Nursing Commons^™

Promoting Diabetes Self-Managment Eduaction And Training In Out-Patient Clinics, Inemesit Godwin Udo

Walden Dissertations and Doctoral Studies

Abstract

Type 2 diabetes mellitus (T2DM) is a long term metabolic disorder characterized by high blood sugar, insulin resistance, and relative lack of insulin. T2DM is a leading cause of cardiovascular disease, blindness, kidney failure, lower-limb amputation, and other complications that are costly to patients and the U.S. health care system. Lack of knowledge and underdeveloped skills for self-management of diabetes continues to be the biggest problem for patients with T2DM. Using a team approach and Rosswurm and Larrabee's (1999) conceptual model as a framework, the purpose of this doctorate of nursing practice quality improvement project was to develop an …

Evaluation Of Clinical Reasoning Of Nursing Students In The Clinical Setting, Stefanie Lynn Legrande

Walden Dissertations and Doctoral Studies

The primary focus of nursing education in the 21st century is to graduate students with well-developed critical thinking and clinical reasoning skills. This descriptive case study explored the perceptions of 6 faculty and 6 unit staff nurses concerning the assessment of critical thinking and clinical reasoning skills of nursing students in the clinical setting. Benner's novice to expert theory served as the conceptual framework for the research. The guiding research questions focused on faculty and staff perceptions concerning unit staff nurses' level of preparedness to assess the critical thinking and clinical reasoning ability of nursing students, and explored how faculty …

Implementation And Evaluation Of Dietary Modification With Gestational Diabetes, Celia T. Ojeaga

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus (GDM) negatively affects the health of both mothers and babies, and is the most common pregnancy complication in the United States. Many dietary modification programs for pregnant women diagnosed with GDM rely on a one-size-fits-all approach to menu planning. The purpose of this project was to develop a diet modification program for GDM management using a patient-centered approach. The project objective was to develop the policies, procedures, and supporting documents needed to implement a successful GDM management program for pregnant women receiving antenatal care at an obstetrical clinic. The developed program incorporated strategies for clinic nursing staff …

Self-Care Activities And Nurse Manager Well-Being, Gretchen Eileen Johnson

Walden Dissertations and Doctoral Studies

The role of the nurse manager is important in organizations and influences outcomes such as the safety and quality of care provided on a unit, satisfaction, turnover of nursing staff, and overall health of the work environment. Stressors for managing nurses can impair physical and emotional health and lead to poor patient and staff satisfaction, safety, and outcomes. The evidence-based practice project will explore nurse managers' well-being and self-care activities. The theoretical framework of the project is the Relationship-Based Care Model as well as Kotter's change theory. The literature suggests that self-care activities can reduce stress and improve well-being. A …

Development Of Assessment And Screening Tool To Assist With Prevention And Identification Of Charcot Foot In Type 2 Diabetics, Louise S. Wade

Walden Dissertations and Doctoral Studies

Abstract

Development of Assessment and Screening Tool

to Assist with Prevention and Identification of Charcot Foot in Type 2 Diabetics

by

Louise Wade MSN, RN

MS, West Texas A&M University, 2010

BS, West Texas A&M University, 2010

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2016

Abstract

According to the World Health Organization, up to 50% of type 2 diabetic patients

develop neuropathy, which may cause major infections, amputation, and Charcot foot due

to impaired sensation. Early recognition and care is essential for treatment of Charcot

foot and prevention …

Promoting Annual Depression Screening In A Federally Qualified Healthcare Center, Denise Lesley Alleyne

Walden Dissertations and Doctoral Studies

According to the World Health Organization, depression affects about 350 million people worldwide. In 2014, only 50% of the adult patients were screened for depression in the community-based Federally Qualified Healthcare Center (FQHC) for which this doctorate of nursing practice (DNP) project was developed. In an effort to meet the 100% benchmark set nationally for the screening of adult patients in the primary care settings, the FQHC's quality improvement team now requires that 80% of adult patients in the clinic be screened for depression. Framed within the Iowa model of evidence-based practice, the purposes of this project were to: (a) …

Fall Safety Bundle, Baili Denise Campbell

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services (CMS) report thousands of falls in hospitals each year. The CMS does not reimburse hospitals for fall related injuries, costing the hospital system organization for which this DNP project was designed millions of dollars each year. Framed within the Iowa model of evidence-based practice and using a team approach, the purpose of this project was to develop an evidence-based (EB) fall safety bundle for use by nursing staff and a curriculum to educate staff on prevention strategies. The components of the EB fall bundle kit were approved by the stakeholder committee. Evaluation of …

Examining Nurse Practitioners' Perceptions And Beliefs Regarding Hospice Referrals For African Americans, Karen Jackson Mcclary

Walden Dissertations and Doctoral Studies

Terminally ill patients often have difficult choices at the end-of-life, and electing to receive hospice services is one of them. Hospice has been linked to improved quality of life and death and is accessible to terminally ill patients. Despite the accessibility, African American patients often make the decision to forgo hospice services. The purpose of this descriptive study was to explore perceptions and beliefs of nurse practitioners (NPs) regarding the lack of utilization of hospice for African American patients and the feasibility of NPs for initial referral for terminally ill African American patients. The research questions addressed whether an NP's …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

Patient Safety: Improving Medication Reconciliation Accuracy For Long-Term Care Residents, Annisa Leachman Stover

Walden Dissertations and Doctoral Studies

Patient Safety: Improving Medication Reconciliation Accuracy

for Long-Term Care Residents

by

Annisa L. Stover

MSN, Southern University, 2008

BSN, Our Lady of the Lake College, 2005

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2016

During transition of care, inaccurate medication reconciliation is associated with increased risk of adverse events for patients. Older adults are the population most often affected by medication errors, and long-term care facilities struggle to accurately document medication reconciliation. Errors are more common at hospital discharge, but the critical moment for detecting and resolving them …

Electronic Learning Management System Integration Impact On Tertiary Care Hospital Learners' Educational Performance, Ahmad Tassi

Walden Dissertations and Doctoral Studies

Technological innovations have been shown to improve the quality of health information and improve safety in health care systems. The purpose of this project was to offer hospital nurses a more flexible and practical alternative to education and training than the traditional face-to-face method, supporting nurse educators in overcoming many of the obstacles in responding to nurses' needs in the clinical areas. This project used a randomized, 2-group posttest-only experimental design to measure the effect of treatment at a targeted hospital. The experimental group received a new instructional approach using an Electronic Learning Management System (ELMS) and the control group …

Frontline And Middle-Level Nursing Leader Transition Within The Military Health System, Rudolph George Newman

Walden Dissertations and Doctoral Studies

Healthcare delivery within the military requires a multifaceted approach to achieve the desired outcomes of safe, effective, patient-centered, timely, efficient, and equitable health care. The prospect of maintaining a cycle of continuous process improvements within military clinical settings hinge on frontline leaders and middle-level managers who must be prepared to execute the mission and motivate, supervise, coach and mentor the staff. This project showcases a review of current literature translated into the development of an evidence-based Transformational Leadership Induction Program (TLIP) module that consisted of 4 subsections: the environment of care, clinical decision support systems, human resources management, and change …

Development Of A Guide To Successful Onboarding Of New Nurse Graduates, Jacquelyn Estelle Young

Walden Dissertations and Doctoral Studies

The literature indicates that serving as a preceptor for new nurse graduates can be challenging and stressful without proper training in this role. Many organizations appoint preceptors without providing training and support for the role, which negatively impacts both the new nurse and the preceptor. Evidence shows that a preceptor workshop can cultivate the knowledge and skills needed to train and precept new nurse graduates. Further, there is evidence that preceptorship programs ease new graduates' transition to practice, increase employee satisfaction, and improve the quality of care provided to clients. The purpose of this developmental project was to develop a …

Standardized Assessments, Care Planning, And Improved Quality Of Life For Residents Of Adult Family Homes, John A. Rogers

Walden Dissertations and Doctoral Studies

Quality of life for adults living in adult family homes requires further attention as the elderly population continues to grow and moves from minority to majority. There is a lack of data on residents in adult family home settings and their quality of life. The purpose of this project was to identify if individualized nursing care plans had an impact on the residents' quality of life in the adult family home. In this study, a registered nurse assessed the residents to create an individualized nursing care plan that would be implemented to improve quality of life. These care plans were …

Bedside Nurse Recognition Of Delirium In The Medical-Surgical Setting, Bridget Ann Denzik

Walden Dissertations and Doctoral Studies

Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was …

An Educational Initiative To Prevent Unnecessary Hospitalization For Hospice Patients, Alkeisha Hill Mims

Walden Dissertations and Doctoral Studies

Avoidable hospitalizations of hospice patients cost Medicare $3 billion a year. When hospice nurses are able to identify early signs and symptoms of acute illness and provide appropriate interventions to prevent such admissions, 20-60% of the hospitalizations are preventable. The practice problem addressed in this quality improvement doctor of nursing project was the 30% hospital admission rate of hospice patients as evidenced by chart review, admission data, and revocation data. The first purpose of the project was to identify evidence-based nursing care paths in the literature for the top 5 medical diagnoses related to avoidable hospital admissions. The second purpose …

Type 2 Diabetes Prevention And Management In A Primary Care Clinic Setting, Ada Nwachuku Nwachuku

Walden Dissertations and Doctoral Studies

Approximately 8.3% of the U. S. population has type 2 diabetes. Preventing the onset and improving the management type 2 diabetes are crucial for health care professionals. The purpose of this project was to develop and evaluate a type 2 diabetes prevention and management education program in a primary care setting using group medical appointments (GMAs). The chronic care model provided the framework for the study. The education program consisted of information from the Centers for Disease Control on the management of type 2 diabetes to be delivered by clinic staff using a GMA approach, a timeline for implementing the …

An Evaluation Of Robotics In Nursing Homes To Reduce Adverse Drug Events, Ozell Ueal Jr.

Walden Dissertations and Doctoral Studies

Adverse drug events (ADE) cause many deaths annually in addition to affecting the quality of life of many others. The descriptive mixed methods approach, specifically exploratory case study and experimental design that guided this research utilized the survey and focus group methods to evaluate perceptions about robotic technology (RT) to reduce the rate of ADEs in U.S. nursing homes (NH). There is a lack of scholarly research into whether a conceptual approach rooted in RT can be implemented to assist with drug administrations in NHs. The purpose of this study was twofold. The first purpose was to evaluate the causes …

บทบาทพยาบาลในการดูแลหญิงตั้งครรภ์ที่ประสบอุบัติเหตุฉุกเฉิน, ชัชวาล วงค์สารี, ธนันต์นิภา ภัคศุขนิธิวัฒน์

Journal of Nursing Research, Innovation, and Health

อุบัติเหตุในระหว่างการตั้งครรภ์ เป็นสาเหตุอันดับแรกของสาเหตุที่ไม่เกี่ยวข้องกับสูติกรรมที่ทำให้หญิงตั้งครรภ์เสียชีวิต หญิงตั้งครรภ์จะมีการเปลี่ยนแปลงทางร่างกายหลายอย่าง ความเข้าใจอย่างลึกซึ้งต่อการเปลี่ยนแปลงดังกล่าวนี้จะส่งเสริมการช่วยเหลือให้มีประสิทธิภาพดีที่สุดต่อมารดาและทารกในครรภ์ การช่วยเหลือหญิงตั้งครรภ์ที่ประสบอุบัติเหตุฉุกเฉินต้องทำงานร่วมกันเป็นทีม โดยพยาบาลต้องรู้จักบทบาทที่ตนเองสามารถปฏิบัติได้ทั้งในบทบาทอิสระและกึ่งอิสระภายใต้ขอบเขตกฎหมายและจรรยาบรรณวิชาชีพกำหนด บทความนี้จึงมุ่งเสนอบทบาทของพยาบาลในการจัดการดูแลหญิงตั้งครรภ์ที่ประสบอุบัติเหตุฉุกเฉินโดยรวม 4 บทบาทหลัก ดังนี้ 1) บทบาทการประเมินสภาพของหญิงตั้งครรภ์และทารกในที่ประสบอุบัติเหตุฉุกเฉิน 2) บทบาทการช่วยเหลือเบื้องต้นในหญิงตั้งครรภ์ที่ประสบอุบัติเหตุฉุกเฉิน 3) บทบาทการช่วยกู้ชีพในหญิงตั้งครรภ์ที่หัวใจหยุดเต้นในที่ประสบอุบัติเหตุฉุกเฉิน และ 4) บทบาทการป้องกันการเกิดอุบัติเหตุในหญิงตั้งครรภ์

การวิเคราะห์ปัจจัยจำแนกการตั้งครรภ์ในวัยรุ่นที่ตั้งครรภ์และวัยรุ่นที่ไม่ตั้งครรภ์, นุชรีย์ แสงสว่าง, ณัฐธยาน์ วิสารพันธ์

Journal of Nursing Research, Innovation, and Health

วัตถุประสงค์: 1) เพื่อศึกษาลักษณะครอบครัวของวัยรุ่นที่ตั้งครรภ์และวัยรุ่นที่ไม่ตั้งครรภ์ 2) เพื่อวิเคราะห์ปัจจัยจำแนกกลุ่มและอำนาจพยากรณ์การเป็นสมาชิกกลุ่มที่จำแนกกลุ่มวัยรุ่นที่มีการตั้งครรภ์ในวัยรุ่นและไม่ตั้งครรภ์ในวัยรุ่น\n\nรูปแบบการวิจัย: กลุ่มเปรียบเทียบ (Case control study)\n \nวิธีดำเนินการวิจัย: กลุ่มตัวอย่างเป็นหญิงวัยรุ่นอายุ 13-19 ปี โดยแบ่งเป็นกลุ่มศึกษา คือ หญิงวัยรุ่นตั้งครรภ์ที่มาฝากครรภ์ในโรงพยาบาลตติยภูมิ และกลุ่มควบคุม คือ วัยรุ่นหญิงที่ไม่ตั้งครรภ์ที่ศึกษาในโรงเรียนมัธยมศึกษา จำนวนกลุ่มละ 85 คน เก็บรวบรวมข้อมูลด้วยแบบสอบถามข้อมูลส่วนบุคคล แบบสอบถามการสื่อสารเรื่องเพศกับผู้ปกครอง และแบบสอบถามการรับรู้ผลกระทบของการตั้งครรภ์ในวัยรุ่น มีค่าสัมประสิทธิ์อัลฟ่าของครอนบาคเท่ากับ .87 และ .66 วิเคราะห็ข้อมูลด้วยสถิติการวิเคราะห์จำแนกประเภท (Discriminant analysis)\n\nผลการวิจัย: 1) วัยรุ่นที่ตั้งครรภ์มีอายุเฉลี่ยของมารดาที่มีบุตรคนแรก และคะแนนเฉลี่ยการรับรู้ผลกระทบของการตั้งครรภ์น้อยกว่าวัยรุ่นหญิงที่ไม่ตั้งครรภ์ (21.84 vs. 26.08; 45.12 vs. 51.68, p = .000 ตามลำดับ) 2) ปัจจัยที่สามารถจำแนกกลุ่มวัยรุ่นที่มีการตั้งครรภ์ในวัยรุ่นและไม่ตั้งครรภ์ในวัยรุ่นได้มี 4 ปัจจัยคือ อายุของกลุ่มตัวอย่างการรับรู้ผลกระทบของการตั้งครรภ์ในวัยรุ่นอายุที่มารดามีบุตรคนแรก และการสื่อสารเรื่องเพศกับผู้ปกครอง (.712,-.496, -.475 และ .241 ตามลำดับ) 3) สมการจำแนกกลุ่ม พยากรณ์การเป็นสมาชิกของกลุ่มวัยรุ่นที่มีการตั้งครรภ์ในวัยรุ่น ได้ร้อยละ 76.5 และกลุ่มที่ไม่ตั้งครรภ์ในวัยรุ่น ได้ร้อยละ 89.4 และพยากรณ์การเป็นสมาชิกของกลุ่มโดยเฉลี่ยได้ร้อยละ 82.9\n\nสรุป: ปัจจัยด้านอายุของกลุ่มตัวอย่าง การรับรู้ผลกระทบของการตั้งครรภ์ในวัยรุ่น อายุที่มารดามีบุตรคนแรก และการสื่อสารเรื่องเพศกับผู้ปกครอง เป็นปัจจัยที่สามารถจำแนกกลุ่มวัยรุ่นที่ตั้งครรภ์และไม่ตั้งครรภ์ได้ จึงควรนำปัจจัยดังกล่าวมาวางแผนเพื่อลดปัญหาการตั้งครรภ์ในวัยรุ่นต่อไป\n