Nursing Commons^™

A Delphi Survey Of Leadership Attributes Necessary For National Nurse Leaders’ Participation In Health Policy Development: An East African Perspective, Nilufa Jivraj Shariff

School of Nursing & Midwifery, East Africa

Background: Nurses’ involvement in health policy development ensures that health services are: safe, effective, available and inexpensive. Nursing history reveals several legendary nurse leaders who have influenced policy and the course of nursing and health care. In the recent times there have been concerns regarding the availability of effective leaders physically, symbolically and functionally at clinical, organizational and national levels, who can effectively influence health policy. Exerting influence in the policy arena requires that nurse leaders acquire attributes that enable them to be effective in policy development activity.

This paper reports part of a larger study whose purpose included: “build …

Infectious Disease Outbreaks And Increased Complexity Of Care, Joan Musau, A. Baumann, C. Kolotylo, T. O’Shea, A. Bialachowski

School of Nursing & Midwifery, East Africa

Aim: This study examined the effects of healthcare-associated infectious disease outbreaks on nurses’ work in a large acute care hospital in Ontario, Canada.

Background: The incidence of healthcare-associated infections has increased. Previous research focuses on epidemiology, healthcare systems, and the economic burden of outbreaks. Few published studies focus on the impact of outbreaks on nurses’ work in acute care facilities.

Introduction: Since the severe acute respiratory syndrome epidemic in 2003, combating infectious diseases has become a key issue. Hospitals have implemented measures related to healthcare-associated infections. However, nurses experience challenges in preventing, controlling, and contending with outbreaks.

Methods: A retrospective …

Knowledge And Attitudes Of Select Ugandan Nurses Towards Documentation Of Patient Care, Grace Nakate, Diane Dahl, Karen B. Drake, Pammla Petrucka

School of Nursing & Midwifery, East Africa

Ideally through documentation, nurses track changes in a patient’s condition, make decisions about needs, and ensure continuity of care. However, nursing documentation has often not met these objectives. In Uganda, the systematic nursing specific approach is not reflected in documentation of nursing care. A mixed methods intervention study was conducted to determine knowledge and attitudes of nurses towards documentation, including an evaluation of nurses’ response to a designed nursing documentation form. Forty participants were selected through convenience sampling from six wards of a Ugandan health institution. The study intervention involved teaching nurses the importance of documentation and using of the …

Psychobiobehavioral Model For Preterm Birth In Pregnant Women In Low- And Middle-Income Countries, Shahirose S. Premji, Ilona S. Yim, Aliyah Dosani (Mawji), Zeenatkhanu Kanji, Salima Sulaiman, Wangira Musana, Pauline Samia, Kiran Shaikh, Nicole Letourneau

School of Nursing & Midwifery, East Africa

Preterm birth (PTB) is a final common outcome resulting from many interrelated etiological pathways; of particular interest is antenatal psychosocial distress (i.e., stress, anxiety, and depression). In LMI countries, both exposure to severe life stressors and rate of PTB are on average greater when compared with high-income countries. In LMI countries women are exposed to some of the most extreme psychosocial stress worldwide (e.g., absolute poverty, limited social resources). High prevalence of antenatal stress and depression have been observed in some studies from LMI countries. We propose a psychosocial, biological, and behavioral model for investigating the complex multisystem interactions in …

Perceptions Of Patients Regarding Quality Nursing Care (Qnc) At A Tertiary Hospital In Karachi, Pakistan, Ayyub Rehan, Zeenatkhanu Kanji, Dias J., Roshan R.

School of Nursing & Midwifery, East Africa

Background: Patients’ experiences regarding the quality of care continue to be a hot topic of discussion in the healthcare industry. Exploring the quality of nursing care from the patients’ perspectives is a vital element of quality evaluation. The purpose of this study was to explore the patients’ perspectives regarding quality nursing care.

Methodology: A qualitative descriptive exploratory design was used. A total of twelve participants were recruited from one medical and one surgical unit at a tertiary care hospital in Karachi, Pakistan. Purposive sampling was used to select the participants. Data was collected through semi-structured interviews. A thematic analysis approach …

Pedagogy And Culture: An Educational Initiative In Supporting Uae Nursing Graduates Prepare For A High-Stakes Nurse Licensing Examination, Sharon Brownie, Ged Williams, Kate Barnewall, Suzanne Bishaw, Jennifer L. Cooper, Walter Robb, Neima Younis, Dawn Kuzemski

School of Nursing & Midwifery, East Africa

Graduates of an Abu Dhabi transnational nursing degree struggled with the mandatory national licensing examination. Poor pass rates undermine graduate career futures and impact on the workforce capacity building contributions of the partnering transnational educational providers. This paper describes how the design and delivery of an intensive examination preparation program dramatically reversed this trend. The objectives of this educational initiative involved the design, delivery and evaluation of a program that would align with cultural learning preferences and which improve the success rates of graduates attempting the national nurse licensing examination. To achieve these objectives, the program combined a range of …

The Changing Role Of Nursing: Opportunities For Nurse-Led Services For The Management Of Chronic Disease And Diabetes In The Uae, Sharon Brownie

School of Nursing & Midwifery, East Africa

There is little debate that current and future healthcare is, and will continue to be, dominated by the prevention and management of increasingly complex chronic health disease; the UAE is no exception. Preventive and disease management services directed at groups and individuals at risk of unfavourable health outcomes are core to the make-up of an effective health system. The burden of noncommunicable, chronic and diabetes-related diseases places a heavy strain on health service cost and service delivery requirements. The UAE is faced with the challenge of identifying and developing effective strategies for the prevention and management of the burgeoning prevalence …

Birth Preparedness And Complication Readiness – A Qualitative Study Among Community Members In Rural Tanzania, Furaha August, Andrea B. Pembe, Edmund Kayombo, Columba Mbekenga, Pia Axemo, Elisabeth Darj

School of Nursing & Midwifery, East Africa

Background: Birth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR.

Design: A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used …

Exploring Unprotected Anal Intercourse Among Newly Diagnosed Hiv Positive Men Who Have Sex With Men In China: An Ethnographic Study, Haochu Li, Eleanor Holroyd, Joseph Lau

School of Nursing & Midwifery, East Africa

Background: Unprotected anal intercourse (UAI) is a major pathway towards secondary HIV transmission among men who have sex with men (MSM). We explored the socio-cultural environment and individual beliefs and experiences conducive to UAI in the context of Southern China.

Methods: We employed an ethnographic approach utilizing a socio-ecological framework to conduct repeated in-depth interviews with thirty one newly diagnosed HIV positive MSM as well as participant observations in Shenzhen based healthcare settings, MSM venues and NGO offices.

Results: Some men (6/31) reported continuing to practice UAI after an initial diagnosis of being HIV positive. For MSM who had existing …

Stigma, Subsistence, Intimacy, Face, Filial Piety, And Mental Health Problems Among Newly Hiv-Diagnosed Men Who Have Sex With Men In China, Haochu (Howard) Li, Eleanor Holroyd, Joseph Lau, Xiaoming Li

School of Nursing & Midwifery, East Africa

High rates of mental health problems among people living with HIV (PLWH) have been widely reported in the literature; however, an understanding of the socioecological contexts of these presentations remains limited, particularly in China. In order to explore potential socioecological factors associated with mental health problems among newly diagnosed HIV-infected migrant men who have sex with men (MSM), we employed a life profile approach conducting semistructured in-depth interviews with 31 newly diagnosed HIV-infected MSM residing in a city in Southern China. Participants’ life profile accounts outlined their concerns, including internalized stigma, subsistence living, difficulties finding a lover or a stable …

Exploring The Relationships Between Mindfulness And Biobehavioral Factors Associated With Cvd In Women, Susan Ghodrat, Jo Lynne W. Robins

Undergraduate Research Posters

Purpose: This study examined the relationship between mindfulness and specific biobehavioral factors associated with increased cardiovascular disease risk in women. Design: A secondary data analysis was conducted on baseline data collected in a larger study examining the effects of tai chi on cardiovascular disease risk in women. Subjects: 96 women aged 35-50 years with increased waist circumference and a family history of cardiovascular disease. Measures: Biological measures included: fasting glucose, insulin and lipids, as well as C-reactive protein and cytokines. Behavioral measures included: mindfulness, fatigue, perceived stress, depressive symptoms, social support, self-compassion and spiritual thoughts and behaviors. Results: Mindfulness was …

Rapid Response Teams Versus Critical Care Outreach Teams: Unplanned Escalations In Care And Associated Outcomes, Valerie Danesh

Electronic Theses and Dissertations

The incidence of unplanned escalations during hospitalization is undocumented, but estimates may be as high as 1.2 million occurrences per year in the United States. Rapid Response Teams (RRT) were developed for the early recognition and treatment of deteriorating patients to deliver time-sensitive interventions, but evidence related to optimal activation criteria and structure is limited. The purpose of this study is to determine if an Early Warning Score-based Critical Care Outreach (CCO) model is related to the frequency of unplanned intra-hospital escalations in care compared to a RRT system based on staff nurse identification of vital sign derangements and physical …

Impact Of Interruption Frequency On Nurses' Performance, Satisfaction, And Cognition During Patient-Controlled Analgesia Use In The Simulated Setting, Kristi Campoe

Electronic Theses and Dissertations

Problem: Interruption during medication administration is a significant patient safety concern within health care, especially during the administration of high risk medications in nursing. Patient-controlled analgesia (PCA) devices are frequently associated with adverse events and have a four-fold increased risk of patient injury compared to non-PCA related adverse events. While the nature and frequency of interruptions have been established for nurses* medication processes, the impact of interruption frequency on nurses* PCA interaction has not been fully measured or described. Purpose: The purposes of this study were to quantify the impact of interruption frequency on registered nurses* (RN) performance, satisfaction, and …

Family Care Giver Knowledge, Patient Illness Characteristics, And Unplanned Hospital Admissions In Older Adults With Cancer, Patricia Geddie

Electronic Theses and Dissertations

Unplanned hospital admissions (UHA) in older adult populations are a recurring problem in older adults with cancer. Older adults comprise approximately 60% of cancer diagnoses and receive the majority of cancer treatment. However, little is known about why older adults under treatment for cancer experience a high number of unplanned hospital admissions. A review of the literature provided few study findings and a gap in the current knowledge was identified regarding the factors associated with unplanned hospital admissions in older adults under treatment for cancer. A conceptual framework based on the literature and this researcher's clinical experienced guided this study. …

Nurse Managers, Work Environment Factors And Workplace Bullying, Joy Parchment

Electronic Theses and Dissertations

The purpose of this dissertation is to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of nurse managers in acute care settings across the United States. Over 30 years of workplace bullying research exists. Consequences are linked to intent to leave, turnover, and harmful emotional and physical effects. Published studies identifying nurse managers as targets of workplace bullying and work environment factors that contribute to nurse managers being recipients of workplace bullying either, downward from their leaders, horizontally from their nurse manager peers, and upwards from their clinical nurses were not identified. …

Flipping The Classroom To Teach Population Health: Increasing The Relevance., Vicki Simpson, Elizabeth Richards

School of Nursing Faculty Publications

In recent years, there have been multiple calls to enhance the population health and health promotion aspects of nursing programs. Further impetus has been provided by passage of the Affordable Care Act in 2010 with its focus on prevention. The need to develop students who can critically think and apply knowledge learned is crucial to the development of nurses who can integrate and apply the concepts of population-focused practice in society and a healthcare system undergoing transformation. This coupled with the ever changing needs of learners requires a different approach to content delivery and presentation. Flipped classroom courses, with an …

Diffusion Of Innovations Of Videoconference Technology: An Instrumental Case Study Concerning Undergraduate Degree-Seeking Nontraditional Learners, Bruce G. Campbell

Theses and Dissertations

This applied dissertation is an instrumental case study based on diffusion of innovations theory designed to gather student opinions regarding videoconference (VC) technology use in facilitating courses to undergraduate degree-seeking nursing students. The author of diffusion of innovations theory, Rogers (2003), recommended that more qualitative studies be conducted in education. Rogers and Jain (1968) recommended these studies should be conducted from the aspect of “receivers of innovation diffusion” (p.1) to provide feedback instrumental to implementation of technological innovations in academe. Further, Rogers stated that multiple data points should be used during the process of trialing an innovation. Therefore, a current …

"A Compromise To Help The Community": Rural Sexual Assault Nurse Examiner Experiences, Rebecca R. Gonnering

All Graduate Theses, Dissertations, and Other Capstone Projects

Victims of sexual assault require specialized medical care when they report to hospital emergency departments including physical examination, evidence collection, and emotional support. Sexual Assault Nurse Examiners (SANEs) are medical professionals trained to complete the examination and evidence collection in a prompt and sensitive manner. In fact, where SANE programs exist, emergency room waiting times are shorter, evidence collection improves, and revictimization from untrained staff is reduced. Unfortunately, SANEs are not widely available, particularly in rural areas. This lack of trained examiners employed at local hospitals creates a gap in access to proper care, often resulting in long waits as …

The Effect Of Breastfeeding Self-Efficacy On Breastfeeding Initiation, Exclusivity, And Duration, Adria Vincent

Walden Dissertations and Doctoral Studies

Breastfeeding self-efficacy is considered one of the key components of a successful breastfeeding experience. The benefits of breastfeeding are well established in the literature and have been widely communicated to the public, resulting in an increasing trend of breastfeeding initiation. However, the United States still falls short of Healthy People 2020 breastfeeding goals. The purpose of this project was to examine the effects of a standardized hospital-based prenatal breastfeeding class on breastfeeding self-efficacy. Dennis's breastfeeding self-efficacy theory was the foundation for the breastfeeding self-efficacy tool used in this project. A quasi-experimental design used a convenience sample of 30 breastfeeding class …

Racism Vs. Social Capital: A Case Study Of Two Majority Black Communities, Bruce W. Strouble

Walden Dissertations and Doctoral Studies

Several researchers have identified social capital as a means to improve the social sustainability of communities. While there have been many studies investigating the benefits of social capital in homogeneous White communities, few have examined it in Black homogeneous communities. Also, there has been limited research on the influence of racism on social capital in African American communities. In this dissertation a comparative case study was used within a critical race theory framework. The purpose was to explore the role of racial oppression in shaping social capital in majority African American communities. Data were collected from 2 majority Black communities …

Laying The Foundation For New Approaches In Evidence-Based Sex Education Curriculum Programs: A Family Life Policy Change, Rina Marie Prosser

Walden Dissertations and Doctoral Studies

The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the …

Educational Intervention To Impact Parental Decisions To Consent To Human Papillomavirus Vaccine, Tawa Bimbola Ibikunle-Salami

Walden Dissertations and Doctoral Studies

Educational Intervention to Impact Parental Decisions to Consent to Human Papillomavirus Vaccine

by

Tawa B. Ibikunle-Salami

MSN, Indiana Wesleyan University, 2010

BSN, Indiana Wesleyan University, 2005

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

September 2015

Human Papillomavirus (HPV) is a global health issue that is transmitted sexually and affects both genders. Evidence shows that approximately 79 million people are affected in the United States with 14 million newly affected yearly. The Centers for Disease Control and Prevention indicates that teens and young adults under age 25 are at particular …

Nclex-Rn Predictor Test Scores And Nclex-Rn Success, Annie Ruth Grant

Walden Dissertations and Doctoral Studies

Health care professionals and nurse educators are concerned about increasing percentage of first time test takers failing the NCLEX-RN exam. The purpose of this retrospective study was to examine predictive accuracy of the Assessment Technologies Institute (ATI) RN Comprehensive Predictor for passing or failing the NCLEX-RN exam in a cohort of nursing students (N = 195). South Eastern Technical College in South Carolina is in jeopardy of losing accreditation for their nursing program because of the low percentage of first time test takers failing. The college's pass rate on the NCLEX-RN exam has been below the national and state averages …

Transforming Vulnerable Interactions To Effective Communication: An Application Of Evidence For The Tele-Intensive Care Unit Nurse, Bethann Mendez

Walden Dissertations and Doctoral Studies

Tele-intensive care collaboration in care of critically ill patients improves both the safety and quality of nursing care. However, the full benefits of the telemedicine service may not be realized unless tele-critical care nurses have the ability to communicate clearly with their remote nursing peers. The purpose of this DNP project was to create and validate an acronym style communication tool to assist the tele-critical care nurses with their communication. The relational coordination theory was the primary communication theory utilized for tool development. The tool creation phase of the project included informal observations and discussion with a convenience sample of …

Conducting A Needs Assessment At Outpatient Medical Clinic, Fidelia Ijeuru Ukah

Walden Dissertations and Doctoral Studies

Colorectal cancer is one of the most common cancers in the United States and confronting its challenges has remained a problem to the United States health sector, especially among outpatient clinics. Guided by health belief model, the purpose of this needs assessment was to identify patients age 50 and older in outpatient clinic located in a large metropolitan city in Texas who should receive information on the need for colorectal cancer screening based on their risk for developing colorectal cancer as outlined by American Cancer Society. A sample of 70 charts of patients age 50-75 years was randomly selected and …

The Effects Of A Concept-Based Curriculum On Nursing Students' Nclex-Rn Exam Scores, Patricia Allen Edwards

Walden Dissertations and Doctoral Studies

The Institute of Medicine and the National League of Nursing have called for curricular reform that promotes high first-time pass rates on the National Counsel of Licensure Examination for Registered Nurses (NCLEX-RN). A campus in the southeastern region of the United States implemented a concept-based curriculum; however, the effect on the first-time NCLEX-RN pass rates was unknown. The purpose of this comparative study was to determine if the concept-based curriculum improved student scores on the NCLEX-RN. Dreyfus' model of learning guided this study because of the andragogy tenets, which in turn supported the concept-based curricula. The research questions examined the …

Implementing An Evidence-Based Educational Module On Nurses' Role On Management Of Postpartum Hemorrhage, Stella Motanya

Walden Dissertations and Doctoral Studies

Postpartum hemorrhage is the second leading cause of maternal death in the United States. According to American College of Obstetricians and Gynecologists, postpartum hemorrhage is an obstetric emergency. Between 2012 and 2013, a medical facility reported 369 postpartum hemorrhages, a 4.7% increase from previous years. It is important to address this practice issue because postpartum hemorrhage can lead to maternal mortality. The purpose of this project was to increase staff nurses' awareness and knowledge of their role on the management of postpartum hemorrhage. The outcome of the project paper was implementation of an educational module on postpartum hemorrhage at this …

Alarm Safety In A Regional Neonatal Intensive Care Unit, Piper Probst

Walden Dissertations and Doctoral Studies

Alarm fatigue is a practice problem that applies to hospitalized patients and the nurses who care for them. Addressing alarm fatigue is important to promote alarm safety and to decrease the risk of patient harm or death. The purpose of this study was to decrease alarm fatigue and improve alarm safety in a regional neonatal intensive care unit (RNICU). Guided by the conceptual model for alarm fatigue and alarm safety, this study addressed whether or not alarm management protocols designed to decrease false and nuisance alarms in the physiological monitoring of neonates improve alarm safety via decreased alarm burden and …

Strategies To Prevent The Unintentional Retention Of Foreign Objects In Surgical Patients, Leonard Harichand Ramdas

Walden Dissertations and Doctoral Studies

The Institute of Medicine's report in 2000, To Err Is Human: Building a Safer Health

System, highlighted the seriousness of medical errors in the U.S. health care system. The unintentional retention of foreign objects in surgical patients is one of those errors. At the time of this study, there was no standardized counting policy and process across operating rooms in the United States. The purpose of this project was to develop a best practice educational counting program to help prevent the unintentional retention of foreign objects in surgical patients. The Logic Model was used to guide the design of the …

Development Of Mentors To Facilitate Evidence-Based Practice In A Nurse Residency, Susan Annette Breit

Walden Dissertations and Doctoral Studies

Evidence-based practice has resulted in better patient outcomes, higher patient satisfaction, and effective patient-centered care. Leadership of a large teaching hospital determined that new nurses lacked the education and experience to design and implement an evidence-based project at the bedside, which was an expected outcome for completion of the established nurse residency program. The purpose of this project was to develop a design-only project in which Masters of Science in Nursing-prepared mentors were added to the residency program to establish the required evidence-based project. A mentor workshop was developed to guide the mentors in this role using Benner's novice to …