Nursing Commons^™

An Evaluation Of Robotics In Nursing Homes To Reduce Adverse Drug Events, Ozell Ueal Jr.

Walden Dissertations and Doctoral Studies

Adverse drug events (ADE) cause many deaths annually in addition to affecting the quality of life of many others. The descriptive mixed methods approach, specifically exploratory case study and experimental design that guided this research utilized the survey and focus group methods to evaluate perceptions about robotic technology (RT) to reduce the rate of ADEs in U.S. nursing homes (NH). There is a lack of scholarly research into whether a conceptual approach rooted in RT can be implemented to assist with drug administrations in NHs. The purpose of this study was twofold. The first purpose was to evaluate the causes …

Compassion Fatigue In Emergency Department Nurses, Dionne Hutson Hendy

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is a problem seen within healthcare institutions worldwide, especially critical care units and emergency departments (EDs). The problem identified in this quality improvement (QI) project was CF, experienced by nurses in the ED. The effects of CF cross nurse-patient boundaries and negatively impact a patient's expectations of having a quality care experience. The Iowa model's evidence-based team approach was used to guide the development of the education initiative for nurses on recognizing, preventing, and identifying methods of coping with CF in the ED. The outcome products for the project included an extensive review of the literature, a …

Systematic Review: Barriers That Prevent Compliance With Hydroxyurea In Sickle Cell Disease, Uchechukwu Imegi

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a blood disorder that is inherited from both parents and affects millions of people globally. The symptoms of SCD may be debilitating and pose a significant challenge to nursing care. Hydroxyurea (HU), the Food and Drug Administration (FDA) approved treatment for SCD in adults is reportedly effective, but its usage is still minimal among adolescents with SCD. The purpose of this systematic review was to evaluate existing literature on the barriers to HU use in adolescents with SCD. The Johns Hopkins Nursing Evidence-based Practice (JHNEBP) Rating Scales guided this study. An extensive electronic search of …

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, …

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 …

Self-Efficacy And Select Characteristics In Nurses Who Respond To A Pediatric Emergency, Nancy Mcneill

Walden Dissertations and Doctoral Studies

Self-Efficacy and Select Characteristics in Nurses Who Respond to a Pediatric Emergency

by

Nancy McNeill

MA, New York University, 1996

BS, New York University, 1987

Doctoral Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Education

Walden University

June 2016

Nurses at a suburban northeastern U.S. community hospital reported that they felt unprepared to effectively respond to a pediatric emergency. Empirical data were not available to identify if this local problem was due to a lack of the nurses' self-confidence or if other factors were involved. The purpose of this study was to determine …

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 …

Developmental Evaluation Of A Centralized Denials Management Program, Lisa Schiener

Walden Dissertations and Doctoral Studies

Health care reimbursement is changing, and hospitals are finding it difficult to receive payment due to insurers' denial of services already rendered to patients. A denial can be considered an underpayment by the insurer to the hospital. Using a Six Sigma approach, a large hospital system in the southeast United States found that individual hospitals were not focused strictly on denials, but other tasks as well. Hospital administrators conducted a literature review and found that centralizing denials management team has improved reimbursement outcomes elsewhere. Therefore, the hospital system implemented a centralized denials unit to focus on overturning insurer denials while …

Improving Bedside Swallow Screening In Acute Stroke Patients: An Evaluation Plan, Juliette Segree

Walden Dissertations and Doctoral Studies

A stroke is a life-changing event for a patient and his or her family. The acute stroke patient is at risk for developing aspiration pneumonia, whether silent or overt. Prevention of pneumonia in this population requires timely completion and documentation of the bedside swallow screen to identify those patients at risk for aspiration pneumonia; however, anecdotal data from the emergency department at the site of this project suggested that completion and documentation of the screening were inconsistent. Guided by the quality caring model adopted by the project site as well as the logic model, the aim of this project was …

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 …

Reducing Length Of Hospital Stay For Intellectually Disabled Psychiatric Patients With Chronic Medical Problems, Joseph Wigwe

Walden Dissertations and Doctoral Studies

Length of hospital stay (LOS) is a major indicator for measuring efficient care. Intellectually disabled psychiatric patients (IDPP) with chronic medical problems have longer LOS due to challenges faced by providers in jointly managing both psychiatric and medical problems. The purposes of this study were to understand the significance of LOS for IDPP, create an intervention toolkit to reduce LOS, establish the content validity of the toolkit, and recommend its implementation. The items of the toolkit are pharmacology, somatic, rehabilitation, psychosocial, and monitoring patients' psychiatric and medical symptoms across care domains. The toolkit was created from the constructs of the …

An Exploration Of Bullied Nurses, Witnesses, And A Hospital's Bottom Lline, Brenda Kay Williams

Walden Dissertations and Doctoral Studies

Nurses experiencing bullying or witnessing other nurses bullied may choose to vacate their hospital positions. Nurse attrition negatively impacts a hospital's bottom line, which can lead to insolvency and a lack of access to healthcare by patients. The purpose of this phenomenological study was to understand the choices nurses made regarding their careers after experiencing or witnessing bullying and to calculate a hospital's cost of loss. Freire's oppressed group theory provided the conceptual framework for the study. The basis of the research questions was to understand how the nurse felt when bullied or observing a coworker bullied, the actions taken, …

Reducing The Use Of Indwelling Urinary Catheters During Cesarean Deliveries, Michelle Renee Borland

Walden Dissertations and Doctoral Studies

One concern for medical professionals and women experiencing cesarean deliveries is the use of indwelling urinary catheters, which is associated with a delay in first void time, slower ambulation time, increased discomfort, longer hospital stays, and an increased risk for urinary tract infections. The purpose of this project was to determine if a practice change regarding the use of urinary catheters among pregnant women decreases the number of women receiving a catheter prior to having a cesarean section in a small community hospital. The knowledge to action and Rosswurm and Larabee's models were used to guide this project, which was …

Promoting Diabetes Self-Managment Eduaction And Training In Out-Patient Clinics, Inemesit Godwin Udo

Walden Dissertations and Doctoral Studies

Abstract

Type 2 diabetes mellitus (T2DM) is a long term metabolic disorder characterized by high blood sugar, insulin resistance, and relative lack of insulin. T2DM is a leading cause of cardiovascular disease, blindness, kidney failure, lower-limb amputation, and other complications that are costly to patients and the U.S. health care system. Lack of knowledge and underdeveloped skills for self-management of diabetes continues to be the biggest problem for patients with T2DM. Using a team approach and Rosswurm and Larrabee's (1999) conceptual model as a framework, the purpose of this doctorate of nursing practice quality improvement project was to develop an …

An Effective Succession Planning Educational Program For Operating Room Nurses, Sherly Bejoy Alexander

Walden Dissertations and Doctoral Studies

The current nationwide shortage of registered nurses is a growing problem impacting patient care and hospital operations. The operating room is the area most affected by the nursing shortage. Reasons cited for this shortage include ineffective nursing orientation programs and a decline in job satisfaction. The purpose of this project was to develop a best practice succession planning educational program to provide novice operating room nurses with an introduction to the operating room. The Dreyfus model of skills acquisition and Benner's novice to expert theory guided this project. A 2-step process was used to assess and validate the content and …

The Use Of The Illness Perception Questionnaire: Enhancing Clinical Staff Understanding, Typhanie Beasley

Walden Dissertations and Doctoral Studies

Women with Type II diabetes face unique challenges coping with the physiologic complications of the disease, which can be enhanced or hindered by their perception of their ability to effectively manage their diabetes. The Illness Perception Questionnaire (IPQ-R) is a tool that evaluates factors influencing patient-provider communication and assesses patient's perception of their health. Guided by the common sense model of self-regulation, this quality improvement project focused on familiarizing health care providers with the IPQ-R and evaluating their receptiveness to implement it with women with Type II diabetes. Seven Primary Care providers participated in an educational in-service that included information …

Effects Of Education On Pressure Ulcer Prevention In Developmentally Disabled Individuals, Jasneth M. James

Walden Dissertations and Doctoral Studies

Pressure ulcers were a continuing concern among the nonverbal developmentally disabled population of a state institution. The lengthy use of wheelchairs, the inability to body shift, and physical and mental impairment were attributes of the target population that have been cited in the literature as contributing to pressure ulcer. The purpose of this quasi-experimental pretest/posttest project was to evaluate the effectiveness of an education intervention for direct care staff on the prevention treatment, and eradication of pressure ulcers among patients with developmental disabilities. Orem's self-care deficit theory, particularly the emphasis on the need for nursing staff to perform self-care activities …

Improving The Completion Rate Of Advance Directives In Home Health Agencies, Ndidiamaka Ezinne Mbakpuo

Walden Dissertations and Doctoral Studies

The number of individuals aged more than 65 years in the United States and their life expectancy has been increasing in the past decades. In spite of the presence of federal and accreditation policies recommending completion of advance directive documents by patients admitted to health care settings, advance directive completion rates are low in most health care organizations. The purpose of this study was to determine the level of advance directive completion among home health patients. The health belief model provided the theoretical framework that guided this study. A retrospective chart review was carried out in a home health agency …

Evaluating The Role Of Nurses In Educating Women During The Preconception Period, Oluwatoyin Ottun

Walden Dissertations and Doctoral Studies

Nurses play a crucial role in promoting educational programs aimed at informing women about their reproductive health. However, the role of nurses in providing the health related information is not well defined. Guided by the continuum model, this project evaluated nurses' perceived role in promoting the reproductive health of women during the preconception period. Twenty nurses from 2 outpatient offices wrote responses to an open-ended questionnaire. A summary of the responses indicated that 70% of the participants refer women to community-based programs to enhance awareness for preconception care. Twenty percent of the nurses indicated that they have an educational program …

Dementia Caregive Module And Pamphlet, Shawen Denise Ransby

Walden Dissertations and Doctoral Studies

Dementia care is an immediate and growing issue that affects everyone. People are living longer increasing the likelihood that they may be diagnosed with dementia. Friends and family are become caregivers but are often unprepared for the role. The purpose of this project was to develop a 15-minute dementia care module to assist caregivers with the home care of dementia patients. A pamphlet was created to reinforce the module information and to provide a quick reference for dementia support. The self-efficacy theory, along with the review of best practice guidelines and evidence from literature, informed the development of the module. …

Managing Acute Pain In Postoperative Surgical Patients, Sabrina Gregory

Walden Dissertations and Doctoral Studies

Every year, millions of Americans suffer from either chronic or acute pain that results in tremendous healthcare cost, rehabilitation, and loss of work productivity. Pain is an unpleasant sensation associated with sensory and emotional experiences that can cause potential or actual tissue damage. One plausible solution to managing pain is the use of nonpharmacological modalities such as guided imagery. The purpose of this project was to determine if there was a difference in pain scores following pharmacological interventions and the use of guided imagery among postoperative same day surgical patients. Guided imagery is a nonpharmacological modality that uses pictures, music, …

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 …

Development Of A Patient And Family Educational Document Following Cancer Treatment, Debbie Slipkovich

Walden Dissertations and Doctoral Studies

New pharmacological interventions for oncology patients have resulted in longer lifespans after treatment completion and a large population of cancer survivors in communities. When patients complete treatment regimens for cancer, they leave the oncology practice with minimal knowledge of community resources that may assist them during this time of transition. These patients may not interact with care providers again until they return for a surveillance appointment in the future. Guided by Bandura's social cognitive theory, this project's aim was to develop a community-specific brochure that described the variety of services available to oncology patients and their families. The practice-focused question …

Mobile Device Acceptance In Nursing Education, Deanna Gapp

Master's Theses and Doctoral Dissertations

Mobile devices such as smartphones and tablets are being used in healthcare settings for better patient outcomes. By laying the foundation for mobile device use in the educational setting, students can be better prepared for nursing practice in this technology-rich environment (National League for Nursing [NLN], 2008). The purpose of this cross-sectional study was to investigate the mobile device acceptance (MDA) model that guides nursing students’ decision to use mobile devices as educational tools. The MDA model also guides the measurement development and psychometrics testing for the MDA constructs in order to understand mobile device use and to examine correlates …

Effects Of Sepsis Protocols On Health Outcomes Of Adult Patients With Sepsis, Monika U. Mróz

Theses and Dissertations

Sepsis is a condition that arises from the host’s own exaggerated response to an infection, directed towards pathogens, but causing multiple organ failure. Sepsis is one of the most common causes of death, and a considerable absorber of healthcare resources. This frequently fatal condition, despite progress in technology and improving knowledge of pathophysiology, is still poorly understood, carries high mortality and morbidity rates, and survivors are often left with permanent disabilities and poor health outcomes.

Initial presentation of sepsis is often nonspecific, making diagnosis difficult, and causing lifesaving treatment delays. Sepsis guidelines are derived from emerging evidence-based research. While there …

Nurse Staffing And Patient Outcomes: A Longitudinal Study On Trend And Seasonality., Jianghua He, Vincent S. Staggs, Sandra Bergquist-Beringer, Nancy Dunton

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Time trends and seasonal patterns have been observed in nurse staffing and nursing-sensitive patient outcomes in recent years. It is unknown whether these changes were associated.

METHODS: Quarterly unit-level nursing data in 2004-2012 were extracted from the National Database of Nursing Quality Indicators® (NDNQI®). Units were divided into groups based on patterns of missing data. All variables were aggregated across units within these groups and analyses were conducted at the group level. Patient outcomes included rates of inpatient falls and hospital-acquired pressure ulcers. Staffing variables included total nursing hours per patient days (HPPD) and percent of nursing hours provided …

Nutritional Status And Tuberculosis Risk In Adult And Pediatric Household Contacts, Jerome T Galea, Rosa Yataco, Gustavo E Velásquez, Karen Tintaya, Judith Jimenez, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children.

METHODS AND FINDINGS: We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used …

Workplace Violence, Organizational Culture, And Registered Nurses' Incident Reporting Patterns In Acute Hospitals In California, Feodora Jacobsen

Doctoral Dissertations

The purpose of this study was to increase understanding of the reporting patterns of WPV Type II in acute hospital settings. Although some patients are abusive toward nurses, that the abuse is underreported to hospital administrators. Qualitative studies identified common themes for underreporting including fear of being blamed, abuse considered part of the job, and not having sufficient time to fill out a formal report. This study is the first quantitative study to explore the changes in mean scores of organizational-culture factors under two mutually exclusive conditions: registered nurses (RNs) who do not report hospital incidents and RNs who do …

The Development And Content Validation Of An Adult Obesity Educational Program, Abel Okuma

Walden Dissertations and Doctoral Studies

Overweight and obesity in patients with intellectual and developmental disabilities (IDD) are at epidemic levels in the United States. The problem identified for this DNP project is the incidence of overweight and obesity in IDD. The framework used involved the quality model for improvement. For this DNP project a new program called the Daily-Enhanced Physical Activities Program (DEPA) was developed to promote weight loss, reduce sedentary activities, and optimal body mass index (BMI) for IDD patients. Local experts consisting of two registered nurses, two physical therapists, and one direct support personnel working with IDD patients were recruited. Each expert reviewed …

A Curriculum On Culturally Competent Practices To Prevent Retraumatization In Diverse Survivors, Luana Rodriguez

Walden Dissertations and Doctoral Studies

This DNP project addresses the healthcare issue of intimate partner, domestic, and sexual violence (IPDSV), its impact on survivors, and reducing the potential for retraumatization by those who care for them in the clinical, behavioral, and social settings. Trauma-informed care interventions are designed to address the sequelae of trauma, promote recovery, and support resilience. Since IPDSV is a global health issue, supporting cultural needs of all clients is an essential aspect of trauma-informed care. This project was guided by a central research question that examined if trauma-informed, culturally competent curriculum be viewed by community stakeholders as an appropriate intervention for …