Nursing Commons^™

Relationship Between Engagement And Level Of Functional Status In Older Adults, Thomas A. Dombrowsky

Nursing Faculty Publications & Presentations - Archive

Functional status is an important component of quality of life for older adults and for their caregivers. Factors associated with level of functional status include age, comorbidity, cognitive status, depression, social support, and activity. Of the types of activity linked with functional status, the strongest evidence is for physical exercise, with weaker evidence for social and productive activity. Engagement is a construct including motivation, commitment, and participation. Objective: The objective of this study was to determine whether or not engagement is associated with level of functional status after controlling for age, comorbidity, and depression among older adults. Methods: In all, …

Designing And Testing A Comprehensive Fall Prevention Program With Mastery Outcomes: A Case Study, Emily C. Piercy

Theses and Dissertations--Curriculum and Instruction

Existing research demonstrates the usefulness of multi-factorial approaches to the challenge of patient fall prevention (Spoelstra, Given, & Given, 2012; Wexler, D’Amico, & Rolston, 2011; Hart-Hughes, Quigley, Tatjana, & Scott, 2004). Some of the current strategies include assessment of a patient’s risk for falling based on a valid assessment instrument, management of a patient’s environment to provide a safe space, medication monitoring and management to avoid use of medications that could lead to falls, patient teaching, post-incident evaluation, and more. Implementation of these strategies is dependent upon patient care employees including nurses, nursing assistants, and physical therapists.

Instructional systems design …

Examining Biological And Psychological Variables In Hypertensive Disorders Of Pregnancy, Stephanie A. Kehler

Theses and Dissertations--Nursing

Despite advances in obstetric care, hypertensive disorders continue to complicate pregnancies at a high rate. Worldwide, hypertensive disorders affect up to 10% of pregnancies. The United States has seen a 25% increase in the incidence of hypertensive disorders over the last two decades (American College of Obstetricians and Gynecologists, 2017). These complications constitute one of the greatest causes of maternal and perinatal morbidity and mortality with an estimated 50,000 to 60,000 deaths per year across the world (American College of Obstetricians and Gynecologists, 2017). Although the etiology of hypertensive disorders remains unclear, there may be an association with both maternal …

Determinants Of Pap Screening Among Sub-Saharan African Immigrant Women, Adebola Olamide Adegboyega

Theses and Dissertations--Nursing

The purpose of this dissertation was to explore the determinants of Pap screening completion among sub-Saharan African immigrant women. Cervical cancer is a public health problem globally. The risk of invasive cervical cancer remains high among sub- Saharan African immigrant women in the US despite being a preventable cancer. Early detection through Pap screening is crucial for prevention, treatment and prognosis. The specific aims of this dissertation were to 1) examine Pap screening practices among African immigrant women and to identify gaps to guide future research; 2) explore barriers and motivators that influence Pap screening decisions among African immigrant women; …

Social Determinants Of Health And Disparities In Outcomes Related To Cardiovascular Health In Vulnerable Populations, Jennifer L. Miller

Theses and Dissertations--Nursing

The purpose of this dissertation was to explore the mechanism of association between social determinants of health (SDH), particularly limited health literacy, and disparate outcomes related to cardiovascular disease in vulnerable populations. Specific aims were to 1) compare quality of life (QOL), anxiety, and depressive symptoms between genders in implantable cardioverter defibrillator (ICD) recipients; 2) examine the association between multi-morbidity burden and QOL; 3) determine whether health literacy levels independently predict CVD risk in the male prison population; 4) examine the relationship between health literacy and decisiveness regarding end of life (EOL) choices, and 5) examine SDH as predictors of …

Development Of Couplet-Care Education, Annette L. Backus

Walden Dissertations and Doctoral Studies

The facility under study has had a traditional postpartum and nursery, with different nurses for the mother and baby. A decision was made to change the care model to couplet-care (CC). CC is an evidence-based care model that promotes newborn care at the mother's bedside. Establishing an education and implementation plan is important to the success of the transition. The purpose of this project was to develop an evidence-based education and implementation plan for CC implementation and to provide for staff barriers and pushback to change. The goals of the study were to identify an approach to implement evidence-based practice …

Bedside Reporting: Improving Practice, Lori Wichman

Walden Dissertations and Doctoral Studies

Bedside reporting is one way to improve communication among the health care team. At the study site, at least 50% of bedside reporting was being conducted at the door of the patient's room instead of at the patient's bedside. The project question addressed whether a computer-based education and training video on bedside reporting and a standardized bedside reporting checklist would increase the rate of bedside shift-to-shift reporting among a medical surgical unit (MSU) to 100%. The project addressed the implementation of standardizing bedside reporting through education and training using Agency for Health Care Research and Quality's (AHRQ) Guide to patient …

Development And Validation Of An Adult Diet And Physical Activity Program In Primary Care Setting, Christiana Chinyere Keke-Ekekwe

Walden Dissertations and Doctoral Studies

Obesity is a national health problem with serious medical, psychological, and economic outcomes. Nurses and nurse practitioners (NPs) are frequently the first point of patient contact and play an essential role in the management of obesity. The current literature noted that practitioners working in primary care settings demonstrate inadequate knowledge related to evidence based practice (EBP) strategies to treat obesity, including diet modification and physical activity. The purpose of this DNP project was to develop and validate an EBP provider educational module related to diet modification and physical activity education for adult patients diagnosed with obesity in a primary care …

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

Walden Dissertations and Doctoral Studies

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

Examining Venous Thromboembolism Post-Operative Orthopedic Care Using Electronic Order Sets, Kelly Remancus

Walden Dissertations and Doctoral Studies

Venous thromboembolism (VTE) is a serious health concern of patients undergoing orthopedic surgery. Analysis of the study site semiannual reports from January 2014 through March 2015 indicated 10 VTE events in 546 orthopedic cases. The community hospital was classed as an outlier performing in the bottom 10th percentile when compared to other hospitals. To standardize the ordering of VTE prophylaxis, the hospital developed a postoperative electronic VTE order set. The purpose of this project was to assess the difference in orthopedic VTE occurrences in the postoperative total hip arthroplasty (THA) patients before and after the implementation of the electronic VTE …

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

Walden Dissertations and Doctoral Studies

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

Screening For Opioid Misuse And Abuse In Chronic Pain Patients, Gloria Jean Farris

Walden Dissertations and Doctoral Studies

Abstract

In 2012, opioid prescriptions exceeded 250 million, which is equivalent to providing a prescription to every adult in the United States. Prescription opioids have contributed to over 100,000 deaths since the late 1990s with the greatest impact among adults 35 through 54 years of age. The purpose of this doctoral project was to introduce an evidence-based screening tool that will identify patients who are at risk of opioid misuse and aid in the development of the most effective treatment plan to manage chronic pain and avoid abuse. The Screener and Opioid Assessments for Patients with Pain (SOAPP), a screening …

Nurses' Reflection, Compassion Fatigue, And Work Burnout - A Correlational Analysis, Sarah Urban

Walden Dissertations and Doctoral Studies

Compassion fatigue and work-related burnout are harmful reactions to patient situations and work environments that negatively affect nurses' well-being and ability to provide safe, effective patient care. However, research is needed to understand how reflection as a self-care response to patient situations is related to nurses' development of work burnout, compassion fatigue, and secondary traumatic stress, a type of compassion fatigue. The purpose of this correlational, cross-sectional quantitative study was to determine the relationship between hospital-based acute care nurses' levels of reflection and their levels of compassion fatigue, secondary traumatic stress, and work burnout. The study was based on Hentz …

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

Walden Dissertations and Doctoral Studies

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

Assessing Provider Adherence To The 2013 Acc/Aha Hyperlipidemia Guideline, Adrienne Johnston

DNP Projects

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States and accounts for more than 17.3 million deaths per year with hyperlipidemia as one of the leading risk factors. The 2013 American Heart Association/American College of Cardiology (AHA/ACC) hyperlipidemia guideline recommends healthy lifestyle habits, risk estimation of the development of cardiovascular disease using a risk calculator, and intensity dosed statin therapy. There has been controversy among providers resulting in confusion and inconsistent application of the guideline. Purpose: The purpose of this project was to examine provider adherence to the AHA/ACC hyperlipidemia guideline in a primary …

Evaluation Of Kentucky Nurses' Knowledge And Self-Efficacy Related To Safe Sleep And Sudden Unexpected Infant Death Risk-Reduction Strategies, Lisa Mcgee

DNP Projects

Sudden Unexpected Infant Death (SUID) claims the lives of about 3700 infants in the United States each year (CDC, 2015). It is the second leading cause of infant death in Kentucky (KDPH,2015) where it has a rate almost three times that of the nation. The American Academy of Pediatrics (AAP) has made recommendations to decrease the risk of SUID and indicates hospital professionals, including nurses, have a responsibility to educate and model safe sleep strategies for parents. An evaluation of the knowledge and self-efficacy about safe sleep and SUID risk-reduction strategies of neonatal and perinatal nurses in Kentucky birthing and …

Relationships Between Interprofessional Teamwork And Clinical Management Of, Jacqueline G. Stephens

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is a highly prevalent chronic disease that affects 29 million people in the United States including over 2 million veterans who receive care through the Veterans Administration. Patient-aligned care teams (PACTs) are an interprofessional teamwork system designed to improve outcomes of chronic illness, but empirical explorations of the efficacy of the PACTs have been insufficient. Utilizing the chronic care model, the purpose of this retrospective study was to determine if PACTs have been efficient in the diabetic management of veterans receiving care through a Southeastern VA. Medical records for 114 veterans with type 2 DM were randomly …

The Effect Of Music Listening On Anxiety And Agitation In Adult Mechanically Ventilated Patients: A Systematic Review, Kristen M. Trowbridge, Hailee N. Horstman

Williams Honors College, Honors Research Projects

Mechanical ventilation causes anxiety and agitation in patients in intensive care units, which increases risk for complications and prolonged hospital stays. Since pharmacological interventions have adverse effects and are not always effective at reducing anxiety and agitation, nonpharmacological interventions, such as music listening, could be considered. The purpose of this systematic review is to identify, review, and critically appraise the evidence from studies that examined the effect of music listening, compared with standard care, on anxiety and agitation in mechanically ventilated patients in the intensive care unit (ICU). Using search engines, data bases, key words, and criteria, twenty studies are …

The Use Of Seclusion And Restraints In The Inpatient Psychiatric Hospital Setting: A Systematic Review Of The Literature, Angela M. Kaucic

Williams Honors College, Honors Research Projects

The use of seclusion and restraint (S/R) is a practice that has been shown to be potentially harmful to patients on a physical and emotional level. This review examines 20 research publications in order to address the attitudes of staff and service users regarding use of this intervention, as well as to explore how use of alternative behavioral and environmental modification interventions compares to standard nursing care in terms of S/R prevalence. The review found that there are many viable interventions alternative to S/R that are more palatable to patients and nurses. Variability of interventions addressed in the included studies …

The Scope Of Social Work Practice In Transition To Adulthood Care, Teresa Hickam

Posters

This is a study of roles executed by social workers and nurses to address common transition planning needs in a pediatric hospital. Duties were stratified based upon tasks assigned only to social work versus those shared with nursing or other team members.

The Lived Experience Of The Western Australian Graduate Registered Nurse Who Is Male, Dianne Juliff

Theses

Nursing professionals are ageing and alternate career opportunities for females threatens nursing workforce sustainability. Largely untapped human resource and underrepresented within nursing in Australia are men. Therefore, the attraction and retention of men into nursing is imperative for the profession to support a sustainable workforce.

A qualitative longitudinal phenomenological study, explored the lived experience of nine newly graduated registered nurses who are male during their first year in their professional-practice environment. The methodological approach that guided this study was Interpretive Phenomenological Analysis (IPA). The IPA enhanced the exploration of the lived experiences of these participants by investigating the meaning of …

Discharge Teaching, Readiness For Discharge, And Post-Discharge Outcomes In Parents Of Hospitalized Children, Marianne E. Weiss, Kathleen Sawin, Karen Gralton, Norah L. Johnson, Carol Klingbeil, Stacee M. Lerret, Shelly Malin, Olga Yakusheva, Rachel Schiffman

College of Nursing Faculty Research and Publications

Purpose

This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).

Design/methods

In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3 weeks post-discharge …

Evaluation, Treatment, And Education In The Hospice Setting By Initiating A Formalized Pain Card, Alyssa M. Soprano

Theses and Dissertations

The purpose of this DNP quality improvement project was to evaluate the use of a formalized pain card that Nurse Practitioners could use to assist clients and caregivers in making the decisions necessary for safe and effective pain management with improving outcomes by using the Brief Pain Inventory Form for measuring: 1) decreased pain, 2) increased pain, 3) pain relief. The appraised evidence suggested that there was a need for a policy standard for patients to notify when pain is unrelieved despite exhausting all other efforts to control pain (Glowacki, 2015). Forty-one (n=41) hospice patients were surveyed pre and post …

Losing Weight With Five A’S (5 A’S): Assess, Advise, Agree, Assist, Arrange Framework And Motivational Interviewing (Mi) For Health Behavior Change Counseling, Jacqueline Baer

Theses and Dissertations

According to the Centers for Disease Control and Prevention (CDC), obesity has reached epidemic levels and has associated with increased risk of morbidity and mortality rates. The increasing prevalence of obesity is a major public health concern. Researchers calculate that health care costs are 44% higher among moderately and severely obese older persons than for persons at normal weights. Seventy-five percent of African American (AA) women are overweight and obese according to data from the CDC and The State of Obesity: Better Policies for a Healthier America. Compared to any other racial ethnic group, AA women are more likely to …

Second-Generation Thai American Women's Perceptions On Cervical Cancer Screening, Essie Asawapornmongkol

Dissertations

Background: Cervical cancer is one of the most preventable diseases in the United States (US) (Center for Disease Control and Prevention, 2015a). Despite advances in early detection and a vaccine available, it continues to affect Southeast Asian American (SEAA) women in high numbers. Multiple barriers to cervical cancer screening are seen among SEAA women, which include acculturation, age, marital status, apprehension, financial burden, access to healthcare, and knowledge about cervical cancer, screening, and preventative health (Ho & Dinh, 2010). Studies on SEAA women and cervical cancer screening primarily involve women who were born in Southeast Asia. These studies have not …

Contraceptive Use Among African Caribbean And African American Women With History Of Intimate Partner Violence, Desiree R. Bertrand

MUSC Theses and Dissertations

There is a paucity of research on contraceptive use among women experiencing intimate partner violence (IPV). Several factors may influence contraceptive use in this population, including cultural background, geographical location, and timing of IPV experience. However, current studies on contraceptive use among women with IPV histories are not focused on minority populations, particularly African Caribbean and African American women who have a higher incidence of IPV. This dissertation compendium addresses that research gap. The compendium includes three manuscripts: A scoping review, an integrative review, and the dissertation study, using data obtained from a multi-site study using a case (women experiencing …

Online Positive Thinking Training Intervention For Caregivers Of Individuals With Asd: Necessity, Acceptability And Feasibility, Abir K. Bekhet

College of Nursing Faculty Research and Publications

Background: More than 3.5 million people in the United States are diagnosed with autism spectrum disorder (ASD). Caring for children with ASD can be stressful and can be detrimental to the well-being of the caregivers (CGs). However, the adverse effects of caregiving on the well-being of CGs may be avoided with appropriate interventions. CGs of persons with ASD might benefit from a positive thinking training (PTT) intervention to help them cope with the stress of caregiving. However, the necessity, acceptability and feasibility for PTT in ASD CGs have not been studied.

Objective: To examine the necessity, acceptability and feasibility of …

Nurse Educators’ Perceptions Of Using High-Fidelity Simulation In Teaching, Marlene Whigham

Theses and Dissertations

Nurse Educators’ Perceptions of Using High-Fidelity Simulation in Teaching. Marline Whigham, 2017: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler College of Education. Keywords: nursing education, learning strategies, simulation, staff development, teaching styles.

High-fidelity simulation in nursing refers to the use of computerized manikins to offer realistic hands-on training to nursing students. The problem addressed by this dissertation was resistance among some faculty to the use of new computerized simulation technology in the nursing curriculum. The research question for this case study investigated how faculty members can incorporate simulation into the curriculum and barriers faced in setting the stage for …

Parents Of Children Who Had Hypoxic-Ischemic Encephalopathy: A Mixed-Methods, Exploratory Study, Natalene Kramer

Electronic Theses and Dissertations

Background: There is scant literature addressing the parents of children who had hypoxic-ischemic encephalopathy (HIE). therefore only inferences may be made as to issues of that experience affecting parents.

Purpose: The purposes of this study was to uncover the lived experiences of parents of children who had HIE, evaluate issues of stress, depression, coping, and impact of neurologic disability in order to better care for them and thus their families

Methods: A parallel, convergent mixed-methods design was used to explore experiences and perceptions of these parents regarding their experiences and life changes. The quantitative strand addressed four research questions which …

Factors Influencing The Perceived Stressors Of New Graduate Nurses Transitioning Into Acute Care Settings: A Secondary Data Analysis, Eileen K. Mahler

Theses & Dissertations

Background: The transition into practice of new graduate nurses continues to be of concern to the nursing profession. Smooth transition into practice takes on increased importance in the current era of healthcare transformation and resulting impact on the clinical environments within which nurses practice. It is important to study the stressors and challenges new graduates face in the practice environment. Methods: This descriptive study utilized secondary data analysis to explore new graduate nurses' self-report of clinical stressors during their transition into the professional RN role. Meleis’ Transitions Theory and Lazarus and Folkman’s Transactional Model of Stress and Coping provided the …