Nursing Commons^™

Relationships Between Early Academic Indicators And Accelerated-Baccalaureate Student Nurse Success, Bonnie J. White

Walden Dissertations and Doctoral Studies

In 2013, the National Council Licensure Examination for Registered Nurses' (NCLEX-RN) passing standard was increased, leading to a decrease in NCLEX-RN pass rates. The passing standard increase was prompted by an advisory panel's determination that a gap in safe, competent practice existed among new graduate nurses. New graduates' success on NCLEX-RN is critical to meet workplace demand for new nurses. The purpose of this study was to examine whether cumulative grade point average at completion of 200-level nursing courses and scores on the standardized final exam in the 200-level fundamentals course were related to on-time nursing program completion and a …

Relationship Between Student Characteristics And Attrition Among Associate Degree Nursing Students, Wendy Elizabeth Watson

Walden Dissertations and Doctoral Studies

High nursing student attrition has been a pervasive problem in the nursing program at the research site of this study. The purpose of this project study was to investigate the relationship between attrition and nursing student characteristics, including age, gender, ethnicity, English as Second Language (ESL) background, licensed practical nurse (LPN) licensure, grade point average (GPA), the number of preadmission college credits, and the Test of Essential Academic Skills (TEAS) scores. This correlational study of archival data was guided by Jeffreys's nursing undergraduate retention and success model and included a convenience sample of 240 students admitted to the program between …

Differentiating Successful And Unsuccessful Nursing Students, Trilla Mays

Walden Dissertations and Doctoral Studies

Administrators of nursing programs in community colleges are aware of the need to retain and to graduate students to meet the growing demand for licensed practical nurses (LPNs). High attrition in a 2-year nursing program in South Carolina affected the number of students either graduating as a LPN after completing the third semester, or continuing in the program to become a registered nurse (RN). Guided by Jeffreys's nursing undergraduate retention and success model, this causal comparative study investigated the differences between students who were and were not successful in the initial 3 semesters of the program. Archival student records for …

Quality Improvement Through Evidence-Based Education: Advancing Obesity Awareness And Clinical Management Strategies For People Living With Mental Disorders, Ellis Ehizele Opusunju

Walden Dissertations and Doctoral Studies

People living with mental disorders (PLWMDs) are at an increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the general-population obesity rate is 36% compared to more than 50% for PLWMDs. Mental health professionals (MHPs), focused on addressing psychiatric conditions, seldom recognize and clinically manage obesity. Furthermore, this population is socioeconomically disadvantaged with poor dietary habits while consuming psychiatric medications that stimulate hunger, further exacerbating the risk for obesity. The Promoting Action on Research Implementation in Healthcare Services (PARISHS) framework guided this quality improvement project to improve obesity awareness and management …

Women And Coronary Artery Disease, Gwendolyn Yvonne Stancell-Smith

Walden Dissertations and Doctoral Studies

Heart disease, including coronary artery disease, affects approximately 42 million women in the United States. Many of those affected are not aware they have the condition. Contributing to the problem is the fact that women are more likely than men to be misdiagnosed and undertreated for heart disease. Morbidity and mortality are high in women affected by heart disease, making the problem important to address. The purpose of this project was to understand the coronary artery or heart disease risk and the treatment for the condition provided for 31 participants at a cardiology service in the Northeast U.S. The project …

An Evidenced-Based Pain Management Module To Improve Clinicians' Knowledge, Mark A. Wells

Walden Dissertations and Doctoral Studies

Chronic pain syndrome continues to be a national health concern among all medical specialties. It has an impact on the entire health care system and if current trends continue, the economic impact alone will exceed 100 billion dollars. In 2014, 254 million prescription opioids were written in the United States. During this time, an increase in prescription opioid related deaths was seen, with approximately 20,101 deaths occurring in 2015. Properly trained clinicians across the health care system are needed to achieve successful patient outcomes, while reducing cost, morbidity, and mortality. The purpose of the scholarly project was to develop a …

The Impact Of Nursing Staff Ratios On Falls Rates In Skilled Nursing Facilities, Akudo Okeorji

Walden Dissertations and Doctoral Studies

Falls and complications from falls are a common problem among adults aged 65 years and older. About 60% of older adults fall every year, causing injuries, hospitalization, nursing home placement, and even death. Most studies on falls among skilled nursing facility (SNF) residents focus on fall preventive measures that fail to include staffing variables such as nursing hours. Although researchers have examined the relationship between nursing staff and patient outcomes in hospital settings, similar studies have not occurred in long-term care facilities. The purpose of this retrospective longitudinal study was to determine whether a correlation exists between nursing staff hours …

10,000 Step Challenge For Bedside Registered Nurses Working 12 Hour Shifts, Katherine Louise Schnebly

Walden Dissertations and Doctoral Studies

Obesity is a pandemic that directly affects chronic health problems and mortality. Researchers have shown that more than 54% of nurses are obese. The increasing rate of obesity among nurses and the long hours they work make healthy lifestyles, including daily physical activity, difficult. Tracking daily activity using a pedometer or fitness application has shown improved awareness and sustainability of daily physical activity. This project was an investigation of the daily steps of bedside nurses working a 12-hour shift, and their subsequent awareness of their daily physical activity. Pender's Health Promotion Model was used to consider motivating factors for improving …

Designing And Evaluating An Educational Initiative Promoting Condom Use Among Hiv+ Hispanic Men, Gilberto Andino

Walden Dissertations and Doctoral Studies

In 2013, the Centers for Disease Control and Prevention estimated that between 252,000 and 312,000 Hispanic men and women in the United States were unaware of their risk for transmitting HV/AIDS. Guided by the logic model and Leininger's theory, the purpose of this project was to design a culturally sensitive HIV/AIDS educational program for HIV+ Hispanic males and to evaluate the program content with the staff at a medical center in South Florida, with the goal of implementing the program at that center. The educational program content focused on increasing the knowledge of Hispanic HIV+ men on the effectiveness of …

Conducting An Assessment For Hypertension In African American College Students, Frances Eugenia Montague

Walden Dissertations and Doctoral Studies

Conducting an Assessment for Hypertension

in African American College Students

by

Frances E. Montague

MS, Hampton University, 1985

BS, Hampton University, 1979

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2017

Abstract

Hypertension (HTN) in African American (AA) young adults is diagnosed, treated, and controlled at a lower rate than it is among older AA adults and Caucasians. Untreated high blood pressure (BP) can progress to pre-HTN, HTN, and cardiovascular disease (CVD), which is the leading cause of death in the United States. Guided by Pender's health promotion model, …

The Impact Of Maternity Healthcare Employees Professional Development On Pregnant Teen Health, Patricia.Kelley Kelley

Walden Dissertations and Doctoral Studies

Knowledge gaps exist related to the care and education of pregnant teens. This project study addressed the problem of an inadequate amount of professional development (PD) and training for healthcare professionals (HCPs) caring for pregnant teens at a maternity clinic in the Southeastern United States. Unless HCPs are appropriately trained, the ability to meet the needs of pregnant teens is deficient and negative health outcomes for these patients are likely to be exacerbated. The humanistic learning theory was used in this phenomenological exploratory study to explore perception of 9 HCPs who had the responsibility for patient teaching, clinical care, and …

Needs Assessment For A Lifestyle Intervention Weight Loss Program For Hospital Employees, Karen Baumann

Walden Dissertations and Doctoral Studies

The rate of obesity is increasing in the United States. In Florida, almost 60% of the population will be obese by 2030. This increase is expected to contribute to millions of cases of preventable chronic diseases costing the state an estimated $34 billion dollars. Employer-sponsored health programs can positively influence employees' lifestyle choices and support weight loss programs to reduce health-related costs to the employee and the employer. Guided by the transtheoretical model, the purpose of the project was to conduct an employee assessment to determine the need for, interest in, and readiness for a lifestyle intervention weight loss program. …

Walking Versus Jogging In Patients With Cardiac Problems Including Congestive Heart Failure, Rosalie Roberta Garcia

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a growing epidemic that affects more than 50% of the world's population. CHF is a preventable disease, but prevention requires a healthy lifestyle from a young age. Most patients already diagnosed with CHF receive advice and strict instructions for care to prevent further cardiac injury. This quantitative descriptive research study was designed to address walking and jogging as the best exercises for patients diagnosed with CHF and in patients diagnosed with other cardiac problems. The results revealed that walking is the best exercise to improve patients' resting heart rate and overall cardiac function. This study …

The Relationship Between Pre-Licensure Employment And Student Nurse Self-Efficacy, Khristina Lee Grimm

Walden Dissertations and Doctoral Studies

Student nurses transitioning to acute care practice often feel unprepared to accept the responsibilities associated with their new role. Lack of self-efficacy in nursing practice contributes to high levels of stress and anxiety as the new nurse enters the workforce which causes turnover during the first year of practice. Little is known about how the type and amount of pre-licensure employment affects the self-efficacy in nursing practice of the student nurse. Using Bandura's social cognitive theory, the purpose of this quantitative study was to examine the relationship between type and amount of pre-licensure employment and self-efficacy in nursing practice of …

Identification, Diagnosis, Counseling, And Referral Of Overweight Military Dependent Children To Reverse Early Childhood Obesity, Gerald William Hall

Walden Dissertations and Doctoral Studies

Since 1980, the obesity rate in children 5 to 11 years of age has increased from 7% to 18%. The lack of structured physical activity and poor dietary habits childhood are primary risk factors for obesity related comorbidities in adulthood. Guided by primary care providers, families can reverse childhood obesity by implementing healthy dietary habits and engaging in structured physical activity. The purpose of this quality improvement project was to develop an evidenced-based policy with procedures to standardize the timely and consistent identification of overweight children at a primary care clinic serving military families. With an emphasis on obesity prevention …

Applying Clinical Guidelines To Curtail Opioid Overprescribing In Primary Care, Glenda Leflore

Walden Dissertations and Doctoral Studies

The purpose of this scholarly project was to evaluate an evidence-based quality improvement program implemented in 2016 in a clinical practice setting to curtail overprescribing of opioids for noncancer pain management. In 2001, the National Pharmaceutical Council and The Joint Commission on Accreditation and Hospital Accreditation initiated a standard of practice for opioid use in noncancer pain management that resulted in opioid overprescribing and a 200% increase in opioid-related deaths and incalculable societal costs. Primary care providers including nurse practitioners issue the greatest number of opioid prescriptions; therefore, to address the problem of opioid overprescribing, the 2016 Centers for Disease …

Hourly Rounding: A Fall Prevention Strategy In Long-Term Care, Robyn Mitchell

Walden Dissertations and Doctoral Studies

Falls and injuries related to falls are some of the most common and costly incidents that occur in the long-term care environment. Purposeful hourly rounding is a proactive way for nursing staff to identify patient needs and demonstrate positive fall prevention outcomes. This project examined a process improvement endeavor of a long-term care unit that experienced an increase in the number of falls over 3 months. The purpose was to evaluate whether staff education and implementation of an evidence-based hourly rounding program would affect the number of patient falls. The Johns Hopkins nursing evidence-based conceptual model, Kurt Lewin's change model, …

Performance Outcomes Of Nurses Based Upon Nursing Students'classroom Expereinces, Beatrice Obiageli Eweni

Walden Dissertations and Doctoral Studies

Schools of nursing educators are faced with redesigning nursing education to meet the complexity of implementing communication and patient- centered care to improve patient safety. This qualitative case study addressed the problem that teaching communication and patient- centered care were not threaded throughout curriculum, which left many new graduates nurses unprepared. The purpose of this study was to understand classroom experiences of new graduate nurses to meet performance outcomes. The research questions focused on understanding the classroom experiences of new graduates' of a nursing program by assessing the two concepts and how to address preparatory practices. The target populations were …

The Meaning Of Feeling Fearful For New Community/Public Health Nurses, Demetrius Ann Jones

Walden Dissertations and Doctoral Studies

This study examined the meaning of feeling fearful for nurses entering community/public health (C/PH) nursing. Nurses are entering the C/PH workforce with less experience and education than ever before, and may feel afraid or fearful in their jobs. Additionally, the autonomous nature of C/PH nursing poses significant challenges for this population such as fear of isolation and/ or abandonment. Therefore, the purpose of this qualitative descriptive study was to explicate the meaning of feeling fearful for new C/PH health nurses. Ten nurses with up to 2 years of C/PH experience volunteered for this study. The research questions were guided by …

Clinical Simulation And Nursing Student Perceptions Of Satisfaction, Self-Confidence, And Critical Thinking, Jaime Magnetico

Walden Dissertations and Doctoral Studies

Although the number of nursing programs has increased in Florida, the number of hospital sites available for clinical experiences have not, resulting in limited clinical time for each nursing program. To address this shortage of clinical time, local colleges are increasing the use of simulations in the curriculum. Guided by andragogy, this sequential mixed methods study was conducted to explore differences in students' perceptions of satisfaction, self-confidence, and critical thinking between two groups of students with different amounts of clinical simulation. In an associate degree nursing program, 34 nursing students completed a single survey on student perceptions of satisfaction and …

Evaluation Of The Safety Of Mri Scanning Of Patients With Mr Conditional Pacemakers, Shelly Lynn Mcgurk

Walden Dissertations and Doctoral Studies

Magnetic resonance imaging (MRI) of patients with cardiac implantable electronic devices (CIED) has been associated with risks such as device/lead movement, device dysfunction, and lead heating. New technological advancements have made it possible for MRI to be safely performed when adhering to an evidence-based protocol; however, this practice has not yet been widely adopted. The purpose of this practice-focused question project was to examine the safety of MRI as a diagnostic modality for the aggregate population of adult patients with MR conditional pacemakers when a nurse-practitioner-led, evidence-based protocol was used. The Iowa model served as the guide for implementation of …

Understanding Self-Management Decision Making In Heart Failure, Constance Louise Schumacher

Walden Dissertations and Doctoral Studies

Heart failure patients are responsible for managing fluctuations in symptoms between exacerbations by employing treatment adherence, active monitoring, and management strategies based on expert guidelines. Despite education, delayed help seeking persists among those in the need of acute medical intervention, as evidenced by high hospital admission and readmission rates. The purpose of this qualitative grounded theory study was to explore the decision making processes undertaken by heart failure, community-dwelling individuals as they experience symptom changes. Eighteen face-to-face interviews were conducted with participants who had heart failure and received self-management education from a home care agency in Southern Ontario, Canada. Data …

Quality Improvement Initiative About Patient Engagement With Clinicians In A Community Hospital, Cheryl Simpson

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a global health problem and efforts are needed to improve the care of individuals affected by the disease. A recent strategy for improving care within the healthcare system is patient engagement. Nurses and other health care clinicians can apply patient engagement into their clinical practice to improve the care they provide to their patients. Therefore, the purpose of this project was to increase the knowledge and awareness of patient engagement among clinicians who work with CKD patients. This quality improvement project used Lewin's force field analysis to analyze driving and restraining forces to help develop …

Development Of A Graduate Nurse Residency Program In Women's Services, Dinez Diamond Esmail

Walden Dissertations and Doctoral Studies

Graduate nurses' transition from school to the work place is challenging and often leads to burnout. There was no graduate nurse residency program in women's services at the practicum facility. As a result, this facility had been unable to recruit or hire graduate nurses in the women's services unit. The purpose of this project was to develop a nurse residency program in women's services to address the lack of formal orientation for new graduate nurses at this facility. A graduate nurse residency program will provide further training for nurses to care for a more complicated population of pregnant women. Theoretical …

Professional Development And Self-Efficacy Of Nurses Who Care For Patients Requiring Biocontainment, Denise Occhiuzzo

Walden Dissertations and Doctoral Studies

Increasing global occurrences of highly infectious, easily transmissible diseases unfamiliar to nurses affect the learning environment and the required skill set for professional nurses. The global threat of Ebola Virus Disease and other high-risk diseases requiring biocontainment necessitates competency in the management of complex patient needs, while ensuring safety measures that prevent spread of the potentially fatal disease. Guided by Bandura's social cognitive theory, this quantitative correlational study addressed the relationships between nurses' professional characteristics and their perceived self-efficacy when providing care to highly infectious patients requiring biocontainment. A full census of 92 nurses was used to recruit participants from …

Low Health Literacy And Preoperative Instruction Compliance Among Patients Undergoing Surgical Procedures, Mariefel Casino Paqueo

Walden Dissertations and Doctoral Studies

In addition to cancelations and delays of needed surgical procedures, serious or fatal complications can occur when patients with low health literacy do not comply with preoperative instructions. The purpose of this quality improvement project was to provide more insight about ways to decrease on cancelled and delayed surgical procedures in low health literacy patients' due to noncompliance with preoperative fasting instructions. The project was informed by the reach, effectiveness, adoption, implementation, and maintenance model (King, D. K., Glasgow, R. E., and Leeman-Castillo, B. (2010). The project question centered on whether health literate preoperative fasting instructions could decrease cancellations and …

An Assessment Of Heart Failure Screening Tools For An Outpatient Arrhythmia Devices Clinic, Lucy Joanne Paul

Walden Dissertations and Doctoral Studies

People living with heart failure (PLHF) should be screened for symptoms at every

healthcare visit since they are 3 times more likely to experience ventricular arrhythmias. This quality improvement project (QIP) compared 3 self-administered HF symptoms questionnaires to determine the best screening tool for a tertiary hospital arrhythmia devices clinic. The instruments included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Kansas City Cardiomyopathy Questionnaire (KCCQ), and the Self-Reported Heart Failure Symptoms (SHEFS) questionnaire. For a 30-day period, 76 people were eligible to participate in the QIP, with 55 participants included in the final analysis (72.5% participation). The questionnaires …

Effects Of Authentic Leadership Style And Nurse Engagement On Patient Satisfaction, Kimberly Dawn Washburn

Walden Dissertations and Doctoral Studies

Ineffective leadership and disengaged nurses reduce the quality of care and patient satisfaction in healthcare organizations. Healthcare leaders can benefit from understanding the factors that improve leadership ability and nurse engagement to improve healthcare outcomes. The purpose of this correlational study was to examine the relationship between the demonstration of authentic leadership characteristics and nurse engagement. The study's population comprised acute care registered nurses in a rural hospital in central Washington State. Authentic leadership theory and engagement theory constituted the theoretical framework. Independent variables were the 4 constructs of authentic leadership theory, self-awareness, balanced information processing, relational transparency, and internalized …

Developing An Educational Module On Compassion Fatigue, Francisca Chinyere Hennes

Walden Dissertations and Doctoral Studies

Compassion fatigue is viewed as a disconcerting issue facing healthcare professionals in the clinical care milieu, and nurses are identified as the most susceptible population among healthcare professionals. The purpose of this project was to create positive social change by helping oncology nurses find ways to enhance self-care and self-awareness, thereby reducing the risk of compassion fatigue and burnout among healthcare professionals. This project investigated an educational module on compassion fatigue that focused on (a) identifying the occurrence rates of compassion fatigue among oncology nurses, (b) evaluating the demographic features that were associated with the most frequent rates of compassion …

Impact Of Nursing Certification On Patient Perception, Satisfaction, And Outcomes, Rodney Baccus

Walden Dissertations and Doctoral Studies

Increased responsibilities for patient care within the nursing profession leads one to examine the correlation between nursing care and patient satisfaction. Current evidence indicates that higher levels of nursing education are associated with better patient outcomes. The literature further demonstrates that increased expertise and certification within a nursing specialty leads to increased nursing empowerment, improved intrinsic value and better collaborative relationships. However, the relationship between certification status and patient satisfaction remain unclear. This systematic review sought to understand the relationship between nursing certification and patient satisfaction. Guided by Rogers' diffusion of innovation theory this project examined the peer-reviewed literature using …