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2020

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Articles 2221 - 2250 of 2469

Full-Text Articles in Nursing

Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens Jan 2020

Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens

Walden Dissertations and Doctoral Studies

Adolescent obesity is a worldwide multifaceted epidemic. This disease affects the medical, physical, psychosocial, and family aspects of adolescent life. Identification, diagnosis, and referrals to providers that can initiate early interventions that improve weight status have been recommended as critical steps in curtailing childhood obesity. This evidence-based clinical practice guideline (CPG) was developed for the healthcare providers at a rural clinic in Southwest Arkansas to provide consistency in the identification, diagnosis, and referral of adolescents. The health belief model (HBM) and the trans-theoretical model (TTM) were used to consider adolescents’ individual characteristics and beliefs as well as their readiness to …

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Medication Reconciliation In An Outpatient Clinical Setting, Tilena Martin Jan 2020

Medication Reconciliation In An Outpatient Clinical Setting, Tilena Martin

Walden Dissertations and Doctoral Studies

Medication reconciliation is a fundamental step in the delivery of safe care, because if it is not done correctly, it can set the stage for medication errors. Medication reconciliation has been shown to alleviate safety issues that lead to mortality, falls, and adverse drug reactions. The project question examined how in-service training can improve the knowledge of nurse practitioners and medical assistants about medication reconciliation. The project was guided by Knowles’ theory of adult learning and Rosswurm and Larrabee’s health belief model. A 1-hour educational module was prepared, and all participants completed the training prior to a discussion period. Sources …

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The Hospital Consumer Assessment Of Healthcare Providers And Systems And Readmissions, Sheri Matson Jan 2020

The Hospital Consumer Assessment Of Healthcare Providers And Systems And Readmissions, Sheri Matson

Walden Dissertations and Doctoral Studies

Patient perception of care has become a main priority in the delivery of high-quality health care. The creation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provided a nationally standardized method of evaluating patient perception to be incorporated in the reimbursement process defined by the Centers for Medicare and Medicaid Services (CMS). The purpose of this study was to examine the relationship between HCAHPS scores and readmission rates in 2 states in the South Atlantic region of the United States. Using social construction theory, this quantitative study utilized multiple regression analysis to analyze HCAHPS scores (independent …

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Learned Helplessness Among Acute Care Nurses And Its Influence On Inpatient Fall Incidence, Jennifer Glendening Jan 2020

Learned Helplessness Among Acute Care Nurses And Its Influence On Inpatient Fall Incidence, Jennifer Glendening

Walden Dissertations and Doctoral Studies

Over one million inpatient falls with injury are reported across the United States annually resulting in harm which are consistently linked to the quality of nursing care delivery in acute inpatient settings. Learned helplessness (LH) emerges as a behavioral concept to consider among acute care nurses, specifically medical-surgical nurses, because the effects of LH may include an overall decrease in efforts, persistence, and learning due to the repeated exposure to the challenges of balancing complex patients and working environments. The purpose of this study, guided by Donabedian’s model, was to determine if there was a relationship between acute care nurses’ …

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English As A Second Language Students' Experiences In Associate Degree Nursing Programs, Angie Lundgren Jan 2020

English As A Second Language Students' Experiences In Associate Degree Nursing Programs, Angie Lundgren

Walden Dissertations and Doctoral Studies

The general nursing shortage experienced in the U.S. leads students who speak English as a second language (ESL) to enter into nursing school programs. Although these students may enter the nursing programs, they may not successfully complete the nursing programs due to various barriers they face during their enrollment. The purpose of this phenomenological study, guided by the NURS model, was to understand the perceptions and experiences of ESL nursing students related to learning and the barriers to learning and success while enrolled in an associate degree nursing program. Semi structured, face-to-face interviews were conducted with 10 associate degree ESL …

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Barcode Medication Administration In The Emergency Department To Mitigate Medication Errors, Holly Gauthier-Wetzel Jan 2020

Barcode Medication Administration In The Emergency Department To Mitigate Medication Errors, Holly Gauthier-Wetzel

Walden Dissertations and Doctoral Studies

Electronic health record systems (EHRs) have been adopted in healthcare facilities to unify the workflow process of healthcare professionals. Studies have demonstrated the addition of barcode medication administration (BCMA) software technology within the EHR has decreased medication errors within hospitals and long-term care facilities. However, limited research has been conducted to establish whether using BCMA in outpatient areas has had an influence on medication error rates. Literature reveals that many facilities have not adopted BCMA in outpatient areas. The purpose of this study was to investigate whether medication errors were mitigated after BCMA was implemented in the emergency department (ED). …

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Increasing Awareness Of Lateral Violence In The Perioperative Setting, Laura Licea Jan 2020

Increasing Awareness Of Lateral Violence In The Perioperative Setting, Laura Licea

Walden Dissertations and Doctoral Studies

Lateral violence (LV) among nurses has been widely known to occur in specialty units, such as the operating room, where disruptive behavior can breed behind closed doors. Research on LV among nurses has only identified the issue, and further research is needed to properly address the negative behavior. LV affects not only the nursing profession but also patient outcomes. The purpose of this DNP project was to shed light on the topic by improving knowledge regarding the issue in the perioperative setting. Watson’s theory of human caring provided the conceptual framework for the project. The practice question for this DNP …

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Systematic Review Of Falls Among Older Individuals In The Long- Term Care Settings, Nonyelum Patience Odenigbo Jan 2020

Systematic Review Of Falls Among Older Individuals In The Long- Term Care Settings, Nonyelum Patience Odenigbo

Walden Dissertations and Doctoral Studies

Falls are common in the older population and can result in disability, increased dependence, or mortality. Falls have received increased attention in the literature as the most common cause of injuries among older individuals. The incidence of falls in the older population has a positive correlation with adverse health issues necessitating major lifestyle adjustments. The problem is magnified for older patients in long-term care settings where they are 3 times more susceptible to falls. The purpose of this project study was to conduct a systematic review of the literature to understand the impact and incidence of fall rates among older …

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Evidence-Based Strategies For Improving Medication Adherence Among Psychiatric Patients: A Systematic Review, Omah S. Tsikada Jan 2020

Evidence-Based Strategies For Improving Medication Adherence Among Psychiatric Patients: A Systematic Review, Omah S. Tsikada

Walden Dissertations and Doctoral Studies

Nonadherence to psychotropic medications among patients with serious and persistent psychiatric disorders, including bipolar disorder and schizophrenia, is approximately 70%. Nonadherence is a common barrier to the treatment of individuals with mental health disorders. However, there is limited awareness of evidence-based interventions and strategies to address this problem. Therefore, the question for this project asks whether a systematic review can identify strategies to improve adherence of psychotropic medications among individuals with serious and persistent mental illness. The purpose of this systematic review was to explore the evidence-based strategies that can aid in increasing medication adherence in patients with mental health …

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Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza Jan 2020

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …

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Association Between Mental Health Problems, Substance Use, And Social Support In Youth, Venida Gray Jan 2020

Association Between Mental Health Problems, Substance Use, And Social Support In Youth, Venida Gray

Walden Dissertations and Doctoral Studies

Mental health problems are a major public health concern and may be associated with substance use among youth. Youth who receive inadequate social support are at risk of experiencing mental health problems and engaging in substance use. The purpose of this study, guided by the relational regulation theory of social support and the self-medication theory, was to determine whether there was an association between mental health problems, social support, and substance abuse among middle school (MS) and high school (HS) students and whether this association varies with age, using secondary data from the Maine Integrated Youth Health Survey This study …

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Work-Life Balance Best Practices, Amy Marie Higgins Jan 2020

Work-Life Balance Best Practices, Amy Marie Higgins

Walden Dissertations and Doctoral Studies

Poor balance between workplace and family life has been shown to increase stress and impact emotional well-being. Nurses continue to report burnout and high stress levels from time spent in the workplace which contributes to an inability to balance work with life. The gap in nursing practice leadership is the lack of knowledge and tools for supporting the emotional well-being of managers and direct care nursing staff. The purpose of this systematic review was to compile a summary of rigorous evidence-based literature on programs and strategies that nursing leaders can use to provide support in achieving work-life balance for nursing …

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Systematic Literature Review On Fall Prevention In An Acute Care Hospital Setting, Sonia A. Hudson Jan 2020

Systematic Literature Review On Fall Prevention In An Acute Care Hospital Setting, Sonia A. Hudson

Walden Dissertations and Doctoral Studies

Falls, with and without injury, in acute care hospitals are quite common but can be prevented if appropriate interventions are in place to address this issue. It is imperative that nurses assess fall risks of all patients admitted to the hospital and advocate for appropriate interventions to prevent falls in those who are found to be at risk. The purpose of this project was to recommend changes to the current fall prevention protocol in the project facility, an acute care hospital, based on best practices identified in a systematic review of the literature. At the time of the project, the …

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Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson Jan 2020

Examining Icu Nurses' Knowledge Of Ventilator-Associated Events And Ventilator-Associated Pneumonia, Dorothy J. Sanders-Thompson

Walden Dissertations and Doctoral Studies

Ventilator-associated events (VAEs) are patients' complications of respiratory conditions including ventilator-associated pneumonia (VAP). Research shows that VAP is the most common hospital-acquired infection among ventilated patients and a leading source of mortality. With greater risk for complications among ventilated- supported patients, nurses working in the ICU must keep abreast of new knowledge and update expertise to develop technical and clinical skills in daily practice. The purpose of this project was to assess whether an educational intervention would increase the ICU nurses' level of knowledge of the evidence-based intervention. Knowles' adult learning theory was chosen for this project. A paired-samples t-test …

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Nitrous Oxide For Pain Management In The Emergency Department, Jagmohan Kaur Ghotra Jan 2020

Nitrous Oxide For Pain Management In The Emergency Department, Jagmohan Kaur Ghotra

Walden Dissertations and Doctoral Studies

The clinical practice problem addressed was pain control in emergency department (ED) patients. The purpose of this project was to establish situations when inhaled nitrous oxide (N2O) could be used to manage pain in the ED. Specifically, a systematic review provided answers to questions related to appropriate uses of N2O in acute pain management, the effectiveness of inhaled N2O in managing acute pain, and the benefits of and barriers to N2O use in the ED. The middle range nursing theory of acute pain management published by the Agency for Health Care Policy and Research served as the theoretical support for …

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Development Of A Staff Education Project On Managing Patients With Nonmalignant Pain, Gerald M. Mcclain Jan 2020

Development Of A Staff Education Project On Managing Patients With Nonmalignant Pain, Gerald M. Mcclain

Walden Dissertations and Doctoral Studies

Opioids, once considered the cure-all for most pain ailments (acute or chronic), have developed into one of the current largest epidemics. Many contributing factors have led to the opioid crisis, but providers have played a significant role in creating this epidemic. Therefore, this project involved constructing a staff education program for providers to present evidence-based practices (EBPs) that are less addictive pharmacological and nonpharmacological methods for managing nonmalignant pain in an ambulatory clinic. The adult learning theory was used to facilitate the learning process, and logic models were used to guide the process. The topics in the education program included …

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Evaluating The Effectiveness Of Clinical Education On Critical Care Practice, Sara Ellen Salen Jan 2020

Evaluating The Effectiveness Of Clinical Education On Critical Care Practice, Sara Ellen Salen

Walden Dissertations and Doctoral Studies

In 2016, the targeted temperature management (TTM) nursing protocol was updated and implemented at a large hospital in South Carolina. Development of a comprehensive evaluation program became a priority project due to reports that 75% of TTM cases during a 2-year period did not meet national benchmarks for quality and safe care for TTM patients. Therefore, this project answered the questions about whether the development, implementation, and standardization of ongoing TTM education would bridge the gap between knowledge and practice (transference of education). The purpose of this project was to evaluate the effectiveness of the education program launched regarding TTM …

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Provider Education Increasing Recommendation For Human Papillomavirus Vaccination, Tiffany Charest Skinner Jan 2020

Provider Education Increasing Recommendation For Human Papillomavirus Vaccination, Tiffany Charest Skinner

Walden Dissertations and Doctoral Studies

Human Papillomavirus (HPV) was the most common sexually transmitted disease in the United States in 2018 according to the Centers for Disease Control and Prevention (CDC). The CDC established the Healthy People 2020 initiative for HPV vaccination uptake of 80% to effectively eliminate HPV associated cancers. The project site, a rural multispecialty clinic in the Mid-Atlantic United States reported a 3% vaccination compliance rate, well under the national average and the benchmark of 80% recommended by the CDC. The practice-focused question for this project was to determine how education of primary providers will increase recommendation rates for vaccination of HPV. …

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Student Perceptions Of Academic Integrity In An Online Psychiatric Nurse Education, Anne Burlington Jan 2020

Student Perceptions Of Academic Integrity In An Online Psychiatric Nurse Education, Anne Burlington

Walden Dissertations and Doctoral Studies

This study explored student perceptions of academic integrity at an online nursing college with a high rate of plagiarism in Western Canada. Social cognitive theory and the theory of student cheating and plagiarism were used as the conceptual framework for this case study. Participants from a second-year cohort were sent a survey gauging their interest in participation. The ten students were interviewed to better understand what decision making they used to ensure academic integrity during their program of study. Employing a qualitative exploratory case study approach, each interview was taped and transcribed. The interview data were coded by numeric identifiers …

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Use Of Spanish Audio Podcast To Educate Visually Challenged Hispanics With Diabetes, Baiju Issac Jan 2020

Use Of Spanish Audio Podcast To Educate Visually Challenged Hispanics With Diabetes, Baiju Issac

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among the Hispanic population, requiring solutions at the individual, community, and population levels. Self-management helps to manage diabetes and prevent complications, but it is a challenge in nursing practice. Health care providers use printed information to teach patients about self-management of diabetes. However, patients with visual impairment are not able to use these resources. Limited English proficiency, low health literacy, and visual challenges result in the underutilization of health care services within Hispanic communities. Therefore, the purpose of this study was to develop a Spanish audio podcast and lesson plan as teaching tools …

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Staff Education: Prediabetes Lifestyle Modification Toolkit, Vivian Elege Jan 2020

Staff Education: Prediabetes Lifestyle Modification Toolkit, Vivian Elege

Walden Dissertations and Doctoral Studies

Prediabetes patients are at a high risk of developing Type 2 diabetes. The purpose of this project was to educate the medical staff of the project site clinic on lifestyle modifications that can help patients prevent prediabetes from progressing to Type 2 diabetes. The project took place at an outpatient clinic in the Southwestern United States. The clinic patient population is mostly African American, a population at risk for diabetes. The theoretical framework to support the project was the Iowa model of evidence-based practice. Staff education on patient diabetes prevention was the goal of the project. The project question focused …

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The Impact Of Human Resources On Nurses' Turnover Intention, Anita Estell Jackson Jan 2020

The Impact Of Human Resources On Nurses' Turnover Intention, Anita Estell Jackson

Walden Dissertations and Doctoral Studies

Nurse retention is of great concern to healthcare organizations including hospitals. With so many countries reporting a shortage in nursing personnel, healthcare organizations are now seeking ways to reduce this shortage. It is known that job satisfaction and turnover intention impact nurses' continued employment. However, the role of human resources (HR) impact on nurses' job satisfaction and turnover intention is unknown. The theoretical basis of this study came from the work of Bowen and Ostroff who argued the strength of HRM system regulates employee perceptions and outcomes within an organization. Therefore, the purpose of this study was to evaluate the …

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Enhancing The Resilience Of Acute Care Psychiatric Nurses Through A Brief Gratitude Intervention, Patricia D. Sullivan Jan 2020

Enhancing The Resilience Of Acute Care Psychiatric Nurses Through A Brief Gratitude Intervention, Patricia D. Sullivan

Walden Dissertations and Doctoral Studies

Stressors affecting healthcare providers have accelerated in recent years, causing increasing rates of burnout and emotional exhaustion. Evidence suggests that improving general mental well-being of nurses could enhance their resilience and ability to cope in stressful situations. Psychiatric nurses are at risk by caring for involuntary and manipulative patients who can be violent and abusive. The purpose of this project was to improve psychiatric nurses' mental well-being through the implementation of a gratitude practice and examined the effect of this brief gratitude intervention on their mental well-being. Models informing this project were human caring theory, resilience theory, and positive psychology …

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Stroke Prevention Through Education, Laura Lee Ballance Jan 2020

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

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Coping And Support Strategies Portrayed In Rheumatoid Arthritis Illness Blogs, Folasade Bolanle Alagbada Jan 2020

Coping And Support Strategies Portrayed In Rheumatoid Arthritis Illness Blogs, Folasade Bolanle Alagbada

Walden Dissertations and Doctoral Studies

The symptoms of rheumatoid arthritis (RA), such as pain, fatigue, stiffness, and inflammation, limit individuals’ abilities to care for themselves, participate in social events, and complete tasks associated with gender norms. RA is a chronic and debilitating disease that people struggle to cope with physically, mentally, emotionally, socially, and financially, but many have not established effective coping and support strategies. The purpose of this hermeneutic phenomenological qualitative study guided by a combination of Orem’s theory of self-care and Watson’s theory of the human caring was to explore the coping mechanisms and support strategies of women and men with RA as …

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Development Of A Clinical Practice Guideline For The Care Of Transgender Patients, Wayne Zeh Wellington Jan 2020

Development Of A Clinical Practice Guideline For The Care Of Transgender Patients, Wayne Zeh Wellington

Walden Dissertations and Doctoral Studies

AbstractTransgender persons face stigma and discrimination while receiving health care services. The gap in nursing practice at a clinic serving transgender patients in the Southeastern United States was a lack of understanding by providers of evidence-based practices for the provision to patient-centered care. The purpose of this project was to develop a clinical practice guideline (CPG) for the care of transgender patients. The project question asked, based on current evidence, what CPG for patient-centered care should be recommended to providers in the clinic. The patient-centered care model developed around the Donabedian model of quality improvement was used to guide the …

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Qualitative Evaluation Of A Hospital-Based Preceptor-Guided Clinical Orientation Program, Brian Eigelbach Martin Jan 2020

Qualitative Evaluation Of A Hospital-Based Preceptor-Guided Clinical Orientation Program, Brian Eigelbach Martin

Walden Dissertations and Doctoral Studies

Effective preceptor-guided clinical orientation programs (PGCOP) help new graduate nurses (NGNs) across the theory-practice gap to provide safe, effective, and efficient patient care. This constructivist-designed qualitative program evaluation study explored NGNs’ and preceptors’ perceptions of a local hospital’s PGCOP as an effective transition vehicle. The conceptual framework combined Knowles’ andragogical process model for learning with the new world Kirkpatrick model evaluation model. The sample included 7 NGNs who graduated in the past year and had no prior orientation experience and 5 preceptors employed by the study site for at least 1 year. A goal-free approach guided data collection with face-to-face …

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Use Of Simulations To Improve Clinical Judgment In New Graduate Nurses, Aaliyah Sabreen Franks Jan 2020

Use Of Simulations To Improve Clinical Judgment In New Graduate Nurses, Aaliyah Sabreen Franks

Walden Dissertations and Doctoral Studies

The goal of healthcare organizations across the world is to provide safe, efficient healthcare for patients and their families. The practice problem for this DNP Project, a staff education project, addressed simulation as a strategy to improve clinical judgment in new graduate nurses. Recent studies have shown that 23% of new nurses do not demonstrate entry-level competency and are not as effective as more experienced nurses when making clinical judgment decisions. This lack of efficacy poses a threat to patient safety. This was based on nurse’s progression through Benner’s five levels of competency and was designed to enhance new graduate …

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Clinical Practice Guideline: Early Screening For Dementia In Diabetes Mellitus, Angelyn Levell-Smith Jan 2020

Clinical Practice Guideline: Early Screening For Dementia In Diabetes Mellitus, Angelyn Levell-Smith

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus (DM) is a recognized cognitive impairment risk factor. Even with hyperglycemia being a modifiable risk factor in dementia, primary care is without an evidence-based screening tool to screen patients with diabetes for cognitive abilities. Current literature supports developing an evidence-based standardized guideline for early screening for cognitive impairment in elderly patients with DM. The purpose of this doctor of nursing practice (DNP) clinical practice guideline (CPG) project was to develop an evidence-based CPG for early screening of dementia in patients with DM, providing a means for early recognition of cognitive decline in these patients, making early intervention more …

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Staff Education On American Diabetes Association Standards Of Medical Care For Diabetes, Christine Nsubuga Jan 2020

Staff Education On American Diabetes Association Standards Of Medical Care For Diabetes, Christine Nsubuga

Walden Dissertations and Doctoral Studies

Diabetes is a commonly encountered chronic illness that leads to other lifelong comorbidities if left uncontrolled. Ranked as the seventh leading cause of death in the United States, diabetes affects over 29 million Americans. Although 90%-95% of all diabetes cases are preventable with proper planning and management, clinicians continue to be challenged as they strive to achieve the desired patient care goals. This Doctor of Nursing Practice (DNP) staff education project addressed the lack of standard evidence-based care for diabetic patients in the federally qualified health center look-alike practice for which this project was developed. Guided by the practice-focused questions …

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