Nursing Commons^™

Preparing Novice Nurses For Early Recognition Acute Deterioration, Norma Patricia Harris

Walden Dissertations and Doctoral Studies

Hospitalized patients increasingly present with complex health issues that place them at risk for acute patient deterioration (APD). Novice nurses are ill-equipped with the critical clinical skills to function competently in recognizing APD, placing patients at risk for negative health outcomes. This project addressed the need to educate novice nurses to recognize APD and answered the project focused questions that asked if an educational intervention with high-fidelity simulation (HFS) would improve nurse knowledge and clinical confidence in recognizing APD. Benner's novice-to-expert and the constructivism theory were used to guide the project. Based upon a review of the literature, the HFS …

Educating Psychiatric Nurses To Improve Medication Adherence Among Schizophrenic Patients, Chandrika Mcqueen

Walden Dissertations and Doctoral Studies

The purpose of this project was to implement an educational program that provided psychiatric nurses with the knowledge and skills to engage patients with a diagnosis of schizophrenia in self-care management regarding medication and treatment adherence. The theory employed in the project was the educational theory. Evidence of effectiveness came from a pre- and postintervention assessment of nurses' knowledge and confidence in teaching about medication, along with a pre- and postassessment of knowledge gained as a result of the educational intervention. Pre- and posteducational rates of patient rehospitalization for medication nonadherence were compared. The results indicated a 15% rate of …

Achieving Glycemic Control In Rural Clinics, Gayla Diane Mclaughlin

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States and is the main cause of chronic kidney failure, nontraumatic limb amputations, blindness, myocardial infarction, and stroke. Many patients with diabetes do not meet goals for at least 1 control measure of blood sugar, blood pressure, or cholesterol. The purpose of the project was to implement a template for documentation--a toolkit for patient care management-to improve blood glucose and blood pressure levels in a rural health clinic in central Texas for 33 patients with diabetes during a 6- to 8-week timeframe. The practice-focused question asked whether management of …

Impact Of End-Of-Life Education On Nurses' Moral Distress, Jenniffer Lynn Mullen

Walden Dissertations and Doctoral Studies

Moral distress is a state of concern or anxiety that occurs when there is a correct action to take but an individual's ability to take that action is constrained in some way. Nurses, especially those who work in intensive care units (ICUs), may struggle with moral distress due to feelings of futility when caring for end-of-life patients. The purpose of this 1-group pretest-posttest quasi-experimental study, guided by Lazarus's theory of stress, coping, and adaptation, was to determine whether End-of-Life Nursing Education Consortium (ELNEC) education reduces moral distress in ICU nurses caring for end-of-life patients. A revised Moral Distress Survey (MDS-R …

Education Protocol For Type Ii Diabetes Mellitus, Raegan Elizabeth Quandt

Walden Dissertations and Doctoral Studies

Diabetes mellitus is one of the leading causes of death in the United States, contributing to rising health care costs and increased morbidity and mortality rates. Researchers demonstrated that aggressive heath measures involving ongoing diabetes self-management education are paramount in minimizing associated complications of diabetes. The management and prevention of diabetes is not standardized and providers within a health clinic in Illinois reported challenges in providing self-management education during scheduled patient appointments due to limited resources and time. The purpose of this DNP project was to develop a clinical practice guideline to be used by all providers within the health …

Dementia-Spcific Education In An Assisted Living Facility, Sharon Dianne Samarin

Walden Dissertations and Doctoral Studies

Providing competent, high-quality, and person-centered care is important in the healthcare environment, including the care for the aging and training of those who provide care. A knowledge gap in dementia-specific training was identified at an assisted living facility. The purpose of this project was to answer the question whether a dementia-specific educational staff training program would improve staff members' knowledge and application of dementia-specific competencies as well as caring behaviors. Watson's theory of human caring, the theory of planned behavior, and Leininger's framework of culture care were used to inform this project. The educational project evaluated the success of implementing …

Educational Outcomes Of Online Registered Nursing To Bachelor Of Science In Nursing Students, Shuba Samuel

Walden Dissertations and Doctoral Studies

The projected nurse workforce shortage and the need for nurses with bachelor's degree has increased the number of accelerated and online programs in nursing education. The evolving healthcare system demands registered nurses (RNs) to demonstrate critical thinking skills and evidence-based practice in varied healthcare settings. The purpose of this quantitative study was to analyze if academic variables, such as preadmission grade point average (GPA), predicted evidence-based skills and research utilization skills among students enrolled in the online RN to Bachelor of Science in nursing program. The theoretical foundations of this study was comprised of Knowles's adult learning theory, Benner's stages …

Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell

Walden Dissertations and Doctoral Studies

Tobacco use is the leading cause of premature and preventable death in the United States, yet millions of Americans continue to use tobacco. Nursing professionals comprise the largest health care provider group and can help improve tobacco cessation among their patients. The purpose of this doctoral project was to increase nursing staff and advanced practice providers knowledge, skills, and confidence related to tobacco cessation interventions. The project took place in a family medicine clinic in Central Texas. The nursing staff (which included 1 registered nurse and 3 licensed vocational nurses) and advanced practice providers (which included 3 nurse practitioners and …

Nursing Students Experiences Of Career And Technical Education Health Science Programs, Precious Simmons

Walden Dissertations and Doctoral Studies

The state of education in the United States faces many challenges in preparing students for the workforce and postsecondary education. These challenges are heightened at the postsecondary level for schools of nursing. The current shortage of nurses will continue to rise if recruitment and retention strategies are not employed. The purpose of this qualitative hermeneutic phenomenological study was to understand and explore the experiences of former health science program students enrolled in nursing school. Research questions focused on the experience of career and technical education (CTE), motives and perceived benefits of CTE, nursing experience, career choice, and academic interests. The …

Reducing Home Health Copd-Related 30-Day Hospital Readmissions Using Telehealth Technology, Steven Eric Stammer

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a collection of chronic conditions that results in irreparable lung damage and stress to patients. COPD also has considerable financial impacts on health care entities due to frequent hospital readmissions of COPD patients. The Centers for Medicare and Medicaid Services penalize care entities for 30-day hospital readmissions. Many rehospitalizations attributed to COPD are due to exacerbations, often preceded by physiologic and emotional changes that can be monitored, allowing action to be taken to prevent readmissions. The practice problem for this quality improvement project explored whether the use of remote home monitoring of COPD patients …

Education Plan To Empower Wound Care Nurses For Evidence-Based Practice, Patricia Stevenson

Walden Dissertations and Doctoral Studies

Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also …

Educating Nurse Managers To Create A Culture Of Nurse Retention, Stacey Trotman

Walden Dissertations and Doctoral Studies

Nurse managers are stakeholders in creating a culture of nurse retention. The purpose of this staff education project was to identify evidence-based best practices that promote nurse retention and to educate nurse managers about these strategies. Knowles's theory of adult learning was the theoretical framework for the project. The practice-focused question addressed whether an education program for nurse managers would increase their understanding of evidence-based strategies to create a culture of nurse retention. The education program centered on 4 themes: professional development, communication and relationships, culture and work environment, and organizational structures and support. The concepts of 5 domains-- status, …

Teaching Heart Failure Patients A Low-Sodium Diet, Karen Faye Wright

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a progressive medical condition affecting more than 7 million people in the United States (US) with 700,000 new cases reported annually. More than half of those treated for CHF are readmitted at least once a year. The problem addressed by this quality improvement initiative was lack of adherence to low sodium diet (LSD) among CHF patients, knowledge and skill deficit, and excessive 30-day CHF readmissions. The health belief model and the self-care deficit theory guide nurses in acquiring the skills needed to teach LSD. Twelve months of data were selected from 93 CHF readmissions from …

Training For Advanced Practice Providers In A Heart Failure Unit, Merlyn Chua

Walden Dissertations and Doctoral Studies

Information from anecdotal interviews at a practicum site indicated a lack of training for advanced practice providers (APPs) in core competencies critical for effective practice in a heart failure (HF) unit. The goal of this project was to assess the APPs' verbal reports and develop HF unit-specific training for APPs. The practice-focused question examined whether unit-specific training for HF APPs improved knowledge and skills in HF management. The Johns Hopkins nursing evidence-based practice model and Knowles's adult learning theory were used to create a survey, a focus group, and a pre/posttest assessment of knowledge and skills gap. Descriptive and inferential …

Factors Influencing Emergency Registered Nurse Satisfaction And Engagement, Catherine Larock-Mcmahon

Walden Dissertations and Doctoral Studies

Employee satisfaction and engagement have a direct impact on customer satisfaction. Dissatisfaction and disengagement lead to an increased intent to leave a job, poor patient outcomes, and decreased productivity. The retention and recruitment of qualified staff becomes an urgent priority to ensure safe and prudent patient care. The purpose of the qualitative research study was to better understand the beliefs, attitudes, perceptions, and reasons for emergency department registered nurses (ED RN) satisfaction and engagement in the workplace focusing on Herzberg's, Vroom's, Yetton's, Maslow's, Benner's, and Kahn's motivation and engagement theoretical frameworks. The qualitative case research study focused on satisfaction and …

Succession Planning And Development Of Nurse Leaders, Christina Martin

Walden Dissertations and Doctoral Studies

Health care organizations can provide comprehensive, formal learning opportunities to develop nurse leaders for advanced leadership roles. The purpose of this doctoral project was to create an evidence-based nursing leadership academy focused on development of advanced leadership skills and competencies to cultivate frontline and midlevel nurse leaders for executive nursing and health care leadership positions. The practice-focused question addressed how an advanced nursing leadership education program would affect the knowledge level and competencies of nurse leader participants. The American Organization of Nurse Executives' (AONE) 5 nurse executive competency domains served as the framework for this project. Data were collected from …

Improving Hand Hygiene In An Intensive Care Unit, Charles Chukwuemeka Njenje

Walden Dissertations and Doctoral Studies

Health-care-associated infections (HCAIs) affect hundreds of millions of people worldwide, causing morbidity and mortality among hospitalized patients. About 2 million patients suffer from HCAIs in the United States, and it is estimated that 99,000 of them die each year. Studies have indicated that transmission of health-care-associated microorganisms occurs through contaminated hands of health care workers. Hand hygiene (HH) is the single most effective way to prevent health-care-associated infections, yet health care workers' hand hygiene compliance remains low. One factor responsible for poor compliance with hand hygiene guide-lines are lack of knowledge of good hand hygiene and lack of hand hygiene …

Knowledge And Attitudes Of Emergency Room Nurses Regarding Palliative Care Patients, Pearl Alethea Harrison

Walden Dissertations and Doctoral Studies

Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura's social cognitive theory. The FATCOD was used to assess ED nurses' attitudes toward PC, and the PCQN was used to assess ED nurses' knowledge about PC prior to the …

Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda

Walden Dissertations and Doctoral Studies

Adolescents with Type I and Type II diabetes need to monitor blood glucose and food intake, administer insulin, and participate in activities including physical education during school hours to maintain glycemic control. Glycemic management programs (GMPs) exist for the improvement of diabetes management during school hours. The purpose of this project was to evaluate a GMP in a school system in a rural area in the Southeastern United States. The goal was to determine if the existing GMP met objectives and to make recommendations for continuation, revision, or discontinuation of the GMP. The logic model provided the basic framework for …

Sexual History Screening Tools For Individuals With Developmental Disabilities, Sarah Musu Onyenwe

Walden Dissertations and Doctoral Studies

Individuals with developmental disabilities are at high risk for sexual abuse, exploitation, sexually transmitted diseases and unwanted pregnancies. Thorough screening by clinicians in outpatient settings recommending preventative measures to promote reproductive and sexual health, and developing caregiver trust are essential. The aim of this systematic review was to provide screening tools to assist clinicians in assessing the sexual histories of individuals with developmental or intellectual disabilities. The Iowa model and the cognitive behavioral theory were used as the theoretical frameworks that guided and informed this project. A total of 148 articles were sought and, of the 34 articles reviewed, 19 …

Challenges For Providers Working In Assertive Community Treatment, Ngozi Nkechi Orabueze

Walden Dissertations and Doctoral Studies

This project explored the challenges confronting clinicians who work with the Assertive Community Treatment Program (ACT), a government-sponsored clinic-based program providing services for individuals with persistent and recurrent mental health challenges in a large metropolitan city in the southern United States. The project involved semi-structured interviews with 15 health care clinicians to explore what they perceived as challenges and their recommendations for addressing them. Themes were organized around the 6 dimensions of the the relationship-based care model: leadership, teamwork, professional nursing, care delivery, resources, and outcomes. Identified patient challenges included transportation, lack of health insurance, housing, acceptance of certified peer …

Medication-Assisted Therapy Interventions And Prescription Opioid Misuse, Stella Kiah Jefferies

Walden Dissertations and Doctoral Studies

Opioid drug misuse and dependence are a social and public health problem in the United States. Prescription opioid abuse and misuse have been associated with substantial morbidity and mortality rates as well as social and economic costs. The purpose of this project was to provide a systematic review of literature on the effectiveness of medication-assisted therapy interventions in addressing the problem of prescription opioid misuse in health care settings. The systematic review was completed through a literature search conducted across five electronic databases. The review was guided by the health belief model and eligible studies were rated using Johns Hopkins …

The Impact Of Shared Governance On Nursing Satisfaction And Retention, Melanie Wetmore

Walden Dissertations and Doctoral Studies

Shared governance is a practice model that supports shared decision making between direct care nurses and their leaders. Developed from Kanter's theory of structural empowerment, shared governance allows employees to influence decisions made in an organization. Shared governance has been shown to increase nursing satisfaction, positively impact outcomes, and reduce nursing turnover. The purpose of this project was to examine the relationship between implementation of a system-wide, multihospital shared governance structure and registered nurse (RN) satisfaction, turnover, and perceptions of shared governance. The 3 sources of evidence used in the study were 2016-2017 organizational RN engagement survey results, 2016-2017 organizational …

Medication Reconciliation In The Elderly, Munjanja Yvonne Litell

Walden Dissertations and Doctoral Studies

Medication therapy is the most prevalent and critical intervention of health delivery and the source of most errors in healthcare. Medication errors and associated adverse drug events (ADE) have serious health and economic ramifications, and in elderly patients ADE are the leading cause of morbidity and mortality. Medication reconciliation is the process of evaluating current medication treatment to manage the risk and optimize the outcomes of medication treatment by detecting, solving, and preventing ADEs. This education project answered the question whether education provided to long term care staff would improve knowledge of medication reconciliation and be retained over time. The …

A Clinical Practice Guideline For Pain Management In The Post Anesthesia Care Unit, Susan Mogan

Walden Dissertations and Doctoral Studies

Ineffective pain management in the post anesthesia care unit (PACU) increases patients' risk of adverse effects including decreased mobility, infection, chronic pain, depression, cardiopulmonary complications, increased length of stay, insomnia, fatigue, and overall decrease in quality of life. The PACU in a community hospital did not provide an evidence-based pain management guideline for nurses treating postoperative patients, resulting in nurses' concerns about providing pain management. The purpose of this project was to translate evidence on pain management into an evidence-based guideline for improved nursing practice in a PACU. Evidence was obtained from a detailed literature search using multiple databases and …

Evaluation Of Use Of Teach-Back For Patient Education, Tamara J. Orr

Walden Dissertations and Doctoral Studies

The focus of this quality improvement doctoral project was the evaluation of an organization's standardized use of the teach-back process for patient education implemented in February 2018. Teach-back is a process in which the patient restates the key concepts for self-management, so the nurse can assess the effectiveness of the teaching and learning process. The practice-focused question compared 4 questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey with literature and recommendations from major health care organizations. The Iowa Model was used to guide the project. The literature review was completed using the Cumulative Index to …

Perceptions Of An Ebp Module Mobile Application By New Graduate Nurses, Kristin Wilson Carlson

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is a key driver of care and advancements within nursing. It is essential to emphasize EBP early in a nurse's career to promote inquisitive minds and enthusiasm for seeking evidence. The purpose of this project was to implement an EBP mobile app into a nurse residency program (NRP) to improve the process of providing EBP information and resources to new graduate nurses. The intent of the project was to leverage mobile technology to engage new graduate nurses in evidence-based practice. Roger's diffusion of innovation framework guided the project. The target audience for the project was 16 new …

Addressing Opioid Misuse And Abuse Through Interprofessional Engagement And Education, Marta J. Brooks, Suzanne E. Holm, Shelene Thomas, Amy J. Rich

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this initiative was to develop and implement an interprofessional panel aimed to expose a university audience to the magnitude of opioid misuse and abuse, as well as demonstrate each health professional’s role in curbing the epidemic. Further, this experience was to provide a platform for interprofessional discussion and to share with attendees tangible action items to begin combatting the opioid epidemic.

Methods: An interdisciplinary committee of healthcare professionals collaborated to initiate a dialogue around opioid misuse and abuse to highlight the power of interprofessional (IP) collaboration in addressing the opioid epidemic. Each panel member shared …

ผลของโปรแกรมการประยุกต์ใช้ทฤษฎีความสามารถตนเอง และการสร้างเสริมทักษะชีวิตต่อความมั่นใจในการหลีกเลี่ยง การมีเพศสัมพันธ์และการป้องกันการตั้งครรภ์ในนักเรียนวัยรุ่นหญิงกลุ่มเสี่ยงทางเพศ, ประไพวรรณ ด่านประดิษฐ์, เปรมวดี คฤหเดช, อุดมพร ยิ่งไพบูลย์สุข, บุญศรี กิตติโชติพาณิชย์, ผ่องศรี สวยสม

Journal of Nursing Research, Innovation, and Health

วัตถุประสงค์: เพื่อเปรียบเทียบความมั่นใจในการหลีกเลี่ยงการมีเพศสัมพันธ์และการป้องกันการตั้งครรภ์ของนักเรียนวัยรุ่นหญิงกลุ่มเสี่ยงทางเพศ ก่อนและหลังเข้าร่วมโปรแกรมการประยุกต์ใช้ทฤษฎีความสามารถตนเองและการสร้างเสริมทักษะชีวิต\n\nรูปแบบการวิจัย: การวิจัยกึ่งทดลอง กลุ่มเดียววัดก่อนและหลังการทดลอง\n\nวิธีดำเนินการวิจัย: กลุ่มตัวอย่างคือนักเรียนวัยรุ่นหญิงกลุ่มเสี่ยงทางเพศที่ค้นหามาด้วยแบบสังคมมิติ จำนวน 306 คน เครื่องมือวิจัยคือ โปรแกรมการประยุกต์ใช้ทฤษฎีความสามารถตนเองและการสร้างเสริมทักษะชีวิตร่วมกับการให้คำปรึกษาปัญหาทางเพศด้วยเครือข่ายออนไลน์ทางโทรศัพท์ และแบบประเมินความมั่นใจการหลีกเลี่ยงการมีเพศสัมพันธ์และการป้องกันการตั้งครรภ์ ซึ่งผ่านการตรวจสอบความตรง โดยแบบประเมินมีความเที่ยง Cronbach's alpha coefficient = 0.91 และ 0.93 ตามลำดับ สถิติวิเคราะห์ข้อมูลคือ ร้อยละค่าเฉลี่ย ส่วนเบี่ยงเบนมาตรฐาน และ paired t-test\n\nผลการวิจัย\n1. ความมั่นใจในการหลีกเลี่ยงการมีเพศสัมพันธ์และการป้องกันการตั้งครรภ์ของนักเรียนวัยรุ่นหญิงกลุ่มเสี่ยงทางเพศ หลังเข้าร่วมโปรแกรมฯ มากกว่าก่อนเข้าร่วมโปรแกรมฯ อย่างมีนัยสำคัญทางสถิติที่ .01\n2. ไม่พบการตั้งครรภ์ในนักเรียนวัยรุ่นหญิงกลุ่มเสี่ยงทางเพศ หลังเข้าร่วมโปรแกรมฯ 10 เดือน\n\nสรุป: โปรแกรมมีประโยชน์ต่อนักเรียนวัยรุ่นหญิงกลุ่มเสี่ยงทางเพศในการป้องกันการเกิดการตั้งครรภ์ได้

การประเมินหลักสูตรพยาบาลศาสตรบัณฑิต (หลักสูตรปรับปรุง พ.ศ. 2555) คณะพยาบาลศาสตร์มิชชั่น มหาวิทยาลัยนานาชาติเอเชีย-แปซิฟิก, นารี ญาณิสสร, จิราวรรณ กล่อมเมฆ, สาวิกา ใจบริสุทธิกุล, สมศรี รัตนปริยานุช, พฤกษาชาติ พิบูลธนาวณิช

Journal of Nursing Research, Innovation, and Health

วัตถุประสงค์: เพื่อประเมินหลักสูตรพยาบาลศาสตรบัณฑิต (หลักสูตรปรับปรุง พ.ศ. 2555) คณะพยาบาลศาสตร์มิชชั่น มหาวิทยาลัยนานาชาติเอเชีย-แปซิฟิก\n\nแบบแผนงานวิจัย: การวิจัยเชิงบรรยาย\n\nวิธีดำเนินการวิจัย: ประชากร คือ นักศึกษาพยาบาล 307 คน และอาจารย์ 17 คน เครื่องมือวิจัย คือ แบบสอบถามการประเมินหลักสูตรพยาบาลศาสตรบัณฑิต พัฒนาตามกรอบแนวคิด CIPP model การประเมินคุณภาพการศึกษาของสำนักงานคณะกรรมการการอุดมศึกษา และสภาการพยาบาล ตรวจสอบความตรงตามเนื้อหาโดยผู้เชี่ยวชาญ 3 ท่าน ค่าสัมประสิทธิ์แอลฟ่าของครอนบาค เท่ากับ .97, .98, .98, .98, และ .99 วิเคราะห์ข้อมูลโดยคำนวณ ค่าเฉลี่ย และส่วนเบี่ยงเบนมาตรฐาน\n\nผลการวิจัย: หลักสูตรพยาบาลศาสตรบัณฑิต (หลักสูตรปรับปรุง พ.ศ. 2555) ตาม CIPP model โดยรวมมีความเหมาะสมในระดับมากที่สุด (x ̄ = 4.28, SD = .44) และองค์ประกอบที่มีความเหมาะสมในระดับ มากที่สุด คือ บริบท (x ̄ = 4.38, SD = .50) กระบวนการ (x ̄ = 4.27, SD = .51) และผลผลิต (x ̄ = 4.33, SD = .51) ส่วนปัจจัยนำเข้า มีความเหมาะสมในระดับมาก (x ̄ = 4.13, SD = .46)\n\nสรุป: ผลการวิจัยนี้ใช้เป็นข้อมูลในการปรับปรุงหลักสูตรพยาบาลศาสตรบัณฑิต (หลักสูตรปรับปรุง พ.ศ. 2560) เพื่อผลิตพยาบาลในระดับวิชาชีพให้มีคุณภาพสำเร็จตามวัตถุประสงค์ของสถาบัน ความต้องการของสังคมและประเทศชาติ