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Articles 2071 - 2100 of 2607
Full-Text Articles in Nursing
Compassion Fatigue And Burnout: Awareness And Prevention For The Novice Nurse Population, Jamie B. Lopez
Compassion Fatigue And Burnout: Awareness And Prevention For The Novice Nurse Population, Jamie B. Lopez
Walden Dissertations and Doctoral Studies
Compassion fatigue (CF) and burnout (BO) in the novice nurse population can negatively affect the organization, patient safety, patient satisfaction, and the individual. Novice nurses are susceptible to the development of CF and BO due to a lack of knowledge about the causes and the stress experienced as the novice nurse transitions to practice. The purpose of this staff education project was to fill the gap in practice by creating awareness about CF and BO during the nurse orientation process and by providing prevention strategies. The relationship-based care model and the theory of planned behavior were used to guide the …
Effects Of Transformational Learning On Student Nurses' Perceptions And Attitudes Of Caring For Dying Patients, Kristina Mccall
Effects Of Transformational Learning On Student Nurses' Perceptions And Attitudes Of Caring For Dying Patients, Kristina Mccall
Walden Dissertations and Doctoral Studies
Nurses spend more time with patients than members of any other discipline in the hospital setting, and most nurses will provide care for dying patients. However, nurses tend to feel uncomfortable providing care to dying patients, which may be due to a lack of education and knowledge about care for dying patients. The purpose of this quasiexperimental 1-group pretest-posttest study was to determine the effect education had on nursing students' attitudes and perceptions about the care they give to their patients at the end of life. The End of Life Nursing Education Consortium (ELNEC) education modules were used for quality …
Evaluation Of A Difficult Urinary Catheter Team In An Academic Medical Center, David Price
Evaluation Of A Difficult Urinary Catheter Team In An Academic Medical Center, David Price
Walden Dissertations and Doctoral Studies
The placement of an indwelling urinary catheter (IUC) is a commonly performed clinical procedure which may become challenging for the clinician and painful for the patient. In response to urologic complications attributed to repeated failed IUC insertion attempts by nurses, a difficult urinary catheter (DUC) team program was launched in October 2012. The purpose of the doctoral project was to conduct a quality improvement evaluation of the effectiveness of the DUC team program using retrospective data from May 1, 2013 through May 31, 2017. Benner's novice to expert model was chosen as the theoretical framework to guide the additional training, …
Evidence-Based Practice For Influenza And Pneumococcal Nurse-Driven Protocol, Melissa Tunc
Evidence-Based Practice For Influenza And Pneumococcal Nurse-Driven Protocol, Melissa Tunc
Walden Dissertations and Doctoral Studies
At the project site in New Jersey, eligible patients were leaving the hospital without receiving the influenza or pneumococcal vaccine. The field site has an established, evidence-based, nurse-driven protocol. The purpose of this project was to increase adherence to the current influenza and pneumococcal nurse-driven protocol on one medical-surgical unit. This unit had experienced low adherence rates to the nurse-driven protocol for vaccines, not reaching the New Jersey state target of 96% administration prior to discharge. The practice-focused question was: Will increasing awareness of evidence-based practice increase adherence to the influenza and pneumococcal vaccine protocol? A quality improvement plan was …
Using Diabetes Self-Management Education To Enhance Adolescent Transition, Jessica Adkins
Using Diabetes Self-Management Education To Enhance Adolescent Transition, Jessica Adkins
Walden Dissertations and Doctoral Studies
Type 1 diabetes is a long-term diagnosis, the prognosis of which is directly related to the patient's ability to self-manage the disorder. Adolescents are not currently taught how to manage diabetes; instead, parents and educators expect self-management to be more of a learned behavior from their parents. The purpose of this project was to create a quality improvement plan which the regional pediatric diabetes center study site could implement to improve adolescent glycemic control. Orem's self-care theory was used as theoretical framework for the design and evaluation of the project. The practice-focused question for this doctoral project was: Can a …
Addressing Spiritual Care Needs In Primary Care, Olayinka Akerele-Olufidipe
Addressing Spiritual Care Needs In Primary Care, Olayinka Akerele-Olufidipe
Walden Dissertations and Doctoral Studies
This DNP project focused on the spiritual aspects of care that are often neglected in the outpatient setting. Most patients value their spiritual health and believe that it is just as important as their mental and physical health. The purpose of this project was to improve the overall spiritual care provided to patients, their families, and/or caregivers in times when they were experiencing spiritual distress. This quality improvement (QI) project was designed to determine whether embedding a chaplain in an outpatient clinic instead of providing a pamphlet about chaplain services increases patient satisfaction. Secondary analysis of the data in this …
Chronic Disease And Injury Prevention Programming For Canada's Indigenous Population, Nicole Blackman
Chronic Disease And Injury Prevention Programming For Canada's Indigenous Population, Nicole Blackman
Walden Dissertations and Doctoral Studies
Local public health units in the province of Ontario, Canada, are often the primary source of health promotion and health education resources, but many do not provide programming specific to the Indigenous population. As of January 2018, modernization of the Ontario Public Health Standards requires public health units to work with the Indigenous population in providing culturally appropriate programs and services. The practice question guiding the capstone project was to determine what chronic disease and injury prevention programs exist that are culturally appropriate for the Indigenous population. The purpose of this project was to do an environmental scan and compile …
Use Of Antipsychotic Medications In Individuals With Alzheimer's Disease In Nursing Facilities, Michelle M. Dionne-Vahalik
Use Of Antipsychotic Medications In Individuals With Alzheimer's Disease In Nursing Facilities, Michelle M. Dionne-Vahalik
Walden Dissertations and Doctoral Studies
Patients with Alzheimer's disease or other types of dementia often require long-term care in nursing facilities (NF) where they may display out-of-character behaviors complicating their care. While antipsychotic medications are sometimes prescribed for NF residents, their use is considered inappropriate for the control of dementia behaviors. The Centers for Medicare and Medicaid Services have rated Texas the worst state in the country for the inappropriate use of antipsychotic medications for NF residents with dementia. This project was guided by the star model of knowledge transformation with the goal to reduce inappropriate use of antipsychotic medications through NF staff education. The …
Clostridium Difficile Infection (Cdi): Use Of Preventive Bundle To Decrease Cdi Incidences, Lisa Feliciano
Clostridium Difficile Infection (Cdi): Use Of Preventive Bundle To Decrease Cdi Incidences, Lisa Feliciano
Walden Dissertations and Doctoral Studies
The challenge of combating Clostridium difficile infections (CDI) is a major problem within many health care organizations as CDI adds to the cost of care and is an uncomfortable and sometimes fatal complication of hospitalization for the patient. The practice-focused question for this doctoral project was targeted at patients in hospital settings on a medical surgical floor and asked if clostridium difficile preventive bundles reduce the incidence of CDI compared with nonstandardized preventative methods. Using the plan-do-study-act framework, the purpose of this DNP project was to use a clostridium difficile bundle approach to study the effects of clostridium difficile incidence …
Assessment Of Evidence-Based Practice Readiness And Plan For Implementation Of Clinical Practice Guidelines In A Tertiary Hospital, Linda Keller
Walden Dissertations and Doctoral Studies
Using evidence-based practice (EBP) to deliver patient care in a hospital setting improves patients' care and their outcomes. The use of clinical practice guidelines (CPG) enables nurses and other healthcare professionals to translate current evidence into bedside care. However, there continue to be barriers for hospitals in adopting and implementing evidence-based care using CPGs, including a lack of understanding about EBP by nursing staff. The purpose of this project was to explore readiness of registered nurses in a tertiary hospital to use EBP and provide recommendations for a plan to implement CPGs successfully. Melnyk's research identified EBP as an approach …
Evaluating 30 Day Rehospitalization After Sbar Implementation In Rounding, Michell Mulberry
Evaluating 30 Day Rehospitalization After Sbar Implementation In Rounding, Michell Mulberry
Walden Dissertations and Doctoral Studies
Transferring from an acute care setting to a sub-acute rehabilitation (SAR) setting can be challenging for both patients and providers because communication errors may occur. The purpose of this project was to evaluate the effectiveness of a 2017 quality improvement (QI) initiative that was implemented to reduce 30-day rehospitalization in a SAR setting serving older patients. The project involved an evaluation of the implementation of the Situation, Background, Assessment, and Recommendation (SBAR) tool for patient rounding to decrease the incidence of 30-day re-hospitalizations. Aristotle's linear model of communication, which emphasizes the impact of message delivery on audience response, provided the …
A Staff Education Project And Screening Tool To Identify Calciphylaxis, Janice Pennington
A Staff Education Project And Screening Tool To Identify Calciphylaxis, Janice Pennington
Walden Dissertations and Doctoral Studies
Calciphylaxis is a deadly disease seen primarily in patients with end stage renal disease. Literature indicated that improved patient outcomes are seen with routine screenings. Many dialysis providers lack fundamental knowledge that would enable early identification of calciphylaxis in patients with renal disease. The purpose of this project was to design a screening instrument and develop a staff education program that would transform calciphylaxis management by promoting early identification and treatment of the disease. Knowles's theory of andragogy was used as the theoretic framework for the project. Dialysis center staff (n = 26) participated in the education. The number of …
Effectiveness Of Continuous Subcutaneous Insulin Infusion Therapy Education In A Clinic Setting, Kimberly Rizzo
Effectiveness Of Continuous Subcutaneous Insulin Infusion Therapy Education In A Clinic Setting, Kimberly Rizzo
Walden Dissertations and Doctoral Studies
Diabetes affects an estimated 29.1 million Americans, with approximately another 1/3 of Americans not yet diagnosed. Complications associated with diabetes include heart disease, stroke, hypertension, blindness, kidney disease, neuropathy and death. All of these complications can be prevented with optimal control of blood glucose levels. Advances in technology provide people living with diabetes (PLWD) a multitude of treatment options such as continuous subcutaneous insulin infusion (CSII) therapy. Unfortunately, sustained improvement in glycated hemoglobin A1c (HgA1c) is not always achieved even with this advanced therapy. The purpose of this doctoral project was to educate nurses on CSII therapy and promote improved …
The Impact Of Diabetes And Obesity In The African American Population, Andrea Lynette Swails
The Impact Of Diabetes And Obesity In The African American Population, Andrea Lynette Swails
Walden Dissertations and Doctoral Studies
Within the 21st century, Type II diabetes has emerged as a public health crisis. African Americans and Hispanic Americans have the highest rates of Type II diabetes and obesity compared to European Americans. The purpose of this DNP project was to teach medical assistants (MA) to provide self-management of diabetes and obesity for the African American population in the local clinical setting. An educational tool kit for health providers was developed to guide the educational project. The chronic care model was used to guide the development of the educational toolkit. A pretest posttest design was incorporated into the educational program. …
The Effects Of Hourly Rounding On Patient Safety And Satisfaction, Renee Allatzas
The Effects Of Hourly Rounding On Patient Safety And Satisfaction, Renee Allatzas
Walden Dissertations and Doctoral Studies
The clinical practice problems addressed by the DNP project were the low patient satisfaction scores and the high number of falls on a hospital neurological step-down unit. The purpose of this project was to improve the Hospital Consumer Assessment of Healthcare Providers and Systems score on one patient satisfaction question and decrease the number of patient falls by implementing hourly rounding, using a script related to patient comfort and toileting needs. The scripted questions were expected to increase the satisfaction of patients and decrease unassisted falls due to increased attention to patient pain and positioning and timely help with toileting …
Nurse's Role Within The Informed Consent Process: A Systematic Review Of The Literature, Maria Faison
Nurse's Role Within The Informed Consent Process: A Systematic Review Of The Literature, Maria Faison
Walden Dissertations and Doctoral Studies
Each year, over 50 million surgical and nonsurgical inpatient procedures are performed and yet, shared decision making between patients and health care providers is not achieved. Obtaining patients' informed consent is part of a nurse's daily routine during admissions and before a procedure. The purpose of this project was to evaluate evidence to answer the practice-focused question regarding support for a policy change to implement a nurse-driven informed consent protocol. The systematic literature review was conducted using the adapted literature review by Souz, Silva, and Carvalho, which consisted of 6 levels for evaluating evidence. A total of 15 articles were …
Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes
Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes
Walden Dissertations and Doctoral Studies
Chronic pain affects approximately 100 million adults in the United States annually, and costs exceeding $635 billion. Pain is the most common complaint in primary care, and chronic pain accounts for up to 16% of emergency room visits. Additionally, chronic pain accounts for 25% of missed workdays annually. Veterans are particularly vulnerable to chronic pain and have an increased incidence of chronic non-cancer pain. Chronic pain for veterans cost the Veterans Administration (VA) about $385 billion each year. This project evaluated the Patient Aligned Care Team (PACT) model to manage chronic lower back pain (CLBP) at a VA primary care …
Practice Guidelines For Continuous Pulse Oximetry Monitoring For Obstructive Sleep Apnea Patients, Bridgette Smart
Practice Guidelines For Continuous Pulse Oximetry Monitoring For Obstructive Sleep Apnea Patients, Bridgette Smart
Walden Dissertations and Doctoral Studies
As the rate of obesity has increased in the United States to include approximately 40% of the adult population, there has been a corresponding rise in the number of patients with obstructive sleep apnea (OSA). The OSA population is at risk for adverse perioperative respiratory depression. Continuous pulse oximetry monitoring is indicated for these patients upon discharge from the recovery room into other treatment settings and when cared for by telemetry or by trained hospital staff in the patient's room. The practice question was whether an evidence-based practice guideline could be developed to help ensure safe postoperative monitoring of patients …
Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze
Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze
Walden Dissertations and Doctoral Studies
This project explored the challenges confronting clinicians who work with the Assertive Community Treatment Program (ACT), a government-sponsored clinic-based program providing services for individuals with persistent and recurrent mental health challenges in a large metropolitan city in the southern United States. The project involved semi-structured interviews with 15 health care clinicians to explore what they perceived as challenges and their recommendations for addressing them. Themes were organized around the 6 dimensions of the the relationship-based care model: leadership, teamwork, professional nursing, care delivery, resources, and outcomes. Identified patient challenges included transportation, lack of health insurance, housing, acceptance of certified peer …
Evaluating The Impact Of An Evidence- Based Weight Reduction Program Among The Obese At A Medical Facility In North Central United States, Petronilla Eke
Evaluating The Impact Of An Evidence- Based Weight Reduction Program Among The Obese At A Medical Facility In North Central United States, Petronilla Eke
Walden Dissertations and Doctoral Studies
In September 2016, the Centers for Disease Control and Prevention (CDC) determined that more than one-third (36.5%) of U.S. adults have an obesity problem. According to the CDC, this issue results in other medical conditions such as type 11 diabetes, hypertension, cancer, heart disease, and stroke. This project was designed to evaluate the effectiveness of an evidence-based weight reduction program for obese individuals at a medical facility in the North Central United States. The methodology used consisted of a retrospective chart review of pre- and post-data for 45 people who participated in the medical facility's weight-reduction program over a 6 …
An Rn Sepsis Training Program That Supports Registered Nurses In The Emergency Room Setting, Daphne Marjorie Davis-Patrick
An Rn Sepsis Training Program That Supports Registered Nurses In The Emergency Room Setting, Daphne Marjorie Davis-Patrick
Walden Dissertations and Doctoral Studies
Sepsis is a severe blood stream infection that claim the lives of almost 220,000 Americans annually. Delayed patient treatment results in multi-organ failure, morbidity, mortality, and increased hospital length of stay. Timely sepsis management enables hospitals to have decreased expenses, increased patient survival, and judicious interventions. The problem addressed in this project was the lack of sepsis- training for registered nurses (RNs) working in the emergency department (ED) of a 628-bed hospital in the southeastern United States. Under the direction of the director of the ED, 269 patient charts were reviewed during 2014 to February 2015 for data related to …
Faculty Perspectives On Effective Integration Of Simulation Into A Baccalaureate Nursing Curriculum, Linda Jane Howell
Faculty Perspectives On Effective Integration Of Simulation Into A Baccalaureate Nursing Curriculum, Linda Jane Howell
Walden Dissertations and Doctoral Studies
Research shows that use of high fidelity simulation (HFS) as a teaching strategy requires extensive amounts of faculty time and financial resources for faculty development and equipment. This project study addressed the challenges encountered in the integration of HFS into a Midwestern metropolitan baccalaureate nursing program. The purpose of this qualitative case study was to explore perceptions of nursing faculty about best practice elements for successful integration of HFS into undergraduate nursing programs. Guiding questions were developed using Donabedian's structure-process-outcome model and focused on faculty perceptions related to successful implementation of simulation in their programs. Purposeful sampling was used to …
Design And Development Of An Educational Intervention On Nurse Perceptions Of Caring, John S. Norris Iii
Design And Development Of An Educational Intervention On Nurse Perceptions Of Caring, John S. Norris Iii
Walden Dissertations and Doctoral Studies
Caring is central to the nursing profession and important to patients and family members who expect nurses to display caring attributes. The acute care hospital in this study did not have an education program on caring practices for nursing staff although the organization acknowledged the importance of and need for a culture of caring practices in the organization. The purpose of this project was to design an educational program based on Watsons' theory of caring for registered nurses at the acute care hospital where the project took place. Rosswurm and Larrabee's model for change and Watson's theory of caring were …
New Graduate Nurses' Perceptions Of Their Delay To Professional Practice, Ruth Ann Obregon
New Graduate Nurses' Perceptions Of Their Delay To Professional Practice, Ruth Ann Obregon
Walden Dissertations and Doctoral Studies
This project study addressed the problem of knowledge and skills lost by new graduate RNs while delayed in transitioning to professional nursing practice. There is a paucity of knowledge about how new RNs experience their delay and how a delay may affect their future clinical performance. Mezirow's transformation learning theory was the conceptual framework for this qualitative case study. Research questions addressed new RNs' understanding of their experiences during a delay to professional practice. A purposeful sample included 8 new RNs who had completed a New Graduate Residency Transition Program (NGRTP) after a delay to practice of 6 months to …
Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser
Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser
Walden Dissertations and Doctoral Studies
Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …
Advanced Triage Protocols In The Emergency Department, Lijuan Zhao
Advanced Triage Protocols In The Emergency Department, Lijuan Zhao
Walden Dissertations and Doctoral Studies
Overcrowded emergency departments (EDs) are a major problem in the United States resulting in inefficiency in operation and performance. A Southern California hospital ED was the site for this project because it had operated over its maximum capacity during the last decade. Advanced triage protocols integrating standard order sets were implemented to improve quality of care; however, no evaluation of the protocols had been done. The purpose of this project was to evaluate the effect of the advanced triage protocols. Two project questions determined whether advanced triage protocols reduced ED length of stay (LOS), number of patients who left without …
Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan
Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan
Walden Dissertations and Doctoral Studies
Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, few studies have examined hypertension in the Armenian American population in the Los Angeles area, one of the most concentrated Armenian American communities in the United States. The purpose of this study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. The theoretical basis for this study was Pender's health promotion model and the health promoting lifestyle profile (HPLP-II), …
Standardized Communication At The Bedside: A Review For Reimplementation, Eunice Rosas
Standardized Communication At The Bedside: A Review For Reimplementation, Eunice Rosas
Walden Dissertations and Doctoral Studies
This paper discusses a developmental, interdisciplinary quality improvement project that seeks to improve healthcare communication by standardizing clinician communication across all levels of care. The purpose of this project was to develop an organizational policy and interdisciplinary practice guidelines to standardize the patient handoff at the bedside. The initiative intended to use processes already in place in the organization and to integrate the knowledge from a literature review to plan the implementation of bedside handoff procedures. The quality improvement project process included assembling an interdisciplinary committee; reviewing relevant peer-reviewed literature; and developing policy, relevant guidelines, as well as long-term plans …
Development Of A Transformational, Relationship-Based Charge Nurse Program, Kimetha D. Broussard
Development Of A Transformational, Relationship-Based Charge Nurse Program, Kimetha D. Broussard
Walden Dissertations and Doctoral Studies
Leaders of a rural Southwest Oklahoma hospital requested the development of an evidence-based program that could transform unit charge nurses into effective leaders in order to improve the leadership of direct care nurses. Nursing executive leadership discovered staff members were demonstrating high levels of stress, dissatisfaction, and burnout. Press-Ganey survey results revealed that staff felt they were not supported and did not believe nurses cared for patients' or other co-workers' well-being or safety. The Hospital Consumer Assessment of Healthcare Providers and Systems outcome scores, which were below hospital and national desired benchmarks, revealed that patients were not satisfied with the …
A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy
A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy
Walden Dissertations and Doctoral Studies
Lung cancer affects many individuals each year and accounts for many deaths around the globe. Lung cancer screening is a preventative health measure that has the ability to detect lung cancer earlier. The purpose of this project was to focus on the education of nursing staff within a community health system, with subsequent implementation of an electronic health record clinical decision support system, to create a direct referral pathway to lung cancer screening, delivered through patient education. The concept of prevention was the framework for this project design, which was further organized around the plan-do-study -act model, while taking into …