Nursing Commons^™

Nclex-Rn Predictor Test Scores And Nclex-Rn Success, Annie Ruth Grant

Walden Dissertations and Doctoral Studies

Health care professionals and nurse educators are concerned about increasing percentage of first time test takers failing the NCLEX-RN exam. The purpose of this retrospective study was to examine predictive accuracy of the Assessment Technologies Institute (ATI) RN Comprehensive Predictor for passing or failing the NCLEX-RN exam in a cohort of nursing students (N = 195). South Eastern Technical College in South Carolina is in jeopardy of losing accreditation for their nursing program because of the low percentage of first time test takers failing. The college's pass rate on the NCLEX-RN exam has been below the national and state averages …

Moving From Productivity To Professional Value Model Of The Hospital-Based Registered Nurse, Crystal Maree Billings

Walden Dissertations and Doctoral Studies

There is a gap between organizational commitment to professional value of the nurse and the achievement of quality outcomes. This study explored the relationship between the productivity model and the professional value (PVS) model of the hospital-based registered nurse (RN). It was essential to understand how to measure nursing's contribution to patient care as a means to promote patient care outcomes. The current professional nursing dynamic provides an unprecedented opportunity for nurses to achieve their highest professional potential through increased demonstration of advocacy and accountability for the central tenets of nursing. The intent of this project was to explore the …

Unit Retention Strategies, Steven Trush, Rosa Filomeno, Joyce Jones, Martha Gaitan

All Publications

No abstract provided.

Attitudes And Beliefs Of Registered Retired And Registry Nurses Regarding Holistic Spiritual Care, Beverly S. Ward

Walden Dissertations and Doctoral Studies

The purpose of holistic spiritual care is to assess and provide for the spiritual needs of patients. Current literature indicates that holistic spiritual care is important to the healthcare of patients. Researchers suggest that nurses who practice holistic spiritual care are more aware of the attributes of caring, respect, and emotional support. This project study addressed a problem at the research site reported by local community nurses and holistic spiritual care experts of nurses not practicing holistic spiritual care. Mezirow's transformational learning theory was used as the theoretical foundation for this qualitative study, which was designed to examine the attitudes …

Role Ambiguity, Role Strain, Job Dissatisfaction, And Difficulty Transitioning Into Academia Among Nursing Faculty, Paula Stallard Whitehead

Walden Dissertations and Doctoral Studies

Registered nurses with experience in the clinical area entering academia go through a transition that may lead to difficulties such as role ambiguity and role strain when beginning a new job. The purpose of this study was to understand the experiences leading to role ambiguity, role strain, difficulty with role transition, and job dissatisfaction among the faculty at colleges of nursing in the mountain region of Western North Carolina. Guided by Kahn's organizational role theory and Schlossberg's transition theory, research questions investigated the nursing faculty experience of role ambiguity, role strain, difficulty transitioning into academia, and job dissatisfaction. A qualitative …

International Family Nursing Association: Family Nursing Practice Survey Findings, Kathryn H. Anderson

Nursing: Faculty Publications

No abstract provided.

Are E-Cigarettes An Optimal Choice For Harm Reduction For Tobacco Smokers?, Brenda Talley, Deborah Allen, Kathryn H. Anderson

Nursing: Faculty Presentations (1990-2022)

This presentation was given at the Sigma Theta Tau International Congress.

Success Experiences Of Hispanic Nursing Students Who Persisted And Graduated After Academic Failure, Barbara Ninan

Walden Dissertations and Doctoral Studies

Twenty percent of Hispanic nursing students at a west coast university are being dismissed from the nursing program due to repeated failures in nursing courses. The purpose of this study was to gain a better understanding of Hispanic nursing students' experiences of successfully completing a nursing program, earning a baccalaureate of science degree, and passing the state licensing examination for registered nurses despite having failed a nursing course and having been placed on academic probation. Guided by Tinto's theory of academic integration, a descriptive phenomenological design was used to explore Hispanic nursing graduates' success experiences. Purposive sampling was used to …

Exploring Strategies For Implementing Barcode Medication Administration Systems, Julie A. Frederick

Walden Dissertations and Doctoral Studies

The number of medication errors associated with preventable deaths in healthcare facilities remains at a high rate for healthcare leaders. Practices of medication delivery remain similar to those 10 years ago. Hospitals that have implemented barcoding medication administration systems have reported a decrease in medication errors ranging from 60% to as high as 93%. Despite this utility of barcoding, only 50% of U.S. hospitals have implemented barcode medication administration. This comparative case study explored the strategies hospital leaders used to implement barcode medication administration systems, utilizing the sociotechnical theory for a conceptual framework. Face-to-face, semistructured interviews were used to identify …

The Relationship Between Stressors And Intent To Leave Nursing Homes Among Directors Of Nursing, Crystal R. Williamson

Journal of Sustainable Social Impact

According to the Centers for Medicare and Medicaid Services, some nursing homes have been ranked worst in the nation when rating the quality of resident care. The purpose of this study was to determine the relative strength of workplace stress, job satisfaction, organizational support, and personal data (number of years employed, age, highest education level) in predicting director of nursing (DON) intentions to leave the position. This information contributes to social change because it is important to know that DONs need to experience general satisfaction in order to maintain stable leadership that positively contributes to the quality of care in …

Attitude, Subjective Norm, And Perceived Behavioral Control As Indicators For Nurse Educators’ Intention To Use Critical Thinking Teaching Strategies: A Structural Equation Model Analysis, Angerlita Yolanda Smith

Dissertations

Problem

Deficiencies in new nursing graduates’ ability to use critical thinking skills have been documented. Researchers have found that the continued use of traditional teaching methods and less student-centered approaches for critical thinking development has contributed to this problem. This particular issue has evoked much concern for institutions and organizations involved with the safe delivery of patient care. The purpose of this study was to examine (a) the relationship between the factors educator characteristics, attitude, subjective norm and perceived behavioral control in a hypothesized model that may influence nurse educators’ intention to use instructional methods that promote critical thinking in …

The Road Was Paved With Good Intentions, Kristina Dreifuerst, Suzie Kardong-Edgren

College of Nursing Faculty Research and Publications

No abstract provided.

Differences In Inflammatory Markers Between Nulliparous Women Admitted To Hospitals In Preactive Vs Active Labor, Jeremy L. Neal, Jane M. Lamp, Nancy Lowe, Shannon L. Gillespie, Loraine T. Sinnott, Donna O. Mccarthy

College of Nursing Faculty Research and Publications

Objective

To determine whether labor-associated inflammatory markers differ between low-risk, nulliparous women in preactive vs active labor at hospital admission and over time.

Study Design

Prospective comparative study of low-risk, nulliparous women with spontaneous labor onset at term (n = 118) sampled from 2 large Midwestern hospitals. Circulating concentrations of inflammatory markers were measured at admission and again 2 and 4 hours later: namely, neutrophil, and monocyte counts; and serum inflammatory cytokines (interleukin -1β, interleukin-6, tumor necrosis factor-α, interleukin-10) and chemokines (interleukin-8). Biomarker concentrations and their patterns of change over time were compared between preactive (n = 63) and active …

Inefficiency In The Post Anesthesia Care Unit: A Quality Improvement Initiative, Ashley St. Martin

Master's Theses and Capstones

Background: The post anesthesia care unit (PACU) is a busy environment in which nurses communicate with patients, family members, and a large team of perioperative professionals. PACU nurses were experiencing an unmanageable number of work interruptions due to a higher patient census which increased the daily surgical caseload.

Aim: The purpose of this project was to improve efficiency and nurses’ job satisfaction by making work interruptions manageable in the PACU.

Methods: Based on Kotter’s Change Theory, a quality improvement initiative was implemented using a change in the communication process. Qualitative and quantitative data was gathered in the PACU and on …

Using Shock Index As A Predictor Of Icu Readmission: A Quality Iimprovement Project, Melissa Sykes

Master's Theses and Capstones

Background: Adverse events will occur in one-third of patients discharged from the intensivecare unit (ICU) and evidence shows that ICU readmissions increase a patient’s length of stay,
mortality, hospital costs, and nosocomial infections, as well as decrease long-term survival.Specific predictive factors that will accurately predict which patients are at risk of adverseevents requiring readmission are needed.Aim: The specific aim of this project was to identify if shock index (SI) values higher than 0.7at the time of transfer from the ICU are a useful predictor of ICU readmission.Methods: Using the Plan, Do, Study, Act (PDSA) framework, a retrospective chart review wasperformed …

Contributing To A “Culture Of Safety” By Increasing Usage Of The Drug Library On Smart Infusion Pumps: A Quality Improvement Project, Heidi Armstrong

Master's Theses and Capstones

Background: Computerized infusion devices called smart infusion pumps or smart pumps are clinical tools capable of decreasing IV medication infusion calculation errors through the use of embedded drug libraries. These devices are now important tools contributing to a “culture of safety” defined by the Joint Commission. Reports from April 2015 indicated a 22% occurrence rate in which the devices were not correctly programmed before infusion.

AIM Statement: The global aim of this quality improvement project was to improve usage of the IV pump drug library by ensuring medication is correctly labeled before infusion. The specific aim was to increase the …

Prevention Of Icu Delirium Through Implementation Of A Sleep Promotion Bundle, Victoria Bennett

Master's Theses and Capstones

Background: Intensive care unit (ICU) delirium is the prevalence of delirium in ICU patientswho do not have a history of drug/alcohol abuse, an admission for a mental status change, or anadmission to the ICU for less than 24 hours. Serious adverse outcomes have been linked to thepresence of ICU delirium resulting in overall longer hospital lengths of stay, longer duration ofmechanical ventilation, higher rates of mortality, and long-term neuropsychological deficits afterdischarge. At the site of this quality improvement project, the prevalence of ICU delirium was92.3% in a population determined to be high risk using the PRE-DELIRIC screening tool. Aim: The …

A Culturally Appropriate Cognitive Assessment Screening For Bhutanese Refugees, Holly Milligan

Master's Theses and Capstones

Background: As the incidence of cognitive impairment continues to rise, timely and accuratediagnoses are essential. Aim: The aim of this quality improvement project was to evaluate the standard cognitiveassessment screening for Bhutanese refugees in a medical home, and compare an alternative,validated, and potentially more culturally appropriate tool. Also, an assessment of provider,nurse and interpreter satisfaction with the two tools was performed. Method: Mixed methods including qualitative observations and quantitative satisfaction surveysrelated to the implementation of a culturally appropriate cognitive assessment tool. Results: When assessed with the standard tool, all 10 people screened positive for cognitiveimpairment. However, when using the alternative …

Be Seen And Heard Being Clean: A Patient-Centered Approach To Hand Hygiene At Concord Hospital, Ashley Pinkham

Master's Theses and Capstones

Background: Regular hand washing is recognized as the most effective means to combat the spread of infectious illness; however hand washing behavior amongst health care workers (HCW’s) is inconsistent. Furthermore, measurement of hand washing behavior is subject to bias.

Aim: This quality improvement project aimed to remove the Hawthorne effect and improve the behavior of HH at Concord Hospital.

Methods: A quasi-experimental, pre-posttest design was used to evaluate HH rates on a 32 bed med-surge unit at Concord Hospital. Baseline data was collected for 30 days by asking patients if they had seen or heard staff cleaning their hands. Using …

Implementing A Checklist & Hourly Huddles To Increase Situational Awareness During The Second Stage Of Labor-A Perinatal Quality Improvement Project, Kelly Knowles

Master's Theses and Capstones

Background: Current management of the second stage of labor often follows tradition-based routines rather than evidence-based practices. A lack of situational awareness and tunnel vision can limit medical decision-making. Northern New England Perinatal Quality Improvement Network (NNEPQIN) has listed Second Stage Situational Awareness as a priority initiative. Standardized checklists are useful for maintaining situational awareness. Regular debriefings using a standardized tool have been shown to improve communication and team based care, which generally leads to improved patient outcomes. Based on this evidence, developing a standardized checklist including regular hourly care team “huddles” is valuable and could result in improved birth …