Nursing Commons^™

The Effect Of Race On Parents' Intent To Vaccinate Their Children Against Human Papillomavirus, Ariana L. Ruiz Aguilar

Honors Undergraduate Theses

Human papillomavirus (HPV) is a sexually transmitted disease that often presents as genital warts, but may also lead to cancers, including those of the vagina, penis, mouth and tonsils. Despite three vaccines being currently available to prevent HPV, the HPV vaccine retains a low national average vaccination rate when compared to the Tetanus-Diptheria- Pertussis (Tdap) vaccine. Considering the need for improvement it is important to identify factors that may be contributing to this low national immunization rate, one of them being parental race. The purpose of this literature review is to identify whether race affects parents' intent to vaccinate their …

Prone Positioning In Acute Respiratory Distress Syndrome Patients, Sarah Rose H. Thornton

Honors Undergraduate Theses

Introduction: Acute respiratory distress syndrome (ARDS), seen in critically ill patients, is a disease process that affects the lungs and directly impacts a patient’s oxygenation. Despite treatment, patients often die of ARDS secondary to systemic complications. Prone positioning has been introduced as a treatment to improve the outcomes of ARDS patients. This thesis summarized and critiqued recent literature on the outcomes of prone positioning in ARDS patients.

Methodology: An initial literature search was conducted using CINAHL Plus with Text, Medline, Cochrane Database of Systematic Reviews, and US National Library of Medicine National Institutes of Health. Multiple search terms …

The Effects Of Sepsis Management Protocols On Time To Antibiotic Administration In The Emergency Department, Margaret K. Lorch

Honors Undergraduate Theses

Sepsis is one of the leading causes of death in U.S. hospitals, resulting from organ dysfunction caused by an inappropriate inflammatory reaction to an infection. Timely treatment with empiric antibiotics in the emergency department is crucial to facilitate positive patient outcomes. The Surviving Sepsis Campaign (SSC) recommends initiating empiric antibiotic therapy within one hour of presentation to the emergency department. Some emergency departments have implemented sepsis management protocols to guide care and ensure timely treatment. The purpose of this study is to determine the effect of a formal sepsis protocol in the emergency department on the time to antibiotic administration. …

Complementary And Integrative Therapies For The Treatment Of Fibromyalgia, Jennifer Hushla

Honors Undergraduate Theses

Fibromyalgia syndrome (FMS) is a debilitating and chronic condition with an array of symptoms, the most distinguishable being widespread pain. FMS patients experience a marked decrease in quality of life related to intensity of symptoms. Current treatment options and pharmaceuticals do not provide adequate relief. This thesis examines integrative and complementary therapy options for symptom management and improvement of quality of life for FMS patients. A literature review was conducted of English current research using multiple databases. Findings indicate mindful movement therapies (MMT) such as yoga and tai chi, mindfulness, sensory-related relaxation techniques with guided imagery, and cognitive behavioral therapy …

Teaching Life Lessons: When Millennials Fail, Jeffrey Ramirez, Janalee Isaacson, Deborah Smith, Brenda Senger

Nursing Faculty Scholarship

Background: Students who fail may face feelings of diminished self-perception, decreased sense of achievement, and experience negative emotions or moods such as: guilt, embarrassment, thoughts of reoccurring failure, feeling of letting others down or disappointing teachers and parents.

Aim: This paper is to discusses the topic of failure and providing thoughts and reflections on the topic. The authors believe that faculty can help students learn to fail and also maintain their self-worth and dignity. Helping students learn from these failures and promoting resilience and humility when faced with life adversities may be one of the best lifelong lessons faculty …

Six Creative Ways To Implement Interprofessional Education (Ipe) And Practice - Without An Academic Medical Center On Campus, Courtney Reinisch

School of Nursing Faculty Scholarship and Creative Works

It seems logical that health professionals should be taught how to respectfully and effectively communicate across professional lines. However, coordinating this type of academic experience has its challenges. Associate Professor & Undergraduate Program Director at Montclair State University, Courtney Reinisch, shares her experiences with creating opportunities for interprofessional education and partnerships on campus.

American Nursing Students' Immersion Experience In Ghana: A Qualitative Study, Srijana Bhandari

All Graduate Theses, Dissertations, and Other Capstone Projects

Health care providers are more than ever challenged to care for patients due to multicultural nature of American society. Studies report that health care disparities widely exist in our health care system and patients of different racial and cultural backgrounds do not receive adequate health care. Nurses are in the position to prevent and eliminate such disparities by providing individualized care to these patients. Nurses must be well equipped with knowledge and training to deliver care that is relevant and within the cultural context of patients they encounter. Studies have identified study abroad program as one of the approaches to …

The Adaptation To Head And Neck Cancer In The Veteran Population, Diane Marie Sobecki-Ryniak

Wayne State University Dissertations

ABSTRACT

ADAPTATION TO HEAD AND NECK CANCER IN THE VETERAN POPULATION: A PILOT STUDY

By

DIANE SOBECKI-RYNIAK

December 2018

Advisor: Dr. Margaret Campbell

Major: Nursing

Degree: Doctor of Philosophy

Post-traumatic stress disorder in the head and neck cancer veteran population may present a challenge to adaptation during diagnosis and treatment of illness. The evaluation of post traumatic stress disorder, anxiety, depression and quality of life were examined and correlated against symptom occurrence and triggering of post traumatic symptoms across experiences. A significant correlation between PTSD-C and PTSD-S was found (r = 0.91, p = 0.001); there was a non-significant correlation …

Policy Addressing Family Presence During Resuscitation, Crystal Emanuel-Hayes

Walden Dissertations and Doctoral Studies

When hospitals became the primary care setting for very ill patients, visiting hours and restrictions related to family presence during resuscitation (FPDR) became common. During medical crises that occur in hospital settings, families are separated from loved ones because family members may impair resuscitation efforts or such efforts might psychologically traumatize family members. Various national health care organizations have endorsed family presence during resuscitation; however, practices preventing family presence persist. This project used evidence from the peer-reviewed literature to develop a healthcare institution policy that addresses family presence during resuscitation. Theories, concepts, and models that guided this DNP project included: …

Nurses' Perception Of Their Role In Patient Safety, Janeane Walker

Walden Dissertations and Doctoral Studies

Despite efforts to ensure patient safety in the United States, patients are being harmed by preventable errors. There is a gap in the literature from the nurse's perspective as to why medical errors continue to occur despite having evidence-based safety strategies available. The purpose of this constructivist grounded theory study was to develop a theory explaining nurses' perception of their role in patient safety and why medical errors are still occurring despite implementation of evidence-based safety strategies. The systems engineering initiative for patient safety (SEIPS) model provided the conceptual framework for the study. Data collection included interviews with 11 nurses …

Effects Of Transformational Learning On Student Nurses' Perceptions And Attitudes Of Caring For Dying Patients, Kristina Mccall

Walden Dissertations and Doctoral Studies

Nurses spend more time with patients than members of any other discipline in the hospital setting, and most nurses will provide care for dying patients. However, nurses tend to feel uncomfortable providing care to dying patients, which may be due to a lack of education and knowledge about care for dying patients. The purpose of this quasiexperimental 1-group pretest-posttest study was to determine the effect education had on nursing students' attitudes and perceptions about the care they give to their patients at the end of life. The End of Life Nursing Education Consortium (ELNEC) education modules were used for quality …

Evidence-Based Practice For Influenza And Pneumococcal Nurse-Driven Protocol, Melissa Tunc

Walden Dissertations and Doctoral Studies

At the project site in New Jersey, eligible patients were leaving the hospital without receiving the influenza or pneumococcal vaccine. The field site has an established, evidence-based, nurse-driven protocol. The purpose of this project was to increase adherence to the current influenza and pneumococcal nurse-driven protocol on one medical-surgical unit. This unit had experienced low adherence rates to the nurse-driven protocol for vaccines, not reaching the New Jersey state target of 96% administration prior to discharge. The practice-focused question was: Will increasing awareness of evidence-based practice increase adherence to the influenza and pneumococcal vaccine protocol? A quality improvement plan was …

Chronic Disease And Injury Prevention Programming For Canada's Indigenous Population, Nicole Blackman

Walden Dissertations and Doctoral Studies

Local public health units in the province of Ontario, Canada, are often the primary source of health promotion and health education resources, but many do not provide programming specific to the Indigenous population. As of January 2018, modernization of the Ontario Public Health Standards requires public health units to work with the Indigenous population in providing culturally appropriate programs and services. The practice question guiding the capstone project was to determine what chronic disease and injury prevention programs exist that are culturally appropriate for the Indigenous population. The purpose of this project was to do an environmental scan and compile …

Screening And Educating Military Veterans About Post-Traumatic Stress Disorder, Jane Egbufoama

Walden Dissertations and Doctoral Studies

Veterans are at increased risk for developing mental illnesses because of separation from families, distressing experiences in the military, and previous injury to the brain. Approximately 30% of U.S. veterans returning from war suffer from post-traumatic stress disorder (PTSD). The incidence of acute PTSD is reduced when victims are aware of the condition and its associated factors. Through education and screening, the project bridged the gap between deployment of military veterans and treatment of PTSD in this population by addressing whether screening veterans and providing an educational process affected veterans' early PTSD recognition and treatment. The project study addressed the …

Clostridium Difficile Infection (Cdi): Use Of Preventive Bundle To Decrease Cdi Incidences, Lisa Feliciano

Walden Dissertations and Doctoral Studies

The challenge of combating Clostridium difficile infections (CDI) is a major problem within many health care organizations as CDI adds to the cost of care and is an uncomfortable and sometimes fatal complication of hospitalization for the patient. The practice-focused question for this doctoral project was targeted at patients in hospital settings on a medical surgical floor and asked if clostridium difficile preventive bundles reduce the incidence of CDI compared with nonstandardized preventative methods. Using the plan-do-study-act framework, the purpose of this DNP project was to use a clostridium difficile bundle approach to study the effects of clostridium difficile incidence …

Creation Of An Evidence-Based Practice Guideline For A Seclusion Alternative, Patricia Green

Walden Dissertations and Doctoral Studies

Seclusion is a behavioral management intervention used at the practicum site to manage maladaptive behaviors seen in mentally ill patients. Seclusion is not a voluntary occurrence for patients. The practice-focused question asked: Can development of an evidence-based practice (EBP) guideline help guide health care providers in the development of a multisensory room as an alternative to seclusion for people living with mental health disorders (PLWMHD)? The purpose of this DNP project was to develop the EBP guideline for a multisensory room as an alternative to seclusion for the practicum site. To aid in the development of the EBP guideline, the …

Evaluating 30 Day Rehospitalization After Sbar Implementation In Rounding, Michell Mulberry

Walden Dissertations and Doctoral Studies

Transferring from an acute care setting to a sub-acute rehabilitation (SAR) setting can be challenging for both patients and providers because communication errors may occur. The purpose of this project was to evaluate the effectiveness of a 2017 quality improvement (QI) initiative that was implemented to reduce 30-day rehospitalization in a SAR setting serving older patients. The project involved an evaluation of the implementation of the Situation, Background, Assessment, and Recommendation (SBAR) tool for patient rounding to decrease the incidence of 30-day re-hospitalizations. Aristotle's linear model of communication, which emphasizes the impact of message delivery on audience response, provided the …

Evidence-Based Pulmonary Rehabilitation Reduces Hospital Readmissions In Adults With Copd, Christiana Otuwa

Walden Dissertations and Doctoral Studies

Many patients are affected by chronic obstructive pulmonary disease (COPD), a progressive lung disease that obstructs air flow, resulting in dyspnea and inability to carry out daily activities. Despite optimal pharmacological management, COPD patients make frequent emergency room visits and are hospitalized due to exacerbations of COPD. Literature has suggested that pulmonary rehabilitation (PR), a nonpharmacological treatment, could help to decrease the symptoms that lead to illness exacerbation, hospital readmissions, and decreased quality of life in patients with COPD. The purpose of the project was to increase the quality of life and reduce admission rates for patients diagnosed with COPD …

Weight Bias In Healthcare: An Investigation Of Impact On Obesity, Jennifer Scheffler, Fnp

Walden Dissertations and Doctoral Studies

More than two-thirds of Americans are obese or overweight. Obesity rates have risen to an epidemic level, contributing to health inequalities and leading to reduced health-related quality of life. When obese and overweight persons face weight bias by health care providers, fragmented care may occur. Ensuring positive relationships with healthcare providers is important in helping those who are obese or overweight. The purpose of this project was to understand the factors that contribute to negative weight bias in the provider-patient relationship and to identify the most effective interventions that would reduce stigmatizing attitudes and support self-awareness, acceptance, and resolution for …

Perinatal Residents' Perceptions Of Confidence Gained Through Their Preceptors, Veritta Henderson

Walden Dissertations and Doctoral Studies

The importance of preceptorships, as a mechanism to transfer knowledge of evidence-based nursing practices and developing confidence in nurses, is well-known. However, the effectiveness of preceptorships to develop confidence in perinatal nurses who provide safe care to childbearing women is unknown. Guided by Kolb's model of experiential learning and using a narrative analysis approach, this study examined perinatal nurse residents' perceptions of experiences that enhanced learning and developed confidence during preceptorship. Twenty nurses who completed a perinatal nurse residency of 18 weeks or more in the past 12 months participated in audiotaped, structured interviews. Their answers were transcribed and data …

Nurse Practitioners' Experiences With Role Transition: Supporting The Learning Curve Through Preceptorship, Viktoriya Y. Pleshkan

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role transition is difficult and ill-supported before and after graduation. Although preceptorships are essential in supporting a NP's role transition, there is a paucity of data on student and novice NPs' experiences with their role transition and how it is supported through preceptorships. The purpose of this hermeneutic phenomenological study was to understand and describe the meaning of NPs' role transition experiences while in a preceptorship before and after graduation. Schlossberg's transition theory and the cognitive apprenticeship models were used to guide the exploration of concepts of role transition and preceptorship. One face-to-face, 3 Skype, and …

Preoperative Nurses' Teaching For Open Heart Surgery Patients, Sofya Alshvang

Walden Dissertations and Doctoral Studies

Every year thousands of patients in the United States undergo cardiothoracic surgery. These patients have high levels of anxiety because they do not know what to expect. At the same time, many nurses on the cardiac telemetry/surgical floor are not aware that effective preoperative teaching can make a significant difference in patients' outcomes; thus, nurses had focused on postoperative teaching. The purpose of this project was to develop a preoperative teaching program through which nurses could help patients undergoing open heart surgery. The mentioned above practice initiative used Neuman's systems model as a framework. The project used a before-and-after design: …

Minimizing Home Health Care-Acquired Pressure Injuries Through Effective Nursing Teamwork, Juliana Baah

Walden Dissertations and Doctoral Studies

Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain …

Improving Nursing Knowledge, Satisfaction, And Retention In Long Term Care, Ghislaine Barry

Walden Dissertations and Doctoral Studies

Through advancements in modern medicine, human beings worldwide are living longer. The increase in life expectancy creates a need for a more qualified and knowledgeable nursing workforce for the delivery of quality geriatric health care. Although nurses are the primary care providers for vulnerable older adults, they are generally not well trained or prepared in geriatric care. Therefore, the purpose of the project was to develop an education program aimed at improving nursing knowledge of geriatric care in the long-term care (LTC) setting. The goal of the project was to answer the research question: What impact would attendance in the …

Development Of Patient-Centered Team-Based Care Certification, Stephanie Lynn Stewart

Walden Dissertations and Doctoral Studies

Accountable care units (ACU-?¢) provide a new model for integrated patient care. The ACU-?¢ promotes patient centeredness in nursing units as team members work collaboratively with physicians to improve patient outcomes and reduce unwarranted variations. A health system in the southeastern United States incorporated the ACU-?¢ as part of their care model. These units were held accountable for their clinical, service, and cost outcomes but lacked a validation process to demonstrate the effective utilization of their data. The purpose of this DNP project was to create a patient centered care (PCC) certification process, guided by the Donabedian model, that would …

Meeting The Nutritional Needs Of Very Low Income Diabetic Patients, Mary Hossley

Walden Dissertations and Doctoral Studies

Adult Type II diabetes is an increasing public health problem, particularly among very low-income minority populations. The purpose of this study was to create a nutritional guide for a diabetic specific meal plan with an accompanying food pantry nutrition packet for very low-income Type II diabetic patients at a rural Mississippi Free Clinic. The practice-focused question is: Will a nurse-prepared nutritional guide with supplemental food packets improve the glucose control in low income diabetic patients? The gap in practice is that there has been no structured nutrition education guide and no food pantry support plan for Type II adult diabetics. …

A Staff Educational Initiative To Improve The Use Of Childhood Obesity Guideline Recommendations, Kris Kuhlmann Louque

Walden Dissertations and Doctoral Studies

Obesity affects one out every six children in the United States, which places them at risk for other chronic conditions such as cardiovascular disease, diabetes, and continued obesity into adulthood. Considering military children are more likely to enter the Armed Forces than their civilian counterparts, an increase in obesity among military families decreases the number of potential future military recruits who are physically eligible to serve. Despite this growing epidemic, providers report a lack of education and a low self-efficacy in the treatment of this condition. This doctorate of nursing practice study addresses this educational gap by attempting to improve …

Evaluating A Discharge Bundle For Chronic Obstructive Pulmonary Disease, Sharon Scardina Jones

Walden Dissertations and Doctoral Studies

Acute exacerbation of chronic obstructive pulmonary disease (COPD) is one of the leading causes of hospital readmissions within 30 days. Frequent readmissions negatively affect hospital reimbursements and patient outcomes. Creative strategies, such as COPD care bundles, have been shown to reduce readmission rates according to existing studies. A COPD discharge bundle was developed and implemented at 1 community hospital in response to an identified problem with COPD readmissions. Evaluation of this quality improvement initiative was the purpose of this project study. The practice-focused question was: Have 30-day readmission rates changed following the implementation of a COPD discharge bundle prior to …

Trauma-Informed Education Toolkit For Screening Pediatric Victims Of Sexual Abuse And Maltreatment, Analena Michelle Lunde

Walden Dissertations and Doctoral Studies

The complex challenges facing the sexual assault nurse examiners program in a midwest state are underreporting, late reporting, and poor coordination of care for pediatric victims of child maltreatment with sexual abuse. The main objective of this quality improvement project was the identification of necessary practice-related approaches to care to decrease barriers associated with reporting suspicions of abuse or neglect. An evidence-based, multidisciplinary assessment clinical toolkit that followed clinical components of trauma-sensitive, child-centered screenings triggering a coordinated response to conduct a forensic medical exam within 96 hours of the alleged incident was evaluated. During 3 rounds of surveys following the …

Veterans With Chronic Back Pain Managed In Primary Care: Patient Aligned Care Team, Bonnie Grimes

Walden Dissertations and Doctoral Studies

Chronic pain affects approximately 100 million adults in the United States annually, and costs exceeding $635 billion. Pain is the most common complaint in primary care, and chronic pain accounts for up to 16% of emergency room visits. Additionally, chronic pain accounts for 25% of missed workdays annually. Veterans are particularly vulnerable to chronic pain and have an increased incidence of chronic non-cancer pain. Chronic pain for veterans cost the Veterans Administration (VA) about $385 billion each year. This project evaluated the Patient Aligned Care Team (PACT) model to manage chronic lower back pain (CLBP) at a VA primary care …