Nursing Commons^™

The Effect Of Covid-19-Related Stress On Registered Nurses In The United States, Samantha Jacqlyn Genova

Honors Undergraduate Theses

The United States, as of October 2021, is the country with the most reported COVID-19 cases and COVID-19 deaths in the world. Since the first case was confirmed, Registered Nurses working in the acute care setting have been at the forefront of this public health crisis. As the pandemic has continued, studies have been conducted to collect, analyze, and reveal the effect of COVID-19-related stress on Registered Nurses in the United States. This critical literature review takes eleven published studies related to this topic, discusses the commonalities between them, addresses limitations in the literature and offers recommendations for future research. …

Home Healthcare Embodied Agents: Priorities And Opportunities, Faith Sauber

Honors Undergraduate Theses

Prevention is a central tenet of modern healthcare. New ways of informing, educating, and allowing patients to keep track of their health are continually developing. Integrating technology that bridges the gap between healthcare providers and their patients is essential in today's digital age. One emerging idea is the use of home healthcare embodied agents. Embodied agents are conservational interfaces that can interact and look like human beings. They can exhibit both verbal and non-verbal language cues and be capable of having a natural conversation. This kind of technology could help both patients and healthcare providers by giving patients a helpful …

Effectiveness Of Virtual Reality On Reducing Pain In Burn Patients, Jillian R. Carr

Honors Undergraduate Theses

Burn patients undergo excruciating levels of pain throughout their treatment in the hospital. Pain levels increase during medical procedures, such as wound care and debridement. As a part of the treatment plan, traditional pharmacologic interventions are provided. Over time, patients become tolerant of pain medications, specifically opioids. The developed tolerance contributes to more pain felt by the patient. Medical providers limit the number of opioids prescribed to prevent addiction and other adverse effects, contributing to the challenge in treating burn pain. Virtual reality (VR) has been studied as an intervention across various settings to alleviate distressing symptoms in patients. Many …

Home-Based Interventions To Lower Neonatal Mortality Rates In Developing Countries, Josee Sarah Etienne

Honors Undergraduate Theses

Aim: To evaluate Home-based interventions to lower neonatal mortality rates in developing countries.

Background: A developing country is a country that is lacking in the services and facilities enjoyed by people in developed countries, such as personally owned automobiles and homes with indoor plumbing and water-carried sewage disposal systems. The difference in resources compared to developed regions, has been evident to the correlation of the increase neonatal mortality rates.

Method: An electronic, systematic review of four databases were used to retrieve 209 articles initially, later filtered to 42 articles utilized in this review. The following databases used are as listed: …

Facilitation Of Enviromental Factors To Reduce Sound Decibels In The Neonatal Intensive Care Unit: A Literature Review, Cassandra Hanlon

Honors Undergraduate Theses

This literature review investigates nursing interventions to reduce decibel levels in the neonatal intensive care unit (NICU). The secondary purpose of this review was to evaluate if the interventions to reduce noise in the NICU had different outcomes for normal weight premature infants and infants afflicted with neonatal abstinence syndrome. The data bases for completing this review were Google Scholar, the Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus), PubMed, and Elton B. Stephens Co. (EBSCO). The key search words included ‘NICU and decibels', ‘reducing decibels', ‘neonatal abstinence syndrome' ‘decibels', ‘preterm infants' and 'normal weight preterm infant*'. The …

Use Of Mechanical Pronation Beds In Acute Respiratory Distress Syndrome In The Intensive Care Unit: An Integrative Review Of The Literature, Amanda St. John

Honors Undergraduate Theses

The increasing rate of Acute Respiratory Distress Syndrome (ARDS) reinforces the need for additional resources to assist clinical staff with an individual's care and recovery. Pronation therapy involves physically rotating an individual from the posterior position to the prone position. Pronation therapy has successfully been used for individuals diagnosed with ARDS in Intensive Care Units for decades. However, manual pronation maneuvers by staff members poses risks for those who are critically ill and risk of physical injury to caregivers. Mechanical pronation beds have revolutionized the art of pronation therapy, minimizing risks, and decreasing possibility of kinking or pulling out life …

Race-Based Adjustment In Egfr Algorithms: An Integrative Literature Review, Leah E. Utt

Honors Undergraduate Theses

Background: There is a 3-fold risk of developing end stage kidney disease in Non-Hispanic African Americans compared to Non-Hispanic White Americans (Centers for Disease Control and Prevention, 2017). Estimated glomerular filtration rate (eGFR), one of the fundamental algorithms for coordinating treatment for kidney disease which factors in age, race, gender, and levels of creatinine, may pose an issue in this vulnerable population. Currently African Americans receive a correction factor between 1.21 and 1.16 to their eGFR to adjusting the value higher, potentially impacting appropriate kidney disease classification, and delaying beneficial interventions (National Kidney Foundation, 2020).

Methods: A systematic literature search …

Impact Of A Standardized Situation, Background, Assessment, And Recommendation Tool On Satisfaction And Communication In The Perioperative Area, Salomy Abraham

Walden Dissertations and Doctoral Studies

AbstractEffective communication among health care providers is critical to maintain patient safety during the handoff of care. Communication breakdown during handoff can lead to medical errors and sentinel events. The perioperative area is a vulnerable area that is prone to communication errors due to the involvement of providers from various disciplines and the nature of the quick patient turnovers within the perioperative area. To ensure proper communication during the handoff in the perioperative area, a unit-specific handoff tool is required. The focus of the project was to implement a standardized situation, background, assessment, and recommendation (SBAR) communication tool in the …

Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …

Behavioral Health Audit Tool Implementation And Health Care Documentation, Stephanie Lou Weatherly

Walden Dissertations and Doctoral Studies

Quality documentation is a foundational element in healthcare. This QI project was conducted to examine the extent to which the implementation of a standardized behavioral health audit tool influenced compliance with required documentation elements. The context, input, process, product evaluation model was used to support the need for documentation compliance in behavioral health. A new audit tool was developed and implemented. Retrospective audit data were gathered from 86 locations over a period of 3 years, reflecting quarterly corporate audits and monthly program self-audit results. The first five quarters exhibited the widest variation in scoring; 28 locations required action plans for …

Perceived Learning Needs Of High School Teachers Regarding Suicide Prevention, Miranda Lynne Bevilacqua

Walden Dissertations and Doctoral Studies

Suicide is the second leading cause of death among youth in Canada. Though school-aged youth are surrounded by teachers, mentors, and school mental health nurses (SMHN), little is known about what teachers want to know regarding suicide and whether the teachers have the knowledge to recognize youth at risk. The purpose of this generic exploratory qualitative study, guided by the health belief model, was to explore the perceived learning needs of high school teachers in northwestern Ontario (NWO) regarding suicide prevention. The data collection process involved semistructured virtual interviews with 14 high school teachers in NWO recruited via social media. …

Nurse Executives’ Intuitive Decision Making And Leadership Personality Styles During Organizational Change, Chaudron Carter Carter Short

Walden Dissertations and Doctoral Studies

Within the complex and multifaceted health care environment, nurse executives are challenged to effectively make decisions and lead organizations through change. How nurse executives make those decisions is determined in a variety of ways, one being through intuitive decision making. The purpose of this quantitative correlational study, guided by the dual process theory, was to examine nurse executives’ intuitive decision making and leadership personality styles during organizational change. The Agor Intuitive Management Survey and the Multifactorial Leadership Questionnaire were administered to 70 nurse executives recruited by direct email obtained from public hospital organizations’ websites and social media platforms. Regression analysis …

Educating Pediatric Emergency Department Nurses On Autism Spectrum Disorder, Melanie Lynn Cardona

Walden Dissertations and Doctoral Studies

Caring for patients with autism spectrum disorder (ASD) that present to a pediatric emergency department (ED) poses many challenges for nurses. The multifaceted characteristics and needs exhibited by a child with ASD presenting to an ED has the potential to lead to poor patient outcomes. The purpose of this doctoral project was to increase registered nurses’ knowledge and confidence level for caring for patients with ASD in a pediatric ED. The practice-focused question for this doctoral project explored whether the implementation of an ASD educational intervention increase registered nurses’ knowledge and confidence level for caring for patients with ASD in …

Staff Education On Fall Prevention For Inpatient, Geriatric, Psychiatric Patients, Shannon C. Hampton

Walden Dissertations and Doctoral Studies

Falls among hospitalized, geriatric patients are a leading cause of injury. Geriatric patients with psychiatric illnesses are at an even greater risk of falls. The project site was experiencing an increase in the number of patient falls and identified a need for staff education on fall risk assessment and implementation of interventions specific to the hospitalized, geriatric, psychiatric patient. Thus, the practice-focused question for this project was whether an educational program on evidence-based assessment and fall prevention strategies would improve nurses’ knowledge and skills to assess risk for falls and implement appropriate interventions for inpatient, geriatric, psychiatric patients. Knowles’s adult …

Clinical Practice Guideline For Early Identification Of Sepsis In The Emergency, Delta Williams

Walden Dissertations and Doctoral Studies

Sepsis, a life-threatening condition caused by infection, is a leading cause of mortality and morbidity globally. Researchers suggest that early identification of sepsis upon admission to the emergency department (ED) can help mitigate the consequences of sepsis. The emergency department of a hospital in a large urban U.S. city has participated in the Centers for Medicare & Medicaid Services’ sepsis reporting system (SEP-1) since 2015; however, recent reports indicated below benchmark scores. As more than half of patients diagnosed with sepsis were admitted or readmitted through the ED, the purpose of this project was to develop a clinical practice guideline, …

Education Of Staff On Promoting Yoga Activities In Women With Depression, Ahaoma Roselima Nnebedum

Walden Dissertations and Doctoral Studies

Major depression is a serious global health issue and one of the most common mental health problems women face in the United States. The problem in this DNP project, Education of Staff on Promoting Yoga Activities in Women with Depression, was the lack of staff knowledge in using yoga activity to treat women with depression resulting in suboptimal care of women with depression. The DNP project questions were addressed by collecting evidence-based information from the literature to develop the education and to explore if the DNP project would improve the staff knowledge of yoga allowing for the application of the …

Relationship Between Employee Satisfaction And Patient Satisfaction Within The Veterans Affairs Health Care System, Krista Penn

Walden Dissertations and Doctoral Studies

Within health care organizations, the experience of care is a critical measure of the quality of a health care system and is an important measure of success. Over the past several years, the quality and experience of care have been criticized within the Veterans Health Administration. Veterans Health Administration hospitals suffer from low patient satisfaction scores and high nurse turnover rates. Research shows a correlation between patient satisfaction and employee satisfaction within other health care organizations, yet there has been limited research on whether this type of relationship exists within facilities across the Veterans Health Administration. Using Donabedian’s quality health …

A Clinical Practice Guideline: Hospice Care In The Emergency Room, Samer Saad

Walden Dissertations and Doctoral Studies

Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff’s minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging …

Introduction Of Simulation To A Rural Health Care Facility, Jaime Lynn Duke

Walden Dissertations and Doctoral Studies

AbstractDisparities exist between the quality and safety of care provided to patients seen in rural critical access hospitals and patients seen in metropolitan and suburban hospitals. These disparities result from lack of education opportunities and the infrequent exposure of staff to high-risk patient situations. The project addressed the lack of continuing education opportunities by introducing the hospital’s nurse leaders to simulation-based education to improve staff competence. The practice-focused questions asked if providing the nurse leaders of the hospital with information about the benefits of simulation-based staff education would lead to increased knowledge about and support for this type of education. …

Relationship Between Nursing And Nurse Practitioner Instructors’ Online Teaching Self-Efficacy And Their Students’ Online Academic Self-Efficacy, Pauline C. Stoltzner

Walden Dissertations and Doctoral Studies

AbstractTo meet the high demand for nurses and nurse practitioners (NPs) and address the national shortage of these professionals, nursing and NP schools are rapidly moving courses online. With this trend, and with the COVID-19 pandemic, many universities across the United States have been conducting classes in the online environment. The rapid transition from brick-and-mortar classes to online education has been a challenge for underprepared educators. The purpose of this correlational study was to investigate whether a relationship existed between potentially underprepared instructors’ online teaching self-efficacy and their students’ online academic self-efficacy. Bandura’s self-efficacy theory served as the theoretical framework. …

Barriers To Effective Personal Protective Equipment Use In Public Health Workers, Sheila Storr-Mathis

Walden Dissertations and Doctoral Studies

Exposure to infections continues to be a significant concern for nursing practice and for other health care professionals. Personal protective equipment (PPE) minimizes occupational exposure; however, their use is subject to variability. This quality improvement project addressed the impact of an educational intervention on attitudes and barriers to proper use of PPE for public health workers at the study site. The health belief model and the literature review provided theoretical support for the project and evidence of current trends in PPE use. There were 44 employees who completed the preintervention survey and 22 who completed the postintervention survey to gauge …

Clinical Guideline To Support Diabetes Education For Adult Nursing Home Residents, Adediwura Ajadi

Walden Dissertations and Doctoral Studies

AbstractDiabetes is a major cause of increased disease burden and cost of care for patients in long-term care (LTC) settings. Of common diabetes-related complications, hypoglycemia has the most catastrophic implications for this population. Poor understanding, reporting, and management of hypoglycemia by LTC staff can cause increased diabetes-related hospitalizations, disability, deaths, and financial burden for LTC patients and nursing homes. This DNP project focuses on developing a clinical guideline to address the recognition and management of hypoglycemia in LTC settings. It will advance the skills and knowledge of LTC staff regarding hypoglycemia management. The project is grounded in nursing theoretical models …

Development Of A Clinical Guideline For An Emergency Department Fast Track Protocol, Cyrus C-Max Doe

Walden Dissertations and Doctoral Studies

AbstractDue to the large influx of patients, emergency departments (ED) across the United States strive to efficiently manage and improve workflow to increase the quality of care and reduce wait times for patients who present at the ED for care. Well-organized workflow is critical to providing efficient and time-sensitive care, beginning with the Fast Track (FT) area. The FT is a designated area of the ED where lower acuity or noncritical patients are seen and treated. Improving workflow in the FT area of the ED can help lessen wait times and overall length of patient visit and improve the delivery …

Increasing Provider Awareness About The Use Of Cbt In Treating Insomnia In Adults, Ayorinde Oluwagbemiga Oyeneyin

Walden Dissertations and Doctoral Studies

AbstractThis doctoral project addressed the issue of prescribing cognitive-behavioral therapy (CBT) as the first-line treatment for insomnia. Despite being less efficacious, medications are the most preferred form of treatment for insomnia among most psychiatric clinicians. Providers at the clinical site where the project took place were foregoing CBT in preference to medications. Providers preferred the pharmacotherapeutic approach due to its ease of prescription compared to the psychotherapeutic intervention. An educational program was provided for the providers regarding the advantages of prescribing CBT over medications, for the treatment of insomnia. The program was in the form of a PowerPoint presentation, which …

Increasing Staff Knowledge Regarding The Use Of Nonpharmacological Interventions With Long-Term Care Residents Diagnosed With Dementia, Larissa Latrice Anderson

Walden Dissertations and Doctoral Studies

Dementia is an umbrella term that describes a clinical syndrome of progressive cognitive decline. The prevalence of a dementia diagnosis increases with age, making it a common occurrence within the older population. In long-term care facilities, where 5% of the older population reside, antipsychotic medications are the first line of defense and the choice of treatment among patients diagnosed with dementia. Recently, the Center for Medicare and Medicaid Services (CMS) announced a new goal of decreasing antipsychotic medication usage by 15% by the end of 2019. Guided by Watson’s Theory of Caring, this project was conducted to determine if an …

Perceptions Of Midwestern Msn Nps Of The Dnp Degree, Margaret Gallagher

Walden Dissertations and Doctoral Studies

Strong professional forces have emerged within healthcare with expectations for a Doctor of Nursing Practice (DNP) degree for nurse practitioner (NP) practice. While NP contribution to societal healthcare is evident, most of these frontline workers are still only masters’ prepared nurses (MSN). A problem exists in that their views of the DNP have been minimally studied. Hence, the purpose of this study was to investigate perceptions of Midwestern MSN NPs of the DNP. The study was supported by the self-determination theory (SDT) proposing that motivation for goal achievement was driven by perceptions of intrinsic and extrinsic rewards, which set priorities …

Pharmacological Management Of The Diabetic Patient: A Staff Education Project, Wilantha Silva

Walden Dissertations and Doctoral Studies

Poorly controlled diabetes can lead to health complications that impact quality of life, increase healthcare costs, and create a negative impact on communities. Pharmacological management of diabetes was identified by stakeholders as a gap in practice at a clinic in the southeastern United States. The purpose of this project was to develop staff education based on American Diabetes Association (ADA) and American Association of Clinical Endocrinologists (AACE) standards of care, deliver education to primary care nurse practitioners (NPs), and evaluate their learning and confidence levels. The primary framework for this project was the chronic care model. An expert panel, including …

Staff Education Module On Beers Criteria For Geriatric Patients, Eyvonne Denise Hinton

Walden Dissertations and Doctoral Studies

One of the main problems affecting geriatric patients over the age of 65 is the heightened risks of severe complications and mortality from adverse drug events (ADEs). Beers Criteria is a suitable framework for identifying potentially inappropriate medications (PIMs) for such at-risk population. The purpose of this project was to develop an evidence-based educational intervention for use by health practitioners to increase their knowledge and confidence regarding the 2012 American Geriatrics Society (AGS) Beers Criteria for PIMs. Lewin’s change theory provided the conceptual framework for the project. The method to evaluate the scores used involved a descriptive analysis of scores …

An Educational Program For Nursing Home Nurses On Sepsis In Older Adults, Wendy Belden

Walden Dissertations and Doctoral Studies

Elderly nursing home patients’ high rates of hospitalization due to sepsis impact their morbidity and mortality and significantly cost the U.S. healthcare system. Skilled nursing facility (SNF) nurses who have the knowledge to assess older adults for signs and symptoms of sepsis and communicate findings to providers are instrumental in providing improved care for patients. The purpose of this doctoral project was to provide a group evidence-based educational intervention on sepsis care of older adults geared toward nurses working in SNFs. The practice-focused question asked whether an educational intervention focused on the signs and symptoms of sepsis in the elderly …

Staff Education On Diabetes Self-Management For Patients, Gloria Eberechukwu Okoye

Walden Dissertations and Doctoral Studies

Abstract Staff Education on Diabetes Self-Management for Patients by Gloria Okoye MSN, Walden University, 2016 BSN, Walden University, 2015 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2021 Abstract Diabetes mellitus is a chronic disease that poses health and financial burdens to patients, families, and society. An outpatient clinic in the Southeastern United States noted a gap in staff knowledge on diabetes self-management education for high-risk, diabetic patients. The purpose of the project was to educate clinical staff on lifestyle modification practices so that they could better educate diabetic …