Nursing Commons^™

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 …

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 …

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 …

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 …

Guiding Nurses To A Healthier Lifestyle, Margaret Yvonne Garcia

Walden Dissertations and Doctoral Studies

AbstractNurses provide continuous patient care around the clock. Nurses who work outside of the 9:00 a.m. to 5:00 p.m. hours are susceptible to fatigue and sleep deprivation that impair their attention to detail, ability to remain focused, information processing, and problem solving. This is especially prevalent among those who work the night shift. Nurses also find that their memory, reaction time, motivation, communication, mood, and empathy are affected with fewer hours of sleep. This project explored the sleepiness that night shift nurses experience and provides nurses with strategies to improve these symptoms. Nurses were provided with a PowerPoint presentation to …

Non-Pharmacological Interventions For Residents With Dementia, Jared Bielanski

Walden Dissertations and Doctoral Studies

The use of antipsychotic medications in persons with dementia has been shown to increase mortality in long-term care (LTC) patients. National guidelines recommend the use of nonpharmacological interventions when possible for LTC residents with dementia. Nurses who work in a local LTC facility are not regularly trained in effective nonpharmacological interventions and lack the knowledge to provide care for patients with dementia. To provide safe and effective alternative interventions to antipsychotic medication use, nurses and direct care staff must have current, evidence-based education available to them about alternative practices. The purpose of this staff education project, guided by Calista Roy’s …

Decreasing Thirty-Day Readmissions For Heart Failure Patients, Willybroad Che

Walden Dissertations and Doctoral Studies

Heart failure (HF) patients have a 20-25% hospital readmission rate within the first month of discharge. Patients experiencing HF often have a decline in health resulting in frequent hospitalizations and encumbering symptoms including dyspnea, fluid retention, and orthopnea. HF is a common condition in nursing homes and accounts for a significant proportion of resident transfers to emergency departments. HF is considered one of the costliest diagnoses in the United States, estimated to cost the healthcare system billions of dollars annually. The purpose of this systematic review was to provide a synthesis of evidence-based literature on the current recommendations and strategies …

Barriers To Reporting Workplace Violence In Emergency Departments: A Systematic Review, Kari Gaston

Walden Dissertations and Doctoral Studies

Underreporting of workplace violence by emergency department (ED) nurses is a global practice concern. When workplace violence is not reported, the breadth of the issue is not reflected in the data, which is necessary to support legislative action, regulatory requirements, and organizational changes to prevent violence. The purpose of this systematic review of literature was to appraise and synthesize evidence regarding ED nurses’ barriers to reporting workplace violence. The practice-focused question addressed the barriers to reporting workplace violence according to emergency nurses. The theory of planned behavior was the theoretical framework for this project. Melnyk and Fineout-Overholt’s critical appraisal of …

Increasing Culturally Competent Care Of Lgbtq Patients By Providing Staff Education, Victoria Jacoby

Walden Dissertations and Doctoral Studies

The majority of health care professionals do not feel confident or competent to adequately care for a lesbian, gay, bisexual, transgender, and queer (LGBTQ) patient. Research has identified a link between poor preparedness of the provider/staff and poor patient outcomes. The purpose of this study was to evaluate the effectiveness of an in-person staff education module about providing culturally competent care to LGBTQ patients. The study focused on providers’ attitudes, preparedness, and confidence in caring for a LGBTQ patient. The Iowa and Kirkpatrick models were utilized to ground and evaluate the study. This study was a one-group pre- and posttest …

Development Of Practice Guidelines Based On Need-Driven Dementia-Compromised Behavior Model, Amy Marie Nolan

Walden Dissertations and Doctoral Studies

People with dementia, who experience cognitive decline, memory loss, and reasoning difficulties, often exhibit compromised behaviors such as agitation or aggressive behavior that impact negatively upon the person’s quality of life and increase safety risks. The purpose of this project was to develop an evidence-based clinical practice guideline (CPG) to improve the use of effective evidence-based interventions by staff in a skilled long-term care nursing facility to manage the compromised behavior of residents with dementia. The Need-Driven Behavioral Model, which suggests that compromised behaviors occur when patient attempts to accomplish a goal or express a need, provided the framework CPG …

Reducing Readmissions For Patients Hospitalized With Congestive Heart Failure, Morgan B. Morgan

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is the leading cause for readmission in hospitals and has a

high mortality and morbidity rate, with implications for hospitals and third-party payers.

Readmissions of patients with CHF are related to inadequate patient knowledge at

discharge, inadequate follow-up with a health care provider, and treatment regimen

nonadherence. Patients report feeling ill prepared to provide appropriate self-care during

the transition from inpatient hospital stay to the home setting. One strategy to assess the

patient's understanding following discharge education is through a process known as

teach-back. The purpose of this quality improvement initiative guided by Knowles's

theory was …

Nursing Faculties’ Perceptions Of Teaching Students Who Speak English As Second Language, Natalia S. Ruiz Muniz

Walden Dissertations and Doctoral Studies

Nursing students who speak English as a second language (ESL) often struggle due to language barriers, the complexity of the medical vocabulary, and the knowledge base that they must develop in a short time. These struggles may be due in part to the preparation of nursing educators to meet the specific needs of the ESL student population. The purpose of this qualitative research study was to develop a greater understanding of nurse educators' perceptions when teaching ESL nursing students. The conceptual framework used was Cummins' framework for the development of language proficiency. Four research questions guided this basic qualitative research …

Relationship Between Burnout And Academic Teaching Level Among Nursing Faculty, Erica Lynn Sciarra

Walden Dissertations and Doctoral Studies

Nursing faculty function as healthcare providers, educators, mentors, advisors, and researchers, which contributes to the development of emotional exhaustion or burnout due to role overload. Symptoms of burnout may vary among nursing faculty depending on academic teaching level, tenure status, and educational preparation and may influence the physical and psychological health of nursing faculty, potentially affecting work productivity, career longevity, and the number of future nurses educated. The purposes of this study, guided by Maslach’s multidimensional burnout theory and the job demands resources model, were to determine (a) if there was a difference in level of burnout between graduate and …

Associate Degree Nursing Graduates’ Experiences Of The Transition From Student To Nurse, Katherine Margaret Slusser

Walden Dissertations and Doctoral Studies

Attrition among newly graduated nurses remains a top concern among nursing leaders in the United States. Many published studies about new graduate nurses focus on bachelors-prepared nurses or on mixed populations of nurses that include both associate and baccalaureate degree graduates. No published studies were located that focused specifically on the Associate Degree Nursing (ADN) graduate. The purpose of this qualitative, interpretive phenomenological study was to understand the experiences of transition after graduation and into professional nursing of newly employed nurses who graduated from an ADN program. The theoretical basis for this study was Meleis’s transition theory. The research question …

Newly Licensed Registered Nurse Generation Cohorts And Retention In First Registered Nurse Positions, Elizabeth S. Gizenski

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to evaluate the association between newly licensed registered nurses (NLRN) generational cohorts and NLRN who plan to leave or have left their first nursing position. The research problem focused on the generational cohorts of NLRN and retention. The research questions addressed different generations of NLRN, their intent to stay in their first job, and whether poor orientation was a factor for those who already left their first nursing position. The theoretical foundation was Strauss–Howe’s generational theory explaining how each generation views the world based on what they experienced in their lifetime. Data retrieved …

Relationship Of Complementary Modes Of Agency In The Self-Management Of Diabetes, Andrew Romo

Walden Dissertations and Doctoral Studies

Effective control of type-2 diabetes mellitus (DM2) is essential for minimizing the likelihood of developing comorbidities that result from poor glycemic control. Extensive self-management considerations are required of people with DM because they must actively participate in their own care and engage with other socially-based sources of self-management support. The purposes of this quantitative study were to determine if there is an association between (a) the extent that the individual mode of human agency is employed and quality of diabetes control among adults who have been diagnosed with DM2 for at least one year and (b) the extent that the …

Exploring The Lived Experiences Of The Prelicensure Hispanic Nursing Student, Mary Valerie Santos

Walden Dissertations and Doctoral Studies

AbstractNursing constitutes the largest group of healthcare professionals in the United States. Despite decades of discussion about the need to diversify the nursing profession, there continues to be a significant lack of diversity, particularly in the number of Hispanic nurses. The purpose of this qualitative study was to explore the lived experiences of Hispanic nursing students who have enrolled in a pre-licensure nursing program using Leininger’s culture care theory as the theoretical framework for this phenomenological study. This study sought to explore the lived experiences of the prelicensure Hispanic nursing student attempting to complete nursing school successfully and what factors …

Effect Of Graded Repetitive Arm Supplementary Programme (Grasp) On Upper Limb Function Among Stroke Patients, Priyanka Noble Ms, Sindhu L Ms

Manipal Journal of Nursing and Health Sciences

Introduction: Stroke is the rapid loss of brain function due to disturbance in the blood supply to the brain. More than 70 % of individuals who have a stroke experience upper limb deficits that impact daily activities. The objective of this study was to evaluate the effect of GRASP on upper limb function among patients with stroke. Methods: It was a quasi-intervention pretest-posttest control group design. The sample consisted of 61 patients with stroke, 31 in the intervention and 30 in the control group attending the outpatient Department of Neurology, Medical College Hospital, Thiruvananthapuram. The upper limb function of patients …

Effectiveness Of Glycerine Magnesium Sulphate Versus Topical Heparin Application In Patients With Peripheral Intravenous Cannula Induced Phlebitis, Neethu M Ms, Sajith B. Pillai

Manipal Journal of Nursing and Health Sciences

Introduction: Peripheral intravenous cannula induced phlebitis is a common and significant problem in clinical practice. Objectives To compare the effectiveness of glycerine magnesium sulphate and topical heparin application and to find the association between the pre-test Visual Infusion Phlebitis (VIP) scores and selected demographic variables. Method: Quasi experimental with two group pre-test post-test design was used. This study was conducted in Bishop Benziger Hospital, Kerala for one month. Using purposive sampling technique 60 patients were selected and assigned randomly into glycerine magnesium sulphate group and heparin group. In glycerine magnesium sulphate group, glycerine magnesium sulphate paste and in heparin group …

The Relationship Of Cognitive Load And Different Participant Roles On Knowledge Retention In Simulation-Based Learning Among Undergraduate Nursing Students, Amanda Houston

Electronic Theses and Dissertations, 2020-2023

Background: High-fidelity simulation (HFS) is a cognitive load inducing educational tool that gives participants an opportunity to emulate clinical scenarios by assuming various roles. HFS offers opportunities for undergraduate nursing students to build fundamental knowledge that can replace, or enhance, clinical experiences. Cognitive load exists on a spectrum and negatively impacts learning when learners are at either extreme of the spectrum. Cognitive load is comprised of the three subcomponents of intrinsic, extraneous, and germane load. Not much is known about different subcomponents or their ability to prediction immediate knowledge and knowledge retention in students who play fundamentally different roles, as …

Undergraduate Nursing Students' Depth Of Reflection And Perceptions Of Self-Debriefing Following Virtual Simulation: A Multi-Method Descriptive Study, Valorie Mackenna

Electronic Theses and Dissertations, 2020-2023

Virtual simulation is a method of simulation-based education in which students participate in a clinical experience within a computer program and away from a clinical environment or classroom. This innovation makes simulation more accessible for learning, but also more challenging when it comes to providing a debriefing activity directly afterward by a facilitator. The purpose of debriefing is to afford learners the opportunity to reflect on the experience with a goal toward improvement. From the best practice standards, two recommendations stipulate that a debriefing session should occur soon after a simulation and should promote reflection. Self-debriefing is uniquely capable of …

Geographic Access To Community Mental Healthcare And Adherence To Treatment Among Patients With Schizophrenia Spectrum Disorders, Marie Smith-East

Electronic Theses and Dissertations, 2020-2023

Disparities in access to mental health care for individuals with schizophrenia spectrum disorders continue to exist in the United States despite the creation of mental health policies seeking to improve access to care. As an integral element of healthcare system delivery, access is influenced by spatial (location) and non-spatial (sociodemographic) factors. Highlighting both spatial and non-spatial dimensions of access to mental healthcare, this study employed an innovative approach encompassing the geography of access and the integration of location analyses to bridge the gap between psychosocial dynamics and mental health services for improving cost-effective continuity of care. The aims were as …

Patients With A Left Ventricular Device And Factors Affecting Readmission, Diana Pitcher

Electronic Theses and Dissertations, 2020-2023

Patients with a left ventricular assist device have a high rate of hospital readmissions after their index (placement of left ventricular device) discharge. With these devices becoming more common providers of care must understand why this population is being readmitted in order to promote well-being and keep patients out of the hospital. The purpose of this study was to identify and describe characteristics of the hospital readmission. This research study was a retrospective analysis of aggregate data from 2013-2019 with a sample size n = 32. The summary of data was described with descriptive statistics. The data was grouped and …

Socio-Spatial And Quality Of Life Themes In Aged Care Architecture: A Qualitative Methods Protocol, Sarah Mcgann, Caroline Bulsara, Holly Farley

Arts Papers and Journal Articles

Aim: To evaluate the connection between residential aged care architecture, the residents’ ability to find home and Quality of Life themes.

Design: This study uses convergent qualitative mixed methods approach across the three phases of the research project to explore the lived experience of residential aged care residents, their family members, and direct care staff.

Methods: The chosen qualitative methodology is based on a constructionist paradigm and uses a combination of observations, photo production and prompted discussions, and architectural visual data collection methods. Funding was approved in March 2018.

Discussion: This research will provide a novel approach to understanding ways …

Mennonite College Of Nursing Annual Report, Fiscal Year 2020, Judy Neubrander

Annual Reports - Mennonite College of Nursing

Annual report of the Mennonite College of Nursing at Illinois State University

Shift Work: Gut Health And Metabolic Disease, Hailey Lane

Senior Honors Theses

The number of people engaged in shift work continues to rise, and with it the research linking shift work to various diseases and conditions. Shift work changes the body’s sleeping patterns and circadian rhythms which has an effect on all parts of the body including the heart, immunity, cancer development, and inflammatory processes. Altered sleeping patterns and circadian rhythms change the composition and anatomy of the gut and microbiome, which in turn affects the development of metabolic diseases. Shift work also changes one’s eating patterns and habits. Altered eating habits similarly changes the composition and anatomy of the gut and …

Gene Editing In Healthcare As It Relates To Oncological Practices, Jennamarie Scanlon

Honors College Theses

No abstract provided.

Health Care Professionals’ Compliance To Tracheal Suctioning Policy At A Tertiary Care Hospital, Rozina Khimani, Fauziya Ali, Salma Amin Rattani, Mohammad Sohail Awan

Department of Surgery Docs

Objective: To assess the compliance of tracheal suctioning practices against the standard guidelines of a tertiary care hospital, with regard to the participants’ professional characteristics.
Methods: Using cross sectional study design, forty health care professionals (HCPs) were assessed twice, using a quantitative structured observational design, for tracheal suctioning practices, in one of the surgical care units of the tertiary care hospital. Tracheal suctioning policy which was used as a tool, its inter-rater reliability was tested and each step showed the Kappa value of 0.65 to 1.000. Data was analyzed using epidata info version 3.5.1 and SPSS version 19.
Results: From …

Perceptions, Impact And Scope Of Medication Errors With Opioids In Australian Specialist Palliative Care Inpatient Services: A Mixed Methods Study (The Periscope Project), Nicole Heneka

Theses

Background: Opioids are a high-risk medicine, and one of the most frequently reported drug classes causing patient harm. In specialist palliative care inpatient services opioids are widely used to manage cancer pain and other symptoms. Palliative care inpatients are vulnerable to both exposure to, and harm from, opioid errors due to a combination of their: advanced age, comorbidities which affect drug metabolism, polypharmacy, and the seriousness of their illness. Despite this potential for harm, and the frequency of opioid administration in this specialist setting, little is known about opioid errors in palliative care. Better understanding the prevalence, patient impact and …

Moral Competence In Nursing: An Exploration Of The Giving Voice To Values Curriculum, Catherine Costa

Theses

The development of moral competence is central to the profession of nursing and its practice. Nurses engage in moral decision making that impacts the health of people, families, and communities. It is important, then, to ensure that nursing graduates possess the necessary moral development for engaging in professional practice. To this end, research was conducted, the principle premise of which was to explore the use of the introduction of the Giving Voice to Values curriculum (Gentile, 2010) and its contribution to the development of moral competence in nursing. The Giving Voice to Values curriculum is a values-based methodology enabling students …