Evaluating State Anxiety Levels In Nursing Students, Rachel Stevens, Rachel Nussbaum, Tyler Blake

Williams Honors College, Honors Research Projects

Anxiety, dependent upon the frequency and severity, can be a serious problem that reduces physical, cognitive, and clinical performance. Nursing students have been found to experience especially high levels of state and trait anxiety which, according to Dorothea Orem’s self-care deficit theory, causes a deficit in health promotion and the health of oneself. There is little evidence available about how progression through a baccalaureate nursing program in the United States impacts anxiety. This research investigates anxiety in baccalaureate nursing students and how progression through the program influences self-reported anxiety levels. A descriptive cross-sectional study was performed on a convenience sample …

Comparison Of Crnas With And Without Supervision On Cost And Safety Of Anesthesia, Kelly Mccurdy, Austin Phillips

Williams Honors College, Honors Research Projects

There has been controversy in the field of anesthesia regarding whether certified registered nurse anesthetists (CRNAs) or anesthesiologists provide safer and more cost-effective care. This study was done to compare CRNAs with and without supervision of an anesthesiologist and how it affects the cost and safety of anesthesia delivery. The results of this systematic review could provide information to affect policies regarding who is responsible for providing anesthesia, with safety and cost as the necessary variables. Twenty articles, published between the years 1999 and 2017, retrieved from the databases PubMed and Cinahl were analyzed and synthesized as part of this …

Long-Term Effects Of Breastfeeding Compared With Alternative Food Sources: A Systematic Review, Charlotte Bates

Williams Honors College, Honors Research Projects

The topic of the long-term impact of breast milk and alternative foods on the health status of children continues to be a focus of discussion and research. The aim of this systematic review was to describe and appraise evidence about the effects of breast feeding on health outcomes in children four years and older. Seventeen studies about on infant feeding were identified using Google Scholar and scholarly databases through The University of Akron. Google Scholar, CINAHL, and MEDLINE PLUS methods of searching were utilized, incorporating keywords, i.e., “breastfeeding” AND “cognitive development;” “obesity,”, “intelligence,”, and “immune system.” Based on appraisal of …

Developing A Preceptor Training Program For Registered Nurses In A Teaching Hospital, Persephone Annis Munnings

Walden Dissertations and Doctoral Studies

In a report on the nursing shortage, the American Association of Colleges of Nursing cited insufficient preceptors as one of the factors influencing the decreased intake of nursing students to registered nurse (RN) programs, thus compounding the shortage issue. The site selected for this project was a teaching hospital that annually facilitates hundreds of nursing students for clinical practice. Graduate nurses rotating through the hospital are assigned to work with RNs within their assigned units. The purpose of this doctoral project was to develop a preceptor training program for RNs in a teaching hospital. The practice-focused question examined whether RNs …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey

Walden Dissertations and Doctoral Studies

A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of …

Hospital-Acquired Pressure Ulcer Prevention, Druscilla Willis Jones

Walden Dissertations and Doctoral Studies

Hospital-acquired pressure ulcers (HAPUs) represent a significant challenge in the care provided for hospitalized patients. HAPUs impact morbidity, mortality, and quality of life. At the local practice site, the incidence of HAPUs increased in the perioperative setting. The practice-focused question for this project asked if an education program for staff nurses working in a perioperative care setting with high HAPU incidence can advance nurse knowledge regarding prevention, early assessment, symptoms, and treatment of HAPUs. The purpose of this educational project was to develop a pretest and posttest designed education program on HAPU prevention and care for perioperative nurses. The Iowa …

Education Program For Critical Care Nurses On Preventing Catheter-Associated Urinary Tract Infections, Olatunde Olatunji

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) are the most frequently reported hospital-acquired condition, affecting more than 560,000 patients each year. CAUTIs prolong hospital stays and increase health care costs, and they can result in patient morbidity and mortality. Nurses can be empowered by receiving education and knowledge to manage and identify urinary catheters that are not clinically indicated. The purpose of this project was to develop an education program on CAUTI prevention for critical care nurses using the teach-back method. The conceptual framework that guided this project was Knowles's adult learning theory. The theoretical model was based on 4 fundamental assumptions …

Promoting Heart Healthy Behavior In Adolescents At The Boys And Girls Club, Morgan Tomasiewicz

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Assessment Of Attitude Of Postgraduate Pediatric Nursing Students’ Toward The Academic Integrity, Asmaa Khamis

Nursing

The present study was a descriptive study that aimed to assess the attitude of postgraduate pediatric nursing students toward the academic integrity in their nursing learning experience. A convenient sample that consisted of 100 postgraduate pediatric nursing students enrolled in academic year (2016-2017) in both two semesters, 80 students enrolled in master program while 20 students enrolled in PhD program. Data were collected using a structured questionner sheet, in addition to Likert - type scale to assess the attitude of the studied students about academic integrity. The results of this study revealed that more than three quarters of the studies …

Systematic Review: The Effects Of Nonpharmacological And Pharmacological Measures In Neonates With Neonatal Abstinence Syndrome, Hannah R. Magyar, Laura D. Metzger, Ariel N. Schrage

Williams Honors College, Honors Research Projects

With the increasing incidence of drug addiction among pregnant women, neonatal abstinence syndrome (NAS) has become a significant problem in the United States and has led to increased hospital costs, longer lengths of stay, and more serious health problems in neonates. This systematic review will explore the evidence about outcome differences for neonates with NAS that receive breastfeeding, rooming-in, and acupuncture in addition to pharmacological agents when compared to infants only receiving pharmacological agents. Twenty-one articles, retrieved from the databases PubMed and CINAHL and published between the years 2000-2017, were described in an integrated review, analyzed with critical appraisal, and …

Kangaroo Mother Care And Traditional Care, Arianna Smola, Kirsten Lawson

Williams Honors College, Honors Research Projects

Prematurity and low birth weight are leading causes of infant death. Throughout recent years care methods for this population have evolved from incubator care to Kangaroo Mother Care (KMC). The purpose of this systematic review was to answer the following PICO question: in the case of preterm and low birth weight (LBW) infants, how does the technique of Kangaroo Mother Care (KMC) compare to traditional incubator use, regarding long and short-term outcomes of preterm and LBW infant recovery. Methods of this study included the selection of twenty peer-reviewed articles that studied the effect of incubators and KMC on premature and …

Advanced Practice Nursing In Nigerian Healthcare: Prospects And Challenges, Raymond O. Chimezie, Sally N. Ibe

Journal of Sustainable Social Impact

This study explored the prospects and challenges of introducing advanced practice nursing (APN) in the Nigerian health system. It sought to address the following: career pathways for registered nurses and midwives, advanced duties performed by them and the circumstances, their views and willingness for autonomous practice, and doctors’ degree of acceptance. Research population composed of registered nurses, midwives and medical doctors in primary healthcare. The conceptual framework for this study was based on the scope of practice, standards and competencies of the APN established by the International Council of Nurses (2008). A 12-item checklist of typical duties of APN from …

Program Evaluation Of The Rn Clinical Learning And Development Specialist, Brittany Montecuollo

Walden Dissertations and Doctoral Studies

The purpose of this project was to evaluate the impact of a quality improvement strategy to implement an RN clinical learning and development specialist (CLDS) with the intent to reduce high turnover in novice nurses and low nurse engagement. The CLDS served as expert, role-model, coach, and mentor. Benner'€™s model of novice-to-expert was used as the conceptual framework to monitor progression of nurses mentored by the CLDS. The Institute for Healthcare Improvement model for improvement was reviewed to assess the effectiveness of the CLDS on turnover rates and nurse engagement. At the time of program evaluation, the CLDS role had …

Strategies To Improve Customer Care Services In Urgent Care Businesses, Marcus Ellis Caster

Walden Dissertations and Doctoral Studies

Healthcare industry owners who have unsatisfactory customer care services may experience a financial risk and create dissatisfied patients. The purpose of this case study was to explore customer care strategies that managers of urgent care businesses used to improve customer care services and patient satisfaction. The target population consisted of 1 urgent care manager from 3 separate urgent care clinics with the highest customer satisfaction ratings in Alabama. The urgent care managers were knowledgeable about effective customer care strategies that improved customer care services and patient satisfaction. Customer loyalty theory with emphases on customer behavior, customer attitude, repeat patronage, and …

Telehealth Integration Influencing Success And Sustainability, Melissa Jean Miller

Walden Dissertations and Doctoral Studies

Telehealth initiated a transformation in the realm of innovative strategies to meet the demands of an ever-changing health care system. Adapting provisions to new delivery care models such as telehealth is one way to improve access to care. The purpose of this project was to explore evidence of best practices in telehealth through an extensive, systematic literature review. The practice-focused question focused on identifying advantages of and barriers to the use of telehealth for improving patient satisfaction and quality of care. The plan-do-study-act cycle served as a model for accelerating quality improvement through improved systems of practice, and the Critical …

Evidence-Based Care In Urgent Care Centers, Kelly Wagner

Walden Dissertations and Doctoral Studies

Concussions are brain injuries--also called mild traumatic brain injuries--that affect the function of the brain temporarily or permanently. The purpose of this doctoral project was to develop an education module for staff at an urgent care center to address the lack of knowledge and low level of comfort regarding the care for patients with a head trauma. This project introduced and educated the clinical staff on an evidence-based protocol for the treatment and management of a patient with a concussion. The Rosswurm and Larrabee model for evidence-based change was used as a foundation for refining the practice question, gathering evidence, …

A Magnet System Implementation Of The Hester Davis Fall Reduction Program, Debra Ann Bauer

Walden Dissertations and Doctoral Studies

A Magnet-recognized academic hospital system experienced an increase in patient falls and patient falls with injury after transitioning to a new electronic health record. The purpose of the project was to evaluate the effectiveness of a system-wide quality improvement practice change. The practice-focused question addressed a Magnet model implementation of a standardized, system-wide, evidence-based Hester Davis Scale (HDS) fall risk assessment and intervention tool and the impact on the nursing-sensitive indicators of patient fall rates and fall rates with injury. Successful implementation and sustained, correct use of the HDS fall risk assessment and targeted fall-prevention-intervention tools added to the evidence …

Strategies For Reducing Nurses' Turnover In Specialty Care Clinics, Lawrence Benjamin

Walden Dissertations and Doctoral Studies

The nursing shortage and high turnover rates are a problem in Canada and the world over. The purpose of this single case study was to explore leadership strategies that nurse leaders in specialty care clinics in Canada use to reduce nurse turnover. The participants were 7 nurse leaders from a single organization with specialty care clinics across Canada who all had above average nurse retention rates when compared to the case organization's average nurse retention rate. The authentic leadership theory was the conceptual framework. Data sources for this study were company documents, participants' semistructured interview responses, member checking of the …

Educating Staff On The Family Caregiver Needs Of Brain Injury Patients, Carrie Maloney Robertshaw

Walden Dissertations and Doctoral Studies

Acute rehabilitation hospitals assist brain injury patients and families who face a life- changing event to achieve greater independence and quality of life. During the acute rehabilitation phase of recovery, care is focused on the patient; however, there is a nationwide movement to implement patient- and family-centered care because caregivers experience grief and uncertainty about how to care for their loved one during hospitalization and upon discharge. The purpose of this staff education project was to educate rehabilitation staff on how to identify and to meet the needs of family members of brain injury patients in an acute rehabilitation center …

Educational Plan For Correctional Officers To Increase Awareness Of Diabetes Mellitus Among Inmates, Zaheerah Yasmeen Shareef

Walden Dissertations and Doctoral Studies

In the United States, approximately 30.3 million or 9.4% of the population have been diagnosed with diabetes mellitus. Of these, 8.3 million remain undiagnosed. There are approximately 2 million people incarcerated in detention centers, jails, and prisons across the United States with approximately 80,000 inmates living with diabetes. Correctional officers are not educated to identify and respond to inmates with evolving medical complications, such as low or high blood glucose, which can lead to preventable adverse events, including permanent injury or death. The purpose of this project was to develop an evidence-based education module to teach correctional officers how to …

Clinical Practice Guidelines For Home Management Of Intravenous Immunoglobulin Therapy, Rosemary Taylor

Walden Dissertations and Doctoral Studies

The infusion of intravenous immunoglobulin therapy in the home setting requires a critical nursing assessment and interventions aimed at managing and preventing the escalation of adverse events. Some patients experience side effects that necessitate a rapid response by field nurses, requiring standing orders for nursing administration and the availability of essential medications to alleviate symptoms in the patient's home. The clinical practice issue was that the home health agency did not have a uniform clinical practice nursing guideline to assist field nurses in providing rapid responses for managing infusion-related reactions. The purpose of this project was to develop an evidence-based …

Educational Intervention On Metabolic Syndrome For Psychiatric Providers, Chika Emelda Okafor

Walden Dissertations and Doctoral Studies

Statistics show a high prevalence of metabolic syndrome (MetS) in patients with mental illness receiving second-generation antipsychotic medications. MetS is associated with elevation of obesity, truncal obesity, blood pressure, cholesterol, and fasting glucose. The purpose of this project was to educate psychiatric providers about the importance of MetS screening, early detection, management, and referral for better treatment and management. The project was guided by Lewin's theory of change model. The project inquired if educational intervention on MetS improved providers' knowledge and intent to adopt MetS guidelines. A literature review and established guidelines of the American Psychiatric Association and American Diabetic …

A Clinical Practice Guideline To Improve Education In The Heart Failure Population, Mailey L. Wilks

Walden Dissertations and Doctoral Studies

Managing heart failure patients in the outpatient setting can pose a challenge for nurses and health care staff due to the need to educate patients on self-care skills and management of disease. Several factors, including health literacy and numeracy, need to be considered when developing an education program for heart failure patients to promote self-care management. The purpose of this project was to provide nursing staff with a clinical practice guideline (CPG) that incorporated health and numeracy literacy assessment into an individualized education program. The Johns Hopkins nursing evidence-based practice (EBP) model, the situation-specific theory of heart failure (HF) self-care, …

Nursing Education To Prevent Resident Falls In Long-Term Care, Henrietta Aguwa

Walden Dissertations and Doctoral Studies

Residents in nursing facilities are more prone to falls than those living in the community. Injuries resulting from falls impact residents, their families, and healthcare costs. The gap in nursing practice was the lack of a comprehensive fall-prevention program in a long-term care facility that had experienced high fall rates among residents. This project addressed whether an educational program using the American Medical Directors Association's clinical practice guideline and the Centers for Disease Control and Prevention's STEADI (Stopping Elderly Accidents, Deaths, & Injuries) toolkit for fall- prevention improved the self-efficacy of direct-care staff in preventing falls among residents in a …

Educating Staff Nurses For Successful Patient Discharge, Julie First-Williams

Walden Dissertations and Doctoral Studies

The definition of a successful discharge is a discharge that results in patients successfully managing a chronic disease for at least 30 days without requiring an acute inpatient hospitalization. Many chronic disease readmissions are preventable. Successful discharge planning takes a multidisciplinary team that includes nurses who assess the discharge plan and provide additional education where needed. The purpose of this project was to determine staff nurses' understanding of their role in discharge education. Dorothea Orem's self-care deficit theory guided the project and root cause analysis was used in the development of the problem statements. Staff nurses (n=12) from evening and …

Prescreening Recommendations For Patients On Medical Cannabis, Wen Chieh Hu

Walden Dissertations and Doctoral Studies

Marijuana is the most frequently used illegal substance in the United States and is most widely used among young people aged 12 to 21 years. Accurate screening and monitored issuance of medical cannabis recommendations have been shown to decrease abuse rates of the substance, create fewer deaths from opiates, reduce crime rates, reduce marijuana use in youths, decrease car crash deaths, and lessen prevalence of suicide in young men. The purpose of this project was to explore whether multiple screening methods for depression and anxiety in patients who seek medical cannabis referrals for anxiety and depression would improve screening and …

Simulation As A Remediation Tool For Clinically At-Risk Associate Degree Nursing Students, Janna G. Lock

Walden Dissertations and Doctoral Studies

Evidence-based remediation options are limited for nursing students who fail their clinical competency evaluations. Scholarly literature provides a paucity of studies related to the use of simulation-based technology to remediate nursing students. The research question focused on the difference in the initial competency demonstration evaluation scores of associate degree nursing students compared to the reevaluation scores after remediation with simulation-based technology. Benner's novice to expert and Kolb's experiential learning theories were used to explain how nurses acquire and develop skills. The researcher used a quantitative one-group pretest posttest design to examine archival data from 149 nursing students from a South-Central …

Pediatric Behavioral Health Best Practices In The Children's Emergency Department, Kristina Marie Pickering

Walden Dissertations and Doctoral Studies

Emergency department (ED) use for behavioral-health-associated diagnoses has steadily increased in adult and pediatric populations, accounting for 1 out of every 8 ED visits. The increase in pediatric behavioral health ED visits, combined with limited resources for treatment, has created a challenge for EDs faced with extended boarding and constant observation of this population. The generalized behavioral health guidelines used at the practice site have not been adapted for the pediatric population. This project focused on providing age- and developmentally appropriate best practice guidelines for children under constant observation in the children's emergency department (CED) using Havelock's theory of planned …

Discharge Phone Call On Unplanned Readmission Due To Chemotherapy Among Cancer Patients, Denise Angelo Moreno Prudencio

Walden Dissertations and Doctoral Studies

The transition after hospitalization is a vulnerable period when adverse events like unplanned readmissions may occur. Unplanned readmissions with patients undergoing chemotherapy that are the result of gaps in communicating the discharge plan may be preventable. Several transitional care interventions have been explored, and one of these is the nurse discharge phone call. This project explored the effect of a nurse-led transitional discharge phone call within 30-days after hospital discharge on unplanned readmission due to chemotherapy among patients in the medical-oncology compared to patients without a nurse-led transitional discharge phone call. A nurse-led transitional discharge phone call was implemented within …