non-Nursing Courses' Impact On Nclex-Rn Pass-Rates In Associate Degree Nursing Programs, Nicole A. Garner
Walden Dissertations and Doctoral Studies
Nurse educators make decisions regarding the inclusion or exclusion of non-nursing courses in a curriculum. The current literature lacks research regarding which courses have the most impact on first-time nursing licensing examination pass-rates. The purpose of this quasi-experimental study was to investigate if there is a specific combination of courses that enhance first-time licensing examination pass-rates, using 161 randomly selected accredited associate degree nursing programs. General systems theory applied to nursing education was the framework for the study. ANOVA and independent t-tests were used to address the questions of non-nursing courses or discipline-specific set of non-nursing courses' impact on first-time …
Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty
Fall Reduction Among The Geriatric Population In Assisted Living Facilities, Marylyn A. Hagerty
Walden Dissertations and Doctoral Studies
Incidents of falls among the elderly increase with age. About $31 million is spent annually in the United States on medical costs related to fall injuries in the elderly. This project evaluated the outcomes of a fall reduction program implemented in an assisted living facility (ALF). The Stop Elderly Accidents, Death & Injury program developed by the Centers for Disease Control and Prevention was implemented by the ALF for 60 days prior to the outcome evaluation project. The program included a convenience sample of 62 residents and involved medication evaluation, exercises, assistive devices, environmental risk reduction, and evaluation of blood …
Scenario-Based Communication Simulation Curriculum And Plan, Sandra Imperial
Scenario-Based Communication Simulation Curriculum And Plan, Sandra Imperial
Walden Dissertations and Doctoral Studies
The Joint Commission reported that communication failures in United States hospitals contribute to 30% of all malpractice claims, and in 2008, The Joint Commission listed the improvement of effective communication among healthcare providers as a National Patient Safety Goal. The purpose of this practice-focused project was to develop a scenario-based communication simulation for implementation approval by a panel of experts. The approved curriculum was designed to integrate a communication-based simulation scenario into the nurse residency program of a large, urban medical center to improve new graduate nurse communication skills, increase nurse communication competency and self-efficacy, and decrease communication errors. Kolb's …
Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth
Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth
Walden Dissertations and Doctoral Studies
Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …
Barriers To Daiy Blood Glucose Self-Monitoring In Type 2 Diabetes Mellitus, Sylvain N. Tientcheu
Barriers To Daiy Blood Glucose Self-Monitoring In Type 2 Diabetes Mellitus, Sylvain N. Tientcheu
Walden Dissertations and Doctoral Studies
Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient's medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients' responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were …
The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach
The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach
Walden Dissertations and Doctoral Studies
Inadequate interprofessional collaboration (IPC) and communication among health care professionals are associated with medical errors and mortality. Guided by the theory of goal attainment and the chronic care model, a systematic review was conducted to explore the evidence related to whether interprofessional collaborative primary care can have a positive effect on health outcomes for patients living with diabetes (PLWD). The systematic review followed the Joanna Briggs Institute method for systematic reviews and results were complied with the PRISMA evidence-based minimum set for reporting. Data were analyzed to identify if IPC positively impacted the health outcomes of PLWD, as evidenced by …
Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda
Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda
Walden Dissertations and Doctoral Studies
Adolescents with Type I and Type II diabetes need to monitor blood glucose and food intake, administer insulin, and participate in activities including physical education during school hours to maintain glycemic control. Glycemic management programs (GMPs) exist for the improvement of diabetes management during school hours. The purpose of this project was to evaluate a GMP in a school system in a rural area in the Southeastern United States. The goal was to determine if the existing GMP met objectives and to make recommendations for continuation, revision, or discontinuation of the GMP. The logic model provided the basic framework for …
Sexual History Screening Tools For Individuals With Developmental Disabilities, Sarah Musu Onyenwe
Sexual History Screening Tools For Individuals With Developmental Disabilities, Sarah Musu Onyenwe
Walden Dissertations and Doctoral Studies
Individuals with developmental disabilities are at high risk for sexual abuse, exploitation, sexually transmitted diseases and unwanted pregnancies. Thorough screening by clinicians in outpatient settings recommending preventative measures to promote reproductive and sexual health, and developing caregiver trust are essential. The aim of this systematic review was to provide screening tools to assist clinicians in assessing the sexual histories of individuals with developmental or intellectual disabilities. The Iowa model and the cognitive behavioral theory were used as the theoretical frameworks that guided and informed this project. A total of 148 articles were sought and, of the 34 articles reviewed, 19 …
Adherence To The Icu Liberation Abcdef Bundle Improves Patient Outcomes In The Icu, Jennifer Sweeney
Adherence To The Icu Liberation Abcdef Bundle Improves Patient Outcomes In The Icu, Jennifer Sweeney
Walden Dissertations and Doctoral Studies
Delirium is a frequent complication of intensive care unit (ICU) admissions manifesting as acute confusion with inattention and disordered thinking. Patients in the ICU who develop acute delirium are more likely to experience long term disability and mortality. The purpose of this doctoral project was to evaluate an existing organizational quality improvement project to guide recommendations on improving care in the ICU. The practice-focused research question was: Does improving adherence to the ICU Liberation ABCDEF bundle for patients admitted to the ICU decrease incidence of delirium compared to outcomes prior to implementation? The Program Logic Model served as a framework …
Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing
Rem Initiative To Develop Educational Strategies For Inductions Of Labor, Chandra Evette Jones-Worthing
Walden Dissertations and Doctoral Studies
Inductions of labor that occur prior to 39 weeks' gestation can pose increased risks for the mother-baby dyad. In the target setting, there is a gap in knowledge among the pregnant women about options for delivery, hospital policies and procedures, and what to expect in the labor and delivery experience. Because of this gap in knowledge, the pregnant patient is unable to make informed decisions regarding her needs, expectations, and care. This lack of knowledge has resulted in a 40-50% rate of inductions of labor at the target site, which is well above the 2014 national average of 25%. In …