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Thesis (M.S.)--Boston University

Heart failure (HF) has a global significance for the older population and is the most common reason for hospitalization. Patients with HF can reduce their risk for hospital readmissions and adverse outcomes through self-management of their disease. Nurses are responsible for educating patients about HF self-management; however, nurses at the project site lacked sufficient understanding and confidence to perform adequate HF patient education, creating a gap in practice. This project was guided by Pender's health promotion model and adult learning theory with the goal to increase nurses' knowledge and confidence with the self-management principles of HF. The purpose of this project was to develop an educational program for nurses to increase their knowledge of HF disease management and patient self-management principles. The education program was supported by research literature and recommendations from the Agency for Healthcare Research and Quality, in addition to input from a planning team consisting of 3 nursing leaders from the project site. The planning team provided process evaluation regarding satisfaction with the planning process by completing an anonymous, 10-question, Likert-type survey. Seven project evaluations were completed and all respondents indicated that they agreed or strongly agreed in response to questions regarding the effectiveness of the project, it's planning, and the leader. At the completion of the project, the education program was delivered to the project site, with a plan for later implementation and learner evaluation using assessment tools of HF knowledge and confidence. This project has the potential to achieve positive social change in relation to nurses' commitment to improving patient outcomes through quality initiatives and dedication to the implementation of evidence-based practice, thus, promoting positive patient outcomes.

Vaccinations are important factors in the eradication of most communicable diseases. Tetanus, diphtheria, and pertussis (Tdap) vaccine has been found to decrease the incidence and further spread of pertussis, and even nullify its existence, yet many postpartum mothers opt not to receive the vaccination even if eligible to do so. It was unknown whether clinical nursing staff at the project site had sufficient knowledge about Tdap vaccine to educate postpartum mothers to accept the vaccine. The practice-focused question explored whether an educational program and a toolkit implemented for nursing staff members on the postpartum nursing unit would improve Tdap vaccination rates among postpartum mothers. The health belief model, theory of planned behavior, and social learning theory provided a framework for the project. Evidence obtained from the results of pre- and post-testing of nursing staff on their vaccine-related knowledge and attitudes showed a statistically significant increase in knowledge (z = -3.366, p = .001). Descriptive statistics were used to evaluate the change in Tdap refusal after the education. The use of Tdap vaccine in the postpartum period improved slightly with fewer postpartum mothers refusing the vaccine in the post-education period. Project findings showed that providing Tdap vaccine education to clinical nursing staff could prepare them to teach postpartum mothers about the benefits of Tdap vaccination, which may improve the percentage of postpartum mothers who will accept the vaccine. Higher vaccination rates might contribute to positive social change by decreasing pertussis transmission rates for newborns.

Nursing is essentially a practical discipline and as such, clinical practice plays an important part in the nursing curriculum. Clinical education is a vital component in the curricula of pre-registration nursing courses and provides student nurses with the opportunity to combine cognitive, psychomotor, and affective skills. Clinical field placement is an integral element in the overall pre-registration nursing program. Clinical practice enables the student to develop competencies in the application of knowledge, skills, and attitudes to clinical field situations. However, the time allocation for the clinical component of pre-registration nursing courses can be rather limited. It is, therefore, vital that the short but valuable clinical time be utilised effectively and productively.One of the objectives of this study was to develop and validate an instrument, the Clinical Learning Environment Inventory (CLEI), to assess nursing students' perceptions of hospital learning environment during clinical practice. Data were collected from 138 second year nursing students in a major university school of nursing in South Australia. Both quantitative and qualitative data were collected. The study confirmed the reliability and validity of the CLEI for use in the hospital learning environment.A second objective was to investigate associations of the CLEI with outcomes. Students' perceptions of the outcome of their clinical placement were found to be strongly associated with all five scales of the CLEI namely; Individualisation, Innovation, Involvement, Personalisation, and Task Orientation. The quantitative and qualitative findings reinforced each other. A third objective was to determine whether there were any differences in students' perceptions of the actual learning environment provided and that preferred by students. It was found that there were significant differences in ++ / students' perceptions of the actual clinical learning environment and their preferred clinical learning environment. Findings from the study suggested that students preferred a more positive and favourable clinical environment than they perceived as being actually present.

<p>Konflikter har alltid funnits, men hur man har löst dem har skett på olika sätt. Mitt intresse för detta område är på grund av att jag tidigare arbetat i skolans värld. Där förekom ofta konflikter, men de flesta konflikter var mellan elev och elev. Men ibland förekom även konflikter i personalgruppen. De tog man itu med ganska omgående. När jag böt yrke och började arbeta inom sjukvården märkte jag att det förekom ganska mycket konflikter även här, framförallt i personalgruppen som ingen försökte lösa. Jag har nu med hjälp av litteraturen funnit några olika sätt som chefer löst konflikter på gruppnivå mellan två eller flera personer. Det jag har funnit i litteraturen är att chefer har gett order direkt till kombattanterna att sluta med sitt beteende, undvikit konflikten, kompromissat, medlat, utsett syndabockar, konfronterat, försökt behandla konflikten själv eller tagit hjälp av extern konflikthanterare. Resultatet i min studie visade att om en chef undvek konflikten så riskerade den att bli ett mycket svårlöst problem. Omplacerade man personalen så flyttades ofta bara problemet till ett annat ställe. Då man tog hjälp av en extern konsult, kunde det bli kostsamt men var oftast det bästa alternativet.</p>

Konflikter har alltid funnits, men hur man har löst dem har skett på olika sätt. Mitt intresse för detta område är på grund av att jag tidigare arbetat i skolans värld. Där förekom ofta konflikter, men de flesta konflikter var mellan elev och elev. Men ibland förekom även konflikter i personalgruppen. De tog man itu med ganska omgående. När jag böt yrke och började arbeta inom sjukvården märkte jag att det förekom ganska mycket konflikter även här, framförallt i personalgruppen som ingen försökte lösa. Jag har nu med hjälp av litteraturen funnit några olika sätt som chefer löst konflikter på gruppnivå mellan två eller flera personer. Det jag har funnit i litteraturen är att chefer har gett order direkt till kombattanterna att sluta med sitt beteende, undvikit konflikten, kompromissat, medlat, utsett syndabockar, konfronterat, försökt behandla konflikten själv eller tagit hjälp av extern konflikthanterare. Resultatet i min studie visade att om en chef undvek konflikten så riskerade den att bli ett mycket svårlöst problem. Omplacerade man personalen så flyttades ofta bara problemet till ett annat ställe. Då man tog hjälp av en extern konsult, kunde det bli kostsamt men var oftast det bästa alternativet.

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Thesis (Ph.D.)--Indiana University, Dept. of Educational Leadership and Policy Studies, 2009. / Title from PDF t.p. (viewed on Feb. 10, 2010). Source: Dissertation Abstracts International, Volume: 70-06, Section: A, page: . Advisers: Margaret R. Sutton; Donald R. Warren.

Report (Ed. D.)--Teachers College. / Issued also on microfilm. Includes bibliographical references.