Nursing Commons^™

Early Recognition And Management Of Aggressive Behaviors In Delirium, Melissa Dawn Martin

Walden Dissertations and Doctoral Studies

Patients experiencing delirium are challenging for nurses, especially when aggressive behavior is also present. Nurses from all specialties have the potential to encounter patients who have or develop delirium during their hospitalization, particularly in the intensive care unit. Nurses may lack the experience needed to recognize impending aggression which often presents as subtle cognitive changes or do not know the proper way to manage these types of patients. This makes standardized guidelines crucial for the safety of both the nurse and the patient. This project addresses that practice gap through developing an evidence-based clinical practice guideline (CPG) that will help …

Effectiveness Of Interventions To Address Nursing Students' Mental Health: An Integrative Review, Aimee Dickson, Shelby Carter

Master's Projects

Background:

The rigors of the nursing school curriculum are associated with higher levels of stress, anxiety, and depression, resulting in unhealthy habits and ineffective coping strategies that lead to initial difficulties in the academic environment and burnout as professional nurses advance into their careers. This phenomenon further burdens the already taxed workforce, leading to ongoing turnover and compromising care. This integrative review aims to look at what coping strategies have proven most successful in fostering nursing students' well-being, leading to lifelong practices that promote strength while addressing the rigors of academia and, later, the workforce.

Methods:

The literature review search …

Staff Education Presentation: Addressing Polypharmacy As A Risk Factor For Falls Among Older Adults With Psychiatric Disorders, Yetunde E. Adegoroye

Walden Dissertations and Doctoral Studies

The focus of this doctoral project was to address the practice problem of polypharmacy and its association with falls among older adults with psychiatric conditions. The existing evidence shows that polypharmacy, which is defined as the concurrent use of five or more medications, increases the risk of falls, which leads to hospitalization, higher healthcare costs, and reduced quality of life (Varghese et al., 2024). Within the practice setting, it is Crucial to manage polypharmacy to enhance patient safety. The purpose of this project was to enhance medical staff knowledge regarding effective evidence-based strategies for reducing polypharmacy, through an educational presentation. …

Psychoeducation On Addiction For Healthcare Providers, Lovester Duncan

Walden Dissertations and Doctoral Studies

Summary Walden University College of Nursing This is to certify that the doctoral study by Lovester Duncan has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Kristina Bohm, Committee Chairperson, Nursing Faculty Dr. Mary Martin, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2024 The DNP project aimed to increase healthcare providers’ knowledge, awareness, and comfort with prescribing medication-Assisted Treatments (MATs). Inadequate treatment and higher overdose and death risks result from providers lacking experience with …

Staff Education: Improving Nursing Knowledge On Patient Medication Adherence Strategies Using Teach-Back, Janie Fleming

Walden Dissertations and Doctoral Studies

A staff education program was implemented for this Doctor of Nursing Practice project to improve nursing knowledge of the teach-back method. The identified practice problem was inadequate nurse-patient communication, which contributes to low patient comprehension, poor adherence to medication regimens, and suboptimal health outcomes. The practice-focused question guiding the project was, “Does an educational program on the teach-back method for patient medication adherence improve nursing knowledge as compared pre to post education?” The purpose of the project was to enhance nurses’ knowledge and skills regarding the teach-back method to improve patient communication, ultimately leading to better patient adherence and outcomes. …

Staff Education For Identifying And Screening Of Depression Using An Appropriate Tool In The Crisis Stabilization Unit, Esther Chiedu

Walden Dissertations and Doctoral Studies

Executive Summary: Staff Education Project Staff Education for Identifying and Screening of Depression Using an Appropriate Tool In the Crisis Stabilization Unit by Esther Chiedu MS, Walden University, 2023. BS, Madonna University, 2010. Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice. Walden University November 2024

Staff Education On Antihypertensive Medication Compliance Post-Stroke, Ernestina Serwaa Bonsu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was staff education to address the practice problem of staff knowledge deficit related to hypertensive medications compliance for post-stroke patients. The practice question was: Will staff education on antihypertensive medication compliance enhance nursing staff knowledge? It is essential to address the practice problem and question within the context of nursing practice because studies have shown that targeted nursing education promotes patient adherence. Participants were 42 nurses from neurology units who were evaluated before and after face-to-face education sessions. Nurses completed a pre-education survey questionnaire first, followed by education sessions and a post-education survey …

Munchausen Syndrome By Proxy Presentation, Giovanna Tomassoni, Meredith Mackenzie

Master's Projects

Munchausen syndrome by proxy (MSBP) is a serious form of child abuse in which the perpetrator is typically the victim’s maternal caregiver. Assessing for MSBP can be very challenging for medical providers due to symptom mimicry and a dearth of information about the disorder. This Integrative Review seeks to shine a light on common symptomatology of MSBP and to make sure that providers leave it on the differential diagnosis until alternative diagnoses can effectively exclude it. A total of 240 records from online databases were reviewing for content, currency, and rigor. This search was narrowed to 10 records for in-depth …

Factors Associated With Quality Of Postnatal Care In Kenya: An Analysis Of The 2022 Kenya Demographic And Health Survey, Lilian Nuwabaine, Angella Namulem, Quraish Sserwanja, Joseph Kawuki, Earnest Amwiine, Mathius Amperiize, Grace Nakate, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Introduction: Despite the significant contribution of postnatal care (PNC) to maternal and newborn survival, few studies have explored the concept of the quality of PNC received by mothers in Kenya. Therefore, this study aimed to determine the prevalence and factors associated with the quality of PNC in Kenya.

Methods: Secondary data from the Kenya Demographic and Health Survey (KDHS) of 2022 were analyzed, comprising 11,863 women who were aged 15 to 49 years. The quality of PNC was indicated as receiving all components of PNC in the first two days after childbirth. Multivariable logistic regression was conducted to determine the …

Advance Care Planning In Rehabilitation: Training Nurses And Social Workers To Facilitate Discussions, Celeste Christiansen

Student Scholarly Projects

Practice Problem: Patients and healthcare workers fail to hold advance care planning (ACP) discussions. Social workers perceive a lack of time and feel unprepared to hold ACP conversations.

PICOT: The PICOT question that guided this project was: Do patients in acute inpatient rehabilitation (P) who receive education and resources about ACP from trained nurses and social workers (I) accept and participate in ACP (O) compared to prior standards of care (C) while on the rehabilitation unit (T)?

Evidence: The public and healthcare workers have limited knowledge of ACPs and their role in these discussions. People are more likely to hold …

Evaluating An Evidence-Based Quality Improvement Initiative For Food Insecurity Screening And Referral In Adults With Diabetes Initiating Continuous Glucose Monitor Therapy, Coni Dennis

Graduate Theses, Dissertations, and Capstones

Diabetes affects 37 million people annually in the United States, with direct medical costs exceeding $237 billion per year (American Diabetes Association, 2018; Xu et al., 2018). Complications account for up to 64% of diabetes-related expenses, emphasizing the importance of glycemic stability in preventing costly and debilitating outcomes (Dieleman et al., 2016). Diet and nutrition, essential for glycemic control, are often undermined by food insecurity—defined as inconsistent access to adequate, nutritious food—affecting 16% of adults with diabetes (Casagrande et al., 2022; Kirby et al., 2021). Food insecurity is linked to higher HbA1c levels, increased complications, and hospitalizations (Thomas et al., …

Clinical Practice Guideline End Of Shift Handover Toolkit, Sasha Samaroo-Burgos

Walden Dissertations and Doctoral Studies

The DNP project is a Clinical Practice Guideline (CPG) to guide nurses in performing end-of-shift reports at a Medical Center in the West Indies. The gap in practice identified is that nurses perform end-of-shift reporting without using a standardized document. This affects patient safety because the absence of a structured handover process disrupts the continuity of patient care and the transmission of vital patient data. The nurse administrator and general manager reported that many adverse events at the facility were related to miscommunication of information among nurses. The purpose of the project was to develop a CPG that nurses will …

Experiences Of Newly Graduated Registered Nurses’ Successful Transition Into Practice In Their First Year, Angelica Calvillo

Walden Dissertations and Doctoral Studies

The transition into nursing practice can be described as a phase that significantly impacts nurses’ professional development, quality of care, and attrition rates. Newly graduated registered nurses’ experiences during the transition into practice may be challenging and stressful, affect job satisfaction, attrition rates, and burnout. The purpose of this interpretive descriptive qualitative study, guided by Duchscher’s transition theory, was to describe the experiences of newly graduated registered nurses who report a successful transition into clinical practice in their first year postgraduation to identify what factors contribute to their success and retention. Nine newly graduated registered nurses, with 9-12 months of …

Perceptions Of Pre-Exposure Prophylaxis Among American Indians, William Joshua Johnson

Walden Dissertations and Doctoral Studies

American Indians have seen a rise in the transmission of HIV infections compared to other racial and ethnic groups. Pre-exposure prophylaxis (PrEP), which is the use of antiviral medications to prevent HIV, there is insufficient literature to describe the acceptability, attitudes, or willingness to utilize PrEP by American Indians. The purpose of this descriptive qualitative study, guided by the health belief model, was to explore perceptions of PrEP among American Indians. Open-ended semi structured questions were used to interview eight participants to ascertain perceptions of PrEP to prevent HIV infections. Using coding and thematic analysis, four themes were identified: (a) …

Pharmacological Interventions Alone Versus Lifestyle Modifications For Reduction In Atrial Fibrillation, Cody Alan Pike Msn, Enp-C, Fnp-C, Cen, Cfrn, Ctrn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Atrial fibrillation is considered the most common arrythmia affecting individuals globally with an estimated occurrence of 12.1 million individuals by 2030 in the US alone (Joglar et al., 2023). Recent evidence suggests lifestyle modification in combination with pharmacological therapy may decrease the overall financial and health burdens associated with atrial fibrillation (Elliot et al., 2023). The aim of this scoping review is to examine the existing literature to evaluate prescription only versus prescription and lifestyle modifications and its effect of reducing negative health outcomes and overall burden of atrial fibrillation diagnoses.

Methods

Ten articles from 2014 through 2024 were …

The Use Of Gamification In Tutoring Sessions, Megan L. Lee

Honors Capstones

Many students entering the college world have grown up around technology and use it in their everyday lives. While students are showing an increased use and understanding of technology, traditional tutoring methods do not incorporate these skills. Tutoring can be a useful adjunct to the classroom setting regarding student success but can be lacking in student engagement when designed in lecture-based formats to mimic the classroom setting. Therefore, this study aims to evaluate the impact of gamification, especially the use of Kahoot, in tutoring sessions on student engagement. A qualitative research study was conducted with sixteen first semester nursing students …

Best Practice Toolkit For Increasing Colorectal Cancer Screenings In At-Risk Adults, Zoe Windfelder

Student Scholarly Projects

Adult individuals at risk for colorectal cancer (CRC) do not have a direct, accessible best-practice toolkit to follow for screening measures. Research showed that at least three guidelines (i.e., American Cancer Society [ACS], American College of Gastroenterology [ACG], and U.S. Preventive Services Task Forces [USPSTF]) are used interchangeably daily by interprofessional staff for individuals with average to high-risk variables. The project was guided by the following PICOT question: For interprofessional staff supporting the at-risk adult population for colorectal cancer (P), how does the development of a best practice for coordination of care toolkit (I) compared to no structured program strategy …

The Effect Of A Virtual Covid-19 Interprofessional Educational Module On Knowledge, Confidence, Attitude, And Practice Among Health And Allied Health Professions Students, Tsu-Yin Wu, Jenni L. Hoffman, Grigoris Argeros, Sarah Lally, Andrea Gossett Zakrajsek, Jillian Graves, Alice Jo Rainville, Olivia Ford, Angela Lukomski, Renuka Roche, John Sonnega, Joan E. Cowdery Phd

Journal of Interprofessional Practice and Collaboration

Purpose: The purpose of this research study was to examine the effect of an innovative, online COVID-19 interprofessional educational module among health and allied health professions students.

Methods: This study utilized a pre- and posttest design with quantitative and qualitative data collected winter 2023 and spring/summer 2023 semesters, and consisted of health and allied health professions students (N=143) from three Midwestern, urban, public universities. Participants completed a pretest, then an IPE module on COVID-19, and a posttest immediately after the educational intervention, and another (the same) posttest one month later. Quantitative and qualitative data were subject to statistical …

Executive Summary: Staff Education Project Staff Education To Enhance Nursing Competency Through Simulation Technology, Mollie Mae Ellington

Walden Dissertations and Doctoral Studies

Simulation-based training is a key component of nursing education, providing immersive, hands-on experiences that enhance clinical skills in a controlled environment. In the local organization, leadership determined there was an underutilization of advanced simulation equipment stemming from a lack of standardized training among staff. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine whether an educational intervention focused on simulation improved competency among nurses at a local health care organization. To measure competency, 15 items from the Nurse Professional Competence Scale were used. Fifty-eight individuals were invited to participate in the educational intervention, and a …

Executive Summary: Staff Education Project Staff Education Regarding Menopause Hormonal Use In A Women's Clinic, Patricia Leal

Walden Dissertations and Doctoral Studies

This DNP project entails staff education regarding menopause hormonal use in a women's clinic. The practice problem was the lack of staff confidence regarding hormone use in menopausal women. It is essential to address the practice problem within the context of nursing practice because it can potentially enhance positive social change by addressing the healthcare needs of an underserved demographic. The project aimed to develop and deliver an education program regarding the care of menopausal women for staff members in the women's clinic. The project question was whether staff education regarding menopause hormonal use could increase confidence among staff in …

Maternal Substance Use And Neonatal Intensive Care Unit (Nicu) Admission Among Medicaid Beneficiaries: A State-Wide Audit, Vidhani Goel, Ana L. Reyes, Bertille Assoumou, Dodds P. Simangan, Farooq Abdulla, Megumi Akiyama, Deborah A. Kuhls, Kavita Batra

Undergraduate Research Symposium Podium Presentations

Introduction: Mounting evidence suggested a strong association between maternal substance abuse and poor neonatal outcomes. This study aims to investigate an association between maternal substance abuse and NICU admissions and transitions in the LOC among newborns who were Medicaid beneficiaries.

Methods: A hybrid linkage approach was utilized to link two datasets (Birth Registry and Nevada Medicaid Claims) spanning 2015-2021 with nearly 85% linkage efficiency. The infant records were analyzed using univariate and bivariate statistical methods with significance level set at 5%.

Results: A total of 84,181 infant records were identified, of which 70,817 (84.1%) admitted to a single LOC during …

Implementing Motivational Interviewing And Psycho-Education To Improve Medication Adherence Among Patients With Schizophrenia, Francis Ihejirika

Walden Dissertations and Doctoral Studies

This quality improvement staff education Doctor of Nursing practice (DNP) project was implemented to address the quality issue related to medication nonadherence in patients with schizophrenia. Medication nonadherence is a major health issue facing psychiatric patients, with studies showing high rates of nonadherence among patients with schizophrenia. Nonadherence to treatment heightens the risk of relapse, rehospitalization, suicide, and early death. This staff education project focused on increasing the knowledge and attitudes of healthcare professionals about evidence-based strategies to improve medication adherence in patients with schizophrenia. Five nurses participated in the education program. The participants completed the pretest prior to participating …

Evaluation Of The Effectiveness Of The Implementation Of A New Workflow Process On The Incidence Of High Blood Culture Contamination (Bcc) Rates In The Emergency Department, Angelita Rodgers

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice Project was to evaluate the effectiveness of a quality improvement (QI) initiative to reduce blood culture contamination (BCC) rates in the emergency department (ED) of a large healthcare organization in the southeastern United States. Evidence-base sources indicated that high blood culture contamination (BCC) rates compromised diagnostic accuracy, leading to unnecessary treatments, increased hospital stays, and elevated healthcare costs. The project was guided by the evidence-based practice question: “How does the implementation of a new workflow process influence the incidence of high blood culture contamination (BCC) rates in the emergency department?” To address …

Developing An Educational Program To Educate Nurses About Sickle Cell Disease And Vaso-Occlusive Episodic Pain, Margaret Sih Buo-Frundi

Walden Dissertations and Doctoral Studies

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Improving Care For Dementia Patients: Music Therapy As An Alternative To Medication, Kristy Haschke

Walden Dissertations and Doctoral Studies

The incidence of dementia in long-term care facilities has been increasing due to early identification and screening. This staff education topic was brought to further attention due to a trend in requests for chemical restraints in the dementia/cognitive impaired patient population by staff had increased. This staff education project was presented to the rehab center based on evidence-based practice to offer training on music therapy as an alternative therapy to medication in dementia patients. The practice-focused question identified was, “Will a staff education module on an evidence-based alternative treatment, music therapy, for dementia patients versus chemical or physical restraints increase …

Disruptive Clinician Behavior: A Qualitative Descriptive Study Of Non-Native English-Speaking Nurses, Seyoung Baik

Dissertations

Background: Disruptive clinician behaviors among healthcare staff are an increasing concern, negatively affecting patient safety. In 2015, 16% of nurses in the U.S. were foreign-born (Shaffer et al., 2022), and 25% of New York and California nurses were immigrants (Shaffer et al., 2021). Nurses' migration to the U.S. has been exploding. Non-native English-speaking nurses experience complications, problems, and discord in their workplace with coworkers.

Aim: The purpose of this qualitative descriptive study was to explore and understand non-native English-speaking nurses’ experiences with disruptive clinician behaviors in the U.S.

Specific aims were to 1) create a comprehensive description of the experiences …

Focused Education On The Roles And Responsibilities Of The New Nurse During A Patient Emergency, Jeanette Canderozzi

Walden Dissertations and Doctoral Studies

Staff Education Project aimed to measure the knowledge and self-efficacy gained from a comprehensive telemetry educational program as part of the onboarding process for nurses. Purpose of this project was to evaluate the effectiveness of the focused training for the novice nurse as it relates to their knowledge and confidence of their roles and responsibilities in a clinical emergency by using the pre-and postsurvey.

Executive Summary: Staff Education Project, Jacquelynn Hays

Walden Dissertations and Doctoral Studies

Ineffective communication in health care can lead to negative outcomes for patients, including medication errors; delayed or missed treatments; delayed or missed testing; poorer health outcomes, including death; and poor patient satisfaction. The project site, a hospital-based outpatient oncology clinic located in the Midwest, had an identified practice gap in the staff’s current perceptions of effective intradisciplinary communication. The purpose of this project was to develop, implement, and evaluate an education program on effective communication. The practice-focused question centered on whether health care staff demonstrated a change in their perceptions of effective intradisciplinary communication. Twelve registered nurses on staff voluntarily …

The State Of Employment In The United States Among Young Adults With Cerebral Palsy, Eduardo Santos Del Rosario, Jennifer Emilie Mannino Ph.D., R.N., Cne, Patricia A. Eckardt, Dawn Distefano Dps

Nursing: Faculty Publications

Young adults with Cerebral Palsy (CP) have lower employment rates compared to young adults in general, as they may be confronted with physical, sensory, and cognitive impairments, coupled with personal and societal barriers as they mature. These challenges are clear, but the solutions are less so. Understanding the factors that impact employment is vital. This study aimed to identify and examine variables related to employment for this population through the lens of the International Classification of Functioning, Disability, and Health (ICF) model. The Rehabilitation Services Administration (RSA-911) federal dataset was used to examine the relationship between functioning and disability within …

Mitigating Compassion Fatigue, Sylvia Lee Christian-James

Walden Dissertations and Doctoral Studies

Compassion fatigue is the physical, emotional, and spiritual result of chronic self-sacrifice and/or prolonged exposure to difficult situations that renders a person unable to love, nurture, care for, or empathize with another’s suffering. The attributes that led nursing leadership to believe compassion fatigue (CF) was an issue for registered nurses (RN) at the project site facility included increased RN turnover, vacancy rates, absenteeism, and dissatisfaction. The project was to develop a clinical practice guideline (CPG) for the RN staff of an inpatient psychiatric hospital. The practice question was as follows: Does the evidence support usability of a standardized practice guideline …