A Mentorship Program For Newly Licensed Registered Nurses, Omin Chandler

Walden Dissertations and Doctoral Studies

The retention of new nurses remains a challenge for most healthcare organizations. Approximately 75% of newly licensed registered nurses (NLRNs) resign their positions within the first year of employment due to transition shock from the academic setting to the practicum setting. Other reasons for resignation include lack of confidence, poor critical thinking skills, and feeling overwhelmed to provide quality patient care. This loss of retention among NLRNs poses a significant threat to the delivery of quality and safe patient care. Nurses who assume the role of mentor to newly licensed nurses face many barriers to fulfilling their role effectively, including …

Evidence-Based Practice Guideline: Breastfeeding Support Of The Active Duty Servicewoman, Heidi A. Koslo

Walden Dissertations and Doctoral Studies

There is no policy on breastfeeding support of the active duty military servicewoman at the targeted military treatment facility, and no global policy serving active duty personnel applicable at the Department of Defense and Defense Health Agency (DoD/DHA) level to span across branches of the U.S. military. Nurses, as members of the most trusted profession, are often expected to know how to assist a mother in meeting her feeding goals. Creation of an evidence-based practice guideline (EBPG) for support of the active duty servicewoman in the military health system was the purpose of this project. The project was conceptualized within …

Education Toolkit On Restraint Reduction In The Intensive Care Unit, Sharon Watkins

Walden Dissertations and Doctoral Studies

The use of physical restraints in hospitals has been in practice for the better part of a century despite the many adverse effects it can have on patients. Socially, restraint use can strip the patient of their dignity in addition to their freedom. This evidence-based project was to build a toolkit to educate intensive care unit (ICU) nurses regarding the negative effects physical restraint use can have on their patients and to present alternatives to their use. Tools developed from prior research were included in the toolkit, and the Neuman systems model was applied to the overall education project. The …

Tool Kit To Address Communication On A Mental Health Unit, Carol L. Barclay

Walden Dissertations and Doctoral Studies

Effective communication by newly graduated, hired nursing staff is a significant issue affecting patient care on mental health units. The rising prevalence of mental illness in the United States has not only increased the healthcare burden, but has also affected the overall economy. The lack of training of new nursing staff regarding communication diminishes the effective recovery rate of patients, further increasing the burden to the healthcare field and the economy. A tool kit for newly graduated mental health nurses working on mental health units may help to improve communication skills and enhance patient safety and quality of care. Therefore, …

Addressing Bullying And Incivility Among Nurses, Caroline Holland Combs

Walden Dissertations and Doctoral Studies

For decades, nurses have experienced some form of bullying and incivility throughout their careers. Incivility contributes to behaviors that constrain the sense of empowerment among nurses and directly encroach upon Provision 6 of the American Nurses Association code of ethics, which addresses sustaining a moral environment and the need to create a contagious culture of respect that is free from uncivil behavior. The nature of this staff education project was to bring awareness to the bullying behaviors and incivility that exist within an organization’s culture by assessing for the incidence of bullying and by providing an educational program for the …

Evidence-Based Pediatric Diabetic Ketoacidosis Education, Sonya Sandhu

Walden Dissertations and Doctoral Studies

Pediatric patients with diabetic ketoacidosis (DKA) are a unique subset of patients who arrive to the emergency department (ED) for care, and differ from adults regarding symptomology, treatment, and adverse effects. Nurses who will encounter this patient population must have adequate knowledge and confidence to care for them, yet research continues to show a gap in practice. The purpose of this doctoral project was to determine if a staff education project would increase ED nurse knowledge and confidence in caring for pediatric emergency patients with DKA. Utilizing Kirkpatrick’s evaluation model, an evidence-based staff education program was formulated, reviewed by an …

Systematic Review Of Loss-Frame Messaging And Change In Health Behavior, Eddie Jean Simmons

Walden Dissertations and Doctoral Studies

Recent analysis estimates Type II diabetes affects 23.4 million people in the US. Approximately 30% of these patients are not in optimal control of their diabetes, raising risks for blindness, amputation, and cardiac disease. A gap in diabetes education practice is that traditional positive-framed messaging has not persuaded many patients to modify their self-management behaviors. There is a need for alternative ways to communicate the risks of not managing the disease to patients who may have different health beliefs. The purpose of this systematic review was to examine the best available evidence regarding the efficacy of loss-frame messaging when used …

Nurse Leaders’ Perspectives On Animal-Assisted Interventions, Samantha Vita Abate

Walden Dissertations and Doctoral Studies

Knowledge deficits and unfavorable attitudes are commonly cited barriers that prevent adoption of animal-assisted interventions (AAIs). Nurse leaders’ (NLs’) knowledge of and attitudes toward AAIs have not been well documented in the literature. The purpose of this study was to identify NLs’ perspective on AAI, including their usage, knowledge, and attitudes. This information may be helpful in overcoming common barriers to AAI usage. The theory of transformational leadership guided this 3-manuscript dissertation study, which included 3 studies on NLs’ use of AAIs, the relationship between NLs’ knowledge of AAIs and NLs attitudes toward AAIs, and the potential impact of AAI …

Improving Suicide Prevention In The Emergency Department, Crystal Hartis Andrews

Walden Dissertations and Doctoral Studies

Suicide is a leading cause of death and a significant public health problem in the United States, especially among the youth population. The wide variability of screening practices and limited educational programs for nurses in terms of identification and management of individuals at risk for suicide exists. The purpose of this project was to conduct a systematic review to identify evidence available in support of adequately preparing nurses to conduct suicide screening and inform suicide prevention efforts for youth in emergency departments. Results from the literature review were correlated to formulate recommendations for improving suicide screening practices through the provision …

Evaluating An Incentive Program To Improve Teamwork And Productivity In The Operating Room, Christopher Bejil

Walden Dissertations and Doctoral Studies

The operating room (OR) is a complex system that must run efficiently to remain profitable and of value to its multiple stakeholders who include the patient, surgeon, OR staff member, and hospital administration. The OR at the practice site struggled with teamwork and efficiency in the areas of first-case on-time starts, turnover time, and last-case out times, resulting in a less than favorable impact on the organizational bottom line. The practice-focused question asked if a performance-based incentive bonus program can improve OR efficiency in the department’s three major problem areas. Using Gittell’s relational coordination theory as a framework, the practice …

Pain Assessment Strategies For People With Cognitive Impairment In Nursing Home Settings, Meskelo Tsegaye Bobo

Walden Dissertations and Doctoral Studies

Assessment of pain in patients with a diagnosis of dementia or cognitive impairment continues to be underdiagnosed as there are no objective ways of assessing their pain. Available evidence also indicates that these patients are not receiving satisfactory pain management. Due to a lack of self-reporting of pain, accurate assessments of pain are challenging. This systemic review aimed to find a pain assessment strategy effective in identifying pain in patients with a diagnosis of dementia. Kolcaba's theory of comfort was used as the theoretical framework for the study. The databases of Medline, Cochrane Database of Systematic Reviews, Embase, and Cumulative …

Hiv/Sti Screening, Testing, And Prophylaxis Among Sexual Assault Survivors In U. S. Emergency Departments, Elizabeth A. Cita

Walden Dissertations and Doctoral Studies

Use of HIV screening/testing and prophylaxis has been found to be low in the general emergency department (ED) population. Less is known about the use of HIV/sexually transmitted infection (STI) screening, testing, and prophylaxis among sexual assault survivors who present to EDs. The main research questions asked whether there was a relationship between race, socioeconomic status (SES), geographic region, or age, HIV/STI, treatment, and prophylaxis among sexual assault survivors that present to U.S. EDs. This study was a secondary analysis of data collected in the NHAMCS years 2010 to 2016 and included 112 geographic primary sampling units, about 480 hospitals. …

Educating Registered Nurses On Decreasing Missed Care Events, Marie St. Clair Dixon-Brown

Walden Dissertations and Doctoral Studies

Abstract

Missed care or partially completed nursing care is a prevalent problem in healthcare with negative consequences for patients, nurses, and healthcare organizations. This project was developed to address a gap in practice by providing staff education regarding the current evidence about missed care along with practical evidence-based strategies to decrease missed care events. Kalisch’s missed nursing care model framed the project. The staff education program used a PowerPoint presentation with interactive discussion and role-play opportunities for nurse participants to engage in and employ strategies to prevent missed care events. A 10-item multiple-choice post-education quiz and 4-point Likert-type program evaluation …

A Guide For Effective Home Health Education, Dianne M. Nissen

Walden Dissertations and Doctoral Studies

Older adults afflicted with chronic conditions present a unique set of challenges for home health nurses. In addition to caring for many of the patient’s physical problems, patient education is needed to enable patients to manage themselves. Patient education focuses on complicated medication and treatment adherence, safety, and preventing complications. The purpose of this oral presentation and supplemental guide was to increase the knowledge and skills of home health nurses by formally preparing them for the responsibility of patient educator. The practice-focused question was whether the provision of education and a supportive guide for individualizing patient education would improve the …

Health Priorities, Current Lifestyle Behaviors, And Barriers To A Healthy Lifestyle Among Emergency Department Nurses, Shannon C. White

Theses and Dissertations--Kinesiology and Health Promotion

Background: Emergency nurses are tasked with managing the hectic, unpredictable, and constantly changing environment of an ED. In addition, emergency nurses have been shown to have high levels of stress, irregular meal schedules, rotating shift work, long hours, and a lack of physical activity. Furthermore, research has suggested that nurses are at an increased risk for non-communicable diseases, such as diabetes, hypertension, and coronary heart disease (Phiri, et al., 2014), in addition to a high prevalence of obesity (Kyle, et al., 2016).

Methodology: In this study, 23 emergency nurses completed a 43-item survey regarding current behaviors and constructs of …

Residential Radon Exposure, Its Contribution To Lung Cancer, And Social Determinants Of Radon Testing, Stacy Stanifer

Theses and Dissertations--Nursing

Lung cancer is a highly preventable form of cancer. Cigarette smoking is the leading cause of lung cancer followed by radon gas exposure and exposure to secondhand smoke. Kentucky leads the nation in both incidence and mortality from lung cancer. Tobacco use in Kentucky continues to be a major public health concern as nearly one-quarter of adults report current tobacco use and just over one-third of Kentucky homes with children lack rules which prohibit smoking in the home. Radon, a colorless, odorless radioactive gas, occurs naturally from the decay of uranium found in rocks and soil and is harmful when …

Associations Between Psychosocial Stressors, Genes, And Cardiovascular Disease In At-Risk Adults, Kaitlin Voigts Key

Theses and Dissertations--Nursing

Psychosocial stressors have a significant adverse impact on cardiovascular health. While better medical treatments and increased emphasis on healthy lifestyle have improved cardiovascular health for many in the United States over the past 50 years, there are persistent inequities in cardiovascular disease (CVD) rates, with the highest rates among populations burdened by chronic exposure to psychosocial stressors such as discrimination and anxiety, among others. Genetic factors may interact with these stressors further influencing the rates of CVD in these populations. The purpose of this dissertation is to examine associations among psychosocial stressors and other CVD risk factors, and the influence …

Tobacco Use And Nicotine Withdrawal Among Patients With Mental Illness, Yazan Daher Al-Mrayat

Theses and Dissertations--Nursing

People with mental illness (MI) are disproportionately affected by tobacco use compared to the general population. In fact, it is estimated that people with MI consume approximately 44% of cigarettes smoked in the United States. Moreover, the MI population is at greater risk for the negative social, economic, and health consequences associated with tobacco use and are reported to have 25-year shorter life expectancies than the general population. The impact of tobacco use is further noticeable among patients with MI who require psychiatric hospitalization. Quitting smoking in this population has been linked to fewer discharges against medical advice, better quality …

Establishing Exclusive Breastfeeding And The Influence Of Hospital Support, Martha Monroe

Theses and Dissertations--Nursing

Maternal-child health authorities recommend that infants breastfeed exclusively for the first six months of life. Currently, 25% of infants in the United States do so. Breastfeeding specific care that mothers receive from their postpartum nurses and lactation specialists is integral to successfully initiating exclusive breastfeeding. Due to the time sensitive nature of establishing milk supply, interrupting the process of lactogenesis with supplementation puts infants at high risk for early termination of breastfeeding. The purpose of this dissertation is to examine the relationship of breastfeeding care received during the postpartum hospital stay, defined as the first 48-72 hours of life, and …

It Matters Who You Live With. The Relationship Of Living Arrangement And Medication Adherence In Patients With Heart Failure, Rana Lindsay-Rahman

Theses and Dissertations--Nursing

Medication adherence is an ongoing challenge for patients with heart failure (HF) that can adversely affect mortality, morbidity, and quality of life. Living with a spouse has been associated with better adherence while living alone has been associated with poor adherence. Other factors demonstrated to affect adherence include medication complexity, perceived barriers to adherence, and depressive symptoms. Interestingly, the effect of these latter factors on adherence has not been examined in the context of the patient’s living arrangement. The purpose of this dissertation was to investigate the relationships among medication complexity, perceived barriers, and depressive symptoms with medication adherence across …

Impact Of Nicu Design On Feeding-Related Outcomes In Preterm Infants, Emma Kate Calvert

Theses and Dissertations--Communication Sciences and Disorders

Many NICUs around the country are moving away from traditional open-bay designs in favor of single-family rooms (SFRs) as more is understood about the impact of the sensory environment on neurodevelopment in preterm infants. SFRs house one infant and their family for the length of the infant’s stay and are associated with improvements in numerous outcomes, including increased milk intake and weight gain and earlier transition to enteral feeding. Oral feeding remains a critical requirement for NICU discharge; however, the impact of NICU design on feeding outcomes remains unknown.

The purpose of this study was to compare feeding outcomes between …

Promoting A Culture Of Civility Among Oncology Nurses In The Ambulatory Care Setting To Improve Patient Safety And Nurse Retention, Sheila Evans

DNP Scholarly Projects

INTRODUCTION: Nurse incivility is a well-documented phenomenon discussed in the literature and woven into the nursing lexicon. Nurse incivility results in negative consequences for nurses, patients and organizations. Adding to its complexity is the fact that nurses may be unable to identify and address covert uncivil behaviors and lack an effective tactic to mitigate situations.

AVAILABLE KNOWLEDGE: The nursing literature describes the existence of nurse-to-nurse incivility and its correlation with negative outcomes. Regulatory bodies such as The Joint Commission (TJC) also recognize the adverse outcomes resulting from civility and issued two alerts addressing workplace behavior. Additionally, the American Nurses Association …

Using The Bedside Care Conference To Improve The Patient Experience, Eileen Keefe

DNP Scholarly Projects

Abstract

Improving the patient experience of hospital care is a priority for nursing leaders. The terms patient satisfaction and patient experience have been used interchangeably to define the patient’s unique perspective on care quality and the impact of patient engagement on health outcomes. Patients and families experience suffering when their expectations are not congruent with their care in the hospital setting, and there are significant cost and financial implications for organizations that do not reach performance thresholds. Communication with nurses is highly correlated to overall patientsatisfaction in the Center for Medicare and Medicaid (CMS) Hospital Consumer Assessment of Providers and …

Moving A Licensed Practical Nurse To A Registered Nurse In New Hampshire: A Health Policy Initiative, Vicki Gamez

DNP Scholarly Projects

Background: The United States is expected to experience a shortage of Registered Nurses (RN) due to a demand for more nurses to care for an aging population. Not only is there a current deficit in the number of RNs, but there is also a lack of ethnic and racial diversity among RNs. Licensed Practical Nurse (LPN) transition programs increase workforce mobility and allow LPNs to build upon their education and clinical experience as they transition to the RN roles. Therefore, the aim of this DNP project was to implement a health policy change initiative that addresses the barriers of workforce …

Patient-Specific Factors Associated With Surgical Delay In A Large Academic Hospital, Natalie Meyers

Dissertations

The high cost of healthcare is driving the search for more efficient practice, especially in high-stakes locations like the operating room. In addition to financial losses, patients suffer physical and emotional distress, including an increased risk of morbidity or mortality when surgical cases are delayed due to inefficiency. While patient-related causes of delay have been implicated, it is unclear which specific factors are most significant. This study aimed to identify specific patient factors correlated with surgical delay and develop a predictive risk algorithm that describes the relationship between patient-specific factors and surgical delay.

A retrospective review of 36,543 patients’ charts …

The Impact Of The Nursing Shortage On The Quality Of Care Of Veterans, Brian Alexander Fainguersch

Honors College Theses

No abstract provided.

Primary Causes And Risk Factors Leading To Nurse Burnout In The Healthcare Field, Alexa D'Angelo

Honors College Theses

Nurse burnout has become a growing issue among hospitals throughout the world. It is a subject that greatly effects both the mental and physical health of current and future nurses going into the field. This study explored the most popular and well-known causes and risk factors of nurse burnout throughout hospitals. Through the use of structured interviews, three participants were chosen with backgrounds in varying specialties. The interviews consisted of ten predetermined questions, with room for the participants to elaborate. Along with the interviews, data was gathered from current, up to date literature on the research topic of nurse burnout. …

Kujdesi Infermieror Te Pacientët Në Dializë, Bukurije Berisha

Theses and Dissertations

Objektivi kryesor i këtij hulumtimi është vlerësimi i cilësisë së jetës në dializë e personave që jetojnë me sëmundje renale kronike (SRK). Përmes këtij hulumtimi janë përcaktuar standardet e kujdesit infermieror për pacientët të cilët janë në dializë. Studimi u realizua në Qendrën e Hemodializës në Ferizaj, në të cilën morrën pjesë 53 pacientë, 59% e tyre meshkuj dhe 41% femra, të përzgjedhur në mënyrë rastësove. Pyetësori mbulon aspekte të ndryshme të shëndetit të pacientëve në dializë duke theksuar edhe sjelljet etike dhe njohuritë e stafit infermieror dhe bashkëpunimin e tyre infermier – pacient.

Nga gjetjet e hulumtimit që i …

Tobacco Use Among College Students, Tasnim Mohamed, Karina Ramirez, Victoria Cruz, Keiko Sayson, Winnie Asrevi, Sarah Kelly

Student Research Symposium

Background: College students engage in various risk-taking behaviors, such as tobacco use. Literature has identified various reasons such as the need for psychological coping for their stress and anxiety, and the social influence of peer pressure from family and friends. Tobacco use comes in different forms such as pipes, cigars, and e-cigarettes. The use of these substances by a parent, sibling, or peer is highly associated with high levels of use among college students. Students are more likely to use an alternative tobacco product as a form of cigarette cessation. Therefore, the purpose of our study is to gain an …

A Qualitative Descriptive Study About The Experiences And Views Of Undergraduate And Postgraduate Nursing Students: What Influenced Them To Choose The Mental Health Specialty, Kaile Moon

Theses

Nurses perform a vital role in the mental health (MH) speciality. The mental health nurse (MHN) role is complex with expectations to manage a safe milieu, practice person-centred care, crisis management, and therapeutic skills, teach coping skills, provide emotional support, and set professional boundaries. However, MHN recruitment and retention continues to be a global struggle. Nursing students typically have low interest in choosing the MH speciality. Strategies to reduce stigma and improve attitudes and beliefs about MH nursing and mental illness have been successful among nursing students, globally and in Australia. However, these successful strategies have not extended to an …