Nursing Commons^™

Incorporating Ada Best Practice Guidelines In Electronic Medical Records To Improve Glycemic Management In Hospitals, Jennifer Claudette Benjamin

Walden Dissertations and Doctoral Studies

Aggressive management of diabetes using American Diabetes Association (ADA) best practice guidelines in hospitalized patients reduces morbidity and mortality. Inpatient electronic medical records systems improve care in chronic diseases by identifying care needs and improving the data available for decision making and disease management. The purpose of this quality improvement project was to evaluate the impact of ADA best practice guidelines of glycemic management once they have been entered into the electronic medical record (EMR) of hospitalized diabetics. Kotter's organizational change process guided the project. The project question investigated whether nurses' use of ADA Best Practice Guidelines incorporated into the …

Communication Skills Of Novice Psychiatric Nurses With Aggressive Psychiatric Patients, Rose Moss

Walden Dissertations and Doctoral Studies

Communication Skills of Novice Psychiatric Nurses with Aggressive Psychiatric Patients

by

Rose L. Moss

MS, University of Hartford, 1996

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

March 2015

The transition from novice nurse to a competent psychiatric staff nurse is often associated with major communication challenges, primarily when caring for aggressive patients. Guided by Peplau's theory, this quantitative study assessed the communication skills of novice psychiatric nurses (N = 25) who worked 24 months or less in the state psychiatric hospital with aggressive psychiatric patients. Additionally, certain demographic data …

Meaningful Use Of Electronic Medical Recording To Improve Diabetic Treatment Compliance Of American Diabetic Association Treatment Standards, Tamara Ann Parrish

Walden Dissertations and Doctoral Studies

Diabetes affects approximately 10% of the American population with an annual expenditure of approximately $174 billion dollars. The utilization of electronic medical records (EMR) combined with the meaningful use (MU) initiative may ensure that diabetic patients receive the recommended preventative care. Dorthea Orem's self-care deficit theory and the transtheoretical model of behavior change was utilized to design this quality improvement project. Medical professionals at a small private practice received education on American Diabetic Association (ADA) treatment standards and how to use the EMR system to track patients receiving the recommended diabetes care. The project question examined the effectiveness of provider …

Interpersonal Safety Of Active Duty Women In The Deployed Environment Of Bagram Afghanistan, Cynthia Tara Ferguson

Walden Dissertations and Doctoral Studies

In the United States Armed Forces, 30% of women in the military suffer physical assault each year; in 2009, there were 22 reported cases of sexual assault in the U.S. Central Command. Aggravated assault, gang violence, sexual assault, homicide, and suicide can damage the morale of military personnel at a deployed site and collectively cost millions of dollars over time. Interpersonal violence in the United States military is destructive to the military system and directly diminishes mission readiness. This study was designed to illuminate the environmental, cultural, and political influences that affect interpersonal safety among military women in the deployed …

The Creation Of A Pacemaker Clinic At A Federally-Funded Patient-Centered Medical Home: A Quality Improvement Project, Tony Anno

Walden Dissertations and Doctoral Studies

It is common for clinicians to implant medical devices, such as permanent pacemakers and implantable defibrillators, for cardiac diseases. These medical devices require follow-up care at regular intervals to ensure proper device function and optimal outcomes. Currently, many individuals without insurance or financial resources lack access to recommended follow-up care after implantation of a cardiac device. The purpose of this project was to determine the number of individuals who have had a medical device implanted without insurance coverage over a 3-year period, and then to establish a clinic that provides this service. The standard of care and operating procedure for …

Factors Contributing To Loss Of Nursing Intellectual Capital, Vera Ligia Grover

Walden Dissertations and Doctoral Studies

In a Level II trauma center, experienced nurses are retiring from nursing positions, which is causing an unstable workforce. According to the literature, there are not enough experienced nurses to mentor the new nurses. Evidence suggests that experienced nurses are associated with improved patient outcomes and that experienced nurse mentors can improve the work environment for less experienced nurses. Focusing on Watson's theoretical framework of caring and Covell's theoretical framework of intellectual capital, this phenomenological study explored the lived experiences of a small group of nurses. Five nurses with 15 years of experience and who had served as mentors were …

Development Of An Evidence-Based Nursing Orientation Program For A Community Health System, Janet Brooke Cuddy

Walden Dissertations and Doctoral Studies

Through discussion with the community health system's administration, it was identified that their current nursing orientation program was not well structured or comprehensive. The nursing staff also reported dissatisfaction with the current program. Therefore, a Doctor of Nursing Practice project commenced to develop an evidence-based nursing orientation program for Registered Nurses (RN) and Licensed Practical Nurses (LPN) at a community health system in Virginia. The Competency Outcomes Performance Assessment model guided development of the project through a comprehensive literature review to identify evidence-based data for competencies, learning strategies, and performance evaluations. This review highlighted the importance and benefits of nursing …

Nurses Knowledge, Skills, And Attitude Toward Electronic Health Records (Ehr), Sharon L. Adams

Walden Dissertations and Doctoral Studies

Information technology (IT) has been rapidly integrated into the healthcare industry, including nursing, and has the ability to reduce errors, cut cost, and enhance patient care. However, approximately 45% of the current nurse workforce lacks adequate training in computer skills, which may hinder the adoption of health-related IT in the workplace. Characteristics of Rogers's diffusion of innovation (relative advantage, compatibility, complexity, trialability, and observability) guided this project. This project was conducted to address the problem of IT adoption on a local level and was designed to assess whether simulation training on a generic electronic health record (EHR) system would improve …

Quality Improvement To Increase Nurse Knowledge On Nursing Informatics Project Management Standards, Elizabeth J. Fleischer

Walden Dissertations and Doctoral Studies

When an inexperienced nurse project manager is assigned to serve as a project manager for health information technology (HIT) tools, there is increased risk the project will not be completed on time, within budget, and in scope. An identified business need at a large military treatment facility was an educational tool to bridge the gap between nursing informatics and project management. The scholarly project was a Nursing Informatics Project Management Guidebook, which served as an educational tool to increase nurses' knowledge to serve in the HIT project manager role. With a quality improvement methodology, the outcome and impact sequence logic …

Improving Attitudes And Perceptions About Teamwork Among Health Care Professionals With A Teamstepps Approach, Tetsuya Umebayashi

Walden Dissertations and Doctoral Studies

Effective communication among health care professionals is essential for the provision of quality patient-centered care; however, effective communication practices are not guided by evidence-based models in many health care organizations. The Joint Commission has estimated that most sentinel events are induced by miscommunication among health care professionals. The problem addressed in this project was poor and ineffective teamwork skills and general communication among health care professionals and a lack of formal models to guide effective communication among the healthcare team. The purpose of the project was to adapt TeamSTEPPS to an institutional context in order to improve health care team …

Guest Editorial, K Ramnarayan Dr

Manipal Journal of Nursing and Health Sciences

No abstract provided.

The Impact Of Scheduled Meal Breaks On Icu Nurses, Ericka L. Privitt

Doctor of Nursing Practice (DNP) Practice Innovation Projects

The goal of this practice improvement project was to evaluate the impact of scheduling meal breaks for intensive care unit nurses at a Midwestern hospital. A literature review identified stress a main source for burnout and the nursing shortage. Recommendations for the creation of a healthy work environment were found and a program to schedule meal breaks was implemented over a nine week period. The Meal Break Impact Survey was utilized to gather pre and post-survey data. The following data was collected on the Meal Break Impact Survey: (a) demographics; (b) questions in Likert scale response on availability, access, beliefs, …

The Male Army Nurse Corps Officer Experience In The Vietnam Conflict, John P. Pelletier

MUSC Theses and Dissertations

Background: A considerable amount of research has been conducted on the wartime experiences of female nurses who served in the Vietnam conflict and as a result, much is known about their experiences and the impact that their service had on their personal and professional lives. The same, however, is not true for male nurses. Anecdotal evidence suggests that the experiences of male Army Nurse Corps (ANC) Officers may have been substantially different from that of their female colleagues, thus making the impact of the experience on them potentially different. Overall Objective: This study explores and interprets the lived experiences of …

Interaction And Cognitive Engagement In Online Discussions In Professional Development Leadership And Management Course At A Private Nursing Institution, Nimira Asif, Samina Vertejee, Sharifa Bashir Lalani

School of Nursing & Midwifery

In the Post RN BScN curriculum, one of the courses “Professional Development and Leadership (PDLM)” was offered as blended mode for the first time. In order to explore the students’ interactions and Cognitive Engagement (CE) in Online Discussion Forums (ODFs), the research team conducted a retrospective study for the first time at a private nursing institution of Karachi-Pakistan. The study was conducted by utilizing the retrospective qualitative paradigm of discourse analysis to understand student’s CE in ODFs. The study has addressed the following one main and three subsidiary research questions: How do threaded discussions (in the part of online forums) …

Academic And Non-Academic Variables As Predictors Of Nclex-Rn Success Among Traditional Associate Degree Students At Southern Adventist University, Christine Moniyung

Dissertations

Problem

The School of Nursing at Southern Adventist University offers both Associate of Science and Bachelor of Science in nursing degrees. A majority of the students who sit for the NCLEX-RN are associate of science in nursing graduates. The pass rate dropped from 94.9% in 2010 to 88.8% in 2011. The pass rate went up to 93.3% in 2012, but dropped again by almost 5% in the following year, and to an all-time low of 76.5% in 2014.

Unlike most AS nursing program student populations in the nation, the majority of SAU students are young and considered traditional-age college students. …

A Faith-Based Primary Diabetes Prevention Intervention For At-Risk Puerto Rican Adults: A Feasibility Study, Sylvia Torres-Thomas

Electronic Theses and Dissertations

Diabetes is a serious health threat that disproportionately affects Hispanics of Puerto Rican heritage. Current evidence supports diabetes prevention programs to change health behaviors in people who are at risk and thus prevent the development of type 2 diabetes. However, few interventions exist for Hispanics, and even fewer have been designed for Puerto Rican adults. A literature review of community-based diabetes prevention programs involving at-risk Hispanics was conducted using a cultural sensitivity framework to determine the state of the science and identify gaps in knowledge regarding diabetes prevention for Puerto Ricans. An integrated theoretical framework was developed using constructs from …

Influence Of Maternal Prior Life Adversity On The Psycho-Neuroendocrine-Immune Profile During Pregnancy, Karen J. Kotz

Dissertations

Pregnancy is accompanied by a multitude of physical and psychological changes. Adaptation to these changes through reduced anxiety and attenuated stress responsiveness is necessary across gestation and into the postpartum period for optimal maternal-infant health. In contrast, exposure to higher amounts of stressors during pregnancy can disrupt neuroendocrine-immune processes required for successful pregnancy outcomes. Evolving evidence demonstrates that exposure to adversity early in life has long-lasting effects on stress response systems that alter stress reactivity during adulthood. Given this evidence, it is posited that women who experience greater pre-pregnancy adversity during their childhood are at greater risk for negative maternal-infant …

Incontinence And Skin Integrity In Immobile Populations, Frederick Green, Alyssa Starr

Nursing Student Work

No abstract provided.

Vcuhs Inquiry Process Diagram, Roy E. Brown, Dale Wright, Vcuhs Ebp Translation Committee

VCU Libraries Faculty and Staff Publications

This diagram outlines the nursing inquiry process when it comes to answering questions that arise in the clinical setting. The diagram shows how a nurse proceeds through the process and when the question is answered though either a evidence based practice project (EBP), a performance improvement (PI) project or when it becomes a research project.

Depressive Symptoms And Violence Exposure: Contributors To Repeat Pregnancies Among Adolescents, Cheryl Ann Anderson

Nursing Faculty Publications & Presentations - Archive

Depressive symptoms and violence exposure (VE) often cooccur and have been recognized to influence childbearing; contribution to repeat pregnancy is unclear and examined in this article. This cross-sectional, descriptive, study screened for depressive symptoms and VE among 193 adolescent mothers at a large county hospital in Southwestern United States. Repeat pregnancy and depressive symptoms characterized one-third and one-quarter of adolescents, respectively. Despite minimal disclosure of VE, repeat pregnancy was significantly influenced by child abuse and past traumatic life experiences. Assessments and interventions with adolescents should focus on frequency of repeat pregnancies and symptoms of depression and VE. Nurses and childbirth …

A Narrative Analysis Of Women's Adaptation Following Sexual Assault, Debra Hurd

Nursing Dissertations - Archive

Sexual assault against women violates every area of their lives: safety, security, physical health, and social status. Available evidence is inadequate to guide interventions to promote effective adaptation following assault. No studies have been found specifically on sexual assault of women from the perspective of the affected woman. The purpose of this study was to describe the narratives and coping strategies of women who have been sexually assaulted. The study questions and analysis were framed using Roy's Adaptation model. Narrative analysis was the research design used to examine stories of the women's experiences after sexual assault and how the women's …

Measuring The Direct Nurses' And Nurse Leaders' Perceptions Of A Healthy Work Environment Within Acute Care Settings, Penny Susette Huddleston

Nursing Dissertations - Archive

Healthy work environments (HWEs) have been described as policies, procedures, and processes designed to empower nurses to meet the organizational objectives and achieve personal satisfaction in the work environment (American Association of Critical-Care Nurses, 2005; Lake, 2007; Schmalenberg & Kramer, 2008; Shirey, 2006). Unhealthy work environments (UWEs) throughout healthcare organizations have been linked to absenteeism, ineffective delivery of healthcare to patients and families, higher stress levels, poor communication, and ineffective collaboration and teamwork among healthcare professionals (Heath, Johanson, & Blake, 2004). The American Association of Critical-Care Nurses (AACN) developed a Healthy Work Environment Assessment Tool (HWEAT) for nurses to use …

Increasing Drug Screens And Prescription Drug Monitoring Program Assessments For Patients Enrolled In Opioid Replacement Therapy, Kimberly Thompson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Opioid use disorder is an epidemic that has a devastating impact on public health, morbidity and mortality, and the escalating economic burden of healthcare (U.S. Department of Health & Human Services, 2013). The rates of prescriptive and nonprescriptive opioid misuse are on the rise (Compton, Boyle, & Wargo, 2015). One approach in managing opioid use disorder is opioid replacement therapy (ORT). In response to increasing rates of opioid use disorder, the Drug Addiction Treatment Act of 2000 permitted "qualifying physicians" to treat opioid use disorder in an office-based setting. The FDA approved medication buprenorphine, a partial opioid agonist, is used …

The Relationship Between Faith-Based Support And Physical Activity Levels Among African American Women In Faith Communities, Sharon Taylor Johnson

Nursing Dissertations - Archive

Physical inactivity is the fourth leading risk factor for death worldwide, and is a major contributor for a number of chronic diseases such as obesity, type 2 diabetes, hypertension, and cancer in the United States (CDC, 2014; World Health Organization, 2010). This public health problem is more prevalent among African American women who have been diagnosed with chronic health conditions and live sedentary lifestyles. Therefore, identifying strategies that contribute to improving physical activity levels are warranted for this population. The purpose of this study was to examine the relationship between participation in faith-based groups and physical activity levels among African …

Promotion Of Advanced Practice Provider Compliance With The 2012 Surviving Sepsis Campaign Three-Hour Bundle Guidelines In The Emergency Department: A Multi-Component Intervention, Michael Watson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Refer to the document.

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

No abstract provided.

An Evaluation Of The Adherence To An Indwelling Urinary Catheter Maintenance Bundle, Jessica Lynn Johnston

DNP Projects

Background: There are more than 1 million Catheter Associated Urinary Tract Infection (CAUTI) occurrences per year in the United States, with an estimated cost to treat of $400 million dollars annually (Clarke et al., 2013). Urinary Tract Infections are the most common hospital acquired infection, comprising roughly 30 - 40% of all infections occurring in acute care hospitals (Gould et al., 2009). In February of 2013, the University of Kentucky (UK) Hospital made drastic changes to the current Catheter Associated Urinary Tract Infection (CAUTI) prevention standards by instituting a CAUTI Maintenance Bundle to prevent the incidence of CAUTIs.

Purpose …

Assessment Of Migraine Management In Adolescents, Kara L. Scott

DNP Projects

Objective: The purpose of this study is to assess how providers are managing adolescent patients with migraines in Kentucky.

Methods: A cross-sectional descriptive study via a 28-item survey instrument, which is distributed electronically via member listserve to members of the Kentucky Coalition of Nurse Practitioners and Nurse Midwives (KCNPNM).

Results: Of the 35 survey respondents, there were 29 respondents who met criteria for participation in the survey. Respondents reported the most common presenting symptom for adolescent migraine was headache. Over half of the respondents (58.6%) initiated treatment with over-the-counter medications, with ibuprofen (65.5%) being the most commonly used. 62.1% of …

The Relationship Between Stressors And Intent To Leave Nursing Homes Among Directors Of Nursing, Crystal R. Williamson

Journal of Sustainable Social Impact

According to the Centers for Medicare and Medicaid Services, some nursing homes have been ranked worst in the nation when rating the quality of resident care. The purpose of this study was to determine the relative strength of workplace stress, job satisfaction, organizational support, and personal data (number of years employed, age, highest education level) in predicting director of nursing (DON) intentions to leave the position. This information contributes to social change because it is important to know that DONs need to experience general satisfaction in order to maintain stable leadership that positively contributes to the quality of care in …

Comparing Must And The Nri Tools In The Identification Of Malnutrition In Heart Failure Patients, Cassondra D. Degener

DNP Projects

The purpose of this project was to test the performance of albumin, NRI and MUST screening tools in comparison to the standardized measure of prealbumin among HF patients admitted to the University of Kentucky Chandler Medical Center. Inclusion criteria included all HF patients with the 428 diagnostic code, admitted from January 1, - December 31, 2013, ages 18 and older, with all laboratory values available specified in the data collection tool (Appendix A). A retrospective electronic medical record (EMR) review was performed for 100 patients who met the inclusion criteria. All data were collected through the University of Kentucky’s secure …