Nursing Commons^™

Improving Pain Management For Hospitalized Patients, Ronda Sweet

Walden Dissertations and Doctoral Studies

Uncontrolled pain has proven effects on both physiological and psychological responses of hospitalized patients. These incapacitating sequelae most often negatively impact patient outcomes resulting in unnecessary suffering and prolong hospitalizations. First line nurses often have preconceived notions about a patient's pain without developing an individualized patient context that considers appropriate pain management knowledge translated from best practice standards. Guided by Bandura's social learning theory and Lippitt's change theory, the purpose of this quality improvement project was to determine if use of the Curriculum Outline on Pain for Nursing from the International Association for the Study of Pain (IASP) improved nursing …

Assessing Nurse Manager Competencies In A Military Hospital, Ruby O. Anderson

Walden Dissertations and Doctoral Studies

Military health care organizations need competent frontline managers with knowledge and skills to manage health care complexity and ensure evidence-based practice. With systematic, planned turn over of military managers, more civilian managers are needed to fill permanent positions in military hospitals. The purpose of this project was to provide a better understanding of the competencies perceived by nurse managers at a military medical center and whether they differed by military or civilian status. The American Organization of Nurse Executives competency model and framework provided the theoretical framework for the project. The design was nonexperimental, with an observational, descriptive, cross-sectional approach. …

Improving Health Literacy With Clear Communication, Carol Barbara Wilson

Walden Dissertations and Doctoral Studies

Health literacy is demonstrated when individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions. Veteran health literacy is believed to be lower than the general population due to the aging and culturally diverse population. Veterans require adequate health literacy to manage their diverse high acuity physical injuries, psychological conditions, and chronic diseases. Clear communication between the clinician and veteran patient is essential to provide high quality health services. The objective of this quality-improvement project was to evaluate the ability of nurses in the ambulatory environment to identify low health literacy patients and …

The Move From Recorded To Bedside Shift Report: Evaluating Barriers To Full Implementation, Elizabeth Jackson Cipra

Walden Dissertations and Doctoral Studies

Many sentinel events in acute care centers can be attributed to miscommunication of patient information at shift change. A growing body of evidence supports the implementation of bedside shift report as the standardized approach to ensure effective communication by staff. The purpose of this study was to identify the barriers that impede nurses from fully participating in bedside shift report in order to create an educational initiative to develop the nursing staff's proficiency in performing bedside report. Lewin's change theory served as the framework for the project. Data for the staff development project were collected using a focus group approach …

The Relationship Of General Science Grades To Program Completion In An Associate Degree Nursing Program, Catherine Edlebeck

Walden Dissertations and Doctoral Studies

High attrition of nursing students in the United States may contribute to a shortage of registered nurses and inefficient use of scarce resources. The purpose of this study was to explore the relationship between nursing student grades in 3 science prerequisites and length of time to program completion on each of the study college's 4 campuses. Ausubel's theory of subsumption, wherein a learner's ability to meaningfully learn new data depends on the existing cognitive structure within which the new material is assimilated, was used as a theoretical framework. Prerequisite science course grades for 575 nursing students attending a Midwestern technical …

Using The Power Of 3 With Total Joint Surgery Patients, Lynda M. Sanchez

Walden Dissertations and Doctoral Studies

The purpose of patient education is to provide patients and their families with the tools needed to care for themselves after discharge from the hospital, but shortened hospital stays, limited health literacy, language, and age can impede the patient's comprehension of the information provided. Researchers have found that the lack of effective patient education is related to 30-day hospital readmissions. The Power of 3 educational tool, designed by Sanchez and Cooknell, addressed the factors that impeded effective patient teaching by using the adult learning theory and low health literacy concepts. The Power of 3 was implemented as a quality improvement …

Development Of Evidence-Based Scenario With High Fidelity Simulation To Improve Nursing Care Of Chest Pain Patients, Ma Zolaica Paragas

Walden Dissertations and Doctoral Studies

Cardiovascular disease remains the leading cause of mortality in the United States, and a primary educational objective is to develop professional competency among nurses to ensure the provision of safe and effective care to the cardiac patient. Benner's theory of novice-to-expert led to the development of an evidence-based scenario for the care of the patient with chest pain using risk-free high-fidelity simulation environments that focused on assessment, history taking, and communication, while evaluating improvements in the competency of nurses providing care to chest pain patients. Thirty-six nurses volunteered in the study. Feedback from nurse educators, which led to modifications to …

Identifying The Beliefs And Barriers To Mammography In Rural African Women, Linda Harper Mangum

Walden Dissertations and Doctoral Studies

Breast cancer is the most commonly diagnosed cancer in African-American (AA) women and is the second leading cause of cancer-related deaths in the United States among AA women ages 40 to 55 years of age. The 5-year breast cancer survival rates for AA women (78%) are lower than are those of Caucasian women (90%). The purpose of this project was to describe the benefits and barriers toward screening mammograms for breast cancer in AA women living in the Southside Health District in Virginia. The subscales of The Champion's Mammography Beliefs and Attitudes Questionnaire (MBAQ, 1999), which is based on the …

Nurses' Knowledge Of Pain Assessments And Reassessments Impacts Hospitalized Patients' Reporting Of Pain, M. Michele Potter Williams Williams

Walden Dissertations and Doctoral Studies

Ineffective pain management can prolong a patient's length of stay and increase cost of care. Inadequate pain control decreases the patient's quality of life and contributes to poor health outcomes. A recent record audit showed that documentation of pain reassessments occurred only 20% of the time within an hour after administering pain medication. Furthermore, nurses may have insufficient knowledge regarding pain assessments and reassessments or hold irrational fears about addiction leading to inadequate treatment of pain. The purpose of this quality improvement project was to evaluate the effectiveness of an educational program for acute care nurses for the assessment and …

Moving Evidence Into Practice: Early Sepsis Identification And Timely Intervention In The Emergency Department (Project Code Sepsis), Jonjon Macalintal

Walden Dissertations and Doctoral Studies

Sepsis is the leading cause of death among hospitalized patients in the United States, is responsible for more than 200,000 deaths annually, and has as high as a 50% mortality rate. Sepsis requires prompt identification so that early goal-directed therapy can be instituted to lead to better outcomes. The purpose of this quality improvement project was to determine if implementing an evidence-based identification and intervention program, Project Code Sepsis, in the emergency department can increase the number of patients who receive antibiotics within the first hour of triage and decrease the length of hospital stay. Specifically, the primary project goals …

Barriers To Exclusive Breastfeeding Among Mothers During The First Four Weeks Postpartum, Jessy V. Thomas

Walden Dissertations and Doctoral Studies

According to the World Health Organization, breastfeeding is natural and the most effective way of nourishment to feed infants and young children to ensure child health and survival. Currently, the World Health Organization, the American Academy of Pediatrics, and other health organizations recommend exclusive breastfeeding during the first 6 months of life. Although exclusive breastfeeding has been shown to reduce the occurrence of adverse health outcomes to the infant and mother, the duration of exclusive breastfeeding remains relatively low in the United States. The theory of planned behavior was used as a theoretical framework for this study. The purpose of …

Nurses' Experiences Transitioning From Staff Nurse To Management In A Community Hospital, Jennifer Sylvia Buffenbarger

Walden Dissertations and Doctoral Studies

This project study addressed the problem of frequent turnover of nurse managers at a Northeastern community hospital. The lack of retention of nurse managers has led to attenuated support for the nursing staff who continued to hold the front line in patient care. The purpose of this qualitative bounded case study was to explore nurse managers' experiences with turnover in order to identify strategies for enhancing retention. Work empowerment and servant leadership theories served as the frameworks for the study. Research questions focused on nurse managers' perceptions of empowerment and servant leadership characteristics that were important in decisions to assume …

Practice Preparedness In New Graduates: Exploring The Education-Practice Gap, Wendy L. Batch-Wilson

Walden Dissertations and Doctoral Studies

As newly licensed registered nurses enter their first nursing role, their perceived preparation for practice may vary. This descriptive study addressed the education-practice gap that exists as nurses transition into nursing practice. The use of Benner's skill acquisition model offers a structure for connecting theory to practice. New graduate nurses responded to the Casey-Fink Graduate Nurse Experience Survey-© to identify gaps in preparedness for novice practice. A convenience sample of nurses within the first 12 months of hire (n = 35) was sent the survey link by educators from the chosen sites. Anonymity was maintained with 18 total responses and …

Nursing Attitudes Towards Suicidal Patients In The Emergency Department: Assessment Interview Training, Belinda Beaver

Theses and Dissertations

This project sought evidence for the effectiveness of pedagogy in professional nursing continuing education and its effect on emergency department nurse attitudes towards patients seeking crisis intervention for suicide. Approximately 12 million emergency department (ED) visits annually were for patients suffering with mental illness and/or suicidal ideation. Emergency department staffs were often not adequately prepared to manage these problems. The purpose of this project was to examine the impact of an educational initiative on nurses’ attitudes about patients expressing suicidal ideation in the emergency departments 2 rural southeastern towns.

The project question was; in two different rural community emergency departments …

Expectations And Quality Of Life During The Antepartum And Postpartum Period, Mary Kathryn Adams

Dissertations

During pregnancy, women frequently anticipate birth and motherhood with unrealistic images and expectations which are formed by personal experience and society’s portrayal of motherhood (e.g., books and movies). How these expectations impact the postpartum period for women has not been well studied. However, research has identified a link between maternal expectations, reality, and negative emotional responses. When expectations are met, the experience of motherhood may be a positive one. However, when these expectations are not met, the potential for negative emotional responses may be greater. The postpartum period is a significant period of adjustment, and depression occurs in about 13%–19% …

Simulation Learning And Transfer To The Clinical Environment In Undergraduate Nursing Students, David A. Miles

Dissertations

Simulation learning is an integral component of many undergraduate nursing programs throughout the country. Experiential learning through simulation allows students to improve their cognitive, affective, and psychomotor skills. Some clinical experiences lack significant practice of clinical skills for students; including the inability to assume the role of the nurse. A recent literature review revealed a need to advance the understanding of simulation learning and transfer; with many questions still remaining unanswered. The aim of this study was to conceptualize the process by which simulation learning transfers to the clinical environment in undergraduate nursing students. Twenty-five, fourth-year traditional nursing students, who …

Attitudes To Lesbian, Gay, Bisexual And Transgender Parents Seeking Health Care For Their Children In Two Early Parenting Services In Australia, E Bennett, K Berry, T Emeto, L Shields

Nursing Papers and Journal Articles

Aim: to examine the attitudes to and knowledge and beliefs about homosexuality, of nurses and allied professionals in two early parenting services in Australia.

Background: Early parenting services employ nurses and allied professionals. Access and inclusion policies are important in community health and early childhood service settings. However, little is known about the perceptions of professionals who work within early parenting services in relation to lesbian, gay, bisexual and transgender families.

Design: This is the final in a series of studies and was undertaken in two early parenting services in two states in Australia using a cross-sectional design with …

Protocol For Care After Lymphoma (Caly) Trial: A Phase Ii Pilot Randomised Controlled Trial Of A Lymphoma Nurse-Led Model Of Survivorship Care, K Taylor, D Joske, M Bulsara, C Bulsara, L Monterosso

Nursing Papers and Journal Articles

Introduction: Lymphoma is the sixth most common cancer diagnosed in Australia and internationally. Owing to the aggressive nature of the disease and intensity of treatment, survivors face long-term effects that impact on quality of life. Current models of follow-up post-treatment fail to address these complex issues. Given that 74% of patients with lymphoma cancer now survive 5 years beyond diagnosis and treatment, it is important to address this gap in care.

Aim: To determine self-reported informational and practical needs, anxiety, depression, stress, coping and empowerment at baseline, 3 and 6 months.

Methods and analysis: A pilot randomised controlled trial will …

Models For Community Based Day Care For Older People: A Narrative Review, Caroline Bulsara, Christopher Etherton-Beer, Rosemary Saunders

Nursing Papers and Journal Articles

Objectives: Older Australians are choosing to live within the community and there are a number of initiatives to enable this sector of the population to do so for longer. In an effort to ensure that they remain both physically and psychologically engaged, one initiative has been to provide community based day care (CBDC). Method: A narrative review was undertaken through searching MEDLINE, CINAHL Plus, Scopus and AgeInfo using keywords related to facility related, target group related and purpose/program of CBDC services. Results: Results indicated that there is a much research investigating different approaches but little consensus regarding the optimal delivery …

A "Clarion" Call For Embracing Ipe As The Status Quo For Preparing Health Professionals To Engage In Interprofessional Health Research, Kimberly Adams Tufts

Ellmer School of Nursing Faculty Publications

Complex health conditions and the social-economic determinants that contribute to disease and injury incidence, prevalence, and health inequalities require multifaceted evidence-based interventions that only interprofessional research teams who collaborate across traditional disciplinary lines can generate. Interprofessionally driven and derived research evidence is the method of du jour. Nonetheless as a whole, health professionals who are often members of interprofessional health research teams are products of educational systems wherein they were educated in disciplinary silos. Health professionals that learn about, with, from, each other during their foundational education will be better prepared to function as interprofessional research team members. With the …