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2021

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Articles 2341 - 2370 of 2494

Full-Text Articles in Nursing

Clinical Practice Guidelines For Nursing Orientation At A Small Clinic, Elizabeth Bemah Jan 2021

Clinical Practice Guidelines For Nursing Orientation At A Small Clinic, Elizabeth Bemah

Walden Dissertations and Doctoral Studies

In the United States, the registered nurse turnover rate was 17.2% in 2018, a 0.4% increase from 2017. The nursing turnover rate at a small out-patient clinic in the northeast United States was 19.1% in 2019 and has not improved to date. The administrator at the out-patient clinic further indicated that the turnover rate has been approximately two nurses per month for the last 6 months and that the facility did not have a formalized nurse orientation program. Nursing orientation is one of the strategies for increasing the confidence levels and retention of newly hired nurses. The purpose of this …

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Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead Jan 2021

Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead

Walden Dissertations and Doctoral Studies

In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives …

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An Orientation Program For Neonatal Nurse Practitioners In A Level Iii Nicu, Lu-Ann Campagnola Jan 2021

An Orientation Program For Neonatal Nurse Practitioners In A Level Iii Nicu, Lu-Ann Campagnola

Walden Dissertations and Doctoral Studies

Due to a nationwide shortage of neonatal nurse practitioners (NNPs), chronic short staffing shifted priority away from hiring novice and newly graduated NNPs in favor of recruiting experienced NNPs and contracting temporary locum tenens to expeditiously fill gaps in NNP staffing. Provision of formal orientation and an infrastructure that supported successful role transition became devalued and inconsistency in clinical approach and decision-making amongst providers raised concerns for patient safety. The goal of this Doctor of Nursing Practice (DNP) project was to develop a formal orientation program for NNPs in a Level III Neonatal Intensive Care Unit. The purpose was to …

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Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo Jan 2021

Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo

Walden Dissertations and Doctoral Studies

Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …

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Increasing Nurse Manager Knowledge Of Authentic Leadership, Patricia Ann Stone Jan 2021

Increasing Nurse Manager Knowledge Of Authentic Leadership, Patricia Ann Stone

Walden Dissertations and Doctoral Studies

AbstractResearch has demonstrated a positive correlation between authentic leadership and positive patient and organizational outcomes. Given that nurses can be educated in authentic leadership, providing nurse leaders with training opportunities will help them develop authentic leadership skills which will benefit patients and the organization. At the project site, there is little opportunity for leadership development among nurse leaders. Thus, the purpose of this DNP project was to determine if an educational intervention focused on authentic leadership increase knowledge and awareness among nurse managers. Authentic leadership theory grounded the DNP project. Twenty-three nurse managers were invited to participate in an educational …

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Staff Education Program For Chlamydia And Gonorrhea Self-Collected Vaginal Swabbing, Cheryl Marie Tugman Jan 2021

Staff Education Program For Chlamydia And Gonorrhea Self-Collected Vaginal Swabbing, Cheryl Marie Tugman

Walden Dissertations and Doctoral Studies

Girls and women carry the burden of negative consequences of untreated sexually transmitted diseases (STDs), such as chlamydia and gonorrhea. Screening for chlamydia and gonorrhea by increasing self-collected vaginal swabbing (SCVS) can improve access of care and prevent delayed treatment. Nurses may support their patients if they receive training in how to teach screening for sexual self-healthcare. The purpose of this project was to develop and conduct a staff education program in an urban primary care clinic. The project addressed whether the education program would increase nurses’ knowledge of SCVS. The goal is to ultimately increase female patients’ access to …

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A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes Jan 2021

A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes

Walden Dissertations and Doctoral Studies

Critical access hospitals (CAHs) encounter unique challenges in terms of providingquality resources to their community, often lacking quality measures and continuity comparable to larger regional and tertiary hospitals. One CAH in rural Minnesota implemented an overnight hospitalist telemedicine service to address concerns with provider resources and quality practice. An evaluation of quality improvement implementation was completed to address data regarding ER transfers and inpatient length of stay (LOS). Following the triple aim framework to improve patient care, population health, and decrease costs, Donabedian’s model of quality improvement was utilized. Three months of pre and postimplementation data were collected one year …

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Nurse Perspectives Of Trauma-Informed Care, Lee Ann Blazejewski Jan 2021

Nurse Perspectives Of Trauma-Informed Care, Lee Ann Blazejewski

Walden Dissertations and Doctoral Studies

There is growing interest in trauma-informed nursing methods to better respond to the needs of patients with histories of adverse childhood experiences and other traumatic events. Recent advances in the understanding of how trauma can negatively affect long-term health outcomes have fostered a shift towards trauma-informed care as a method to decrease patient retraumatization in nursing practice. With the implementation of trauma-informed care in many areas of healthcare and public health, several challenges have been exposed. The purpose of this study was to examine nurses’ lived experience of implementing trauma-informed care into nursing practice for the care of patients with …

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Staff Education And Depression Screening In Pulmonology And Sleep Medicine, Christina Boyle Jan 2021

Staff Education And Depression Screening In Pulmonology And Sleep Medicine, Christina Boyle

Walden Dissertations and Doctoral Studies

AbstractDespite recommendations that all adults be screened for depression, providers at the project site struggled to consistently assess for depression. Identification of depression is an essential step in depression management, which is a concern for patients with sleep disorders and other pulmonary disease served at the site. The purpose of this project was to develop an education training program for clinicians regarding depression screening. The theory of cognitive development using the Iowa model of evidence-based practice (EBP) guided the project, which sought to determine if an EBP education program regarding depression screening would be an effective means for staff education, …

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The Impact Of Self-Esteem And Body Dissatisfaction On Internalized Stigma In Obese, Hispanic Women, Dorothy M. Burns Jan 2021

The Impact Of Self-Esteem And Body Dissatisfaction On Internalized Stigma In Obese, Hispanic Women, Dorothy M. Burns

Walden Dissertations and Doctoral Studies

AbstractThe current literature on self-esteem (SE), body dissatisfaction (BD) and internalized weight stigma (IWS) was limited, albeit evolving. The variables were well established across multiple domains of study: IWS was consistently noted to be a contributing factor for the development of obesity, but no studies explored the relationship between SE and BD on IWS. Therefore, the purpose of this correlational study was to explore the relationship between SE and BD and their effect on IWS in 30–44-year-old, obese, Hispanic women who are 20% more likely to be overweight or obese than non-Hispanic women. The study was guided by symbolic interactionism …

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Leadership Empowerment Behavior And Psychiatric Nurses Intent To Leave, Temitope Kikelomo Gold Jan 2021

Leadership Empowerment Behavior And Psychiatric Nurses Intent To Leave, Temitope Kikelomo Gold

Walden Dissertations and Doctoral Studies

There is a shortage of registered nurses (RNs) who work in the specialty of psychiatric nursing. Attrition among psychiatric RNs is partly due to lack of leadership empowerment which includes autonomy and access to professional development opportunities. The purposes of this study, guided by Kanter’s theory of structural empowerment, were to determine (a) if there was a relationship between leadership empowerment behavior and psychiatric RNs’ intent to leave within the first 2 years of practice in inpatient psychiatric settings and (b) if there was a relationship between leadership empowerment behavior and intent to leave among psychiatric registered nurses who are …

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Exploring Cultural Experiences Of African American Recipients Of Healthcare, Christopher Steven Hairfield Jan 2021

Exploring Cultural Experiences Of African American Recipients Of Healthcare, Christopher Steven Hairfield

Walden Dissertations and Doctoral Studies

Culturally competent care is widely accepted as a strategy to address healthcare disparities based on the perceptions of the individual provider, yet this approach lacks the voice of the African American (AA) communities intended to benefit from the strategy. Individuals in AA communities have been shown to suffer higher incidence of disease, disproportionately poorer health outcomes, and inequitable healthcare treatment. Framed by Leininger’s culture care theory, the purpose of this interpretive phenomenological study was to explore the lived cultural experiences of AA recipients of care when interacting with the healthcare system in an effort to contribute evidence to improve the …

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Developing Nurse Managers Through An Evidence-Based Education Program, Theresa Ann Hannu Jan 2021

Developing Nurse Managers Through An Evidence-Based Education Program, Theresa Ann Hannu

Walden Dissertations and Doctoral Studies

AbstractThis study explored the lack of formalized managerial education and training for nurses new to leadership. This quantitative study specifically explored the knowledge gap of beginner nurse managers based on a lack of formalized education, a universal approach is supported by the research. Currently, there is no standard or formal nurse manager education program through the Department of Nursing or the Department of Learning and Development. The focus of the evidence-based project was to evaluate pre- and post-data assessing the impact of instituting a formal education program for beginner level nurse managers in collaboration with the human resources department of …

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Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas Jan 2021

Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas

Walden Dissertations and Doctoral Studies

AbstractHeart failure (HF) is a progressive and life -threatening disease that places a large burden on the health care systems worldwide with increased rates of re-hospitalization, readmissions, and outpatient visits. With the use of telehealth monitoring and support from nursing case managers, HF patients are able to manage this disease at home. The focus of this project was to evaluate a home health agency (HHA) telehealth program, exploring if there was an improvement in 30-day readmission rates, and patient satisfaction scores for the HHA telehealth program one year after revising the program incorporating nursing virtual case managers. This project used …

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Clinical Practice Guideline On Childhood Obesity, Catherine Nanyongo Manga Jan 2021

Clinical Practice Guideline On Childhood Obesity, Catherine Nanyongo Manga

Walden Dissertations and Doctoral Studies

AbstractFamily care practitioners (FCPs) are important players in the treatment of childhood obesity. However, the evidence-based literature shows that practitioners lack both knowledge of how to diagnose the condition as well as the confidence and education to care for patients with obesity. The primary care setting for this project has a 77% obesity rate among the clinic pediatric population compared to a national average of 19%; the FCPs at the target clinic lacked sufficient knowledge on the diagnosis and treatment of obesity, limiting their ability and confidence to counsel families on weight control measures. Following the Walden University Clinical Practice …

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An Educational Program For Nurses To Improve Culturally-Appropriate Mental Health Assessment For Nigerian Immigrant Youth In Central Florida, Blessing Anyaiwe Onyekachi Jan 2021

An Educational Program For Nurses To Improve Culturally-Appropriate Mental Health Assessment For Nigerian Immigrant Youth In Central Florida, Blessing Anyaiwe Onyekachi

Walden Dissertations and Doctoral Studies

AbstractNigerians, like other immigrants, face many health issues with rising waves of conflict and political instability that contribute to high migration rates. As a result, when they arrive in other countries, these immigrants not only have to deal with the trauma they left behind but face issues such as cultural stereotypes, stigma, lack of insurance, cultural and language barriers, poor communication, social discrimination, and low socioeconomic status. The question that this project addressed was whether an educational program for nurses would improve knowledge on culturally-appropriate mental health assessment for Nigerian immigrant youth in Central Florida. This was a nursing staff …

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Teaching Guidelines For Screening Prostate Cancer In African American Men, Joain Sophie Silvera Jan 2021

Teaching Guidelines For Screening Prostate Cancer In African American Men, Joain Sophie Silvera

Walden Dissertations and Doctoral Studies

AbstractAfrican American (AA) men have the highest incidence of prostate cancer (PCa) compared to their White and Hispanic counterparts and a higher mortality rate than any other ethnicity. While biological and socioeconomic factors are to be blamed, many AA men are not aware of the opportunities for screening or the prognoses for the condition. There is an obvious need for increased awareness in AA men concerning preventative screening for PCa. Following the Walden University Clinical Practice Guideline Manual and guided by the Appraisal of Guidelines for Research & Evaluation (AGREE II) model to guide and validate the newly developed clinical …

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Use Of Evidence-Based Clinical Practice Guidelines In Obesity Management In Women, Chizimako Margaret Eze Jan 2021

Use Of Evidence-Based Clinical Practice Guidelines In Obesity Management In Women, Chizimako Margaret Eze

Walden Dissertations and Doctoral Studies

Obesity is one of the Healthy People 2020 high-priority public health issue. Obesity is of importance due to the troubling higher prevalence in women because of the close link that exists between body weight and reproductive health in females from menarche to menopause and beyond. The identification of guidelines to improve or manage the care of female patients can alleviate the burden and complications from being overweight or obese. This project guided by the ADDIE (analyze, design, develop, implement, and evaluate) model was conducted in a family primary care clinic to address a gap in practice, the lack of knowledge …

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Alarm Fatigue On Medical-Surgical Units, Jody S. Destigter Jan 2021

Alarm Fatigue On Medical-Surgical Units, Jody S. Destigter

Walden Dissertations and Doctoral Studies

Technology use in the medical-surgical acute care setting has increased and leads to alarm, alert, and notification overload, also known as alarm fatigue, which is one of the top 10 health technology hazards leading to patient harm. Alarm fatigue is a new phenomenon within the acute care health care setting and impacts patients, families, staff, leadership, organizations, and the profession of nursing. The purpose of this descriptive, comparative, quantitative study was to examine the difference in the level of alarm fatigue and its impact on performance for nurses who work on a technology-dedicated, inpatient, medical-surgical unit versus a traditional inpatient …

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Influence Of Questioning On Development Of Clinical Reasoning In Prelicensure Nursing, Teresa Maria Brown Jan 2021

Influence Of Questioning On Development Of Clinical Reasoning In Prelicensure Nursing, Teresa Maria Brown

Walden Dissertations and Doctoral Studies

Clinical reasoning is the basis for every clinical decision a nurse makes; however, only 23% of newly graduated nurses are safely able to recognize urgent clinical patient problems and demonstrate appropriate management of those problems. Furthermore, new nurses make 50% of medical errors. This leaves nurse educators looking for evidenced-based teaching/learning strategies to help their students develop clinical reasoning skills. The purpose of this study was to investigate the influence of questioning as a problem-based teaching/learning strategy on clinical reasoning in undergraduate nursing students. The theoretical framework used to guide this study was Tanner’s clinical judgment model. Using Lasater’s clinical …

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The Patient Dignity Project, Jennifer Kepler Flick Jan 2021

The Patient Dignity Project, Jennifer Kepler Flick

Walden Dissertations and Doctoral Studies

The delivery of patient-centered care is central to many healthcare initiatives. However, the national nursing shortage and the task-oriented nature of the nursing process can make the delivery of this type of care difficult. Nursing as a caring science requires nurses to have an in-depth understanding of how the care they provide impacts patient dignity. Although the Patient Dignity Question is effective as a dignity-preserving intervention, the project facility offered no orientation or educational opportunities that specifically related to patient dignity. This project was a multimodal educational intervention on protecting patient dignity with pre- and posteducation survey assessments. The practice-focused …

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Surgical Site Infection Rates After Implementation Of The Surgical Care Improvement Project Initiative, Victor Lao De Guzman Jr Jan 2021

Surgical Site Infection Rates After Implementation Of The Surgical Care Improvement Project Initiative, Victor Lao De Guzman Jr

Walden Dissertations and Doctoral Studies

Surgical site infections (SSIs) reflect a serious complication in modern healthcare and are a substantial burden to healthcare systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. The Surgical Care Improvement Project (SCIP), introduced in 2006, was developed by the Centers for Medicare and Medicaid Services to reduce SSI rates by 25%. However, SCIP was retired in 2015. Given the considerable financial burden of SSIs and because SSIs may be prevented using evidence-based measures, it was worth revisiting and re-evaluating the quality improvement efforts brought about by the success of the evidence-based SCIP initiative. This …

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Staff Education: Nonpharmacological Interventions For Pain In Older Adults With Osteoarthritis, Rachel 'Seunayo Ilesanmi Jan 2021

Staff Education: Nonpharmacological Interventions For Pain In Older Adults With Osteoarthritis, Rachel 'Seunayo Ilesanmi

Walden Dissertations and Doctoral Studies

Osteoarthritis (OA) pain is a major social problem for older adults and has psychological and physical implications. In the clinic where the project was implemented, the family nurse practitioners (FNPs) are not addressing the OA pain of the older adult patients according to the evidence-based practice (EBP) guidelines. The purpose of this project was to educate FNPs on EBP guidelines regarding nonpharmacological intervention for chronic pain in OA patients. Knowles’ adult learning theory guided the development of the education program specific to the unique learning style of the FNPs. Fourteen FNPs who treat patients with OA in 3 clinic settings …

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Systematic Review Of The Barriers To Breastfeeding For Non-Hispanic Black Women, Ketty N. Floyd Jan 2021

Systematic Review Of The Barriers To Breastfeeding For Non-Hispanic Black Women, Ketty N. Floyd

Walden Dissertations and Doctoral Studies

Breastmilk provides the optimal food for newborns and contributes to improved lifelong health. A community hospital in the Eastern United States serving non-Hispanic Black (NHB) women has a breastfeeding exclusivity rate of only 8%, which is low compared to the state’s exclusivity rate of 40%. A systematic review of the literature was conducted to identify the breastfeeding barriers for NHB mothers and to identify strategies to address them. Guided by Fishbein and Yzer’s integrative model and the SQUIRE 2.0 knowledge reporting framework, 30 articles were appraised using Melnyk and Fineout-Overholt’s hierarchy of research and the Caldwell, Henshaw, and Taylor qualitative …

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The Experience Of Women With Opioid Use Disorder Accessing Methadone Treatment, Lizette Cristine Keenan Jan 2021

The Experience Of Women With Opioid Use Disorder Accessing Methadone Treatment, Lizette Cristine Keenan

Walden Dissertations and Doctoral Studies

The number of women experiencing opioid use disorder (OUD) in Canada has increased exponentially. In Canada, healthcare is socialized and free for all citizens and often medications like methadone are free as well, yet few individuals with OUD access treatment services. The purpose of this study was to describe the lived experiences of Canadian women with OUD who were receiving methadone treatment. Interpretive phenomenology was used to investigate the treatment experiences of seven women with OUD. The conceptual framework of self-care of chronic illness was used examine this phenomenon. Data was analyzed using a seven step process of interpretive phenomenological …

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Preparing Staff Nurses For Timely Management Of Hypertension In Acute Ischemic Stroke, Nneoma Oguguo Jan 2021

Preparing Staff Nurses For Timely Management Of Hypertension In Acute Ischemic Stroke, Nneoma Oguguo

Walden Dissertations and Doctoral Studies

When a blood clot obstructs the flow of blood and oxygen to the brain, it can cause an ischemic stroke. Hypertension is the most important risk factor for ischemic stroke because it causes damage to the arteries, making them easy to burst or clog and subsequently increases the risk of stroke. Advanced treatments have been developed to dissolve clots and restore blood flow to the brain. Tissue plasminogen activator (tPA) has been clinically beneficial in acute ischemic stroke if it is given early and under the right conditions. Nurses can improve patient care through application of evidenced-based management. The purpose …

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Benefits Of Using An Electronic-Medical-Record In The Emergency Department: A Systematic Review, Eduardo Paguntalan Monroy Jan 2021

Benefits Of Using An Electronic-Medical-Record In The Emergency Department: A Systematic Review, Eduardo Paguntalan Monroy

Walden Dissertations and Doctoral Studies

AbstractLow quality of care is a problem for many United States (U.S.) emergency departments (E.D.). The use of electronic medical records (EMR) with quick embedded tools, treatment plans, and protocols decrease E.D. overcrowding, reduce boarding time, to approximate the 4- hour recommendation by the Joint Commission on Accreditation of Healthcare Organizations, and improve quality of care. The project question asked whether a systematic review of EMRs with quick embedded tools, treatment plans, and protocols decreased overcrowding and boarding time, and improved E.D. quality care. This systematic review used the Johns Hopkins Model to answer the project question by guiding selection, …

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Associations Between Nurse Manager Engagement And Nursing Quality Indicators, Justin Travis Morris Jan 2021

Associations Between Nurse Manager Engagement And Nursing Quality Indicators, Justin Travis Morris

Walden Dissertations and Doctoral Studies

Individuals serving in the nurse manager role are critical stakeholders supporting frontline nurses delivering quality care within acute care settings. Despite evidence supporting nurse managers’ contributions to improved quality outcomes for patients by proxy, there is scant evidence supporting direct relationships between the role and outcomes. This study intended to provide quantitative evidence of relationships between nurse managers’ engagement, nurse managers’ tenure, and patient outcomes. The leadership complexity theory classified the nurse manager as a meso-level leader, requiring support from the macro- and microlevels of the organization. Acting as a liaison, meso-level leaders’ function in the space between executive leadership …

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Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson Jan 2021

Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson

Walden Dissertations and Doctoral Studies

Healthcare acquired pressure injuries (HAPIs) are a serious and debilitating condition in the elderly, and it is therefore critical to reduce the incidence of HAPIs. Mitigation strategies are often implemented for patients who score in the highest risk categories on the Braden Scale for Predicting Pressure Sore Risk©. Yet, the evidence suggests vulnerable older adults who score in the midrange of the Braden Scale, and specifically, the mobility subscale, develop HAPI more frequently. The review question centered on the evaluation of the current evidence for early mitigation strategies in response to Braden Scale midrange mobility subscale scores. The gap addressed …

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Reducing Fall Rates At A Long-Term-Care Facility, Francis Ortego Jan 2021

Reducing Fall Rates At A Long-Term-Care Facility, Francis Ortego

Walden Dissertations and Doctoral Studies

In the United States, older adults often experience fall events that may result in physical, mental, and financial hardship. Since the project site was experiencing a significant number of patient falls, a fall-prevention quality improvement (QI) program was implemented. Guided by the diffusion of innovation theory and the plan-do-study-act (PDSA) model, the purpose of this doctoral project was to evaluate the effectiveness of that program to determine if the monthly fall rate in the facility would decrease during the next 6 months. The project site provided deidentified data in the form of monthly fall-rate totals as collected from the long-term-care …

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