Dissertations / Theses on the topic 'Adult nursing'

In the current health care environment, caring for the increasing numbers of seriously ill patients require novice nurses to use advanced, intuitive clinical decision-making skills like those of more experienced nurses. Educators are charged with developing instructional strategies to enhance clinical decision-making skills. The purpose of this quantitative study was to investigate the relationship between simulation as an instructional strategy and the use of intuition in clinical decision making among associate degree nursing students. In addition, the influence of age on student performance during simulation and the use of intuition in clinical decision making was examined. An explanatory, correlational design was conducted to examine the relationship between simulation, as measured by the Creighton Simulation Evaluation Instrument (Todd et al., 2008) and the use of intuition in clinical decision making, as measured by Rew’s (2000) Acknowledges Use of Intuition in Nursing Scale. Results from the study found a slight but statically significant relationship between simulation and the use of intuition and no relationship between age and the use of intuition. Indications for future research include further analysis of the concept of intuition and its role in clinical decision making.

This research study was designed to examine accelerated, second-degree prelicensure baccalaureate graduates’ perceptions of the andragogical practices employed by faculty that prepared students best to begin practice as entry level professional nurses. The study further sought to identify the ways in which andragogical practices used by faculty incorporated the students’ prior learning and life experiences as they accrued knowledge of the art and science of nursing. It was anticipated that through the processes of interviewing and listening to the voices of graduates, that an emic perspective of the perceptions of the graduates would emerge. Analysis and interpretation of the results of this study demonstrated six key themes related to the educational experience. Perhaps most significantly, findings revealed that elements external to teaching strategy such as faculty attributes and program design influenced learning significantly for the study participants. This research adds to the existing body of literature related to the education of accelerated, second-degree prelicensure baccalaureate students. Findings of this study can be used to inform faculty about best practices for teaching this particular cohort of students who seek nursing as an alternate career and assist with innovative curricular designs to meet the needs of this unique group. Keywords: accelerated nursing programs, nursing education, second-degree students, teaching practices

To ensure optimal patient care an especially high level of accountability is required when entering the workforce. The purpose of this qualitative study was to explore, describe, and define perceptions of accountability as described by sophomore and senior nursing students in two baccalaureate nursing programs. The research questions aimed to (a) define what it means to be accountable as a student in general and a nursing student in particular (b) describe the importance of accountability to the profession of nursing (c) describe the circumstances and conditions that demand accountability, and (d) engage in actions that promote self-accountability. After obtaining IRB approval, the researcher explained the study to the sophomore and senior nursing students who agreed to participate in the research. Eighteen participants were interviewed.

Six questions were asked during interviews conducted to investigate perceptions of accountability. Content analysis was used to discern the essence of the narratives, from which nine themes emerged. The nine themes identified are: Difficulty defining accountability and the interchangeable use of the terms; accountability and responsibility; emerging knowledge; focus on work of nursing; student attention to tasks and outcomes; motivation/self-discipline; student stress and sources of stress; conditions for accountability and responsibility, and faculty actions; and promoting self-accountability and accountability to others.

Study findings suggested that this group of students understood the importance of accountability but were unable to verbalize a definition, often confusing accountability with responsibility. Students perceived that faculty played a role in their academic success; students also promoted accountability in faculty and in peers who were less successful academically.

The literature established that online instruction consists of cognitive, teaching, and social presence. Studies on the element of social presence linked text-based delivery of instruction with learners’ feelings of isolation and disengagement. This research findings prompted this facilitator creation of five-to-seven-minute companion videos that aligned and complemented weekly text-based learning modules to ascertain students’ perceptions of these videos as a medium for channeling social presence.

Post-video viewing surveys yielded responses to pragmatic and emotional questions. Pragmatic questions were aimed at the visual impact of professor’s delivery of information. Emotional questions gauged the students’ feelings of connectivity with the facilitator. Triangulated interpretations of student responses showed that students perceived that the videos enhanced social presence by decreasing feelings of isolation in their online course. Key results included the feeling of a real classroom and appreciation of the visuality of the videos. The viewed videos supported affective associations, learner cohesion, interaction intensity, instructor involvement, and active learning. The videos helped draw the students from their inner secluded online environment to the outside world. The research includes recommendation of the use of a larger sample size; online facilitator theatrical training, college budget to include production of video funds for further quality video productions, and video cataloging of facilitator-created subject- specific videos.

Nursing programs have embraced distance learning in their curricula, but discussion is ongoing about course assignments and grading criteria to increase examination scores in nursing distance learning courses. Because course examinations are a predictor of success on the postgraduate licensing examination (NCLEX-RN), the purpose of this study was to determine whether differences existed in student examination scores between nursing distance learning courses with and without points aligned to assignments. The theoretical framework was Knowles’s theory of andragogy, which highlights adults’ motivation and self-direction to succeed. The quantitative causal comparative study included a convenience sample of 164 students to compare archival data of 4 examination scores between 2 nursing distance-learning courses. Data analysis included an independent-groups one-tailed t test. No significant differences were found between the 2 courses, suggesting that students do not achieve higher examination scores with course points aligned with course assignments. Nursing administrators and faculty in nursing programs with a distance learning component will benefit from the findings of this study. Findings may be used to draft, revise, and implement assignment criteria and point alignment for nursing distance learning courses. Social change will occur when nursing distance learning faculty use problem-solving and critical thinking assignments, including case studies, discussion boards, group assignments, concept mapping and NCLEX-RN style testing in each nursing distance learning course. Because point alignment to course assignments do not significantly improve examination scores, implementation of problem-solving and critical thinking assignments is necessary to promote student learning and examination success.

Background: Health Care Transition (HCT) describes the purposeful, planned movement of adolescents from child to adult-orientated care. The purpose of this phenomenological study is to uncover the meaning of transition to adult centered care as experienced by Young Adults with Cerebral Palsy (YA-CP) through the research question: What are the lived experiences of young adults with cerebral palsy transitioning from pediatric to adult healthcare? Method: 6 females and 3 males, aged 19 -25 years of age, who identified as carrying the diagnosis of cerebral palsy without cognitive impairment were interviewed. Giorgi's (1985) method for analysis of phenomenology was the framework for the study and guided the phenomenological reduction. Results: The lived experiences of YA-CPs transition to adult health care, expressed from the data is expert novices with evidence and experience based expectations, negotiating new systems (effective/ineffective) interdependently (parents and provider support) accepting less than was expected. Conclusions: More information and support is needed for the YA-CP during transition to ensure a well-organized move to appropriate adult-oriented health care that is considerate of the lifelong impact of the disorder. Nursing's role as advocate, mentor and guide can optimize the individual's response to the transition process.

Student perceptions of academic dishonesty and clinical integrity were explored in this qualitative study, with Bandura’s social learning theory utilized as the primary framework for the study and Kohlberg’s theory of moral development as the secondary framework. A basic qualitative methodology was employed to answer the research question: what are student perceptions of moral beliefs and their actions related to ethical decision making in a four-year Bachelor of Science in nursing (BSN) program? The target population was junior or senior year nurses in a four-year BSN program. The sample included 17 students who met the inclusion criteria. Participants were asked 17 open-ended interview questions to gain insight into their perceptions of academic dishonesty and clinical integrity. Interviews were digitally recorded and transcribed manually to provide further immersion in the data. Data analysis and collection occurred simultaneously and was inductive and comparative. During data analysis, five themes emerged, each with subthemes which were identified through supporting narrative comments from participant interviews. The five identified themes were used to answer the research question and included: student perceptions of academic dishonesty, student perceptions of clinical integrity, student perceptions of moral beliefs, student perceptions of ethical decision making, and student perceptions of what influenced academic dishonesty. This study adds to the current body of knowledge of nursing literature regarding academic dishonesty and clinical integrity. Results could provide assistance to higher education institutions to solve problems involving academic dishonest behaviors on college campuses. This study builds on the current literature and serves as a foundation for future research to solve this decades old problem.

An explanatory correlational study was conducted to explore whether and to what extent a relationship between hours of participation in service learning and commitment to social responsibility exists for students enrolled in pre-licensure baccalaureate-nursing programs currently participating in the Nursing Licensure Compact. The convenience sample consisted of 103 volunteer professional nursing students. The Civic Attitudes and Skills Questionnaire (CASQ), comprised of six subscales: civic action, interpersonal and problem-solving skills, political awareness, leadership, social justice, and diversity, was the tool used to measure social responsibility. The total Cronbach's alpha for the CASQ was .914. The alternate hypotheses stated a significant relationship between the hours of participation in service learning and each of the CASQ subscales. Data analysis using a Spearman's rho correlation coefficient showed no statistically significant correlations between hours of participation in service learning and any of the CASQ subscales. The data did not support that social responsibility relates to how much time the students spend participating in service learning. This study expands the body of knowledge in nursing education by demonstrating that other factors and not time spent in service learning, may contribute to social responsibility. The notion that prolonged hours are always needed to achieve success can discourage educators from incorporating service learning in their courses. In the context of social responsibility, this study demonstrated that service learning may not require extended time to result in positive outcomes. With this information, nurse educators can plan service-learning experiences more efficiently.