The Effects Of Delayed Initial Bathing In Newborns, Danielle Nitzachon

Honors Undergraduate Theses

Delayed bathing of the newborn infant for twenty-four hours after birth can decrease potential newborn complications such as hypoglycemia, hypothermia, and improve the infants skin integrity and breastfeeding rates. The primary purpose of this literature review was to examine the health benefits of delaying initial bathing in newborns for twenty-four hours. A comprehensive review of the literature was performed using peer-reviewed, research articles from multiple databases focusing on delayed infant bathing after birth and health benefits. 15 articles met the inclusion criteria and answered the research questions. Two studies showed the effects of vernix caseosa on improved skin integrity and …

Evaluating Non-Pharmaceutical Sleep Hygiene Interventions For The Prevention Of Delirium And Improvement In Sleep Quality In Critical Care, Sonja L. Colby

Honors Undergraduate Theses

Patients admitted to an adult intensive care unit (ICU) are at risk of developing an acute condition known as ICU delirium, which can impact patients’ length of hospital stay and increase short term and 6-month mortality. The cause of ICU delirium is multifactorial, and lack of quality sleep is a known risk factor. Patients’ sleep in the ICU is frequently interrupted by clinicians involved in their care and equipment alarms. Sleep hygiene interventions to minimize these interruptions for the patient are one strategy to reduce the risk of ICU delirium. Examples of sleep hygiene interventions include eye masks, earplugs, and …

Obstetrical Nursing Care And Cesarean Section Delivery Rates In Laboring Women: An Integrative Review Of Literature, Ayana Cornelius

Honors Undergraduate Theses

Background: There is a documented overuse of C-sections (CS) in the United States. The majority of research surrounding CS overuse focuses on the physician’s role, location (state, city, hospital), hospital policies, and the reason why the CS is being performed. Little research focuses on the nurse’s influence on CS outcomes, although nurses spend the longest amount of time with the patient. Methods: Data for this literature review examined 13 research articles between 1992 to present, exploring factors relating to the overuse of CS, specifically, data relating to the correlation between CS and the nurse’s role. Results: Recent research has shown …

The Effectiveness Of Therapeutic Interventions For The Management Of Vulvodynia: An Integrated Literature Review, Arianna Cohen

Honors Undergraduate Theses

Problem: Vulvodynia, an unexplained vulvar pain, is a medical condition affecting women of all ages, races, and ethnicities and causes pain levels ranging from very mild discomfort to extreme suffering.

Purpose: The purpose of this study was to explore women’s knowledge toward seeking care for vulvodynia and to explore the different types of treatments prescribed after diagnosis. The secondary purpose of this review was to describe the treatments most effective in reducing pain caused by vulvodynia.

Methods: A review of the literature was conducted using articles from 2001 to 2021 that focused on diagnosis of vulvodynia and the relief of …

Bridging The Gaps: Exploring Factors Associated With Goal Achievement Within An Accountable Care Organization Care Coordination Program, Jessica L. Polk

College of Graduate Studies: Theses & Dissertations

Background: Healthcare cost in the U.S. has been increasing at an unsustainable rate due to the growing population diagnosed with multiple chronic conditions and a fragmented healthcare system. The high-risk patient population includes persons who over utilize the healthcare system with frequent avoidable hospitalizations, emergency room visits, and exacerbations of their chronic conditions. This high-risk population makes up five percent of the U.S. but accounts for over fifty percent of all healthcare spending. Care coordination models have emerged to focus proactive health interventions for the highest-risk patient populations to reduce overutilization and empower patients to improve long-term health. Evidence has …

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …

Creating A Clinical Practice Guideline For Patients With Uncontrolled Hypertension, Nar'cissa Mcdonald

Walden Dissertations and Doctoral Studies

Cardiovascular disease is the leading cause of death globally, with hypertension (HTN)the primary causal factor. The nursing professions' role as a critical agent in facilitating the management of patients should be based on best practices. No specific standard exists in the United States for nurses despite the publication of Clinical Practice Guidelines (CPGs) on HTN for adults. A gap in practice was identified in an outpatient primary care clinic located on the Gulf Coast of Mississippi, as there is no comprehensive CPG for nurses to provide patients with complete HTN diagnosis and management care. A literature review revealed that clinical …

Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen

Walden Dissertations and Doctoral Studies

AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …

Food Insecurity In Oncology Patients: An Educational Intervention For Nurses, Chinelo Pernilla Onwuazombe

Walden Dissertations and Doctoral Studies

AbstractFood insecurity is not having enough food or resources or not being able to procure nutritious foods. An observation that nurses in one oncology clinic rarely assessed their patients for food insecurity as part of their regular assessment led to the development and testing of an educational intervention for nurses which was to create awareness on the importance of assessing food insecurity among oncology patients and to learn to use the Household Food Insecurity Assess Scale (HFIAS) in assessing patients. Summative evaluation was done using a pre/and posttest. The Maslow’s hierarchy of needs and the Virginia Henderson nursing need theories …

Nontraditional Former Bachelor Of Science Nursing Students’ Perceptions Of Academic And Social Support Services, Teresa Cowan

Walden Dissertations and Doctoral Studies

Higher education has responded to the nursing shortage by adopting academic and social support services that have increased student retention and promoted higher graduation rates. The purpose of this basic qualitative study was to explore the perceptions of experiences that led nontraditional former Bachelor of Science in Nursing students at a career college to switch from their nursing program to another program within the first 2 years of college, which has contributed to the nursing shortage. This study also explored the perceptions of the participants about the influences, if any, that academic and social support services at the college had …

Identification, Treatment, And Management Of Patients With Suicidal Ideation On The Medical-Surgical Unit For Nurses, Renea Crawford

Walden Dissertations and Doctoral Studies

Suicide and suicidal ideations are among the leading causes of death in the United States. The Joint Commission identifies inpatient suicide as a sentinel event that should never happen. Nurses working on the medical/surgical (M/S) unit in a hospital located in the midwestern region of the United States voiced their concern that they were not prepared to recognize the signs that may indicate an escalating emotional situation in patients with suicidal ideation; in addition, there were no guidelines in the hospital to use as a resource. The purpose of this project was to determine whether an evidence-based (EB) clinical practice …

Systematic Review Of Physiologic Assessment Measures For Mobility Readiness Of Adult Patients In Critical Care, Brenda Kepley Hardin-Wike

Walden Dissertations and Doctoral Studies

Nurses play a significant role in mobility management, an essential element of care for critically ill adults. However, the current practice of mobility management comes from patient orders without the adoption of an evidence-based physiologic assessment guide to support safe patient mobility resulting in unreliable outcomes. Physiologic stability may change during mobility and unsafe patient mobilization can result in negative patient outcomes that increase patient recovery time. The purpose of this systematic review was to look at the current practice of physiologic assessment measures and then use the findings to influence safe patient mobility practices in intensive care units. The …

Increase Knowledge And Attitude In End-Of-Life For Long-Term Care Nurses, Lisa Mitchell

Walden Dissertations and Doctoral Studies

Nurses are key health professionals in long-term care facilities who have an essential role in providing compassionate care at the end-of-life. The customary education that nurses receive in end-of-life care is inadequate to meet the complex care of dying patients. The purpose of this scholarly project was to implement an evidence-based end-of-life educational program to improve the nursing staff knowledge, attitudes towards care of the dying, and standards in long-term care. The theoretical framework to guide this project is Bandura’s self-efficacy to support the confidence and attitude of nurses caring for the dying. The End-of-Life Nursing Education Consortium (ELNEC) Geriatric …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky

Walden Dissertations and Doctoral Studies

Emotional intelligence (EI) is defined as the capacity to recognize and manage emotions and feelings to guide behaviors which is an ability that is crucial for nurse mangers to possess. Understanding the key factors for predicting emotional intelligence in nurse managers may influence hiring practices and the appointment of managers who will influence job satisfaction, employee engagement, retention, and turnover. The purpose of this quantitative predictive correlational study, guided by King’s theory of goal attainment and Mayer and Salovey’s four-branch ability model of EI, was to determine whether age, years of experience as a nurse, and years of experience as …

Primary Care Provider Education On Behavioral Interventions For Management Of Adult, Rose Chinasa Kajuru

Walden Dissertations and Doctoral Studies

The high prevalence of obesity continues to pose significant health challenges globally. According to the U.S. Preventive Service Task Force, obesity affects more than 35% of men and 40% of women in the United States. The national annual cost of medical care related to obesity is estimated at $147 to $210 billion. Intensive behavioral interventions in adults with obesity can lead to clinically sufficient improvements. The project aimed to determine if the current evidence-based clinical guideline of behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults would improve primary care providers’ knowledge of adult obesity management. The …

African American Or Black Nurses’ Perceptions Of Incivility In Nursing Education, Selena M. Murphy

Walden Dissertations and Doctoral Studies

Incivility in nursing education can affect morale, adversely affect patient care, or cause nurses to leave the profession. Bullying, rude comments, and disruptive behaviors are all examples of incivility. These may be perceived as lower in schools like Historically black colleges and universities (HBCUs), where students share the same or similar racial or ethnic background. The purpose of this study was to determine if the perceived levels of incivility experienced in nursing school differ between African American or Black nurses who attended HBCUs and African American or Black nurses who attended non-HBCUs, where the population of nursing students may have …

Fall Prevention Education For Staff In A Long-Term Care Facility, Oluwatoyin Adedun Omola

Walden Dissertations and Doctoral Studies

Older individuals living in long-term care facilities (LTCFs) are more prone to falling compared to those living in the community outside of such facilities. The consequences of falls, including severe injuries, impact not only the patients but also their families and health care costs. The primary purpose of this project was to address the need to reduce and prevent falls in LTCFs. The practice gap was the lack of a comprehensive fall prevention program and education for facility staff about this subject. This staff education project was focused on determining if educating RNs and LPNs about fall risk and prevention …

The Psychological Impact Of Covid-19, Medina Marie Hudson-Odoi

Walden Dissertations and Doctoral Studies

AbstractEmployees from a large government agency were abruptly switched to telework for an extended period of time. There was no plan to address potential psychological stressors associated with the disruption of work-family-life balance that emerged as a result of COVID-19. A knowledge gap in how to support employees was apparent from discussions during team and administrative meetings. The project question explored whether the use of stress first-aid (SFA), an educational program, would enable employees to learn self-care strategies to address stressors in a less protected environment. The purpose of this DNP project was to provide a staff education awareness program …

Development Of An Insomnia Assessment Guideline For Bipolar Disorder, Daniel Oyewusi Oyewole

Walden Dissertations and Doctoral Studies

AbstractBipolar disorder (BD) affects more than 1% of the world’s population regardless of race, sex, ethnicity, or socioeconomic status. BD is a severe and chronic mental illness characterized by insomnia, depressed and elevated mood, racing thoughts, mood swings, anxiety and depression, and suicide. Insomnia is prevalent in BD and occurs across all stages of BD, yet no guidelines exist. The clinical practice guideline entitled the Insomnia Assessment Guideline for Bipolar Disorder (IAGBD) was developed using best-practice evidence from the published literature. The IAGBD is a step-by-step process for assessing insomnia in bipolar patients. Clinicians follow a series of questions in …

Increasing Nurse Leader Knowledge And Awareness Of Information And Communication Technologies, Cory Stephens

Walden Dissertations and Doctoral Studies

Due to the recent coronavirus disease (COVID-19) pandemic, rapid technological innovation and nursing practice transformation exposed a deepening divide in the knowledge and awareness of information and communication technologies (ICT) among nurses. This technological skills gap undermines the benefits of ICT to nursing practice such as increased nurse satisfaction, improved care quality, and reduced costs. Nurse leaders are positioned to promote the use of ICT among nurses but may suffer from the same knowledge deficit of ICT as their followers. Guided by Locsin’s technological competencies as caring in nursing theory, Staggers and Parks’ nurse-computer interaction framework, and Covell’s nursing intellectual …

Opioid Naloxone Education Clinical Practice Guideline, Tat'yana Sahleem Alethia Worthy

Walden Dissertations and Doctoral Studies

As a result of an institution-wide campaign to train providers on the administration of opioid reversal agents within a large medical center in the northeastern United States, the practice problem emerged that there was no patient/family education document for healthcare providers to use as a guide to educate patients on opioid risk and proper administration of naloxone to prevent opioid overdose in the outpatient setting. This scholarly project used an interprofessional team to develop comprehensive opioid naloxone education guidelines to close the gap in clinical practice. The purpose of this project was to develop a patient education clinical practice guideline …

Generational Differences In Nursing Turnover, Adam Bennett

Walden Dissertations and Doctoral Studies

Nursing is currently the largest job category in U.S. health care requiring proper recruitment and retention of nurses. As the current generation of nurses ages out of the workforce due to retirement, new nurses will need to cover the gaps in the workforce. The purpose of this quantitative correlational study was to examine the relationship between voluntary turnover, involuntary turnover, and career change among nurses who were born between 1980 and 1995 (Millennials) and those born between 1965 and 1979 (Generation X). The theoretical framework was Mannheim’s theory of generations. Secondary data were collected from exit interviews with 811 respondents …

Nurses' Experiences Caring For Patients With Opioid Use Disorder, Pamella Maureen Campbell

Walden Dissertations and Doctoral Studies

Over the past 2 decades, opioid use in the United States has taken thousands of lives, reached the level of epidemic in 2017, and has been an area of study among scholars. The problem is health care professionals, including nurses, lack training on how to care for people with opioid use disorder (OUD). Nurses are at the frontline of patient care and understanding the nurses’ experiences in the care of patients with OUD may help to improve the patients’ quality of care. The purpose of this qualitative descriptive study was to develop an understanding of the experiences of nurses with …

Staff Nurse Education To Improve Adherence To Hypertension Management, Veronica Ositadinma Dike

Walden Dissertations and Doctoral Studies

AbstractAdherence to hypertension management medication(s) and lifestyle modification improve outcomes for patients diagnosed with hypertension. In this project, an educational program was developed to reduce the knowledge gap among staff nurses regarding addressing patients’ nonadherence to hypertension management in an outpatient clinic in the southern United States. Guided by andragogy and the health belief model, the staff nurse educational program was developed from evidence-based clinical practice guidelines and best practices from literature to evaluate the impact of education on improving staff nurses’ knowledge related to addressing patients’ nonadherence to hypertension management with the goal of reducing the associated medical costs, …

Staff Education To Improve Knowledge About Suicide Screening, Cidia Alysia Awyie

Walden Dissertations and Doctoral Studies

AbstractHealthcare workers play an essential role in healthcare facilities to help patients with mental health challenges and those at risk of committing suicide. The practice gap that the healthcare facility was experiencing was a knowledge deficit among healthcare staff on the importance of suicide screening. The importance of equipping staff with suicide screening knowledge is to help decrease suicide attempts, suicide thoughts, and completed suicide in patients. The practice-focused question for this staff education project asked if staff education for nursing staff and psychiatrists would increase their knowledge about suicide prevention methods and suicide screening techniques. The purpose of the …

Nurse Managers' Patient Safety Communication, Christine Deatrick

Electronic Theses and Dissertations, 2020-2023

Medical errors are a continuing issue for healthcare organizations and can lead to patient harm or death. To bring about organizational learning and therefore reduce medical errors, information must successfully flow through an organization. Nurse managers play an essential role as the conduit of information between frontline staff and the organization. The primary purpose of this study is to describe the decision-making process of how nurse managers actively select and transmit information on patient safety concerns. A qualitative constructivist grounded theory approach was used. Nineteen unit-level nurse managers, working full-time in an acute care hospital with a minimum of one-year …

Exploration Of The Oral Microbiome In Non-Ventilated Hospitalized Patients, Kimberly Emery

Electronic Theses and Dissertations, 2020-2023

Non-ventilator hospital acquired pneumonia (NV-HAP) impacts 1 in 100 hospitalized patients and is a significant patient concern due to its negative clinical outcomes. Many factors play a role in NV-HAP development: oral health, oral care, microaspiration risk, and the oral microbiome. Little is known about how the oral microbiome alters during hospitalization. This study explored changes in the oral microbiome of non-ventilated hospitalized patients over time and analyzed the relationship between the oral microbiome, pre-hospital residence, and NV-HAP. A prospective, observational design was used to recruit 46 non-ventilated adults 65 years and older from a large medical center in central …

Standardized Postoperative Handoff Tool To Improve Handoff Quality, Haley Durkacz

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Effective communication between healthcare providers is an essential element in the delivery of safe patient care. Loss of relevant information can occur during all phases of patient care but is most inclined to occur during the handoff from the operating room to the postoperative anesthesia care unit (PACU). Evidence has indicated that the transfer of patients by anesthesia providers remains informal and brief despite practice guidelines. When pertinent details are omitted during the anesthesia handoff there is a potential increase for medical errors, delayed treatment, and patient harm. The purpose of this project was to analyze the use of …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …