Nursing Commons^™

Barriers And Values Of Moral Distress Among Critical Care Nurses, Melissa A. Wilson

Nursing Faculty Publications

This dissertation explores the presence of moral distress and effective interventions to lessen its impact on critical care nurses. Manuscript one was completed prior to entering the doctor of philosophy in nursing program but was instrumental in building the foundation for successive work within this dissertation. An exploratory, descriptive designed study was used to examine moral distress and identify situations in which nurse's experienced high levels of moral distress. Nurses completed a 38-item moral distress scale, a coping questionnaire, and indicated their preferred methods for institutional support in managing distressing situations. Manuscript two includes a formal analysis of the Moral …

Driving In Early-Stage Alzheimer’S Disease: An Integrative Review Of The Literature, Rebecca L. Davis, Jennifer M. Ohman

Peer Reviewed Articles

One of the most difficult decisions for individuals with Alzheimer’s disease (AD) is when to stop driving. Because driving is a fundamental activity linked to socialization, independent functioning, and wellbeing, making the decision to stop driving is not easy. Cognitive decline in older adults can lead to getting lost while driving, difficulty detecting and avoiding hazards, as well as increased errors while driving due to compromised judgment and difficulty in making decisions. The purpose of the current literature review was to synthesize evidence regarding how individuals with early-stage AD, their families, and providers make determinations about driving safety, interventions to …

Culture Counts: An Analysis Of Cultural Awareness And Competency Among Nursing Students, Ariel Starr Tate

Undergraduate Honors Theses

As cultural diversity becomes increasingly significant in the field of nursing, so does its inclusion in accredited Bachelor of Science in Nursing (BSN) and Associate Degree in Nursing (ADN) programs. An analysis of one university’s school of nursing program curriculum was conducted to measure the cultural awareness and competency of nursing students progressing through BSN and ADN accredited programs, using the Cultural Awareness Scale (CAS) survey and a qualitative survey. Results indicated BSN students and senior level students score higher on average compared to ADN students and junior level students respectively. However, low means overall and only 15% to 18% …

Evaluating Moral Distress, Moral Distress Residue And Moral Courage In Oncology Nurses, Lolita Melhado

Electronic Theses and Dissertations

Purpose: To examine relationships between moral distress, moral distress residue, and moral courage and to determine which nurse characteristics are predictive of moral distress and moral courage. Methods: The study used a mixed methods cross-sectional correlation design and qualitative content analysis to investigate oncology nurses' characteristics and relationships between moral distress, moral distress residue, and moral courage. A convenience sample of 187 oncology nurses working in inpatient and outpatient settings was recruited through the national Oncology Nursing Society in the Southeastern United States. Hamric's 21-item Moral Distress Scale-Revised (MDS-R) and Sekerka et al. 15-item Professional Moral Courage Scale (PMCS) supplemented …

Impact Of Apgar Score On Asthma Control Among Patients With Bronchial Asthma At Sri Ramachandra Hospital, Porur, Chennai, M Malarvizhi Ms, M Bhavani Ms

Manipal Journal of Nursing and Health Sciences

Introduction: Early identification and commencement of the treatment process prevents the impact of illness, morbidity, and mortality of bronchial asthma. Hence, nurses and the health care professionals should educate the patients and the family members about the disease process in detail. Objective: To identify the impact of APGAR (Activities, Persistence, TriGGers, Adherence to asthma medications, Response to therapy) score on asthma control among patients with bronchial asthma and find the association of APGAR with selected demographic variables. Methods: The study was conducted in Chest OPD adopting a quantitative study design at Sri Ramachandra Hospital, Chennai, and Tamil Nadu. Sixty patients …

Prehabilitation (Prehab): Prevention In Motion, Billie Russell

Electronic Theses and Dissertations

Cardiovascular disease is the leading cause of death for U.S. adults. It adds greater than $100 billion to U.S. health care costs annually. Rates of morbidity, mortality, and economic burden of the disease could be dramatically reduced with improvements in sedentary behaviors among adults with coronary artery disease (CAD). A regular commitment to moderate physical activity can reduce ischemic heart events up to 50%. Although the benefits of physical activity are well-known for individuals with coronary artery disease, an estimated 70% of this population remains relatively sedentary. Hospital-based cardiac rehabilitation programs are the single secondary prevention option offered to improve …

Identifying And Accommodating Education And Research Barriers Of Rural Nursing Staff In The Mississippi River Delta, Anna Watkins

Doctor of Nursing Practice Projects

The purpose of this cross sectional descriptive study is to identify, by survey, what education and research barriers exist for operating room and post anesthesia care nursing staff in the rural hospitals of the Mississippi River Delta.

Identifying And Accommodating Education And Research Barriers Of Rural Nursing Staff In The Mississippi River Delta, L. Todd Hammon

Doctor of Nursing Practice Projects

Nearly 20% of the nursing workforce practice in rural settings. The literature suggest rural nursing staff do not have the same opportunities for continuing education or the implementation of research in their practice as do nursing staff of larger urban hospitals. Rural nursing staff face unique barriers in obtaining the needed continuing education and research. Identifying and accommodating these barriers is needed. The purpose of this study was to identify by survey, what education and research barriers exist for operating room and post anesthesia care nursing staff in the rural hospitals of the Mississippi River Delta.

Improving Nurses' Knowledge Of Stroke, James Trone Mcdaniel

Walden Dissertations and Doctoral Studies

Stroke is a devastating disease. Stroke care has advanced greatly in the past 20 years with innovations in radiologic imaging, development of tissue plasminogen activator (tPA), organized systems of care, telestroke, and best practice guidelines via Get with the Guidelines Stroke (GWTGS). However, stroke remains the 5th leading cause of death in the United States. To provide current and quality care for stroke patients, nurses need ongoing stroke education. Additionally, stroke centers must provide a sustainable stoke education program to their nurses to keep their knowledge current. Guided by Rosswurm and Larrabee's model, this quality improvement project addressed whether an …

Systematic Review: Barriers That Prevent Compliance With Hydroxyurea In Sickle Cell Disease, Uchechukwu Imegi

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a blood disorder that is inherited from both parents and affects millions of people globally. The symptoms of SCD may be debilitating and pose a significant challenge to nursing care. Hydroxyurea (HU), the Food and Drug Administration (FDA) approved treatment for SCD in adults is reportedly effective, but its usage is still minimal among adolescents with SCD. The purpose of this systematic review was to evaluate existing literature on the barriers to HU use in adolescents with SCD. The Johns Hopkins Nursing Evidence-based Practice (JHNEBP) Rating Scales guided this study. An extensive electronic search of …

Reducing Length Of Hospital Stay For Intellectually Disabled Psychiatric Patients With Chronic Medical Problems, Joseph Wigwe

Walden Dissertations and Doctoral Studies

Length of hospital stay (LOS) is a major indicator for measuring efficient care. Intellectually disabled psychiatric patients (IDPP) with chronic medical problems have longer LOS due to challenges faced by providers in jointly managing both psychiatric and medical problems. The purposes of this study were to understand the significance of LOS for IDPP, create an intervention toolkit to reduce LOS, establish the content validity of the toolkit, and recommend its implementation. The items of the toolkit are pharmacology, somatic, rehabilitation, psychosocial, and monitoring patients' psychiatric and medical symptoms across care domains. The toolkit was created from the constructs of the …

A Practice Improvement Project To Improve Knowledge And Perceptions Of Palliative Care Among Patients With Heart Failure And Cancer In The Acute Setting Using Video Enhanced Education, Crystal F. Spellman

DNP Projects

Background: Clear communication of the purpose and benefits of palliative care can reduce barriers to acceptance of such services for patients and families. The purpose of this practice improvement project was to assess and improve knowledge and perceptions of palliative care among patients with a diagnosis of heart failure and cancer in the acute setting using a video enhanced education intervention. Methods: This practice improvement project took place at a 555 bed teaching hospital. 18 patients referred to an inpatient palliative care consult service in the acute care setting with a diagnosis of either heart failure or cancer participated. …

Men In A Female-Dominated Profession: The Lived Experiences Of Ghanaian Male Nurses In The United States, Daniel Kwadjo Frimpong

Educational Studies Dissertations

Minority men are less than two percent of the total nursing workforce in the United States. The small presence of minority men in the nursing profession presents a challenge to healthcare providers as patients are much more responsive and open-minded to healthcare providers of the same cultural and ethnic backgrounds. This qualitative study was designed to explore the lived professional experiences of Ghanaian male nurses in the United States to shed light on the barriers minority men encounter in the nursing profession in order to make suggestions relating to strategies to appropriately support minority men in their nursing practice. This …

Effectiveness Of An Evidence-Based Case Management Intervention On Reducing Diabetesrelated Emotional Distress In A Hispanic Medicare Advantage Population, Mari Nickovich-Finley

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

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Increasing Provider Efficacy On Metabolic Monitoring, Johnes Monyoncho

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Second-generation antipsychotics (SGAs), the mainstay of treatment for persons with serious mental illnesses (SMI), have been linked to obesity and metabolic syndrome. There is an urgent need for providers to adhere to clinically applicable guidelines for screening and monitoring metabolic disturbances in this population. 2 Methods: A randomized retrospective chart review of 60 patient records, one group pre-test data without a comparison group was performed following initiation of SGAs, 6 months before the intervention. This was repeated after a 3-month intervention which involved implementation of a recommended schedule for metabolic monitoring. The intervention included provision of monitoring equipment (weighing …

A Heath Intervention To Improve Medication Adherence In Patients With Epilepsy, Ronnie Tobias

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Epilepsy is a chronic disease and it is estimated that between 30% and 60% patients are non-adherent with their antiepileptic drugs (AEDs) therapy. This project aimed to assess if health education improves medication adherence in patients with epilepsy. Methods: This quality improvement (QI) project used a pre-test and post-test study design, 25 participants were recruited with epilepsy from the Epilepsy Foundation in Houston, Texas using the convenience sampling method. Data were gathered using the Morisky Medication Adherence Scale (MMAS-8). 3 Results: The findings revealed statistically significant differences in the pretest and posttest score distributions. The distribution of MMAS-8 scores …

Sms-Text To Improve Medication Compliance Among Hypertensive African-Americans, Daytral Brown

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension, the second leading cause of end-stage renal disease (ESRD), affects approximately 40% of African-Americans (Mansyur, Pavlik, Hyman, Taylor, & Goodrick, 2009). One well-known barrier to hypertension management among African-Americans is poor medication compliance (Ephraim et al., 2014; Solomon et al., 2015). The purpose of this project was to evaluate the effect of SMS-text messages on antihypertensive medication compliance and hypertension knowledge among hypertensive African-Americans with a known history of antihypertensive medication noncompliance. Methods: African-Americans (n=25), with a known history of hypertension and medication noncompliance, received 12 twice weekly SMS-text messages relating to hypertension knowledge and medication compliance. A …

Improving Adherence To Atypical Antipsychotic Agent Screening Guidelines In Pediatric Patients: A Quality Improvement Project Within An Integrated Community Mental Health Setting, Elishia Riffle

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Approximately 14% - 20% of children and adolescents have a mental health problem (Harrison, Cluxton-Keller, and Gross, 2012). Atypical Antipsychotic Agents (AAA) are used to treat behavioral, emotional, and mental health problems in children and adolescents. A discrepancy between best practices and actual practices exist. Objective: To increase adherence, above baseline, to recommended screening guidelines in children, ages 4-18, prescribed Atypical Antipsychotic Agents over 12 weeks. Results: Aggregate comparison of the mean ranks of scores were tested with the Mann-Whitney U test, U = 1,087.5, n1 = n2 = 70, total N =140, p < .001. All seven variables were observed and tested using the Chi Square with Fisher's Exact tests and are significant at or above 99% confidence (p < 0.01). Conclusion: Educating the Mental Health Provider (MHP) on the recommended screening guidelines and implementing a checklist had a measurable effect on increasing adherence to the recommended screening guidelines.

Biobehavioral Influences Of Anxiety, Depression, And Hostility Symptoms On Health-Related Outcomes In Patients With Heart Failure, Lynn P. Roser

Theses and Dissertations--Nursing

The incidence of heart failure (HF) has increased each year as more people are living longer with heart disease and other chronic conditions. Recently, there has been much interest in the psychological dimensions of HF and the influence psychological symptoms have on the health outcomes (e.g., self-care, rehospitalization, mortality and quality of life) of patients living with HF. Patients with HF frequently experience symptoms of anxiety, depression, and hostility that may be associated with poor health outcomes. The purpose of this dissertation was to examine how psychological variables influence health outcomes of patients with HF, how psychological variables change over …

Effects Of Obesity On United States Farmers: A Pilot Study, Sharon C. Hunsucker

Theses and Dissertations--Nursing

Previous research described the value farmers place on their ability to work. The impact of obesity on workers is an increasing concern in occupational health research; yet, knowledge regarding the impact of obesity on the performance of farm work is limited. Identifying the impact of obesity on farmer’s work ability can guide healthcare workers in promoting and motivating farmers to implement lifestyle changes to improve health and sustain longevity in their ability to work.

The purpose of this dissertation was to examine the impact of obesity on the work ability of U.S. farmers. Specific aims were to 1) examine the …