<p> Nurse residency programs (NRPs) have been identified as a means to promote transitioning of new nurses into the professional nursing role. Questions have arisen related to which elements within those programs are most meaningful to the development of new nurses. As the nursing shortage drives the need for quick transition and development of nurses to meet workforce needs, nursing must identify what is meaningful to nurses in their transition to practice. The purpose of this multi-site study was to explicate meaning from the experiences of newly licensed registered nurses (NLRNs) who have just completed NRPs. The research question was &ldquo;What factors have meaning for NLRNs who have experienced transition to practice in nurse residency programs in acute care settings?&rdquo;</p><p> Semi-structured interviews were used to collect data from six NLRNs from three different NRPs after completion of their programs. Using interpretative phenomenological analysis, themes and variations within those themes were derived from the descriptive narratives provided from participant interviews. Overarching themes identified were <i>Relationships, Reflection, Active Learning, Resources</i> and <i>Organizational Systems</i>. Findings have implications for practice and education as the nursing profession strives to find ways to transform nurses in an effective and efficient manner. </p>

<p> Recent years have seen Ghana pursuing extensive reforms of its healthcare delivery system. The delivery of immunization and other outreach services to the people of Bibiani-Anhwianso-Bekwai (BAB) district in Ghana despite the tremendous efforts by the district directorate to extend services to more people has recently been stalled. Faulty case management techniques used by case managers managing the immunization delivery services may be cited for the slow pace at which this process is moving. CDCynergy, a theoretical framework and model developed by the Centers for Disease Control and Prevention (CDC) was used to examine the case management techniques used in the health services departments in and around the Bibiani-Anhwianso-Bekwai (BAB) district in Ghana to deliver immunization and outreach services to the target community. Using a community-based research approach, 27 community health nurse case managers took part in a semi structured interviews to select participants of the focus group deliberations. The focus group members were all community health nurse case managers involved in managing immunization and immunization related outreach programs. The researcher moderated a focus group discussion with nine community health nurse case managers stationed at the BAB district. Additionally, a district vice chair, a director of health services in the region, primary healthcare providers (PCPs) from health centers in the BAB district, and a nurse from one of the Community Health Post (CHPS) compounds in the Bibiani-Anhwianso-Bekwai (BAB) District participated in separate semi structured interviews. The findings identified the following: (a) majority of the community nurse case managers understand that offering immunization and outreach services to the target population constitutes an important part of their job description, (b) improving the case management techniques used by the outreach and the immunization case managers in the BAB district could improve the context of their service delivery, (c) improving the time management component of the case management techniques could tremendously improve the delivery of immunization and outreach services, and (d) developing a training manual to provide case management guidance and tools to the community health case managers, in order to improve their case management skills. Even though the community healthcare posts (CHPS) serve as a model for bringing immunization and outreach services closer to target populations, the idea of community healthcare worker (CHEW) delivery of more services to hard-to-reach communities is a definite public health measure of improving collaboration between healthcare workers, community residents, community leaders, public health administrators, and local politicians. This measure can positively impact the delivery of immunization and outreach services.</p>

<p> The purpose of this study was to compare the level of basic nutrition knowledge between future nutrition professionals, health professionals, and non-health professionals. Specifically, this study assessed and compared basic nutrition knowledge of nutrition, health-related, and non-health related undergraduate majors enrolled in an introductory nutrition course.</p><p> Participants for this study were recruited through convenience sampling from an introductory undergraduate nutrition class. An online basic nutrition knowledge exam was used to measure nutrition knowledge. Independent one-way ANOVA demonstrated there was no statistically significant difference in basic nutrition knowledge between nutrition, health-related, and non-health related undergraduate majors. Post-hoc analysis revealed there was no significant difference of basic nutrition knowledge between health-related majors and non-health related majors, and there was a significant difference in basic nutrition knowledge between nutrition majors and health-related majors as well as between nutrition majors and non-health related majors. Thus, the results demonstrate there was a statistically significant difference in basic nutrition knowledge between nutrition students, and either health-related, and non-health related undergraduate majors.</p>

<p> Aim &amp; Objective: The aim of this project is to review the background literature and discuss the PICOt question as follows: In adult nursing students, age 30+, who are experiencing anxiety in the clinical setting, does peer dyad mentoring support in the clinical setting enable these students to decrease their anxiety level and pass their clinical effectively over a 90 day period of time?</p><p> Background: Clinical experience is an integral part of nursing education and prepares students nurses to integrate knowing with doing. Anxiety can cause a disruption in the learning and professional functioning of the student, and subsequently of the graduate nurse. Further to this, many non-traditional mature nursing students are adults entering the college or university setting with life experience unrelated to their new nursing career. They are attempting to balance work, home and school responsibilities. This anxiety has a variety of causes and also appears to have a variety of solutions.</p><p> Design: This project is a mixed method analysis, which contains both quantitative and qualitative aspects. Participants in the project were a convenience sample of Nursing students age 30+, in the BSN program at California State University Sacramento, willing to partake in this intervention, to assist in reducing their anxiety level during clinical. The project engages the use of true peer dyads (students at the same level of education) for the purpose of collaborative learning in the clinical setting. All subjects were given pre- and post-tests consisting of the State form of the State-Trait Anxiety Inventory (STAI). The State-Trait Anxiety Inventory for Adults&trade; (STAI-AD) is the definitive instrument for measuring anxiety in adults. The participants also completed a written qualitative interview guide at the end of the semester. </p><p> Results: The mean score of the STAI Anxiety Scale shows a definite decrease in anxiety after the peer dyad intervention in clinical. Of interest is the fact that the trait anxiety level also decreased in the final measurement. All sixteen mature students completed the peer dyad experience. The overall quantitative response to the peer dyad experience in clinical was a positive one according to the mature students involved.</p><p> Conclusions: Nursing students, are stressed and anxious in both the clinical setting (State anxiety) and appear to be more anxious in general (Trait anxiety). Formalized peer learning can decrease anxiety, help students learn effectively and is an important addition to the repertoire of learning activities that can enhance the quality of nursing education. Meeting the present and future challenges of educating nurses will require innovative models of clinical instruction, such as collaborative learning using student peer dyads.</p>

<p> Heart failure affects over 600,000 persons annually across the U.S. The chronic nature of heart failure requires treatment and adequate patient education to prevent exacerbations and frequent readmissions. Health care dollars are expected to increase to $70 billion by the year 2020 to treat heart failure and chronic conditions. A quality improvement project was done within the 300-bed acute care hospital in west Texas. The heart failure patients continue to have frequent readmissions to the critical care unit that coincides with the national average at 21%. The Transformational Learning Theory was used to assess adult learning readiness for knowledge and health behavior change. The purpose of the project involved using the Teach back method as the education process with the <i>Living Well with Heart Failure</i> (2015) booklet as the teaching tool on (n=30) heart failure participants. The Quality of Life (QOL) measurement was analyzed using the Minnesota Living with Heart Failure Questionnaire survey. The project was a pre/posttest design which used SPSS analysis of the test scores. A paired sampled <i> t</i>-test was completed to determine if any significant differences existed between the tests. The results of the pre-scores (M=59.2, SD=17.2) and post scores (M=62.1, SD=17.9) determined the scores were not statistically significant, although the post test scores were higher with the determination of QOL. The readmission rate remained equivalent to 20%. Tools are necessary for measuring QOL in heart failure patients to assess learning or depression. </p>

<p> This paper examines the work of older Black women who used collaborative inquiry to process issues around living with adult children with extraordinary needs. The co-researchers met four times over the course of several months exploring many facets&mdash;economic, psychological, interpersonal, and practical;&mdash;of domestic life when two sets of related adults (older parent and adult child) cohabit. Our work involved cycles of action and reflection, using conversations, journal writing, art, poetry, storytelling, and music. </p><p> Three significant outcomes resulted from these cycles of action and reflection. First, participants grew in their commitment to and practice of self-care. Secondly, participants focused on seeking the good in the other. Thirdly, participants grew in their skills of intentional listening and releasing the outcome. </p><p> In the context of twenty-first century leadership, this focus on parenting has implications for any type of leadership, because the issues addressed and the skills involved have many areas of overlap.</p>

<p> The purpose of this scholarly project was to examine the use of a high-fidelity simulation workshop to improve accuracy with pediatric dosage calculations among practicing pediatric nurses. The NLN Jeffries Simulation Theory provided a framework for this descriptive quantitative project. A convenience sample of 15 pediatric nurses completed a 10-question pediatric dosage calculation pre-test, a high-fidelity simulation workshop, a 10-question pediatric dosage calculation post-test, and a post-simulation evaluation survey. In addition, a one-month follow-up 10-question pediatric dosage calculation post-test and a one-month follow-up post- high-fidelity simulation workshop survey were administered via Survey Monkey^&copy;, in which 12 pediatric nurse participants completed. Pre-tests and post-tests were analyzed for central tendency and a t-test analysis was performed for statistical significance. Results revealed statistical significance between pre-test and post-test as well as statistical significance between post-test and one-month follow-up post-test. The Likert scale post-simulation survey and one month post-simulation survey were analyzed for central tendency. The results from the post simulation survey and one-month follow-up survey revealed the participants agreed to strongly agreed the high-fidelity simulation workshop impacted their proficiency and accuracy in calculating pediatric dosages. The findings from this project provides insights into the use of high-fidelity simulation as a continuing education tool for the practicing pediatric nurse in relation to pediatric medication efficacy.</p>

<p> Heart failure (HF) is a serious, life limiting chronic illness and is the most common cause of &lt;30-day hospital readmission, which is costly both in its profound negative impact on patient mortality and quality of life, and in economics. Limited access to care in rural communities increases the prevalence of hospitalizations for heart disease in rural areas. </p><p> The aims of this project using data mined from Arizona Health Sciences Center Clinical Research Data Warehouse, are to define clinical events (fever, pain, changes in respiratory status, change in level of consciousness, changes in output, bleeding, and suicide ideation) for patients with heart failure, and determine what assessment values are for chronically ill patients and compare to &ldquo;normal&rdquo; assessment values for non-chronically ill patients. A literature review was completed to determine how to define clinical events for chronically ill patients with HF, and how decision making is used at home to manage chronic illness. Assessment value data was mined from the clinical research data warehouse and compared to &ldquo;normal&rdquo; assessment values, with identification of associations between clinical events and action taken in the hospital. </p><p> The project results support that there are differences in &ldquo;normal&rdquo; assessment values for fever, pain, and change in respiratory status between chronically ill patients with HF, and non-chronically ill patients; there was insufficient data to define bleeding, change in output, or suicide ideation. Impacts to care include earlier recognition of worsening HF symptoms that could result in an earlier call or visit to primary care provider forestalling the need for emergent care and hospital readmission. Application of the mined clinical may inform development of evidenced-based algorithm to guide decision-making at home, and it may also provide the foundation for the development of a tool for patient use to prevent &lt;30-day hospital readmission.</p>

<p> Health information literacy influences patient health outcomes, yet almost 90% of adults struggle to understand health information. This study explored the impact of an education course in health literacy on healthcare professionals&rsquo; methods of providing information to patients in order to increase effective communication and improve patient outcomes. This study drew from an integrated theoretical framework that suggests development and validation of tools to measure health literacy. Access to and understanding of reliable, high-quality health care information equalizes many other variables that impact health outcomes, including age, economic class, and cultural background. This study analyzed survey data collected from 2 doctors, 2 nurse practitioners, and 1 staff nurse selected based on their expertise and experience working with patients. They completed a learner- centered course, in which learners interact and instructors provide feedback. Based on survey responses, the participants strongly supported implementing the proposed education module. Four of the 5 experts agreed that a course in health literacy will help health care workers recognize and address patients with low health literacy. Limited health literacy is associated with poor health outcomes and higher health care costs. This type of literacy requires a complex group of reading, listening, analytical, and decision- making skills, and the ability to apply these skills to health situations. The results of this study may guide educators to effectively communicate with patients, increase health literacy, and improve patient outcomes.</p>

Thesis (M.S.)--Boston University