Nursing Commons^™

Implementing A Self-Scheduling Model To Decrease Nurse Turnover In Medical-Surgical Nursing, Rebecca Fuentes

Walden Dissertations and Doctoral Studies

Nurses may experience job stress and burnout due to the amount of hours worked and demanding schedules. At one hospital, nurse turnover rates were high in medical-surgical units. Surveys and interviews conducted by hospital administration found that the bedside nurses were dissatisfied with scheduling practices and that this dissatisfaction could lead to heightened turnover. The purpose of this project was to determine if the implementation of a self-scheduling model would decrease nurse turnover on a medical-surgical nursing unit. This quality improvement project focused on facilitating the empowerment of nurses through a self-scheduling model; it followed the quality improvement steps of …

The Relationship Of Nurse Manager’S Leadership Styles In Maintaining A Just Culture, Aida Solomon

Walden Dissertations and Doctoral Studies

Healthcare leaders must establish a just culture to mitigate preventable medical deaths that occur at 250,000 per year, making medical errors the 3rd leading cause of death in the United States. However, there is a gap in knowledge regarding the attributes of nurse manager leadership styles that contribute to promoting a just culture at the unit level. Guided by the full range leadership theory and the just culture model, the purpose of this descriptive correlational study was to determine the relationship between nurse manager transformational, transactional, and laissez-faire leadership styles and unit level just culture perceptions and the differences between …

Evaluation Of A Postpartum Hemorrhage Protocol, Lori M. Davies

Walden Dissertations and Doctoral Studies

Postpartum hemorrhage is a leading cause of maternal death, yet many deaths related to hemorrhage might be prevented with early recognition and intervention. The birthing unit of a U.S. community hospital formed an interprofessional task force to plan and implement a postpartum hemorrhage protocol that would provide the obstetric team with the knowledge, skills, and tools needed for early identification and quick action when hemorrhage occurred. Lewin's model of change provided a framework for protocol implementation. The purpose of this doctoral project was to evaluate this quality improvement project. Secondary data internal to the organization were collected and analyzed to …

Improving Lesbian, Gay, Bisexual, And Transgender Health Care Outcomes, David Agosto

Walden Dissertations and Doctoral Studies

Many lesbian, gay, bisexual, and transgender (LGBT) individuals report experiencing discrimination in their health care that leads to avoidance of regular appointments with providers. Lack of regular primary care can delay diagnoses of preventable conditions and increase patient risks for chronic disease complications. A systematic review of the literature was conducted to understand LGBT cultural competencies for nursing and other health care providers. The Cochrane Handbook for Systematic Reviews and Melnyk's levels of evidence framed this systematic literature review. Articles for inclusion were limited to those published in English between 2008 and 2018. Keywords used in the literature search included …

An Instructional Module For Nurses To Teach Patients With Gestational Diabetes Mellitus, Josephine Onyekachi Ollawa

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus (GDM) is a carbohydrate metabolism issue during pregnancy that is dangerous for mother and the baby. GDM occurs in 1 out of 3 diabetic women in 16.2% of live births. GDM knowledge and treatment practices among nurses were found inadequate when nurses’ effectiveness in treating a disease they have a shallow knowledge about (GDM) was investigated in the local medical facility. A GDM instructional module was applied and its effectiveness in promoting nurse’s use of GDM education as a treatment strategy tested. The total concept for knowledge and care, empowerment and the social cognitive theories grounded this …

Development Of Nursing Education For An Observation Unit, Donna Mckinney

Walden Dissertations and Doctoral Studies

As healthcare continues to face scrutiny related to the cost and quality of patient care, organizations are challenged with providing the right care to patients in the right setting. Some healthcare organizations are implementing observation units to provide appropriate care to a specific subset of patients. The purpose of this project was to develop education for nursing staff who will work on the dedicated observation unit and are unfamiliar with the care requirements. Benner's novice-to-expert theory was used as the framework for the project. This theorist posits that nurses transitioning to a new area require new knowledge and skills to …

Nursing Staff Development For Novice Nurse Practitioners In Acute Care, Carolyn Berglund

Walden Dissertations and Doctoral Studies

An acute care practice site reported 75% turnover of novice nurse practitioners (NPs),

which indicated a gap in the transition from student to practitioner within the first year of

clinical practice. This gap can leave novice NPs unprepared to manage patients

effectively and contribute to high turnover. The practice-focused question addressed

whether an evidence-based staff development program for novice NPs at an acute care

site could be developed. The purpose of this project was to create a framework based on

evidence to transition novice NPs successfully into practice. Benner's skill-acquisition

in-nursing theory informed this project. Evidence was obtained by searching …

Compassion Fatigue Among Critical Care Nurses, Debra Callender

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF), also known as secondary traumatic stress (STS), impacts critical care nurses (CCN) through exposure to pain, suffering, and loss of those for whom they provide care and results in a reduction of compassion satisfaction (CS). High incidence of CF and turnover (TO) rates at the project site were identified among CCNs. The institution's CCN TO rate was at 81% in comparison to peers in other areas at 29%–35%. The practice-focused question asked whether leadership education on CF might ameliorate CF at the project site. The purpose of the Doctor of Nursing Practice project was to reduce the …

Emotional Intelligence And Sociodemographic Status In Associate Degree Nursing Students, Melanie Renee Benington

Walden Dissertations and Doctoral Studies

Emotional intelligence (EI) is essential for providing quality and competent care in the nursing profession. Because nurses need to be competent in EI, it is important to determine if inherent factors and academic performance contribute to the development of EI. The purpose of this study, guided by the 4-branch ability model of EI by Mayer and Salovey, was to examine the relationship of EI levels and academic performance, gender, and ethnic background in associate degree nursing (ADN) students who attended a community college. Using convenience sampling, 110 ADN students completed the Schutte Self-Report Emotional Intelligence Test and sociodemographic data. Data …

Increasing Depression Screening And Treatment For Adults Living With Hiv/Aids, Velma Asneth Frasier

Walden Dissertations and Doctoral Studies

The lifetime prevalence of clinical depression in patients living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is approximately 22% compared to 3% to 10% in the primary care population. The nursing practice problem at the project site concerned nurses' lack of knowledge and understanding of procedures to help ensure that all patients living with HIV/AIDS were properly screened for depression and referred for further evaluation and treatment. The purpose of this project was to implement a staff education module to address the use of the PHQ-9 screening tool to identify depression in people diagnosed with HIV/AIDS. The theoretical framework …

Depression Screening For Bariatric Surgical Patients, Cova Teresa Stidham

Walden Dissertations and Doctoral Studies

Obesity in the United States has increased to epidemic numbers over the last decade. Practitioners need to reverse the trend. To address the problem of depression in obesity, a practice guideline from a bariatric clinic for under-served populations was proposed to an expert panel. The Spell Out on First Use (PHQ-9) screening is a valid and reliable self-screening tool to assist the practitioner in determining the level of depression if any. The PHQ-9 has nine questions. No formal screening existed at the bariatric clinic, and the practice guideline (with algorithm and revised workflow) was proposed for use at the clinic. …

ผลของโปรแกรมการทบทวนชีวิตต่อความผาสุกทางจิตวิญญาณของผู้สูงอายุโรคมะเร็งระยะสุดท้าย, อัจฉรา วงศ์คณิตย์

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยครั้งนี้เป็นวิจัยแบบกึ่งทดลอง (Quasi Experimental Research) แบบสองกลุ่มวัดผลก่อนและหลังการทดลอง (The pretest-posttest control group design) มีวัตถุประสงค์ เพื่อศึกษาผลของโปรแกรมการทบทวนชีวิตต่อความผาสุกทางจิตวิญญาณในผู้สูงอายุโรคมะเร็งระยะสุดท้าย กลุ่มตัวอย่าง คือ ผู้สูงอายุโรคมะเร็งระยะสุดท้าย โดยแบ่งออกเป็นกลุ่มทดลองและกลุ่มควบคุม กลุ่มละ 20 คน รวม 40 คน โดยวิธีการจับคู่ (Matched pair) กำหนดให้แต่ละคู่มี ลักษณะคล้ายคลึงกันในเรื่องช่วงอายุ เพศ สถานภาพการสมรสความรุนแรงของโรค ระดับความผาสุกทางจิตวิญญาณ กลุ่มควบคุมได้รับการพยาบาลตามปกติ กลุ่มทดลองได้รับโปรแกรมการทบทวนชีวิต เครื่องมือที่ใช้ในการวิจัย คือ กลุ่มทดลองได้รับโปรแกรมการทบทวนชีวิตที่พัฒนาโดย Ando (2010) ตามแนวคิดการทบทวนชีวิตของ Butler (1963) เก็บรวบรวมข้อมูลโดยใช้ แบบบันทึกข้อมูลส่วนบุคคล แบบทดสอบสมรรถภาพสมองเบื้องต้น ฉบับภาษาไทย (MMSE-Thai 2002) แบบสอบถามความต้องการด้านจิตวิญญาณ แบบประเมินความผาสุกทางจิตวิญญาณ (The Geriatric Spiritual Well Being Scale: GSWS-Thai) มีค่าดัชนีความตรงตามเนื้อหาเท่ากับ .875 และค่าความเที่ยงเท่ากับ .854 นำเสนอข้อมูลโดยหาค่าเฉลี่ย ร้อยละ ส่วนเบี่ยงเบนมาตรฐาน และสถิติทดสอบค่าที ผลการวิจัย พบว่า 1. ความผาสุกทางจิตวิญญาณภายหลังได้รับโปรแกรมการทบทวนชีวิตมีความผาสุกทางจิตวิญญาณสูงกว่าก่อนได้รับโปรแกรมอย่างมีนัยสำคัญทางสถิติที่ระดับ .001 2. ความผาสุกทางจิตวิญญาณในกลุ่มทดลองที่ได้รับโปรแกรมการทบทวนชีวิตมีความผาสุกทางจิตวิญญาณสูงกว่ากลุ่มควบคุมอย่างมีนัยสำคัญทางสถิติ ที่ระดับ .001

A Study Of Work Safety Behavior Of Professional Nurses, Government University Hospitals(การศึกษาพฤติกรรมความปลอดภัยในการทำงานของพยาบาลวิชาชีพ โรงพยาบาลมหาวิทยาลัยของรัฐ), Chaweechat Chalok-Kongthavorn, Kanyadar Prajusilpa

Journal of Nursing Research, Innovation, and Health

Purpose:This study were to study work safety behaviors and to compare work safety behaviors classified by personal factors; position, work experience, safety training and the work unit.Design:A cross-sectional survey research.Methods:The sample was 378 professional nurses at least 1 year of work experience in government university hospitals. Research instrument was the work safety behaviors of professional nurse. This questionnaire was tested for the content validity and reliability. The Cronbach's alpha coefficients of work safety behaviors of professional nurse was .98. Statistical methods used for data analysis was frequency, percentage, t-test and Anova.Findings:1) The work safety behaviors of professional nurses Government University …

Determination Of Infusion Phlebitis From Peripheral Intravenous Catheter From Nurse Perspective(การประเมินการเกิดหลอดเลือดดำส่วนปลายอักเสบจากการให้สารน้ำจากมุมมองของพบาบาล), Pramote Thangkratok, Thanan Supasir, Nutcharee Jungvanichar, Agnes Chiachuabsilp, Pattrarat Tannukit, Krit Pongpirul

Journal of Nursing Research, Innovation, and Health

Purpose:Explore the confidence of determining signs/symptoms of phlebitis by nurse practitioners.Design:Cross-Sectional Questionnaire SurveyMethods:Fifteen signs/symptoms of phlebitis identified from a systematic review were included in the questionnaire survey among the nurses from Infusion Nurse Network of Thailand. Respondents were asked for their confidence in determining each of the 15 signs/symptoms, using a 5-point Likert scale.Findings: From 344 participants (77.83%) responded to the survey, the mean age was 34.73 years, 98.8% were female, 77.62% had no experience with phlebitis management. Overall, the nurses were most confident in determining fever/ pyrexia (X - = 4.23, SD = 1.01), followed by erythema/ redness (X …

The Effects Of Yoga Exercise On Fatigue And Quality Of Life In Primiparous Mothers(ผลของโปรแกรมการออกกําลังกายด้วยโยคะต่อความเหนื่อยล้าและคุณภาพชีวิตของมารดาหลังคลอดครรภ์แรก), Panyupa Naosrisorn, Siriwan Sangin, Piriya Suppasri

Journal of Nursing Research, Innovation, and Health

Purpose:The study aimed to test the effects of yoga exercise on fatigue and quality of life in primiparous mothers.Design: Quasi-experimental research, two group pretest-posttest design.Methods:Sample consisted of 52 primiparous mothers receiving postnatal care at Obstetrics and Gynecology Care at Nakhonphanom Hospital. Purposive sampling with inclusion criteria was used to recruit participants. They were divided into a control group (n = 26) and an experimental group (n = 26). The control group received routine nursing care. The experimental group received a yoga exercise program with routine nursing care. The instruments used in this study were personal and obstetric questionnaire, The Modified …

Nonfatal Strangulation Continuing Education Program For Forensic Nurses, Pamela Susan Holtzinger

Walden Dissertations and Doctoral Studies

Patients experiencing nonfatal strangulation during intimate partner violence (IPV) are suffering the consequences of unrecognized injuries and delayed life-threatening medical sequela. Forensic nurses offer expertise in the physical assessment and documentation to a variety of assault victims including those impacted by IPV. This project addressed whether an educational program on nonfatal strangulation increased the knowledge and assessment skills of forensic nurse examiners. The purpose of this doctoral project was to develop a continuing education program on the topic of nonfatal strangulation for forensic nurse examiners. The project design was created using Knowles's adult learning theory principles. The content outline was …

Depression Screening In Poststroke, Shannah Lowe

Walden Dissertations and Doctoral Studies

Depression, a sequela of stroke, is underrecognized and underreported. The American Heart/Stroke Association estimated 1/3 of patients develop depression after a stroke. Depression after a stroke has negative influence on stroke recovery through decreased participation in rehabilitation, and increased morbidity and mortality. The American Heart/Stroke Association recommended that depression screening be conducted on stroke patient; however, there is a lack of guidance regarding the optimal time and tools for depression screening. The practice problem identified was the absence of depression screening in poststroke patients at the project site. The project question focused on identifying evidence-based approaches for depression screening in …

Evaluation Of Postoperative Air Leak And Chest Tube Drainage Systems After Pulmonary Resection, Kristina Jacobsen

Electronic Theses and Dissertations

Postoperative air leaks are the most common complication after a pulmonary resection. There is no data in the literature comparing the traditional and digital chest drainage system after a robotic-assisted pulmonary lobectomy. In 182 eligible patients, this retrospective study evaluated the association between digital and traditional drainage systems with postoperative chest tube days, hospital length of stay, chest tube reinsertion during hospitalization, and 30-day readmission for pneumothorax following a robotic-assisted lobectomy. The groups did not differ significantly in terms of age, gender, BMI, smoking, adhesions or neoadjuvant therapy. Patients with the digital drainage system had a mean chest tube duration …

Just Culture: It's More Than Policy, Linda Paradiso, Nancy Sweeney

Ellmer School of Nursing Faculty Publications

[Description] Paradiso and Sweeney discuss the relationship between trust, just culture, and error reporting in medical care. Errors rarely occur in a vacuum, rather they're a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. Just culture is a safe haven that supports reporting. In a just culture environment, organizations are accountable for systems they design and analysis of the incident, not the individual. The shift to a just culture is a slow process that takes years to develop and hardwire. Hospital-wide policies that incorporate …

Nurse Practitioners Perceptions On Leadership And Research [Slides], Mary Ryder, Elisabeth Jacob, Joyce Hendricks

Research outputs 2014 to 2021

Conclusion:

• Participants identified themselves as clinical leaders focused on direct patient care
• The NP role was misunderstood
• Support from nursing academics and management was identified as a research opportunity
• Confidence in research abilities was a barrier to research
• The NP role was similar in Ireland and Australia

Traditional Methods For Managing Illness In Newborns And Infants In An Arab Society, Diana H. Arabiat, Lisa Whitehead, Mohammad Al Jabery, Amanda Towell-Barnard, L. Shields, E. Abu Sabah

Research outputs 2014 to 2021

Aim: This study explored self‐management practices in relation to traditional methods for managing illness in newborns and infants and the implications of these practices on infant health.

Background: Self‐medication with folk remedies is believed to have short‐ and long‐term impacts on well‐being. Little is known about how mothers in Arab societies used their traditional beliefs and practices in self‐managing their newborns’ and infants’ health.

Methods: Data were collected from five focus groups using open‐ended questions with 37 mothers. Participants were selected using snowball sampling and were recruited from four different cities in Jordan between June 2016 and August 2016.

Ethical …

Evaluating Ways To Reduce Errors In Medication Reconciliations Performed By Nurses In A Rural Hospital Setting, Kalen T. Freeman

MPA/MPP/MPFM Capstone Projects

Medication reconciliation, also known as “med recs”, are an important part of a patient’s care during their hospitalization. A med rec is when hospital personnel generate a list of the medications the patient takes at home. Med recs are vital in the hospital admission process because home medications need to be restarted at appropriate times to fully care for the patient. Also, mistakes in a home medication list can lead to serious consequences in the patient’s health. This study focuses on med recs being performed at Marcum and Wallace Hospital in Irvine, Kentucky. More specifically, the study explores the different …

A Psychoeducational Support Group For Family Caregivers Of Elders With Major Neurocognitive Disorder/ Dementia, Brooke D. Katz

Doctor of Nursing Practice Projects

Background: Dementia is a major public health problem impacting an estimated 65.7 million people worldwide by 2030. It primarily occurs in the elderly population (over age 65) and also affects family caregivers, who often experience significant stress and burden. A psychoeducational support group may be an easy and cost-effective solution to caregiver stress and financial burden.

Objective: To determine whether or not there is an effect on self-reported stress and burden on family caregivers of elders with dementia (EWD) of a voluntary psychoeducational support group in the setting of Assisted Living, Memory Support, and Skilled Nursing led by a psychiatric …

Primary Care Panel Comanagement By A Physician And An Advanced Practice Clinician: Impact On Provider Burnout, Jennifer Strobel

Doctor of Nursing Practice Projects

Background: Levels of burnout have reached epidemic proportions among health care professionals, resulting in a number of negative consequences, including loss of productivity, increased turnover, and increased organizational costs. Advanced Practice Clinicians (“APCs”- a term that encompasses both ARNPs and PAs) were integrated into teams with physicians at a network of primary care clinics in a greater metropolitan area in the United States with the goal of reducing provider burnout. This approach has not yet been evaluated to determine whether there are benefits for reduction of burnout levels in clinicians. Few studies have been conducted to date about the …

Reducing Fall Recurrence In Institutionalized Elderly Residents On Narcotics, Paul Niyungeko

Walden Dissertations and Doctoral Studies

Falls constitute a health care safety concern, specifically among the geriatric population institutionalized in health care facilities. From the pattern of observed falls at the project site, a discrepancy between fall prevention measures and expected outcomes was noted. Knowledge deficiency, inadequate practice skills, and insufficient organizational support were found to be the major obstacles to improving fall prevention. The purpose of this systematic literature review project was to identify evidence-based actions to reduce falls. The project was guided by Taylor's personality theory and Watson's theory of care. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was used to …

Improving Hypertensive Therapy Outcomes Among African Americans, Tanya Sullivan

Walden Dissertations and Doctoral Studies

The effects of nonadherence to prescribed blood pressure medication adversely impacts

African Americans (AA) in comparison to their European American counterparts. The

associated health consequences of uncontrolled hypertension include heart failure, stroke,

and renal dysfunction. And the treatment of the complications negatively impacts quality

of life and contributes to increased health care costs. To address the problem at 1 clinic, a

quality improvement (QI) project was developed by the clinic nursing staff, but the

project had never been evaluated. The project included blood pressure measurements

assessed among AA patients before and after implementation of a 4-item Morisky

Medication-Taking Adherence Scale …

Standardized Clinical Guideline For Assessment, Documentation, And Treatment Of Statins, Esther Onyirimba

Walden Dissertations and Doctoral Studies

The purpose of this project was to develop a practice guideline for screening patients at risk for cardiovascular disease, educate the staff at the site about the guideline, and implement the guideline at a primary care clinic. The intention was to identify and treat patients at risk for cardiovascular disease to prevent occurrence of heart disease. Cardiovascular disease includes hypertension, coronary heart disease, heart failure, and stroke. Coronary heart disease is one of the leading causes of death in the Western world. The local practice problem and focus of this project was underprescribed statin therapy for patients at risk for …

Male Students And Stress During Their Nursing Education, Stephen Joseph Alves

Walden Dissertations and Doctoral Studies

Stress is a common phenomenon experienced by nursing students; however, there is a gap regarding the perception of stress by male nursing students. It is important for nurse educators to be aware of the stressors that are unique to male students to provide appropriate resources and ensure their success in nursing school. The purpose of this qualitative study was to identify the lived experiences male nursing students’ stress. Lazarus and Folkman’s transactional model of stress was the theoretical framework for this study. Semistructured interviews were conducted with 8 participants, who were male students enrolled in associate degree nursing programs, to …

Instrumental Role Modeling And The Sensitive Topic Of Obesity: A Grounded Theory, Tulie Blot Gay

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role is more prominent now than ever before in primary healthcare, positioning them as providers who defend initiatives and ongoing health agendas. Obesity is among those agendas. The concept of instrumental role modeling was explained as a combination of understanding and physical presence that gives meaning and quality to inspire change. It implied that health professionals are not merely insightful clinicians but suggested their expertise is complimented by demonstrations of wellness in knowledge and practice. This topic of weight was perceived as sensitive but must be addressed. In this grounded theory study, the perspectives of NPs …

Improving Spiritual Care In Preoperative Nursing, Victoria Ngozi Ogbuji

Walden Dissertations and Doctoral Studies

Spirituality and nursing have been intertwined from the beginning of the profession; however, there is little evidence that clearly defines spiritual nursing care and no standardized practices that can be included in the routine preoperative plan of care for patients undergoing invasive surgical procedures. The purpose of this project was to conduct a systematic review of the literature to define spiritual care and identify specific spiritual nursing care interventions. The biopsychosocial model, Narayanasamy's transcultural care practice model, and Watson's theory of human caring provided the theoretical framework for the project. MEDLINE, PubMed, Wiley online library, SCIENCE, WOS, Cochrane, and SciELO …