Nursing Commons^™

The Relationships Among Job Satisfaction, Length Of Employment, And Mentoring Of Nursing Faculty, Zelda Suzan

Walden Dissertations and Doctoral Studies

The shortage of faculty in nursing education programs has been well documented by the National League for Nursing. Job satisfaction is important in retaining nurse educators, and one New York nursing program was interested in examining the potential impact of mentoring on satisfaction. The purpose of this quantitative study was to examine job satisfaction, measured by the Job Descriptive Index/Job in General scale (JDI/JIG), between nurse faculty participants in formal mentoring programs compared to participants receiving an informal type of mentoring. In addition, the length of employment was examined as a possible factor in predicting job satisfaction. The theoretical framework …

The Effectiveness Of An Organizational Hospital-Acquired Pressure Ulcer Prevention Workshop On Pressure Ulcer Prevalence Rates, Stacey Johnson

Walden Dissertations and Doctoral Studies

The goal of this project was to evaluate a hospital acquired pressure ulcer (HAPU) prevention program implemented in a New York City hospital in 2012. The program objective was to encourage collaboration of team members to prevent HAPUs in order to reduce prevalence rates to national target benchmarks. The program provided caregivers information about epidemiology, etiology, prevention, and treatment of HAPUs, and presented HAPU prevention as a collaborative process in order to foster greater awareness in each participant's role as an agent of change by emphasizing the importance of communication between members of the health care team. This project evaluated …

Initiating Nicotine Cessation In A Community Mental Health Center, Rosalind R. Keith

Walden Dissertations and Doctoral Studies

Individuals suffering from mental illness are often adversely affected by tobacco use. Historically, clinicians are reluctant and inadequately prepared to recognize and treat comorbid nicotine addiction in the chronic mentally ill (CMI) client. As evidenced by a review of the literature, healthcare providers are missing opportunities for nicotine cessation treatment. There is a lack of educational preparation amongst clinicians to treat nicotine addition and a concern that treatment of nicotine addiction can negatively impact existing psychiatric disorders. The purpose of this project was to create an educational plan for nicotine cessation for CMI clients at a community health center. The …

Educating Nurses About Spirituality's Effects On Quality Of Life With Chronic Illness, April Gant

Walden Dissertations and Doctoral Studies

Spirituality has been associated with wholeness, inner peace, and key elements of well-being or quality of life. Spirituality support is particularly important for patients with chronic illness and patients who view spirituality as a way of coping with suffering. Evidence-based education is lacking in schools of nursing and in places of nursing employment on spirituality interventions that nurses can use to improve patient quality of life. The purpose of this project was to determine whether an educational intervention would increase knowledge of spiritual care in a small sample of clinic nurses (n = 37). This project used Watson's caring theory, …

An Integrative Review Focusing On Accuracy And Reliability Of Clinical Thermometers, Julie Black Black

Walden Dissertations and Doctoral Studies

Technological advances in clinical thermometers have resulted in a variety of minimally invasive devices that give rapid results but may not have the accuracy necessary for use in acutely ill adults. Inaccurate temperatures can result in missed opportunities for the early identification and treatment of infection and sepsis. Following the methodology outlined by Whittemore and Knafl, the purpose of this project was to conduct an integrative review of the research on the accuracy of clinical thermometers used for acutely ill adults. The evidence was categorized using the Hierarchy of Evidence for Interventional Studies, and the quality of the studies was …

Chronic Disease Self-Management Program, Raquel Marie Biati

Walden Dissertations and Doctoral Studies

The World Health Organization noted that 2 global health problems have reached epidemic proportions: obesity and type 2 diabetes. These conditions affect nearly 170 million people worldwide. The clinical practice problem addressed by this project was the prevalence of adults ages 50 and older in an ambulatory care setting who suffer from obesity and diabetes and may benefit from a tailored weight management and nutrition education intervention. The purpose of this project was to design a program that would decrease body mass index and hemoglobin A1c in older patients through adaption of the Chronic Disease Self-Management Program. The evidence supporting …

Health Literacy Program Proposal For Health Care Workers, Shevon Naomi Howard

Walden Dissertations and Doctoral Studies

Health information literacy influences patient health outcomes, yet almost 90% of adults

struggle to understand health information. This study explored the impact of an education course in health literacy on healthcare professionals' methods of providing information to patients in order to increase effective communication and improve patient outcomes. This study drew from an integrated theoretical framework that suggests development and validation of tools to measure health literacy. Access to and understanding of reliable, high-quality health care information equalizes many other variables that impact health outcomes, including age, economic class, and cultural background. This study analyzed survey data collected from 2 …

Preventing Urinary Tract Infections In The Acute Care Setting, Charlotte Evette Philyaw

Walden Dissertations and Doctoral Studies

More than 13,000 deaths and $340 million in health care costs are the result of catheter-associated urinary tract infections (CAUTIs) annually in the United States. CAUTIs can also result in acute patient discomfort and potentially preventable exposure to antibiotics. The hospital for which this quality improvement project was developed was above the National Healthcare Safety Network CAUTI bench mark. Framed within the Iowa model of evidence-based practice, a multidisciplinary team of 8 hospital stakeholders guided the project (n=8). The purpose of the project was to develop an indwelling urinary catheter maintenance checklist using evidence-based practice guidelines related to preexisting inappropriate …

A Needs Assessment Of African American Women's Risk For Cardiovascular Disease, Chikaodi Priscilla Eziaha Banor

Walden Dissertations and Doctoral Studies

Suboptimal cardiovascular health among African American (AA) women contributes to high costs of care related to acute illness, chronic illness, and disability. Using the health promotion model, this needs assessment project examined risk factors that predispose adult AA women between the ages of 21 to 64 years of age to higher incidence of cardiovascular disease (CVD). Seventy of the 300 charts that met the inclusion criteria (female AA patients, 21 to 64 years of age, receiving care in a community clinic in an urban city of Texas) were audited for this project. Descriptive analysis showed that 66% of the women …

Increasing Awareness And Consideration Of Bariatric Surgery Treatment Option In Obese Type 2 Diabetes Mellitus Patients, Cynthia Bolaji

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Current research indicates the efficacy of bariatric surgery (BS) in the treatment of obese Type 2 Diabetes Mellitus (T2DM) patients, but only a few actually get this treatment option. This is evident when a comparison of the prevalence of T2DM and obesity is compared to the actual number of surgeries conducted. The American Society of Metabolic and Bariatric Surgery (ASMBS) states that less than 1 % of eligible patients (general) have access to BS. The option most frequently considered to manage obesity and T2DM (i.e. lifestyle modification), is ineffective and results in weight regained in an average of 4 …

Improving Medication Adherence Among Adult Patients With Coronary Heart Disease: A Pilot Study, Xinxin Tang

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Medication adherence reduces morbidity, premature mortality, and healthcare costs related to CHD treatment. Therefore, a patient-centered intervention for both staff and patients was conducted to improve medication adherence in an outpatient setting. 4 Methodology: A pilot study was conducted utilizing a quasi-experimental, pre-post, one group design. Study participants completed an eight-item modified Medication Adherence Scale (MMAS-8) questionnaire to measure self-reported medication adherence before and after the intervention, which consisted of an interview and six weekly follow-up counseling sessions. The study compared the difference in MMAS-8 scores before and after the intervention. The Statistical Package for the Social Science (SPSS) …

The Influence Of Obstructive Sleep Apnea On Post-Anesthesia Duration Of Monitoring: Informing Policy Recommendations For Best Practice In A Veteran Population, George Chris Bone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Obstructive sleep apnea (OSA) is a common problem affecting millions of Americans annually. In fact, between nine and fourteen percent of the entire population is affected by OSA (Diffee, Beach & Cuellar, 2012). Its impact on post-operative care unit (PACU) patients can necessitate the need for an extended recovery time. At the Dallas Veterans Affairs North Texas Health Care System (VANTHCS) hospital, there was no minimum PACU stay time policy specified for OSA patients. These patients had an increased risk of complications beyond the thirty minute period of stability (as defined by the general PACU stay-time policy). While there was …

The Transition-To-Practice Gap And Graduate Nurse Proficiency, Maxine Coleman

Walden Dissertations and Doctoral Studies

After nursing school, graduate nurses complete a licensure examination to demonstrate possession of the minimal knowledge necessary to practice nursing. Even with the successful completion of the examination, many new graduate nurses still lack the competencies required for safe practice. This discrepancy between demonstrated knowledge and competent practice, which is termed a transition-to-practice gap, is a safety issue especially for persons with chronic illnesses. The purpose of this study was to identify and clarify this transition gap to determine possible solutions in the local setting of a large health care system. The theoretical model framing this investigation was Benner's novice …

Creating A Safe Newborn Environment Education Program For Postpartum Registered Nurses, Melanie Myers

Walden Dissertations and Doctoral Studies

In the United States, sudden infant death syndrome (SIDS) is the 3rd leading cause of death for infants; other unintentional sleep injuries are the 5th. In addition, the estimated newborn fall rate in the United States is 1.6 to 6.6 falls/10,000 live births. At the project facility, postpartum registered nurses observed parents engaging in behavior that did not contribute to a safe newborn environment such as placing the infant at risk for injury from a fall or from a sleep injury. This observation led to this current project, which examined the development of an educational program for post-partum nurses to …

Education Program For Nurses Working In An Immigration Detention Facility, Dr. Tiney Elizabeth Ray

Walden Dissertations and Doctoral Studies

Nursing response to medical emergencies has been an ongoing issue in immigration detention centers. Lack of teamwork and poor communication with medical and security staff have resulted in detainees sustaining injuries during medical emergencies. This project was developed to persuade Immigration and Customs Enforcement Health Service Corps (IHSC) leaders to consider piloting the TeamSTEPPS emergency response curriculum for nurses working in the immigration detention center. Tuckman and Jensen's model of group development will provide guidance to IHSC leaders in understanding the transformational stages of forming a successful team. TeamSTEPPS will address gaps in emergency health care competency by improving collaboration, …

Nurse Education And The Reduction Of Nosocomial Infections In Acute Care Settings, Charmaine Amoy Byrd

Walden Dissertations and Doctoral Studies

Nosocomial infections are acquired in health care settings and they can lead to catastrophic health care consequences for patients. These infections can also pose significant financial burdens on society and health care systems. Educating nurses on hand hygiene is essential to reducing infection rates. The research question for the study examined the effectiveness of hand hygiene among nurses in reduction of nosocomial infections and how can health care organizations develop educational strategies to reduce nosocomial infections to improve public confidence in health care systems. The purpose of this study was to educate nurses on how to reduce the incidence of …

An Evidence-Based Asthma Management Plan For The Pediatric Practice Setting, Foroogh Narmani-Mohammadi

Walden Dissertations and Doctoral Studies

Asthma is the most common chronic disease in childhood. Education directed toward asthma self-management is vital and emphasizes patient participation in symptom monitoring and control. The practice problem addressed in this quality improvement project was the lack of an asthma management plan in the pediatric setting for which the project was developed. The purpose of the project was to develop an evidence-based asthma initiative consisting of a staff education curriculum with a pretest/posttest and a patient self-management component. Using a team approach, Rosswurm and Larrabee's conceptual model served as the practice framework to guide the development of the project. Two …

Improving Colorectal Cancer Screening In Primary Care, Jenerie Reniedo Navarrete-Pak

Walden Dissertations and Doctoral Studies

Despite indications that colorectal cancer (CRC) screening strategies can decrease mortality and morbidity, screening rates among veterans remains to be low. In the Veterans Affairs (VA), the performance measure for CRC screening is lower than the national standard. This quality improvement (QI) project evaluated the effect of a team-based approach, effective electronic information structures, and the provision of education to nurses and patients in increasing CRC screening rate in primary care from 77% to 85%. CRC screening data were retrospectively collected prior to the start of the project and then compared to screening data 3 months after project implementation. The …

Strategies To Mitigate Nurse Turnover In Eastern And Northern Virginia, Fred E. Echoles

Walden Dissertations and Doctoral Studies

Registered nurses leaving the workplace are estimated to cost healthcare organizations and society between $1.4 and $2.1 billion annually. The purpose of this multiple case study was to explore what strategies leaders of healthcare organizations from the Eastern and Northern regions of Virginia can use to mitigate the effects of nurse turnover and its cost to the organization. The target population consisted of 8 RNs who experienced turnover during their nursing careers. The conceptual framework for this study was Herzberg's dual-factor theory. Face-to-face semistructured interviews were conducted and publically available documents were garnered. Thematic reduction of participants' interviews, coupled with …

Impact Of Simulation On Nurses' Satisfaction, Confidence, And Communication In Neonatal Resuscitation, Kathryn Rudd

Walden Dissertations and Doctoral Studies

Teamwork and communication in clinical practice improves with simulation using the TeamSTEPPS program. However, there is limited research about simulation efficacy for improving neonatal resuscitation through enhanced communication. Based on a needs assessment and literature review specific to quality improvement strategies for neonatal resuscitation, an enhanced neonatal resuscitation provider (NRP) course was infused with TeamSTEPPS communication strategies, and an NRP case was adopted for simulation training. Also, utilizing clinician feedback, the flow of the resuscitation documentation was revised. The purpose of this project was to evaluate the perceived level of confidence, satisfaction, and communication skills in nurses performing neonatal resuscitation …

Development Of A Church-Based Educational Program To Increase Prostate Cancer Screening For Black Men 40 And Older, Dawn Marie Silvera-Ndure

Walden Dissertations and Doctoral Studies

Prostate cancer is the most common cancer among men in the United States and is one of the leading causes of cancer death among men of all races. However, African-American men are at particularly high risk. These men are diagnosed more often with prostate cancer, are diagnosed later, and are more than twice as likely to die from prostate cancer than are Caucasian men. A strategy to address this inequity was to develop a community based program that would reach this at risk population. The goal of the project was to develop an evidence-based, theory-supported education and referral program to …

Case Study Of Stakeholders' Views On Retention And Self-Efficacy In Texas Nursing Programs, Durcilla Kay Williams

Walden Dissertations and Doctoral Studies

Retention of students through the completion of the nursing degree is a problem that exists at local Texas nursing programs, adding to the nursing shortage at local Texas hospitals. The purpose of this qualitative research study was to identify the best practices used by a local Texas college with graduation rates above the benchmark of 85% set by the Texas Higher Education Coordinating Board. The study framework was based on Bandura's theory of self-efficacy and Tinto's theory of student retention. The research questions for the study focused on reasons the college maintained a high retention rate, best practices currently used, …

Pharmacogenomic Management Of Familial Hypercholesterolemia: An Integrative Review Of The Literature, Brian V. Skibo

Honors Undergraduate Theses

The purpose of this thesis is to examine familial hypercholesterolemia (FH) and emerging pharmacogenomics therapies that propose to lower serum low density lipid (LDL) levels. The search of various data bases resulted in nine research articles being selected for review. Syntheses of the articles suggest emerging phamacogenomic drug therapy can improve treatment outcomes for individuals with a diagnosis of FH. The Human Genome Project (HGP) has had far reaching applications for genomic technologies and pharmacagenomic interventions, tailored to human conditions associated with select genomic traits. Synthesis of nine research articles demonstrate that little is known on the topic and reveals …

Nursing Knowledge And Perceived Comfort Level In Acute Infusion Reactions From Antineoplastic Agents, Andrea L. Maiorini

Honors Undergraduate Theses

INTRODUCTION: Acute infusion reactions from antineoplastic agents can include hypersensitivity reactions, anaphylaxis, and cytokine release infusion reactions. Severe acute infusion reactions happen in about 5% of the oncology patient population and nurses are responsible for assessment and management of the reaction. This is a high-stress task for a nurse magnified by the lack of exposure. This project explores nursing knowledge and perceived comfort level of acute infusion reactions caused by antineoplastic agents.

METHODOLOGY: An original survey was created to test nursing knowledge and assess comfort level. Nursing knowledge was broken down into six subscales: general knowledge of acute infusion reactions, …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Participant's Perception Of Realism And Pediatric Pain Assessment Utilizing A Virtual Patient: A Pilot Study, Alexandra Carson

Honors Undergraduate Theses

The use of simulation in curriculum affords students with the opportunity to enhance clinical skills in a safe environment. However, certain aspects of patient assessment are difficult to reproduce in current simulators, such as changes in facial expressions. Facial expressions are of particular importance when assessing for the presence and severity of pain in the pediatric population. Inconsistencies found in accurate identification of pain suggest the necessity of improved pain assessment training. This study evaluated nursing student’s perceptions of a virtual patient designed to realistically display varying levels of pain in the pediatric patient. Additional purposes of this study were …

Behavioral Interventions Versus Pharmaceutical Interventions To Reduce Preoperative Anxiety In School Aged Children, Jennifer J. Cline

Honors Undergraduate Theses

Surgical procedures that require general anesthesia can be stressful and create needless anxiety for school-age children. Interventions aimed at reducing preoperative anxiety can improve cooperation and enhance postoperative outcomes by lowering anxiety levels prior to induction of general anesthesia. The purpose of this study was to examine the effects of behavioral interventions versus drug therapy in reducing pre-operative anxiety in children. The secondary purpose was to compare methods used to integrate anxiety reduction interventions into pre-operative care and to evaluate the most widely used and effective strategy for clinical practice. A literature review exploring behavioral based stress reduction interventions and …

Exploring The Art Of Nursing And Its Influence On Patient Satisfaction In Acute Care Settings, Enid Tirado

Honors Undergraduate Theses

‎Nursing is a trusted profession aimed at delivering quality, patient-centered care perceived by patients as caring and satisfactory. While empiric care components are measurable as associated with clinical outcomes, patients’ perceptions of care are increasingly important in determining satisfaction with the patient care experience. Not clearly defined, nor empirically measurable, the “art” of nursing is taking on increasing importance as a component of satisfaction with the patient experience. The purpose of this integrative literature review was to review the literature in order to find common themes influencing determination of the art of nursing on patient satisfaction in acute care settings. …

Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John

Honors Undergraduate Theses

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.

Methods: A total of 768 articles were found in a literature search including all literature from 2005 to …

The Effect Of Alternative Labor Positions Versus The Lithotomy Position On Birthing Outcomes: An Integrative Literature Review, Kelsey Gaffka

Honors Undergraduate Theses

Traditionally, the lithotomy position is the most commonly used birthing position in western cultures. The purpose of this literature review was to examine the differences in maternal and neonatal outcomes when alternative labor positions are used. Implications for future use of alternative labor positions were explored. Peer reviewed, English-language research articles published from 2009 to 2015 were included for synthesis. Study results revealed that the lithotomy position is linked to multiple negative maternal outcomes. Birthing in a water pool or in a lateral position has been linked to more optimal maternal and neonatal outcomes compared to other positions. Health care …