Nursing Commons^™

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 …

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 …

Nursing Majors’ Attitudes Toward Suicide And Mental Health Training, Beverly Arleen Burton

Walden Dissertations and Doctoral Studies

AbstractThe mental health training of nursing majors may play a role in their levels of confidence in attending to suicide patients as working professionals. The purpose of this quantitative study was to explore what impact, if any, attitudes toward suicide had on nursing majors’ levels of confidence in their mental health training. Pender’s health promotion theory was the theoretical framework. A descriptive correlational survey was used to explore individuals majoring in nursing confidence and perceived skills in mental health training. The 4 research questions asked the relationship between the level of confidence in helping someone with a mental health problem …

The Political Astuteness Of The New Mexico Registered Nurse, Gloria Sue Doherty

Walden Dissertations and Doctoral Studies

The United States spends the most per capita of all the developed countries on healthcare but demonstrates the worst healthcare outcomes. National agencies have turned to Registered Nurses (RNs) to improve healthcare outcomes through participation in healthcare policy development. Although the recommendation for participation in policy development exists, RNs, including those in the U.S. state of New Mexico have not participated at high levels. The purpose of this quantitative cross-sectional study was to measure the political astuteness of RNs in New Mexico and to determine to what extent nursing leaders have been successful in diffusing Institute of Medicine recommendations. Rogers’s …

Nursing Home Nurse Turnover And The Association To Workload, Absenteeism, And Number Of Beds, Justin Ryan Gracieux

Walden Dissertations and Doctoral Studies

The aging population in the United States has resulted in an increased need for quality nursing home care, which includes a stable nursing staff and reduced workforce instability. The purpose of this quantitative correlational study was to examine the relationship between direct care nursing staff turnover rates for RNs, licensed vocational nurses (LVNs), and certified nursing assistants (CNAs) concerning workload, absenteeism, and number of beds in Texas nursing homes. The relational coordination theory provided the theoretical framework for understanding the underlying issues and communication needs that may relate to staff turnover. Secondary data from 11,336 direct resident care nursing staff …

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff’s confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …

Territoriality As A Factor In Nursing Incivility, Carolyn Wright

Walden Dissertations and Doctoral Studies

AbstractIncivility and hazing in health care results in unsafe environments, not only for the nurse but also for the client, facility, and other health professionals. The project site, a privately owned medical clinic, has a high employee turnover rate with exit interviews indicating bullying and incivility from long-term nursing staff toward new employees as critical reasons for employee resignation. The literature offers minimal information regarding territoriality, a concept associated with aggressive (i.e., alpha) behaviors in animals and humans and incivility in nursing. The purpose of the project was to identify whether territoriality was a behavioral factor that may have contributed …

Staff Education On The Use Of The Lace Index In Clinical Settings, Carrole Dorcent

Walden Dissertations and Doctoral Studies

As of 2008, the Centers for Medicare and Medicaid Services has instituted monetary penalties for institutions with excess readmissions. As a result of these initiatives, hospitals are investing resources and efforts to educate their staff to use tools aimed at reducing readmission rates. The LACE index tool is one metric used to identify patients at high risk for readmission. The practice-focused question addressed in this project was whether the use of a teaching module is effective at improving clinical staff knowledge on the LACE index. The purpose of the project was to develop a teaching module to educate advanced practice …

Developing A Core Set Of Nursing-Sensitive Indicators For International Pediatric Oncology Nursing Practice, Courtney Erin Sullivan

All ETDs from UAB

Although nursing sensitive indicators (NSIs) have been developed to measure factors influencing nursing care quality and patient outcomes in general and in select specialty areas, a core set of NSIs for international pediatric oncology nursing practice does not exist. Quality nursing care delivery in pediatric oncology is essential to achieving optimal patient outcomes and closing the 50% survival gap between high-income and low- and middle-income countries. To enhance global childhood cancer outcomes influenced by nursing, this dissertation research was conducted with the purpose of developing a preliminary core set of NSIs for international pediatric oncology nursing that is important, actionable, …

Graduate Nurse Transition Programs Pivotal Point Of Participants’ Practice Readiness Questioned During The Covid-19 Pandemic Crisis: A Scoping Review, Kylie Russell, Dianne Juliff

Nursing Papers and Journal Articles

Background: The COVID-19 pandemic requires an accessible, practice-ready nursing workforce to assist with the increase in health service delivery. Graduate nurse transition programs are the entry point for most graduates into professional practice, and this review focused on both empirical studies and gray literature to identify at what point practice readiness occurs and what can assist graduate nurses’ transition to become practice ready.

Method: A scoping review was conducted using the Joanna Briggs Institute scoping review framework.

Results: Consensus purports supportive environments, ideally in formal structured graduate transition to practice programs, to enhance graduate nurses’ clinical skills and confidence development. …

Delegation Practices Between The Registered Nurse And The Assistant In Nursing In The Acute Care Setting In Western Australia, Carol Crevacore

Theses: Doctorates and Masters

Background:

Delegation is an essential skill that allows the Registered Nurse (RN) to allocate aspects of patient care to other team members including the unregulated Assistant in Nursing (AIN). Concerns have been raised about the activities delegated to AINs in the acute care environment.

Aim:

The aim of this research was to explore the practice of delegation between the RN and the AIN in the acute care environment. This delegation practice was examined through the lens of both the RN and the AIN.

Methodology:

This study used a mixed method explanatory sequential design. The participants were RNs and AINs working …

Workplace Bullying, Psychological Hardiness, And Accidents And Injuries In Nursing: A Moderated Mediation Model, Stephen T. T. Teo, Diep Nguyen, Fiona Trevelyan, Felicity Lamm, Mark Boocock

Research outputs 2014 to 2021

© 2021 Teo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Workplace bullying are prevalent among the nursing workforce. Consequences of workplace bullying include psychological stress and workplace accidents and injuries. Psychological hardiness is proposed as a buffer for workplace bullying and psychological stress on workplace accidents and injuries. This study adopted the Affective Events Theory and Conservation of Resources Theory to develop and test a moderated mediated model in two field …

Nursing And Allied Health Staff Perceptions And Experiences Of A Volunteer Stroke Peer Support Program: A Qualitative Study, Rosemary Saunders, Kien Chan, Renée M. Graham, Elena Adams, Caroline E. Bulsara, Karla Seaman, Marcella Cranny-Connolly

Research outputs 2014 to 2021

Purpose: Stroke brings about physical, cognitive, and psychosocial changes and, conse-quently, many stroke survivors feel underprepared for the transition from hospital to home. Nursing and allied health staff have a key role in stroke rehabilitation. Peer support programs have been found effective in supporting stroke survivors, alongside hospital staff caring for stroke patients, by providing experiential knowledge that staff are not able to provide. Aim: This study explored the perceptions and experiences of nursing and allied health staff of a volunteer peer support program for stroke inpatients. Methods: This study utilised a qualitative, evaluative case study design. This study was …

Clinical Staff Perceptions On The Quality Of End-Of-Life Care In An Australian Acute Private Hospital: A Cross-Sectional Survey, Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

Research outputs 2014 to 2021

Objective: To explore the perceptions of clinical staff on the quality of end-of-life care in an acute private hospital. Methods: A descriptive cross-sectional study with a convenience sample of clinical staff in an acute private hospital were surveyed using a validated end-of-life survey. Data from the surveys were analysed using descriptive statistics for quantitative responses and inductive content analysis for the open-ended responses. Results: Overall, 133 staff completed the survey. Of these, 107 had cared for a dying patient in the hospital. In total, 87.6% of participants felt confident in their ability to recognise a dying patient and 66.7% felt …

Estimating The Economic Cost Of Nurse Sensitive Adverse Events Amongst Patients In Medical And Surgical Settings, Aileen Murphy, Peter Griffiths, Christine Duffield, Noeleen M. Brady, Anne Philomena Scott, Jane Ball, Jonathan Drennan

Research outputs 2014 to 2021

Aims: To identify the costs associated with nurse sensitive adverse events and the impact of these events on patients’ length of stay. Design: Retrospective cohort study using administrative hospital data. Methods: Data were sourced from patient discharge information (N = 5544) from six acute wards within three hospitals (July 2016–October 2017). A retrospective patient record review was undertaken by extracting data from the hospitals’ administrative systems on inpatient discharges, length of stay and diagnoses; eleven adverse events sensitive to nurse staffing were identified within the administrative system. A negative binomial regression is employed to assess the impact of nurse sensitive …

Breeching The System: An Exploration Of Women’S Experiences And Breech Care Recommendations, Sara Morris

Research outputs 2014 to 2021

Aim:

This presentation reports the findings of a mixed methods study exploring women’s experiences of breech birth in Western Australia (WA) and professional recommendations for breech care.

Methods:

This pragmatic study consisted of a clinical guideline review, semi-structured interviews with women who had experienced a breech birth in WA and a multi-national e-Delphi study involving professionals with knowledge and/or experience of caring for women with a breech presenting fetus. These methods were deemed the optimal way of incorporating current clinical practice guidelines, with multi-disciplinary recommendations and consumer feedback.

Findings:

The clinical guideline review revealed similarities in antenatal care structure and …

Questionnaires To Measure Process And Structure Of Quality Indicators For Pediatric Nursing, Maria Forsner, Evalotte Mörelius, Lena Hanberger

Research outputs 2014 to 2021

Introduction The quality of nursing care has a significant impact on the outcomes of care. The specific needs of children requiring hospital care make it essential to monitor and compare data not only on the medically oriented outcome measure but also on nursing care, structure, and process, requiring perspectives from registered nurses (RNs) and nurse managers (NMs). Thus, this project aimed to evaluate the structure and process of nursing quality indicators in pediatric hospital care with questionnaires distributed to RN and NM. Methods We developed separate questionnaires for NMs and RNs to assess the process and structure of the quality …

Improving Clinical Communication And Collaboration Through Technology, Michelle Machon

Doctor of Nursing Practice (DNP) Projects

Problem: Over the last 30 years, clinical communication methodologies in healthcare have evolved to become such disparate systems that they lead to confusion, wasted time, and clinician dissatisfaction. The Joint Commission (2016) reports up to 78% of sentinel events in hospitals are linked to communication failures, which have obvious implications for hospital systems in the quality and safety of their current communication systems.

Context: The purpose of this project was to determine the effectiveness of implementing a unified clinical communication technology platform in an acute care hospital setting and to make recommendations from that implementation to the organization’s larger health …

An Evaluation Of Adolescent Concussion Management And Guidelines By Primary Care Providers In The Outpatient Setting: Dnp Scholarly Project, Mary Beth Newkirk

Doctor of Nursing Practice Scholarly Project

Understanding the pathology of a concussion has been a challenging task for many experts in healthcare. An agreed upon definition has yet to be developed and many health care providers are not properly educated to assess and care for those suffering from a concussion. Management of concussion in adolescents, a vulnerable population, requires even more consideration and training. The purpose of this study was to determine the knowledge current providers in the four-state region regarding sport-related concussion management in the adolescent population, to improve patient care and outcomes, and to improve knowledge learned through exposure to a clinical practice guideline-based, …

Creating A Thriving Informatics Culture, Nicholas Webb

Doctor of Nursing Practice (DNP) Projects

Nurses thrive best when they are empowered to make decisions that can positively impact healthcare delivery. Knowledge and application of nursing informatics principles can influence clinical, quality, operational, and financial outcomes in ways that were not available in previous professional nursing generations.

If nursing informatics is the solution, what is the problem? A survey regarding use and attitudes about nursing informatics was taken of chief nurse executives (CNEs) at an integrated, not for profit healthcare system in the Northern California region, where the author oversees the electronic health record (EHR). The results were surprising. Half said they did not know …

Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario

Doctor of Nursing Practice (DNP) Projects

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …

Creating An Educational Intervention To Combat Nursing Incivility Benchmark Study, Kathleen P. Melancon

MSN Capstone Projects

When most people reflect on the nursing as a profession, the term compassionate typically comes to mind. The association with compassion is no surprise as nursing is considered to be the most compassionate profession in the world. Nurses, by trade and in all areas of practice, have an ethical and professional responsibility to create and uphold an environment of mutual respect and civility. However, the notion of “nurses eat their young” and the behaviors that stem from this mindset are causing detrimental effects not only to those organizations employing nurses but to patients and the nurses themselves.

Over the last …

Emergency Department Workplace Violence Against Nurses, Adam Johnson

MSN Capstone Projects

Emergency room nurses are often thought of as the adrenaline junkies of the nursing world. Emergency nurses interact with a wide array of patients and visitors and are often the first clinician a patient may see upon arriving at an emergency department. With this wide array of patients and visitors, also comes a volatile environment with the increased risks of violence against nurses. This violence could include verbal, physical, and emotional violence from patients, visitors, and even fellow staff members. As violence increases, nursing longevity decreases and thus further increases the expense of nursing on a facility. Therefore, this has …

In-Basket Teamwork: Divide The Work And Multiply The Success The Registered Nurse Role In Ambulatory Clinic Ehr In-Basket Management, James Smoot

Master's Projects and Capstones

Electronic Health Record (EHR) in-basket results (e.g., lab results, pathology reports, etc.) must be reviewed and acted upon in a timely manner by clinical staff in order to provide safe and effective care to ambulatory patients. Delays in reading results are significant contributors to medical errors. A large backlog of in-basket results that have never been appropriately filed is both a safety concern and a symptom of other clinical workflow issues. EHRs have shifted a greater proportion of administrative and triage roles onto providers, contributing to provider burnout. This paper synthesizes some of the best evidenced-based practices available for the …

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

Organizational Strategies To Promote Nurse Resilience In The Acute Care Hospital Inpatient Setting: An Integrative Review, Marcia A. Depolo

Doctoral Dissertations and Projects

Nurses practicing in acute care hospital environments are exposed to constant stressors from a variety of sources. Workplace stress can lead to unhealthy coping behaviors, illness, and burnout, with intent to leave the organization or the nursing profession altogether. Resilience-building strategies can be employed to foster coping, improve nurse wellbeing, increase job satisfaction, promote retention, and enhance quality patient outcomes. This integrative review provides a synthesis of scholarly publications on nursing resilience from January 2014 through October 2020. Themes to promote nursing resilience occurred at three levels: personal or individual, unit or group, and organizational. This paper will provide a …

A Program Evaluation Of A Rural Nursing Academic Partnership, Meagan A. Spencer

Electronic Theses and Dissertations

As the American Association of Colleges of Nursing and Commission on Collegiate Nursing Education continue to promote the implementation and creation of literature on academic partnerships, a Christian university, sought to evaluate its academic partnership with a for-profit hospital for the first time in regard to student perspectives. The purpose of this mixed-methods program evaluation was to describe the student perceptions of the academic partnership in trusting, collaborating, and engaging nursing students and recruiting and retaining nursing graduates to rural hospitals and health care facilities. Measurable impacts included both qualitative and quantitative coding of the levels of trust, collaboration, and …

Initiating A Geriatric Clinical Practicum In The Midst Of A Pandemic, April Wood

Faculty Research, Scholarly, and Creative Activity

No abstract provided.

The Effect Of Asynchronous Versus Synchronous Online Course Delivery On Hesi Scores And Student Engagement For Rural Pre-Licensure Nursing Students, Susan Luke Belliston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since nurses are the primary providers of direct patient care in the United States, a shortage in any community can impact the quality of health care available. Rural areas were among the first to be affected by the current nursing shortage. Further challenges to the rural nurse supply include a lack of access to nursing education, particularly baccalaureate education.Both distance and online education options allow for the increased reach of higher education to rural areas. Existing nursing education literature focuses on graduate nurse education and baccalaureate completion education. The pre-licensure nursing student is mostly absent from the existing literature concerning …

An Exploration Of The Numeracy Skills Required For Safe, Quality Nursing Practice, Anna Wendel

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the numeracy skills required for safe, quality nursing practice. Using a descriptive mixed methods design, this study answered two research questions: 1) What numeracy skills do nurses perceive as important for providing safe, quality nursing care in the first three years of practice? 2) How do nurses incorporate numeracy skills into daily patient care during the first three years of practice? Early career nurses from a not-for-profit health care organization in the mid-Atlantic region of the United States (n=109) responded to an online survey tool developed by the student investigator that ranked …