Nursing Commons^™

The Use Of Scorecards To Improve Documentation Of Obstetrical Blood Loss, Marilyn Cejka Steinberg

Walden Dissertations and Doctoral Studies

Obstetric hemorrhage is one of the most common causes of maternal morbidity and mortality. The measurement of quantitative blood loss (QBL) at delivery prevents clinicians from failing to recognize hemorrhage in healthy obstetric patients who initially compensate for excessive blood loss. The purpose of this project was to improve the compliance of labor and delivery nurses in a community hospital with consistent QBL measurement. Key theories that formed the basis for the project were Lewin's theory of planned change and homeostasis. The project question addressed was: Is the use of weekly scorecards to provide feedback to nurses with both blinded …

Church-Based Intervention On Prostate Cancer Screening For African American Men, Sherly Marie Boulay

Walden Dissertations and Doctoral Studies

African American men have a significantly higher incidence of prostate cancer, they are diagnosed at a later age, have more advanced stages of cancer at diagnosis, and higher mortality rates than other ethnic group. The purpose of this project, guided by the Ottawa decision support framework and the health belief model, was to investigate whether church leaders could be trained to deliver an educational program about the value of prostate cancer screening to African American males in a church setting. The 2 participants were church leaders in a predominantly African American church. The participants were taught about prostate cancer and …

Systematic Review Of Nurse Residency Programs, Abiola Olatokunbo Ajanaku

Walden Dissertations and Doctoral Studies

The first 2 years of a new graduate nurses career can be stressful and traumatic. Many new graduates leave the profession within their first 2 years of employment. Organizations have sought to implement programs that will promote new graduate job retention. Nurse residency programs (NRPs) are programs geared toward fostering and nurturing new graduates once they begin their nursing careers. Residency programs can last anywhere from 3 months to 1year, depending on the nursing specialty. A key component in retaining new graduates is to facilitate a successful transition into nursing practice. This project served as a systematic review regarding the …

Disseminating The Sepsis Bundle: Evaluating An Evidence-Based Education Module, Elyse Diana Isopo

Walden Dissertations and Doctoral Studies

Due to increasing incidence and noncompliance with sepsis at a local hospital, an educational deficit was identified on the sepsis bundle in the medical intensive care unit. The purpose of this project was to develop and validate a sepsis bundle education program for all frontline staff in the MICU at a local University Hospital. The goal was for the educational tool to be validated by a multidisciplinary team to increase awareness, education, and ultimately, compliance with the severe sepsis and septic shock guidelines. The diffusion of innovation theory was utilized to support the process of change by encouraging the use …

A Practice Change In Adult Obesity Primary Care, Jasmine Tinsley

Walden Dissertations and Doctoral Studies

The rate of obesity in American adults has increased dramatically over the last decade. Obesity has reached epidemic proportions and demands attention to reverse the current trend. This project was developed to evaluate a quality improvement initiative implemented in 2016 to address the problem of obesity in a rural southeastern primary care clinic setting where underserved populations are treated. The quality improvement (QI) initiative was developed using the plan-do-act-check model and the evaluation of the initiative was the focus of the current project. The project question asked if a quality improvement initiative for weight loss monitoring and counseling could improve …

Association Between Work-Related Safety And Work-Related Injuries Among Home Health Care Providers, Sania Mohammed Saleh Abdulkhaleq

Walden Dissertations and Doctoral Studies

Home care nurses (HCNs) have reported a high rate of exposure to work-related injuries (WRIs). Nurses are challenged by the multidimensional problems associated with home care safety. These contextual risk factors increase the physical and social health problems of health care workers and of community suffering as a whole. This quantitative, cross-sectional study was designed to examine the relationship between the organization-related factors (ORFs) and the environment-related factors (ERFs) and their influences on safety behaviors (SBs) and the WRIs of HCNs. The PRECEDE framework was used to guide the study. Self-reported data were obtained from 74 home health care (HHC) …

Program To Prevent Subsequent Fragility Fractures, Kathleen Jean Forti-Gallant

Walden Dissertations and Doctoral Studies

One out of 2 women and 1 out of 5 men over age 50 will sustain a fragility fracture (FF) in their lifetime. The risk of a 2nd FF increases dramatically after the 1st fracture and can lead to pain, disability, and mortality. Despite the evidence that secondary prevention programs are effective, the local facility did not have a formal mechanism to address this need. The purpose of this project was to design a program for secondary prevention of FFs and to address the need for a program for secondary FF prevention that was sustainable locally. The program was designed …

Staff Education Module For Bar Code Medication Administration, Francoise Juste

Walden Dissertations and Doctoral Studies

Bar Code Medication Administration (BCMA) is a technology-supported nursing tool that has become the standard of practice for medication administration. When used effectively and efficiently, this tool has the potential to reduce medication errors in acute care settings. In a pediatric unit at a major urban hospital in the northeast region of the United States, the absence of a BCMA nursing staff educational module affected the use of this safety tool leading to an increase of medication errors. The purpose of this DNP project was to develop a comprehensive educational module to promote BCMA in the pediatric unit of the …

Educating Oncology Nurses About The Emotional Impact Of Cancer Diagnosis, Jonnell Ortiz Zayas

Walden Dissertations and Doctoral Studies

Anxiety and depression are common mood disorders in cancer patients, regardless of mental state prior to diagnosis. A gap in the education of oncology nurses in an eastern Caribbean island was discovered regarding their ability to identify anxiety and depression symptoms and to help patients who suffered from these disorders. The purpose of this project was to improve oncology nurses' assessment skills by reviewing appropriate use of the Hospital Anxiety and Depression Scale (HADS) tool and familiarizing nurses with resources to help patients who score high on the HADS. The Levine conservation model was the theoretical framework for this project. …

An Evidence-Based Clinical Practice Guideline For Childhood Obesity, George Peterson

Walden Dissertations and Doctoral Studies

Childhood obesity is a national problem in the United States and has known implications as a potential cause of chronic illnesses as the child transitions into adulthood. A primary care clinic in the southwestern United States had a high percentage of obese Hispanic children within its population; therefore, the nurses and the pediatrician needed an evidence-based clinical practice guideline (CPG) to manage Hispanic children with a body mass index greater than the 95th percentile for their age. The purpose of the project was to develop a culturally competent CPG to manage childhood obesity in this primary care practice. The social …

A Community Oriented Solution To Access To Care, Margaret Louise Thornell

Walden Dissertations and Doctoral Studies

Access to primary health care services is a significant issue for many communities seeking to improve the health of their populations. This single case study describes the 12-year journey of 2 adjoining rural counties in 2 states towards meeting the primary and specialty care needs of the uninsured and underinsured population. Data were triangulated using historical documents, first-person interviews, and health utilization data. The community leadership moved through various models including a free clinic and a university-sponsored health center before finally establishing a federally qualified health center, which now serves 40,000 citizens in these counties. The site is now hosting …

Development Of A Clinical Nurse Leadership Orientation Program, Sunita Waddell

Walden Dissertations and Doctoral Studies

Nurses are often promoted or hired into leadership positions without the benefit of a formal orientation to their new leadership positions. The challenge of navigating the various expectations of the role of clinical nurse leader (CNL) such as fiscal ownership, staffing patterns, payroll, and disciplinary action process can be overwhelming. The lack of a formalized orientation process and an identified nurse leader to function as a mentor can contribute to the novice CNL feeling unsupported and overwhelmed. The purpose of this project was to identify, develop, and evaluate a CNL orientation manual, outline, and program for newly appointed CNLs. The …

Type 2 Diabetes Management For Geriatric Veterans, Fachecia L. Fort

Walden Dissertations and Doctoral Studies

Managing diabetes in the geriatric long-term care population can be challenging, yet important because diabetes is a chronic, progressive disease. The purpose of this project was to identify clinical practice guidelines for managing Type 2 diabetes in geriatric veterans and to develop a class to educate providers on diabetes management in the geriatric long-term care population at a community living and rehabilitation center. The practice focused question asked if providing education to providers about the clinical practice guidelines for managing Type 2 diabetes in geriatric long-term care veterans would improve knowledge as measured by a pre- and posttest. The project …

Perceptions Of Stress: Employee Participation In A Yoga Class, Rosemarie Lee

Walden Dissertations and Doctoral Studies

Abstract

Employees experience workplace stress that can affect their health resulting in chronic diseases such as diabetes, stress, hypertension, and cardiovascular diseases. Stress also contributes to staff presentism, absenteeism, and high turnover rate. The employee wellness program (EWP) yoga class at a metropolitan teaching hospital has not been evaluated for its effectiveness in employee stress reduction and improvement in employee health. The practice focus question for this project explored employees' perception of the impact of a metropolitan teaching hospital's EWP yoga class on their stress reduction and health promotion activities. The theoretical framework for this project is Lazarus' transactional model …

Postpartum Hemorrhage Evidenced-Based Registered Nurse Staff Education Project, Jessica Powell

Walden Dissertations and Doctoral Studies

Despite medical technology and research advances postpartum hemorrhages (PPH) continue to be a leading cause of morbidity and mortality for pregnant women, even in developed countries. One possible explanation for PPHs continuing to be a leading cause of maternal death is inconsistent recognition and timely treatment of women experiencing a PPH. This doctor of nursing practice project attempts to improve labor and delivery nurse knowledge through an educational intervention which will contribute to rapid identification and treatment of PPH. Knowledge change was demonstrated though change in pretest and posttest scores. The educational information and process was guided by adult learning …

Implementing A Smoking Cessation Educational Module For Clinical Staff Members Who Care For Mentally Ill Outpatients, Anthonia Okeani

Walden Dissertations and Doctoral Studies

In the United States, cigarette smoking is the main contributor to preventable death in all populations; and, among the mentally ill, the prevalence of smoking is a clinical practice concern. Nearly half of all smokers also have a diagnosis of mental illness compared with 23% of the general population. In an effort to reduce the problem of tobacco use within mentally ill populations, this project sought to create an educational module on smoking cessation for staff in a mental health clinic. The theory of planned behavior was used to guide the project that focused on implementation of a behavior change …

Hand Expression With Lactation Support: Effect On Self-Efficacy And Breastfeeding Duration, Florence Omekara

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding method, and breastmilk has many immunological and anti-inflammatory properties that protect babies against illnesses and diseases. It protects the health of the mother and saves society substantial economic costs, as demonstrated in many studies. Studies show that if 90% of U.S mothers breastfed for 6 months, up to $13 billion in healthcare costs could be saved. Despite the health and economic benefits of breastfeeding, most women stop breastfeeding before 6 months postpartum, which falls short of the recommendations of the World Health Organization, U.S. Surgeon General, and American Academy of Pediatrics. This study explored …

Mindfulness Meditation: A Self-Awareness Approach To Weight Management, Michelle Brown

Walden Dissertations and Doctoral Studies

Obesity is a crucial health care issue that has a global effect on the health care industry. Not only does obesity decrease the patients' quality of life, it also places an astronomical burden on health care delivery systems. The purpose of this quality improvement project was to establish a weight management program derived from evidence-based research. The research question is can the utilization of mindfulness meditations and practices with traditional weight loss methodologies produce sustainable weight loss? Pender's health belief model was the conceptual framework utilized to guide and provides structure for this project. The health belief model has been …

A Chronic Obstructive Pulmonary Disease Self-Management Packet To Reduce 30-Day Readmissions, Josette Askratni

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's …

A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson

Walden Dissertations and Doctoral Studies

The increased prevalence rate of childhood obesity in Saudi Arabia is a nationwide health issue. The doctoral project was instituted in the pediatric out-patient clinic (POPC) of a tertiary university hospital in Riyadh, Saudi Arabia. Child obesity clinic and clinical practice guideline (CPG) for primary prevention were not available in the pediatric outpatient clinic with a high incidence of newly diagnose obese children. The focus of this doctoral project was to improve the clinical nursing practice of POPC nurses through the adoption of CPG on primary prevention of childhood obesity. The knowledge translation into action framework provided a summary of …

Systematic Review Of Sedation Management In The Pediatric Critical Care Unit, Myrlene Madelon

Walden Dissertations and Doctoral Studies

Nurse-driven guidelines existed for the management of sedation in adult population; however, there is a lack of guidelines for the critically ill children. Nurses play significant roles in the management of sedation for mechanically ventilated patients in the Pediatric Intensive Care Unit (PICU), nonetheless, comprehensive guidelines for the management of sedation does not exist. The purpose of this systematic literature review was to evaluate and synthesize evidence-based research that can be used to adapt a pediatric clinical guideline for sedation management. The ACE star model and the evidence-based practice model were used as a framework to guide this review. The …

Clinical Decision-Making Skills Among Nurses Working In Selected Hospitals: Comparison Between Government And Private Sector, Pramilaa R Ms

Manipal Journal of Nursing and Health Sciences

Introduction: Clinical decision making (CDM) is a vital component in the professional nursing care. The sound decisions made by the nurses have direct influence on patient’s speedy recovery. Objectives: The objectives of the study were to assess the level of scores of CDM skills among nurses, assess the scores of CDM skills related to subscales and item analysis, compare the scores of CDM between government and private sector nurses and associate the level of CDM skills with selected demographic variables. Method: A comparative study was conducted among 94 nurses working at government and private sector hospitals. A convenience sampling technique …

Perceptions About Ethical Role Responsibilities In Realities Of Nursing Practice, Divia Paul A Ms

Manipal Journal of Nursing and Health Sciences

Introduction: Awareness about different dimensions of nursing ethics, its conceptual origins and relationship to practice is essential for good patient care that has to be reinforced among nursing staff. This present study was aimed to evaluate the effectiveness in rendering the perceptional clarity about the ethical concepts relevant to nursing practice and transparency in executing them on patient care among nursing faculty. Objectives: The objectives under study were to assess the understanding level of nursing students about general and special aspects of nursing ethics, to compare between understanding and execution of special phenomenas in ethics among nursing students, to find …

Oral Care Practices Among Orally Intubated Patients - A Systematic Review, Shalini G. Nayak Ms, Judith Angelitta Noronha Dr, Jyothi Chakrabarty Dr

Manipal Journal of Nursing and Health Sciences

Background: Oral care for orally intubated patient is of paramount importance for various reasons such as to decrease the nosocomial infections, decrease in antibiotic days and length of stay in intensive care unit, reduce the cost of antibiotic use, and decrease the mortality. This review was aimed to identify the various interventions for oral care and its outcomes among orally intubated patients. Materials and methods: A systematic review was done between March and April 2014 by using the combination MeSH words and key words in two data bases such as PubMed and Ovid Medline. Articles published between 2005 and till …

Application Of Rogers’ System Model In Nursing Care Of A Client With Cerebrovascular Accident, Priya Reshma Aranha Ms

Manipal Journal of Nursing and Health Sciences

Rogers’ system model is commonly known as Science of Unitary Human Beings. It views human beings as integral with their environment. As per the concepts of the Rogers system model, nursing focuses on human beings and the manifestations that emerge from the mutual interaction of human and environmental field. It is said that the change in the pattern and organization of man and his environment is transmitted by waves; this pattern emerges as observable event in the life of man. Thus, better understanding of human experience is made possible. In this paper, the author has described the nursing care of …

Sturge-Weber Syndrome: A Case Report, Theresa L. Mendonca Ms, Sunseamol T. Thomas Ms

Manipal Journal of Nursing and Health Sciences

Sturge-Weber disease is characterized by a wine-colored nevus or hemangioma over the face in the ophthalmic division of the trigeminal nerve. Intracranially, hemangiomatosis often calcified occurs over the cerebral cortex on the same side as the facial lesion and usually in the posterior parietal occipital area. This report describes about 13 year old child with this disorder

Practice Guidelines For Continuous Pulse Oximetry Monitoring For Obstructive Sleep Apnea Patients, Bridgette Smart

Walden Dissertations and Doctoral Studies

As the rate of obesity has increased in the United States to include approximately 40% of the adult population, there has been a corresponding rise in the number of patients with obstructive sleep apnea (OSA). The OSA population is at risk for adverse perioperative respiratory depression. Continuous pulse oximetry monitoring is indicated for these patients upon discharge from the recovery room into other treatment settings and when cared for by telemetry or by trained hospital staff in the patient's room. The practice question was whether an evidence-based practice guideline could be developed to help ensure safe postoperative monitoring of patients …

Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett

Walden Dissertations and Doctoral Studies

Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …

Gender-Specific Facilitators And Barriers To Health-Related Quality Of Life In Adults With Cystic Fibrosis: A Mixed Methods Study, Leigh Ann Bray

All ETDs from UAB

BACKGROUND: With the life expectancy of individuals with cystic fibrosis (CF) doubling over the last two decades, it is critical that healthcare providers address both quantity and quality of life. Health-related quality of life (HRQoL) encompasses physical, social, psychological, and functional aspects of daily living and how CF impacts each one. Women with CF consistently report having an overall poorer quality of life across international studies, but the cause of the gender difference is unknown. The purpose of this study was to explore gender differences in HRQoL and then build upon those results to better understand gender-specific facilitators and barriers …

Parental Self-Efficacy, Feeding Practices, And Weight Gain During Infancy: A Secondary Analysis, Jessica Bahorski

All ETDs from UAB

Mechanisms contributing to childhood obesity begin during early life, including infant feeding practices and an excessive rate of infant growth. Parental decisions regarding their infant contribute to these mechanisms. Parental self-efficacy (PSE) is the belief parents have in their ability to accomplish the tasks of parenting and is associated with infant outcomes. A high sense of PSE, breastfeeding self-efficacy, or self-efficacy for feeding has been found to be associated with healthy infant feeding practices. However, this research is limited in scope and has not been conducted in populations at greatest risk for childhood obesity such as low-income or African-American infants. …