Nursing Commons^™

Evaluation Of A Rheumatology Patient Prioritization Triage System, Katharine R. Layton

DNP Projects

The United States health care system is currently experiencing an increase in demand for services due to an aging population. Rheumatology, an Internal Medicine sub-specialty, treats those patients with arthritic conditions as well as other autoimmune and inflammatory conditions. A shortage of rheumatologists is projected by 2025, adding additional stress to an already burdened clinical area.This means patients can face substantial wait times when requesting consultation with a rheumatology provider.This capstone project will present three manuscripts that explore the referral process from primary to specialty care and strategies to reduce wait times. The first manuscript is a literature review that …

Examining Provider Perspectives On Implementation Of An Integrated Primary And Behavioral Health Care Model In The Outpatient Setting: A Qualitative Study, Holly Gray

DNP Projects

AIM The purpose of this qualitative descriptive research study was to identify and describe primary and mental health provider perspectives, including attitudes and knowledge related to integration of primary and behavioral health care in the outpatient setting. One objective of this project was to gather information from providers in both primary and behavioral health settings to ascertain how they perceive the idea of integrated care. Another objective of this project was to gather information about provider perception of current practice protocols for treatment of patients with comorbid physical and mental health issues, perceived facilitators and barriers to integrated care, and …

An Assessment Of Knowledge And Attitude Towards Stock Epinephrine Among Kentucky School Nurses, Brandi M. Duran

DNP Projects

This cross-sectional, pre-post intervention study was designed to gather information on Kentucky School Nurses attitude and knowledge toward non-prescribed epinephrine auto injectors in Kentucky Schools. All 500 members of the Kentucky Schools Nurses Association received a link to the pretest, educational intervention and posttest via email. Of those, 75 nurses responded and 72 were eligible to participate in the study. The data was analyzed through a paired t-test using SPSS. The results showed an increase in level of comfort with epinephrine, although it was not statistically significant. There was a statistical significance between the pretest and posttest when school nurses …

The Effects Of Nutritional Status Assessment By Pre-Albumin Level And Its Effects On Functional Independence Measures (Fim) In Adult Patients After Fall And Fracture, Saeed Niyati

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Fall is leading cause of injury in elderly persons. Nutritional status is an important aspect of elderly life that influences daily activities, quality of life in patients with fall and fractures. Objectives: To evaluate the effects of nutritional assessment by prealbumin level on Functional Independence Measures (FIM) and Length of Stay (LOS)in elderly population with fall and fracture in rehabilitation hospital. Methods: This study design was a one group pretest-posttest without a control group. Seventy one patients (n=71) 65 years or older who were admitted to the rehabilitation hospital with a diagnosis of fall and fracture recruited. Nutritional status …

Mental Health Access Among International College Students, Linda Bett

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The International student population is steadily rising in various campuses across the United States (U.S). Mental health concerns such as mood, anxiety, adjustment disorders, relationship problems, and academic struggles are significant among this population (Mitchell, Greenwood, and Guglielmi, 2007; Yorgason, Linville, and Zitzman, 2008). Lack of knowledge, fear, stigma, poor support resources, unawareness of service availability, beliefs, culture, and mental health experiences have been voiced as reasons that impact help seeking attitudes. Early mental health interventions are therefore warranted; if mental health concerns are left unaddressed they could result in a decreased ability to function or more fatal consequences such …

Psychological Well-Being Among Breast Cancer Survivors: Factors That Influence Transition From Primary Treatment To Early Survivorship, Celestine G. Gochett

Theses and Dissertations--Nursing

Eudaimonic psychological well-being (PWB) refers to a lifelong process of purposeful engagement in goal-driven tasks or activities resulting in positive psychological functioning. These activities reflect autonomy, purpose in life, self-acceptance, personal growth, positive relations with others, and environmental mastery. While more women are surviving breast cancer, they face a multitude of late and long term physiopsychosocial challenges that result from being diagnosed and treated. Protective health effects associated with the experience of PWB can potentially mitigate ill-being and benefit overall health of breast cancer survivors (BCS). Adequate preparation by healthcare teams to transition them from primary treatment to early survivorship …

The Impact Of Prenatal Depressive Symptoms, Intimate Partner Relationship, And Immune Status On Postpartum Depression, Julia J. Hall

Theses and Dissertations--Nursing

The prevalence of depression during pregnancy in the U. S. is approximately 13%. Poor quality of the intimate partner relationship is significantly correlated with depression during pregnancy. The adverse effects of antenatal depression have been widely documented. The relationship between the intimate partner relationship and depression during pregnancy has not been well delineated in the literature. Little data exist regarding the impact of prenatal immune status on risk for postpartum depression. Due to limited evidence, there is a critical need to examine the relationship among trimester specific cytokines, quality of the intimate partner relationship, and antenatal depressive symptoms on risk …

Explore The Relationship Among Lung Cancer Stigma, Social Support, And Psychosocial Distress, Lisa Maggio

Theses and Dissertations--Nursing

There is longstanding causal relationship between cigarette smoking and lung cancer. Smoke-free policies and anti-smoking campaigns have been linked to the decline in smoking acceptance and contribute to the unintended consequence of stigmatizing smokers. Lung cancer is viewed as a self-inflicted disease and patients’ feel judged in a manner different from other cancers affecting social interactions between family, friends, and healthcare professionals. Lung cancer stigma contributes to depression, anxiety, poor self-esteem, guilt, shame, blame, threatens a person’s social identity, and limits social support that deeply affects patients and their support persons.

This dissertation contains a review of the literature related …

Recent Graduates' Perspective On The Efficacy Of Nursing Simulation Laboratory Experiences, Holli Sowerby

Walden Dissertations and Doctoral Studies

It has become progressively difficult to find suitable clinical placement for nursing students. To help meet this need, local schools of nursing are turning to high-fidelity simulation manikins to substitute for clinical experience. There is a lack of research that explores recently graduated nurses' perceptions about the efficacy of simulation experiences. Guided by the constructivist theory, this qualitative case study identified how recent RN graduates viewed simulation experiences and whether associate's-degree RN program graduates and bachelor's-program RN graduates viewed simulation differently. Nine recent graduates participated in individual face-to-face interviews. The data were coded and grouped into 5 major themes in …

Effects Of Education On Victims Of Domestic Violence, Julette N. Anderson

Walden Dissertations and Doctoral Studies

The purpose of this project was to improve support for victims of domestic violence. To that end, this project developed an evidence-based program to provide information about domestic violence including safe and confidential ways to seek assistance, rights as cohabiting intimate partners, and the resources available to community members. Several approaches were used to develop, validate, and plan for implementation and evaluation of this program, which was developed for 3 sites in Broward and Miami-Dade counties where the project is situated. The program logic model and the social ecological model, including the individual, relationship, community, and societal levels, were used …

The Effects Of Nursing Education On Decreasing Catheter Associated Urinary Tract Infection Rates, Pamela R. Gordon

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTIs) account for 40% of all nosocomial infections in the United States, affecting nearly 900,000 patients per year. The indwelling urinary catheter (IUC) is a widely utilized device in modern hospital environments, yet they are not always used appropriately in hospital settings and can result in prolonged use and improper management, increasing risk of infections and length of stay. Nurses are the primary champions to promote preventative measures, provide patient education, and evaluate evidence-based practice (EBP) strategies to decrease CAUTIs. The purpose of this study was to determine if nursing education on EBP guidelines could decrease …

Care Transition Gaps: Risk Identification And Intervention, Michael Howard Jongsma

Walden Dissertations and Doctoral Studies

Hospital readmissions related to chronic heart failure (CHF) are costly, widespread, and often avoidable. Patient education that includes diagnosis, causes, medications, diet, exercise, and exacerbation warning signs has been shown to reduce the number of CHF readmissions. The purpose of this study was to use risk stratification to identify CHF patients at high risk for 30-day readmission. Once a high-risk CHF patient was identified, nursing interventions would be triggered to reduce readmissions and close the gaps in the continuum of care following acute care admission. Transitions of care theory was used as the framework for this project. The methodology had …

The Effect Of Evaluating A Quality Improvement Initiative On Reducing Hospital Transfers Of Nursing Home Residents, Denise Eileen Jarboe

Walden Dissertations and Doctoral Studies

The Effect of a Quality Improvement Initiative on Reducing Hospital Transfers of Nursing Home Residents

by

Denise Eileen Jarboe

MSN, Walden University, 2010

BS, University of Maryland, 1981

Project Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2015

Nursing homes (NH) in the 21st century provide skilled healthcare services for resident populations who are older, frailer, and often suffering from multiple incurable chronic medical conditions. Nurses practicing in this setting must be keen observers and effective communicators with the ability to recognize and report subtle changes in health status …

Improving Nurses' Knowledge To Reduce Catheter-Related Bloodstream Infection In Hemodialysis Unit, Mohammed Jawad Kadium

Walden Dissertations and Doctoral Studies

Central venous catheters (CVCs) are commonly used as vascular access for patients who require hemodialysis. Infectious complications are a serious clinical problem, and they are associated with high rates of morbidity and mortality, prolonged hospital stay, and increased medical treatment costs. The purpose of theproject was to evaluate the effectiveness of educating registered dialysis nurses regarding CVC maintenance care to reduce catheter-related bloodstream infection (CRBSI) in a hemodialysis unit. The project question focused on the educational program derived from the evidence-based guidelines recommended by the Centers for Disease Control and Prevention (CDC) to improve registered dialysis nurses' knowledge regarding CVC …

Development Of An Evidence-Based New Graduate Nursing Orientation Program For The Emergency Department, Mary Ellen Zaleski

Walden Dissertations and Doctoral Studies

The traditional new graduate nurse (NGN) orientation process places NGN with an experienced preceptor for 24 weeks and requires clinical skills checklists to be completed by the preceptor, a practice which is not an evidence-based practice for orienting NGNs. The purpose of this quality improvement project was to develop an evidence-based orientation to decrease time requirements and standardize the processes and evaluation of the NGN in the emergency department. The project was informed by Benner's novice to expert theory and focused on acquisition of clinical skills. The project team included 6 stakeholders: the Doctor of Nursing Practice student-leader, the unit …

Graduate Nurse Pediatric Emergency Nursing Orientation Program, Mindi Lynne Johnson

Walden Dissertations and Doctoral Studies

Research has found that the turnover rate of graduate nurses within their first year is significantly high. Specialties such as pediatric and emergency nursing have even a higher turnover rate. It has been suggested that significant amounts of stress and lack of skills are responsible for the turnovers. This quality improvement project, which is theoretically based on Benner's novice to expert theory, will examine if a lack of a specialized pediatric emergency graduate nurse orientation program is a contributing factor. The purpose of the project is to improve retention of graduate nurses by implementing a specialized orientation program that focuses …

Weight Management Of Women Of Childbearing Age, Marcia Hagen

Walden Dissertations and Doctoral Studies

Black River Memorial Hospital identified obesity as a priority health concern in its rural service area; this concern was in line with the county's needs assessment. It was identified that women of childbearing age affect the lifestyle and health choices of their families and that they are at higher risk for the additional health risks associated with obesity affecting pregnancy and birth. Despite the identification of these risk factors, the factors that affect healthy weight management have not been well understood. Using the life course theory, a qualitative inquiry in the form of a structured interview was developed with local …

Development Of An Electronic Health Record Educational Project For Staff Nurses, Nanah Sheriff Sesay

Walden Dissertations and Doctoral Studies

Abstract

The use for electronic health records (EHRs) by 2015 is being mandated through incentive payments for health care providers. Evidence-based literature has shown that almost half of the hospitals in the Unites States have not adopted EHRs, and many nurses have not been educated to effectively use them. In order to enhance and sustain EHR adoption by hospitals, nurses need to be educated on EHRs' usability. The purpose of this project was to develop an evidence-based EHR educational project for nurses on how to enter nursing assessments, document patients' medical data, and communicate effectively with patients and health care …

Planning A Smoking Cessation Program In A Mental Health Hospital, Victoria Omuson

Walden Dissertations and Doctoral Studies

The incidence of smoking among mentally ill people is very high. Smokers have a 50%, rate of mental illness diagnosis compared with 23% rate for general population. To address this problem, the purpose of this project was to plan a smoking cessation program for patients in a mental health facility. The theoretical foundation for this project was based on the theory of planned behavior, which identifies the predictive nature of smoking and the benefits that can be derived from implementing a systematic approach for change. The project question examined the effectiveness of smoking cessation program using educational support, pharmacological strategies, …

A Guide For Delivering Evidence - Based Discharge Intructions For Emergency Department Patients, Andre Walker

Walden Dissertations and Doctoral Studies

Discharge instructions provided to patients discharged from the emergency department (ED) are often provided in a way that is neither clear nor concise. Patients are often discharged home without a clear understanding of their diagnosis, medications, reasons to return to the ED, follow-up instructions, or how to manage their care at home during their illness. Therefore, a guideline needed to be developed in order to help the ED staff provide clear and concise discharge instructions to patients discharged from the ED. The Ace Star Model of Knowledge Transformation was the foundation for the development of the evidence-based guideline. A formative …