Digital Commons Network^™

Using An Educational Module And Simulation Learning Experience To Improve Medication Safety, Barbara Lynn Durham

Doctor of Nursing Practice (DNP) Projects

The purpose of this evidence-based change in practice project was to provide nurses with an experiential learning opportunity, using simulation, to identify and report near miss events during the medication administration process related to patient-controlled analgesia (PCA) usage. Despite extensive in-service training on a Medical/Surgical (Med/Surg) floor in an acute care hospital, inconsistent, inaccurate and incomplete documentation with use of the new PCA pumps continued to be problematic. A conceptual framework of just culture was used with the quality improvement method of the Plan-Do-Study-Act (PDSA) cycle for testing change. Medication safety education was a valid andragogical strategy to decrease rates …

Specimen Labeling Improvement Project: Slip, Traci Hoiting

Doctor of Nursing Practice (DNP) Projects

Blood specimens are labeled at the time of acquisition in order to identify and match the specimen, label, and order to the patient. While the labeling process is not new, it is frequently laden with errors (Brown, Smith, & Sherfy, 2011). Wrong blood in tube (WBIT) poses significant risk. Multiple factors contribute to mislabeling errors, including lax policies, limited technological solutions, decentralized labeling processes, multi-tasking, distraction from the clinician, and insufficient education and training of staff. To reduce blood specimen labeling errors, a large academic medical center implemented an innovative technological solution for specimen labeling that integrates patient identification, physician …

Using Video Simulation To Enhance Rn-Pca Communication, Boris Chang

Master's Projects and Capstones

The purpose of this project was to develop a video simulation exercise to enhance communication between Registered Nurses (RNs) and Patient Care Assistants (PCAs). From a general microsystem assessment initially performed on an urban hospital medical-surgical unit, 75% of respondents noted that the most pertinent issue to address was improving communication between RNs and PCAs. Literature review of evidence-based practices found several studies that support the use of human clinical simulation to promote teamwork and interdisciplinary communication. RNs (n = 24) and PCAs (n = 9) were then individually interviewed with surveys and responses scored based on the …

Best Practices In High Fidelity Patient Simulation To Enhance Higher Order Thinking Skills, Kathryn S. Mock

Theses and Dissertations

Undergraduate nursing education has begun to use very expensive and time intensive high fidelity simulation activities without making full use of the ability to build higher order thinking skills in students. Current research in high fidelity patient simulation has tended to be subjective and focus on critical thinking. However, reflective thinking habits of mind must be in place before full use can be made of critical thinking skills. A comprehensive search of all reflective thinking literature used in conjunction with simulated patient experiences by healthcare students was undertaken. A guideline

was created for nurse faculty to use that outlined current …

Gate Monte Carlo Simulations In A Cloud Computing Environment, Blake Austin Rowedder

UNLV Theses, Dissertations, Professional Papers, and Capstones

The GEANT4-based GATE is a unique and powerful Monte Carlo (MC) platform, which provides a single code library allowing the simulation of specific medical physics applications, e.g. PET, SPECT, CT, radiotherapy, and hadron therapy. However, this rigorous yet flexible platform is used only sparingly in the clinic due to its lengthy calculation time. By accessing the powerful computational resources of a cloud computing environment, GATE's runtime can be significantly reduced to clinically feasible levels without the sizable investment of a local high performance cluster. This study investigated a reliable and efficient execution of GATE MC simulations using a commercial cloud …

Electronic Medical Record In The Simulation Hospital: Does It Improve Accuracy In Charting Vital Signs, Intake, And Output?, Carel M. Mountain

Doctoral Projects

The introduction of electronic health records has created a shift in the way nursing care is delivered (McBride, Delaney, & Tietze, 2012; Furukawa, Raghu, & Shao, 2010). A factor which heavily influences a nurse’s ability to navigate and utilize EMR is adequate education in the use of computerized documentation (McBride, et al., 2012). There is an increased risk for error at the bedside without the correct knowledge and skills regarding EMR documentation (Kelly, Brandon, & Docherty, 2011). This skill should be introduced during the pre-licensure education of the nurse.

Two groups of associate degree nursing students attending a small community …

Reducing "Failure To Rescue" Occurrences: A Pilot Project Incorporating High-Fidelity Simulation During Mock Codes, To Enhance Pediatric Nurses' Clinical Knowledge And Skills, Denise Dawkins

Doctoral Projects

Thanks to advances in technology, the survival rate of infants and children with critical illnesses has improved. One consequence has been an increase in the acuity levels of hospitalized pediatric patients, which may heighten the risk of in-hospital cardiopulmonary arrest. Patient safety can be compromised by nurses who do not detect subtle clinical changes in a patient's condition, do not perform accurate interventions, or do not apply critical thinking (failure to rescue). The Institute of Medicine (10M) in 1999 estimated that approximately 100,000 people died each year as the result of poor care.

Patients and families place great trust in …

Validation Of A Novel Methodology For Evaluating Surgical Tissue Plane Identification, Syed T. Ali

Electronic Thesis and Dissertation Repository

Introduction: The ability to identify tissues planes is a fundamental surgical skill. This study attempts to validate a previously developed test for assessing this ability.

Methods: 48 video captured images from laparoscopic right hemicolectomies were presented on an iPad to 18 surgeons who were grouped based on experience (Consultants (C), Senior trainees (S), and the Junior trainees (J)). Subjects were asked to draw a line indicating the tissue plane of dissection. Lines were compared by a modified Hausdorff measure. Within group variability represented group precision and trainee accuracy was determined from comparison to Consultants.

Results: Within group comparisons demonstrated Consultants …

Nursing Students' Perceptions Of Mental Health Patients And Mental Health Nursing, Susan Furr

Nursing Theses and Capstone Projects

This Capstone project evaluated the impact of a simulation-based learning experience on nursing students' anxiety levels, preparedness for psychiatric practicum, and stereotypical views towards individuals with mental illness. A sample of 15 bachelor level nursing students was utilized. The experimental group (n=8) was exposed to a four-hour simulation-based learning experience prior to the beginning of their clinical experience. The control group (n=7) began their clinical rotation without any simulation exposure. A pretest, posttest design utilizing the Mental Health Nursing Survey Part 1 (MHN-1) and the Mental Health Nursing Survey Part 2 (MHN-2) was used to measure the students' stereotypical views, …

The Innovation Of Simulation Laboratories And The Novice Nurses In The Clinical Setting, Brenda Washington Moore

Walden Dissertations and Doctoral Studies

The push to generate professional nurses has raised questions about the competency level of the novice nurses that are entering the workforce. Utilization of simulation laboratories is being viewed as an option for bridging the gap for the shortage of nurses, nurse educators, and clinical sites. The theory of goal attainment was used to guide this project, which aimed to develop and validate an ER simulation scenario that mimics a clinical setting as a tool for measuring nursing skills. An additional purpose, to be accomplished after graduation, will be to implement a pilot project to determine the impact of the …

Utilizing Early Simulation To Increase Clinical Confidence In Novice Nursing Students, Dana R. Martin

Nursing Theses and Capstone Projects

The purpose of this project was to determine if early simulation would increase the clinical confidence of novice nursing students. A convenience sample of 20 junior nursing students in their first semester of a baccalaureate nursing program within a small, rural university participated in the project prior to their first clinical experience. The students were administered the Confidence Scale as a pre-test prior to the early simulation experience which consisted of a scenario comparable to what the students would experience in the clinical setting. After the simulation, the primary investigator facilitated a debriefing exercise and then administered the Confidence Scale …

A Retrospective Analysis Of Paramedic Student Performance Under Simulated Stress, Nicholas Franklin Miller

Online Theses and Dissertations

The paramedic profession is an inherently difficult, dangerous and stressful profession. The paramedic is constantly barraged with acute stressors during the performance of his duties. These stressors have predictable, documented, negative effects on performance. The acute and chronic exposure to stress can negatively impact the safety and the well being of the paramedic. These stressors, if not successfully managed, can also result in negative effects to patients. Despite the overwhelming presence of stress in the paramedic environment, most paramedics receive little or no training to successfully perform under stress. One exception was a program called Trauma Lanes that was held …