Other Nursing Commons^™

Beyond Cough Drops And Band-Aids: An Interpretive Phenomenological Study Of Certified School Nurses’ Professional Scope And Enacted Roles In Pk–12 Settings, Brandy Gershon

Electronic Theses and Dissertations

This qualitative dissertation explored the underutilization of certified school nurses (CSNs) in PK–12 educational settings across urban, suburban, and rural school districts in western Pennsylvania. Despite their advanced preparation and wide-ranging scope of practice, school nurses are often limited to providing episodic care, including first aid, medication administration, and treatment of minor injuries. This limited use reflects a significant misalignment with their professional scope of practice, which encompasses chronic disease management, health education, mental health support, care coordination, and leadership in public health. Guided by role theory (Biddle, 1986), this study examined how school nurses perceived and interpreted their professional …

Differences In Peer Social Connections Between Traditional And Online Nurse Residency Programs, Tatum Leonard

Electronic Theses and Dissertations

The anticipated retirement of baby boomer nurses by 2030 will intensify the global nursing shortage, a crisis that demands innovative strategies for onboarding and retaining new graduate nurses. Nurse residency programs (NRPs) are designed to ease the transition from student to practicing nurse, reduce turnover, and foster professional resilience. Amid the COVID-19 pandemic, many NRPs rapidly transitioned from traditional, in-person seminars to synchronous, online formats. This study explored differences in peer social connections between traditional and online NRPs, focusing on three constructs: sense of community, collaborative learning, and peer social support. Using a quasi-experimental, mixed methods approach, this secondary data …

The Lived Experiences Of Navajo Nurses During The Covid-19 Pandemic, Stephnie Ann Leeson

Electronic Theses and Dissertations

When COVID-19 was diagnosed on the Navajo Nation, the impact on the people and the healthcare system was not understood. For almost three years, Navajo healthcare workers battled what was known to the Navajo as Dikos Nitsaaígíí Náhást’éíts’áadah, translated as The Big Cough. The Navajo Nation President, Jonathan Nez, referred to it as a Monster, as did many people in the Navajo Nation. Navajo nurses on the frontlines battled the monster daily as they saw friends and relatives succumb to the insidious disease. Much has been written about nurses off the reservations working on the frontline during the pandemic. However, …

A Theory-Based Intervention To Mitigate Weight Bias Among Nurses: A Pilot Study, Gregory S. Marler

Electronic Theses and Dissertations

Background: As obesity rates continue to rise, a growing number of individuals living with obesity will seek medical care, increasing their exposure to weight-biased healthcare providers. This bias presents a significant risk, as it can lead to compromised care, diminished trust in medical professionals, and ultimately poorer health outcomes. Nurses, as frontline caregivers, must recognize the harmful impact of weight bias and take proactive steps to mitigate its effects. Addressing this bias is essential to ensuring equitable, high-quality care and improving patient outcomes.

Aim: The study explored the acceptability, feasibility, and preliminary efficacy of an intervention for acute care …

The Lived Experience Of New Graduate Nurses Implementing Evidence-Based Practice In A Clinical Setting, Kimberly A. Mcfarland

Electronic Theses and Dissertations

The purpose of this qualitative interpretive phenomenological analysis study was to explore the perceptions and lived experiences of new graduate nurses (NGNs) as they implemented evidence-based practice (EBP) in clinical settings. This study addressed the problem that NGNs often lack the skills and confidence to effectively apply EBP, despite its critical role in improving patient outcomes. The research aimed to provide insight into the challenges, support systems, and strategies that influence EBP integration during the transition from student to practicing nurse. The study utilized the interpretive phenomenological analysis methodology to analyze data collected through semistructured interviews conducted via the Teams …

Impact Of A Transplant Nurse Navigator In The Dialysis Setting, Judith D. Pozzerle

Electronic Theses and Dissertations

Patients with kidney disease have better patient outcomes and quality of life with a kidney transplant. However, the transplant process is complicated with inherent inequalities and biases and patients frequently fail to initiate a referral for transplant evaluation. The Centers for Medicare and Medicaid have now placed financial incentives to improve the number of patients transplanted. The only way to increase the number of patients transplanted is to start with a referral for evaluation. Studies have been done highlighting the barriers, but there is a lack of studies implementing strategies to improve these numbers. Utilizing Kotter’s change theory and describing …

Implementation Of A Transition-Of-Care Model For Adult Ischemic Stroke Survivors, Megan Akacsos

Electronic Theses and Dissertations

The lasting physical and cognitive deficits associated with the complexities of newly acquired

disabilities resulting from an acute ischemic stroke (AIS) may lead to hospital readmissions. The

participating healthcare facility on the U.S. West Coast reported a hospital readmission rate for

AIS survivors of 24.29% within 30 days of discharge. This doctoral nursing project aimed to

determine if implementing the Comprehensive Post-Acute Stroke Services (COMPASS) model

would reduce 30-day readmission rates compared to no standardized transition-of-care model in

adult AIS survivors over 30 days. Implementing the COMPASS model in this patient population

was expected to better educate and support stroke …

Implementing Bedside Shift Report In The Home Health Care Pediatric Setting, Ruth Elena Ramos-Ardila

Electronic Theses and Dissertations

Developing and maintaining good communication is central in nursing because the goal is to achieve the best outcomes for the patient. In the past, written handover reports have been the standard way nurses communicate with each other, especially in the hospital and in home-based practice. Despite this rationale, this approach has considerable weaknesses: its high risk of mistakes and misunderstanding could negatively influence patient outcomes. In light of these concerns, this project examines the role of bedside shift reports in pediatric home care and the patient readmission rate. This project employed a quantitative, cross-sectional research approach involving 32 pediatric home …

Moral Disengagement And The Tendency To Engage In Academic Dishonesty In Prelicensure Nursing Students, Sarah Guimaraes

Electronic Theses and Dissertations

Despite decades of research, academic dishonesty remains a significant concern in nursing education. The connection of academic dishonesty to dishonest clinical practice presents a moral imperative for nurse researchers to find new facets of understanding these phenomena. Literature regarding moral disengagement in health care is minimal and is even less prevalent in the context of nursing education. The purpose of this study was to determine the effects of moral disengagement on prelicensure nursing students’ tendencies to engage in academic dishonesty in their last or next to last semester of a nursing program. A correlational design via survey method was used. …

Implementation Of A Mobile-Based Mindfulness Intervention To Lower Perceived Stress Levels In Undergraduate Nursing Students, Wendy S. Carley

Electronic Theses and Dissertations

This project analyzed the effect of the daily use of a mindfulness-based mobile application on associate degree nursing undergraduate prelicensure students’ perceived stress levels. Nursing students experience elevated stress levels that may be reduced through mindfulness behaviors. Undergraduate, prelicensure nursing students participated in establishing the impact of mindfulness on perceived stress levels in a quantitative pre/postintervention study. The evidenced-based studies chosen for this review consisted of randomized controlled trials, pilot studies, pre/posttest designs, systematic reviews, and quantitative and qualitative studies. The investigator collected presearch data using a pre/posttest design to evaluate the effectiveness of a stress management program in reducing …

Barriers, Facilitators, And Competencies In Advocating For Adults With Intellectual Disabilities With Health Disparities, Carol Adams

Electronic Theses and Dissertations

Background: Nurses working in the specialty of intellectual disabilities are positioned to advocate for individuals with intellectual disabilities and other health disparities. This study explored nurses’ perceived competencies, barriers, and facilitators when advocating for improved health status in adult patients with intellectual disabilities.

Methods: Twenty-five nurses working in the specialty of intellectual disabilities were interviewed using semi-structured interviews, and the data were analyzed using thematic analysis.

Results: Barriers identified in advocacy were: Funding, Communication, Negative Perceptions and Misperceptions, Lack of access, and Diagnostic Overshadowing. Nurses were also facilitated in advocating for improved health status in people with intellectual disabilities. Facilitators …

Modifiers Of The Effects Of Different Dimensions Of Social Support On Cardiac Rehabilitation Adherence., Melissa Amraotkar

Electronic Theses and Dissertations

Introduction: Cardiovascular disease (CVD) is a leading cause of mortality worldwide. Cardiac Rehabilitation (CR) is a Class I, level A indication for treatment and prevention further complications of CVD. The attendance rate for CR in the U.S. is very low, especially among female patients. Dimensions of social support, sex of the support provider, and the quality of primary intimate relationship are associated with health-promoting behavior and may influence CR adherence in patients. Purpose: The purpose of this study was to examine the relationship between dimensions of social support and CR adherence, and whether these relationships were moderated by factors such …

The Lived Experience Of Nurses In Caring For Patients With Covid-19, Jessica Barre

Electronic Theses and Dissertations

Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living …

Coping Strategies And Stress Of The Undergraduate Nursing Student In The Clinical Setting: An Evidence Based Practice Quantitative Study, Ashley Calverley

Electronic Theses and Dissertations

The assessment of perceived stress and coping behaviors related to first-semester clinical might benefit students in nursing education. The assessment of most common coping behaviors and perceived stress related to the clinical setting is essential due to difference in personalities, learning abilities, and coping behaviors among nursing students today. Previous research has suggested the initial clinical period results in adverse outcomes, such as poor academic performance, elevated burnout levels, and diminished personal well-being. These factors are detrimental to academic success in nursing programs. Evidence supports that helping students develop positive stress/coping abilities will aid in adapting in both the academic …

Transformational Leadership Training For Leaders, Kristie M. Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …

The Impact Of Self-Compassion Strategies To Reduce Stress And Support The Transition To Practice For New Graduate Nurses: A Pilot Project, Charity Michelle Ballmann

Electronic Theses and Dissertations

Abstract The purpose of the study was to analyze the impact of self-compassion exercises to reduce stress and support the transition to practice for new graduate nurses. As the years pass, one thing remains a consistent topic in healthcare, and the need for nurses remains constant. The nursing staffing shortage gap seemingly widened further as the COVID-19 pandemic created additional challenges for healthcare systems, patient care, and employees. Retention of the workforce and an intentional focus on new graduate nurses' well-being have become increasingly important. New graduate nurses are a pipeline for the nursing workforce. Supporting the transition to practice …

Examining School Nurses' Knowledge And Confidence Related To Their Intention To Screen For And Report Child Sexual Abuse: A Descriptive Cross-Sectional Study, Suzanne Ackers

Electronic Theses and Dissertations

Background: Child sexual abuse (CSA) in a preventable national public health problem that results in adverse health consequences. Research suggests many victims are currently attending school. Screening for early detection of health issues is integral to school nurse (SN) practice but there is little evidence that screening for CSA is occurring in schools despite recommendations that it should be. Lack of confidence and knowledge related to screening for suspected CSA contribute to a SN’s missed opportunity for early intervention.

Purpose: To describe SNs knowledge and self-efficacy associated with screening for and reporting CSA in school settings.

Methods: A descriptive cross-sectional …

The Transformation: Teaching Critical Thinking And Clinical Decision Making In Nursing Education, Winifred Ferguson Adams

Electronic Theses and Dissertations

Abstract

The profession of nursing has recognized in the past 20 years the need for graduate nurses to enter the profession prepared to care for complex medical patients in an ever-changing healthcare environment. It has become a major challenge for nurse educators to provide students with adequate didactic and clinical education in nursing. The overall purpose of this project was to help nurse educators accept the challenge required to make the radical transformation in education. Faculty participated in the measurement of self-efficacy pre and post-exposure to teaching strategies related to (1) critical thinking, (2) clinical judgment, and (3) clinical reasoning …

Care Transition Assessment Redesign In The Acute Care Setting, Darla M. Johnston

Electronic Theses and Dissertations

There is a gap in case management professional practice with a lack of consistent, research-based transition evaluation (TE) tools available and used in practice. An evidence-based case management TE is necessary to develop a holistic and comprehensive discharge plan for hospitalized patients. Updating and implementing an evidence-based case management TE would positively impact the transition of care and promote improved health outcomes including a reduction in readmissions. This quality improvement project used a quantitative nonexperimental, interventional pretest-posttest design. Kirkpatrick’s multidimensional knowledge attitudes assessment (KAP) education evaluation model was used to assess (1) the influence an educational offering on evidence-based assessment …

Situation Awareness And Cognitive Load In Nursing Students Managing A Computer-Based Virtual Reality Simulated Deteriorating Patient, Tracy Chesney

Electronic Theses and Dissertations

Background: When a patient’s baseline clinical state shifts to a worse clinical state requiring a transfer to a higher level of care within the healthcare system, it is the hallmark of a deteriorating patient situation. Up to 37% of newly licensed nurses fail to identify and manage a deteriorating patient partly due to inexperience and a lack of expertise, contributing to lower situation awareness (SA), specifically in cue perception. Long-term memory schema development leads to expertise that allows individuals to develop higher SA necessary to identify and effectively manage patient deterioration. Expert nurses access long-term memory schema in managing deteriorating …

Venous Leg Ulcers: An Analysis Of Nursing Knowledge, Shelia Moore-Miller

Electronic Theses and Dissertations

This project evaluated the knowledge level of wound center nursing staff on venous leg ulcer etiology and treatments after an educational intervention. To determine the effectiveness of the educational intervention, participants completed a pretest and posttest evaluation. Venous leg ulcers (VLUs) are chronic lower extremity ulcers affecting older Americans. VLUs are painful and negatively affect activities of daily living. Inadequate VLU treatment can become an infectious process that can ultimately threaten limb existence. A quantitative, quasi-experimental study was conducted over three weeks in a hospital-based wound care center in central Florida. The theoretical framework applied to this project is Lydia …

Burnout In Medical Assistants In Primary Care: Can Mindfulness Be A Solution?, Natalee D. Calais

Electronic Theses and Dissertations

Burnout is described as feelings associated with emotional exhaustion, depersonalization of patients, and a loss of sense of personal accomplishment and it is unique to healthcare workers. Current research highlights this condition among physicians, nurses, and mid-level providers; however, insufficient research exists regarding the effects of burnout on medical assistants. Research led to mindfulness as a possible solution defined as an intentional regulation of attention and awareness of the present moment. This project sought to see if mindfulness practices could be utilized to mitigate the effects of burnout in medical assistants. It was hypothesized that mindfulness could be a solution. …

Building Resilience In Graduate Nurses Through Online Virtual Simulation, Robert Grant Harmon

Electronic Theses and Dissertations

Resilience has become a popular topic in nursing research. Nurses experience enormous stress throughout their training process that extends into their first employment as they transition into practice. Simulation training is a standard for training nurses and for continuing professional education within academia. Most simulation training for nurses is focused on building critical thinking skills. While critical thinking is an essential quality equipping nurses to meet professional demands, resilience is a crucial quality to overcome the stress of both training and practice. Resilience is believed to play an essential role in the retention of new graduate nurses and preventing burnout …

Female Ex-Offenders Transitioning Into Society, Stacey L. Forte

Electronic Theses and Dissertations

The purpose of this qualitative study was to examine female ex-offenders’ perceptions of their lived experience(s) while transitioning into society after incarceration. This study examined risk factors that female ex-offenders faced while transitioning into society asking the question, “What are the lived experiences of female ex-offenders who utilized transitional housing for reentry with regard to their perception of the benefits of certain services/offerings and staff support?” Nine participants were part of the study ranging from 25–64 years of age, with the majority being between the ages of 25 and 55 years old, residing originally in five different states. Sixty percent …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Assessment Of Veteran Satisfaction With Telehealth Services During The Covid-19 Pandemic, Rhonda Kay Howard

Electronic Theses and Dissertations

Abstract

With the advent of the COVID-19 public health emergency in the United States, many U.S. veterans were unable to maintain their usual office visits due to safe access concerns. Patients were strongly encouraged to maintain their healthcare needs at home by utilizing online technology resources like telehealth services with their healthcare providers. Providing excellent healthcare services for veterans during COVID-19 became a challenge for primary care providers at many veteran healthcare organizations. Since little was known about the satisfaction of veteran clients with healthcare management using virtual care during the pandemic, this formative program evaluation was designed to survey …

Determinants Of Reproductive Freedom Among Israeli Women Ages 18-50: A Mixed Methods Study, Abby Kra-Friedman

Electronic Theses and Dissertations

Introduction: Reproductive freedom is a social determinant of health (SDOH) that reduces health disparities and increases health equity. Through the National Health Insurance Plan, Israeli women can access a range of contraceptive methods. Scant data on Israeli women limits development of policies and interventions to meet international benchmarks for reproductive freedom. The purpose of this dissertation study is to synthesize current international multidisciplinary literature using the capability approach for reproductive freedom, explore determinants of reproductive freedom among Israeli women ages 18-50 using Nussbaum's capability approach, and make recommendations for nursing research, practice, and theory.

Methodology: Using Whittemore and …

Cognitive Preference And Skill Acquisition: The Relationship Between Student Nurse Anesthetists And Certified Registered Nurse Anesthetists Thinking Styles, Thomas Diller

Electronic Theses and Dissertations

Decision-making in healthcare is a complex and, at times, uncertain process. In the United States Certified Registered Nurse Anesthetists (CRNA) administer the majority of anesthesia. Nurse Anesthetists must draw on their educational background, clinical experience, and cognitive processes to make sound clinical judgments. To avoid errors understanding the relationship between cognitive preference and skill acquisition is critical. This study was designed to describe the cognitive preferences of Student Nurse Anesthetists (SRNAs) and CRNAs in the United States. The 2 cognitive preferences explored are rational (analytical) and experiential (intuitive) decision-making.

The researcher used a quantitative, cross-sectional, descriptive correlational design. The researcher …

Understanding How To Promote Healthy Dietary Habits Among Parents Of Adolescents, Jazmine D. Collins

Electronic Theses and Dissertations

Adolescents in the United States today have record-high prevalence rates for childhood obesity and overweight, which are conditions that have lifelong negative health consequences for individuals, and also carry high financial and social costs for the entire nation. The disproportionate burden of obesity and associated health conditions falls on adolescents of racial and ethnic minority group identities and from lower-income households. The increased risk that adolescents have for developing conditions like childhood obesity is closely associated with youth having diets that are unhealthier than in the past. Parents have a large influence on the eating habits and preferences of their …

Mitigating Weight Stigma In The Medical System: Self-Compassion For Nursing Students, Ellen C. Joseph

Electronic Theses and Dissertations

Weight stigma is a form of oppression that has been shown to have a detrimental impact on the well-being of people with higher weight. Healthcare providers are one of the most common sources of weight stigma, and their stigmatizing beliefs have been found to be associated with differential care for patients with “obesity”. The current study aimed to explore the feasibility of the loving-kindness meditation (LKM) as a brief intervention that reduces weight bias in nursing students by increasing self-compassion, positive, other-focused emotions, and cognitive flexibility, in order to improve compassionate care for patients with higher weight. Participants (189 nursing …