Dissertations / Theses on the topic 'Nursing intervention'

This thesis summarizes research and draws overall conclusions from the body of literature on fall prevention interventions to provide hospitals with a basis for developing evidence-based fall prevention programs in the hospital setting. Data was obtained from published studies. Articles were retrieved that focused on fall interventions in the hospital setting. An analysis was performed based on levels of evidence using an integrative review process. Multifactorial fall prevention intervention programs included fall-risk assessments, fall-risk alerts, environmental and equipment modifications, staff and patient safety education, medication management targeted to specific types, and additional assistance with transfers in both falls and fall injuries in hospitalized patients. Hospitals need to reduce falls by using multifactorial fall prevention programs using evidence-based interventions to reduce falls and injuries.

Abstract Critical care nursing is experiencing a high turnover and a global shortage crisis. The number of critical care nurses (CCNs) leaving the critical care environment is at an unprecedented high rate, negatively impacting the quality of care for the most critically ill of patients.. It is not known if and to what extent CCNs resiliency is affected by self-care and how it is associated with compassion satisfaction, interprofessional relationships, professional quality of life, psychological and psychosocial impairment (PPI), or intent to leave the critical care specialty area. The purpose of this quantitative, cross-sectional, descriptive project was to ascertain if the independent variable for CCNs self-care had an associative relationship among five dependent variables reflective of CCNs resilience: (a) compassion satisfaction, (b) interprofessional relationships, (c) professional quality of life, (d) PPI, or (e) intent to leave the critical care specialty area. An innovative, web-based CCN self-care intervention was introduced and outcomes measured through the administration of a descriptive survey pre- and post-assessment to determine relational association to the variables of CCNs resilience. The project, though limited by time constraints, inferred CCNs and non-CCNs respondents are interested in self-care and creating healthy critical care environments for safe patient care. Keywords: resilience, critical care, stress management, burnout, compassion

Monitoring bodies in the District of Columbia articulated that people diagnosed with an intellectual and developmental disability (IDD) who reside in community-based group home settings are vulnerable to safety issues, poor quality of care from registered nursing services, and poor oversight. Those monitors have identified the lack of knowledge of roles and responsibilities among registered nurses (RNs) in these settings as a significant risk factor. The District of Columbia Developmental Disabilities Administration (DDA) has no formal orientation or training for RNs that encompasses the multifaceted needs of people diagnosed with IDD. This capstone project aimed to identify the effectiveness of an educational intervention and the effect of continuing education on RNs' perception of their practice in the field of IDD. After review of current literature, an educational presentation addressing all facets of entry-level registered nursing was developed. The presentation focused on the fundamentals of IDD nursing. A group of RNs working in the District of Columbia IDD community participated in an all-day educational program and completed a pre- and posttest evaluation to measure their knowledge prior to the intervention and their knowledge gain immediately after the intervention. A standard five-point Likert scale survey was delivered on the third and sixth months after educational intervention (EI). The survey asked the participants to rate the impact of the EI at three and six months post intervention to measure their perceived confidence level and actual practice changes. Eighty-seven percent of the RNs that participated in the EI and responded to the questionnaire reported that their role as an IDD nurse had changed because of participating in this training, and 93.8% reported that they would recommend this training to other RNs entering or working in this subspecialty.

The purpose of this study was to examine the effects of an educational intervention on nurses’ knowledge of, beliefs about, and attitudes toward EBP, and their perceived ability to implement EBP. Also, the study was focused on examining the correlation between nurses’ knowledge of, beliefs about, and attitudes toward EBP and nurses’ perceived ability to implement EBP. A pretest/posttest quasi-experimental randomized design was used. Nineteen nurses employed in a county hospital in California participated in the study. Data were collected via a web-based survey. The knowledge and attitude subscales of the Evidence Based Practice Questionnaire, the Evidence Based Practice Beliefs Scale, and the Evidence Based Practice Implementation Scale were used to measure nurses’ knowledge of EBP, attitudes toward EBP, beliefs about EBP, and their perceived ability to implement EBP respectively. Data analysis included descriptive statistics, Wilcoxon’s signed rank test, and Pearson’s correlation coefficient test. Within subject data analysis indicated that the EBP educational intervention significantly improved nurses’ beliefs about EBP, knowledge of EBP, and their perceived ability to implement EBP (p < .05). Pearson’s r test analysis indicated that there is no relationship between nurses’ knowledge of EBP, beliefs about and attitudes toward EBP, and their perceived ability to implement EBP ( p > .05). The study results could encourage nurse leaders to promote teaching EBP in clinical settings and remove barriers to the application of evidence into nursing practice. The study served as a foundation for future studies on an educational intervention to help nurses adopt EBP.

Problem: Adolescent obesity has reached epidemic proportions globally. Motivational interviewing (MI) is an emerging intervention for adolescent health risk behavior that has promise. Despite its potential fit in primary health care contexts, primary care providers tend to express reticence in learning or adopting MI practices. This program evaluation project assessed the usefulness of Motivational Interviewing (MI) by primary care providers with adolescents in school based health centers that was implemented by a large randomized clinical trial (RCT) in southwest United States high schools.

Methods: As part of the RCT, the primary care providers were required to do MI sessions with 66, 45, 25, and 91 youth participants respectively at their School-based site. It was anticipated that providers would be increasingly comfortable with MI between their first and final participant and that youth would be increasingly satisfied as provider comfort increased. To evaluate this, as part of the RCT, a set of primary care providers working with youth in school based health centers were trained through didactic sessions, homework, and role-play. School-based providers were provided an introductory training in MI, MI reading materials, a study manual, and were required to participate in bimonthly tele-coaching to ensure treatment integrity and fidelity. Primary care provider and adolescent participant survey data from session 1 of the RCT was analyzed to determine provider comfort with MI and adolescent satisfaction with MI.

Summary of findings: Despite the standard training practices, providers showed a range of interest in comfort with the intervention. However, as anticipated, overall primary care providers became significantly more comfortable with MI on the final day of the MI sessions with increased use (p < 0.01). Adolescent participants overall were highly satisfied with MI regardless of time with no significant differences over time.

Implications for Practice: Primary care providers have not embraced MI as it is perceived as time consuming and challenging, yet over time the primary care providers in this project became significantly more comfortable with MI while youth were highly satisfied independent of provider comfort. Integrating MI into clinical practice has promising implications to get more effective treatment to high-need and underserved youth.

This study investigated the use of deliberate practice theory as a technique to improve hand hygiene performance (HHP) of first-semester associate degree nursing program students. Proper HHP at specific intervals during patient care prevents the spread of healthcare-associated infections. HHP consistently falls below industry expectations and this gap exists worldwide. Modifying established HHP behaviors of professionals in the health care setting is resource intensive, yet novice health care professionals such as nursing students are uniquely positioned to acquire optimal hand hygiene habits as they enter professional practice. The research question for this study was as follows: Is there a performance difference between a group of nursing students using a routine practice approach and a group using deliberate practice theory as a technique for the task of hand hygiene in the nursing skills laboratory setting? The research design was a multiple-measures pretest/posttest nonrandomized quasi-experimental design using a convenience sample. The target population was prelicensure first-semester associate degree nursing students in the United States and a sample of 47 nursing students was obtained from an intact cohort of first-semester associate degree nursing students. The method of data analysis was an independent-samples t test to determine if a statistically significant performance difference existed between the control and experimental groups. The experimental group using deliberate practice theory as a technique for HHP had higher performance scores (M = 97.10, SD = 9.60) than the control group using a routine approach (M = 91.67, SD = 14.74); however, it was not statistically significant, with t(39.73) = –1.503, p = .141. An additional analysis was conducted to determine hand hygiene compliance rates. The control group dropped 4.16% for hand hygiene compliance from the pretest to the posttest whereas the experimental group dropped only 0.72%. The most impressive findings from this alternative examination of the findings is that the control group had two (8.33%) of its participants with one hand hygiene omission during the pretest and the experimental group had one (4.35%). For the posttest, the control group had six (25%) of its participants with one hand hygiene omission and the experimental group had two (8.69%). The number of individuals in the experimental group with hand hygiene omissions doubled from the pretest to the posttest whereas the number of individuals with hand hygiene omissions tripled for the control group. This additional analysis indicates that deliberate practice theory as a technique to improve HHP may have important clinical implications.