Occupational and Environmental Health Nursing Commons^™

Patient Education And Coumadin (Warfarin) Therapy: Readmission Rates Pre/Post Coumadin Team Initiation, Rebecca L. Barber

Nursing Theses and Capstone Projects

As a response to the 2011 National Patient Safety Goals (NPSG), a Coumadin Team, consisting of a Physician Chair, Pharmacists, and Registered Nurses, was formed at Mission Health System to focus on International Normalized Ratio (INR) testing, Coumadin dosing, and patient education. The goal of this team has been to identify and eliminate barriers that prevent the stabilization of INRs within the prescribed goal range, and to ensure that all patients receive education about Coumadin therapy in order to prevent harm and reduce readmission rates related to Coumadin therapy. The purpose of this study is to compare readmission rates within …

Relationship Between Psychotropic Drugs And Falls In The Geriatric Population, Lauren E. Fletcher Crotts

Nursing Theses and Capstone Projects

Falls in the geriatric population are extremely common and the risk for falls continues to increase with age. Falls are a leading cause of mortality in the geriatric population, and it is the number one reason for institutionalization in the United States. The purpose of this study was to explore the relationship of the prescribing effects of psychotropic medications such as antidepressants, benzodiazepines, and antipsychotics on falls in the geriatric population who live in a long term care community with a diagnosis of depression, dementia, anxiety, delirium, and Alzheimer's disease. The literature provided mixed conclusions on the effects of psychotropic …

Academic Incivility In Nursing Education, Sherrie Marlow

Nursing Theses and Capstone Projects

A well-documented and growing problem impacting the nursing shortage in the United States is the increasing shortage of qualified nursing faculty. Many factors contribute to the nursing faculty shortage such as retirement, dissatisfaction with the nursing faculty role and low salary compensation (American Association of Colleges of Nursing (AACN), 2005; Allen, 2008; National League of Nursing (NLN), 2010; American Association of Colleges of Nursing (AACN), 2011). Academic incivility has been identified as contributing to nursing faculty role dissatisfaction (Clark & Springer 2010). Academic incivility diminishes the presence of a caring environment, lowers an individual's self-esteem, and negatively impacts the formation …

Cultural Bias Education Of Nursing Faculty, Frank Castelblanco

Nursing Theses and Capstone Projects

A cultural bias education seminar was presented to nursing faculty at a private university in Western North Carolina in an attempt to increase the level of cultural competence. Leininger's "Culture Care and Universality"; a nursing theory was used as the theoretical framework for the project and Campinha-Bacote's Inventory for Assessing the Process of Cultural Competency Among Healthcare Professionals, Revised (IAPCC-R) was employed to measure the pre- and post-cultural competence levels of the nursing faculty. The faculty voluntarily completed the pre-assessment, the seminar was completed and 17 participants completed the post assessment. The statistical findings illustrated an increase in total cultural …

Evidence Based Practice: Patient Discharge Education Barriers To Patient Education, Catherine Lyerly Lingle

Nursing Theses and Capstone Projects

Evidence-based guidelines for discharge instructions, when successfully administered, reduce readmission rates in patients, leading to improved quality of life and economic savings. Unfortunately, effective delivery is complex and time consuming, placing a high demand on already overworked bedside nurses. Failure to provide complete discharge instructions can result in non adherence to patient treatment regimens and lack of essential follow-up, the most commonly identified reasons for readmissions. To improve quality of care, hospitals need to adopt a new model that incorporates delivery of intensive, one on one education to patients during the hospital stay with continuing support, guidance, and education throughout …

The Effects Of A Care Delivery Model Change On Nursing Staff And Patient Satisfaction, Kathleen Gier

Nursing Theses and Capstone Projects

Hospitals across the nation are faced with the challenge of providing high-quality, cost-effective patient care. The purpose of the research study, The Effects of a Care Delivery Model Change on Nursing Staff and Patient Satisfaction, was to examine the impact of implementing a team-approach care delivery model on defined outcomes of staff satisfaction and patient satisfaction. A quasi-experimental design study was utilized to examine the effects of implementing a team-approach care delivery model on a 33-bed Medical-Surgical unit. Prior to and after implementation of the new care delivery model, data were collected regarding patient and staff satisfaction. All nursing and …

Development Of A Lateral Workplace Incivility Nurse Liaison Position In The Psychiatric Healthcare Setting, Christopher L. Brown

Nursing Theses and Capstone Projects

Workplace incivility is becoming commonplace in all work environments including health care. Research highlights the dangerous, distressing, and costly side effects of lateral workplace incivility (LWPI) including nursing staff's overall health, organizational commitment, and intent to stay. Historically, organizations have been considered safe work environments but LWPI has increased over the last several decades. There has also been limited research related to LWPI as it affects psychiatric healthcare staff and no study recommending a needs assessment or developing a position to educate and assist victims. The purpose of this project was to assess psychiatric healthcare staff's understanding and exposure to …

Floating Nurses To Specialty Areas, Deborah S. Hickman

Nursing Theses and Capstone Projects

As the largest group of health care providers, nurses play a vital role in the safety and satisfaction of patients. Despite this vital role, the nursing shortage continues to grow. As a result of this shortage and to fix staffing insufficiencies, nurses are frequently assigned to work in an area that they are not familiar with. This reassignment of a nurse to a different unit from their normally assigned unit is referred to as "floating." Nurses that are reassigned to a different unit from their normally assigned unit are referred to as "float nurses." Some healthcare professionals believe the use …

Medication Safety: Improving Faculty Knowledge And Confidence, Sharon S. Cherry

Nursing Theses and Capstone Projects

The purpose of this capstone project was to increase knowledge and confidence among nursing faculty assisting pre-licensure nursing students with the medication administration process. The project administrator designed a one day Safe Medication Practices seminar that included a Medication Administration Toolkit to increase knowledge and confidence in faculty members about safety and efficiency in giving medications with multiple students on any clinical day. This toolkit included high-fidelity simulation medication scenario case examples as a teaching pedagogy, as well as other teaching strategies to utilize in the clinical environment. Bandura's Social Learning theory provided the framework for this capstone project. The …

Registered Nurses Perceptions Of Patient Advocacy Behaviors In The Clinical Setting, Irma Laney

Nursing Theses and Capstone Projects

Healthcare is becoming more complex and advanced; there is an increase in patient's awareness and safety, higher educational levels of the public, internet access, improved medical technology, development of the Patient's Bill of Rights, and distrust of experts. Patients are often left vulnerable and helpless in the healthcare setting due to limited knowledge about medicine, healthcare, illnesses, and their rights. The purpose of this thesis was to provide an understanding of the RN's perceptions of patient advocacy behaviors in the clinical settings. King's Interacting Systems Framework and middle range Theory of Goal Attainment provided the framework used to identify the …

Nurses' Perceptions Of Shared Medical Appointments, Kristin Monza

Nursing Theses and Capstone Projects

With the increased economic burdens placed on Americans in recent years, the topic of healthcare has been in the forefront. As healthcare reform embraces the country, healthcare organizations are forced to re-examine their business structure more accurately to reflect the changing culture and patient population. The Shared Medical Appointment (SMA) is a model in the chronic disease setting, and many of the benefits and proficiencies have been studied but no studies have assessed nurse experiences or perceptions of SMAs. The purpose of this study was to determine the Registered Nurses's experience with and perception of SMAs. A descriptive exploratory design …

A Structured Orientation Development System For Nursing Faculty, Dana R. Mangum

Nursing Theses and Capstone Projects

A national nursing shortage is nearing its crest. The Baby Boomer generation is beginning to retire in record numbers. Healthcare technology is continually evolving and the topography of nursing education is changing. In order to acquire, develop, and retain excellent nursing faculty to meet the ever changing demands, nursing faculty need to be streamlined into the world of academia. A Structured Orientation Development System (SODS) was developed to aid nursing faculty into the transition from expert bedside nurse to expert nursing faculty. A literature review found no evidence of a structured type nursing faculty orientation system. The purpose of this …

Workplace Violence: Emergency Department Versus Medical Surgical Nurses, Dakeita K. Roakes

Nursing Theses and Capstone Projects

The purpose of this study is to answer the following question: Does a registered nurses department, medical-surgical versus emergency department, change the amount of workplace violence they may experience? To accomplish this, a cross sectional descriptive study using an anonymous web-based Workplace Violence questionnaire survey by Wolters Kluwer Health was used to collect data from nurses working on medical-surgical units and in the emergency department at the facility. The findings indicate more physical violence with more frequent or occasional occurrences in emergency departments. The medical-surgical nurses reported more intimidation or emotional violence and never experience workplace violence.

The Impact Of Simulation-Based Learning Experience On Critical Thinking Acquisition, Candice Rome

Nursing Theses and Capstone Projects

The purpose of this comparative experimental project was to compare the impact of simulation-based learning experiences to traditional clinical rotations on critical thinking acquisition of associate nursing students within a maternal-child course. Innovative pedagogies have been integrated in nursing programs to augment inadequate clinical placement and instructor availabilities. A longitudinal convenience sample of 45 second year associate level nursing students enrolled in a maternal-child course was utilized. Four experimental groups, 24 students were exposed to an eight-hour simulation-based learning experience in place of one clinical rotation. During the eight hour simulation day, students participated in three various maternal-child centered simulations. …

Evaluating The Knowledge And Attitudes Regarding Pain Management Among Nurses In A Surgical Setting At An Acute Care Facility, Barbara Turner

Nursing Theses and Capstone Projects

It is estimated that seventy-three million patients undergo surgical procedures each year in the United States. Of these, 80% experience acute post-operative pain, and approximately 20% experience severe pain (Hutchinson, 2007). Benner's Theory from Novice to Expert was used to guide the study, "Evaluating the Knowledge and Attitudes Regarding Pain Management Among Nurses in a Surgical Setting at an Acute Care Facility". A convenience sample of twenty-one nurses in an acute care hospital in Southwestern North Carolina participated in the Knowledge and Attitudes Survey Regarding Pain. Results showed a weak correlation between knowledge and attitudes of pain management and years …

The Effect Of Education On Healthcare Personnel's Knowledge Of Lymphedema Detection And Prevention, Dolly Wilson

Nursing Theses and Capstone Projects

Secondary lymphedema (SLE) is a serious problem for many of the 2.6 million breast cancer survivors in the United States. It is estimated that 28 - 38% of breast cancer survivors develop lymphedema. The five-year incidence ranges from 43% to 94% (Armer, 2010). The purpose of this study was to evaluate the effectiveness of an education program on healthcare personnel's knowledge of the risk of and preventive measures for upper limb lymphedema in breast cancer patients. A sample of healthcare personnel (N = 32) included both trained healthcare personnel and ancillary staff who are employed in a single oncology center …

Medication Errors: It's A Matter Of Time, Thomas D. Smith Jr.

Nursing Theses and Capstone Projects

A retrospective review of medication errors is presented as a measurement tool. Times of medication errors are separated into categories. The numbers of errors are associated with the numbers of medication administrations. The first data set contains errors that occurred within the first 8 hours of a 12-hour shift and the second data set contains errors that occurred during the last 4 hours of a 12-hour shift.

Data was obtained from a 108 bed critical care hospital in the southeastern United States. A time period will be reviewed between the months of September 2010 until August 2011. All reports of …

Introducing Telehealth To Nursing Students In A Pre-Licensure Program, Dwayne F. More

Nursing Theses and Capstone Projects

Telehealth has emerged as an enhancement to health care, giving clients greater access to care providers than ever before. It has benefited persons living in remote areas who cannot readily access health services and it has helped clients who have chronic disease conditions that require frequent monitoring, saving themselves and hospitals thousands of dollars. Nurses are an important part of delivering telehealth, yet it is not currently being taught in many nursing courses. The purpose of this project is to introduce telehealth into a pre-licensure nursing program via a learning module and to assess the students' understanding of the material …

Increasing Participation In The North Carolina Controlled Substances Reporting System Registration Among Western North Carolina Nurse Practitioners, Elizabeth Scism

Nursing Theses and Capstone Projects

The misuse of prescription drugs for non-medical purposes is a risk to public health and safety. The rates of misuse and diversion of prescription drugs have nearly doubled since the 1990s. This project explored the importance of educating Nurse Practitioners (NPs) in North Carolina (NC) regarding the registration and utilization of the North Carolina Controlled Substances Reporting System (NCCSRS). This reporting system was designed to identify and prevent diversion and to reduce morbidity and mortality of unintentional drug overdoses among primary care patients. A website was developed to showcase the multiple benefits and encourage registration and utilization of the NCCSRS …

The Use Of Peppermint Oil To Reduce The Nausea Of The Palliative Care And Hospice Patient, Mary Seale

Nursing Theses and Capstone Projects

A descriptive study was initiated to investigate the use of peppermint oil to reduce the nausea of the palliative care and hospice patient. Two local palliative care and hospice programs were used as sites for the study. Patients eighteen and older complaining of nausea were invited to participate in the study. The study was conducted for one and a half months. A total of eight patients consented to participate in the study with a mean age of seventy one years. The Bieri Scale, a visual-numeric analog, was used as the measurement instrument for the patients to evaluate their nausea. Results …

Second-Year Associate Degree Nursing (Adn) Self-Efficacy In Relation To Simulation Lab Experiences, Sarah W. Tate

Nursing Theses and Capstone Projects

Second-Year Associate Degree Nursing (ADN) Self-Efficacy in Relation to Simulation Lab Experiences utilized a convenience sample of second-year associate degree nursing students to conduct a survey of their perceptions of an increase in self-efficacy or self confidence in relation to their simulation lab experiences. Albert Bandura's theory of self-efficacy was the theoretical framework for the study. Students who have high levels of self-efficacy have been shown to handle obstacles with less stress, perseverance, and success. In this study, 85% of the students agreed that simulation lab experiences were beneficial in increasing their confidence to perform safely in their preceptorship and …

What Is The Caregivers' (Certified Nursing Assistant) Perception Of Their Role While Caring For A Patient In The Household Model?, Daniyele Feaster

Nursing Theses and Capstone Projects

This was a mixed design study that assessed the caregivers' perception of their role while caring for patients in the household model. A sample of 12 caregivers currently employed in a long-term care facility operating in the household model was asked to complete a survey and answer 11 questions during a one on one interview. This interview tool allowed the caregivers the opportunity to rate their personal experiences, environment and express their feelings associated with their role as a certified nursing assistant working in a household model. The results indicated that the caregivers enjoyed working in the household environment and …

Protocol Adherence During Inter-Facility Transfer Of Acute Ischemic Stroke Patients Treated With Iv Rtpa, Robin Reed Jones

Nursing Theses and Capstone Projects

Stroke is a common and serious health disorder, affecting approximately 795,000 people in the United States every year. Intravenous recombinant tissue plasminogen activator (IV rtPA) is the only FDA approved thrombolytic for treating acute ischemic stroke within 3 hours of symptom onset. Patients treated at rural health centers are often transported within hours to the closest primary stroke center. The purpose of this study was to evaluate the structure, process and outcomes related to the inter-facility transport of ischemic stroke patients treated with intravenous rtPA. The Quality-Caring Model© was the guiding framework.

A quantitative, retrospective, non-experimental analysis of inter-facility transport …

The Effect Of High-Fidelity Human Patient Simulation On Stress Levels Of Associate Degree Novice Nursing Students, Sallie Beth Todd

Nursing Theses and Capstone Projects

The clinical learning environment is an important component in the educational development of a student nurse. Nursing students have identified the clinical experience as one of the most stress producing components of their nursing education. Past research has shown high levels of stress can lead to decreased learning, affect clinical performance, increase clinical errors, and threaten physical or psychiatric wellbeing. Nurse educators' primary responsibilities are to help students effectively cope with their initial stress and facilitate student learning by applying the knowledge they gain in the classroom to the clinical environment. To allow students the opportunity to integrate theory into …

Diabetes Understanding Among Staff Nurses: Examining The Actual Versus Perceived Knowledge In The Acute Care Setting, Rebecca B. Ledbetter

Nursing Theses and Capstone Projects

Diabetes is the fourth leading cause of death world-wide claiming a staggering 3.8 million lives globally each year to related complications (World Health Organization, 2011). Diabetes complications account for 20% of all acute care admissions or 1 in every 5 patients have a diabetes-related condition (American Diabetes Association, 2011). Patient education in the areas of lifestyle modification, healthy eating habits, and proper medication administration is research-supported to clinically decrease the likelihood of acute complications. Bedside, acute care nurses are at the front line of patient education delivery and have the opportunity to determine behavioral stages related to a patient's readiness …

A Comparison Of Patient And Nurse Perception Of Problem Areas Associated With Type 2 Diabetes, Kelley Oglesby

Nursing Theses and Capstone Projects

The purpose of the study was to explore the difference in problem areas perceived and reported by patients with type 2 diabetes and registered nurses caring for patients with type 2 diabetes. Diabetes affects a large number of patients both physically and fiscally. Decreasing perception of problems by nurse case management intervention has the potential to adversely affect patients. A convenience sample of 20 patients and 10 nurses was obtained and completed the Problem Areas in Diabetes (PAID) questionnaire. Statistical analysis found a significant difference in perception of problems among patients and nurses.

Nursing Students' Perception Of Comfort, Norma Mott

Nursing Theses and Capstone Projects

One of the most important goals of nursing care is to provide comfort to patients and their families. In order to provide comfort, nurses must be able to recognize and respond to patients in distress. Inconsistencies in the delivery of comfort care are based largely on the nurse's educational preparation. The degree to which comfort and comforting is evidenced in nursing performance depends in great measure on the way upcoming nurses perceive the concept during their education.

In this descriptive study guided by Kolcaba's Comfort Theory, the researcher surveyed a convenience sample of Associate Degree Nursing students to assess their …

The Incidence Of Individual Sexually Based Counseling By School Nurses In An Urban School System, Tiffany Dunlap

Nursing Theses and Capstone Projects

The purpose of this study is to evaluate the incidence of individual counseling on sexual issues by school nurses in a large, urban, public school system in the Southeastern United States (U.S). Utilizing a descriptive, non-experimental method for the study, a secondary data analysis was conducted by the researcher using information self-reported by 117 school nurses regarding individual counseling of students in grades kindergarten through twelve on sexual topics. The topics included in the study were pregnancy, puberty/reproductive health and sexual abuse. There was a relationship established between grade level and rate of individual counseling. School nurses in the school …

The Effects Of Education And Training On Nurses' Perception Of Lateral Violence In The Healthcare Field, Tamara Cook

Nursing Theses and Capstone Projects

The effects of lateral violence are costly for all aspects of the healthcare profession. Lateral violence is an act of aggression directed towards another nurse. Educating nurses of lateral violence and its appearance may prove to increase nurse's perception of lateral violence therefore decreasing its occurrence. This study will explore the effects of education and training on nurses' perception of lateral violence in the healthcare field. Lateral violence threatens the integrity of each nurse, the nursing profession, and the organization. Increasing the awareness of lateral violence attempts to make a culture change among nurses in the healthcare profession. Minimizing lateral …

Preparing The New Graduate Nurse Entering Critical Or Progressive Care Practice Areas: What Is The Effect Of Blended Orientation Approaches On Their Level Of Self-Confidence And Satisfaction With Current Orientation Methods?, Jennifer L. Forbes

Nursing Theses and Capstone Projects

The transition from student nurse to professional nurse is often difficult for the new graduate especially if transitioning into critical or progressive care areas of practice. It is imperative for new graduates to receive a clinical orientation that meets their educational and transitional needs. The orientation process should provide them with a strong foundation in critical or progressive care practices. Educators are challenged to provide educational opportunities while accommodating diverse learning needs and continuing to maintain competency that ensures the highest quality of patient care and improved patient care outcomes.

New graduate nurses hired into the critical or progressive care …