Digital Commons Network^™

An Evidence-Based And Theory-Guided Teaching Plan On Trauma-Informed Care For Newly Employed Staff Nurses Caring For Acutely Ill Patients Admitted To An Urban Hospital, Hanling Wang Zheng

DNP Scholarly Projects

Trauma carries multiple implications that adversely impact individuals' mental and physical health throughout their lifespan. Trauma-informed care (TIC) has been currently utilized in fields such as addiction and mental health, child protection, and the penal system. The current evidence of TIC points to opportunities and gaps for the TIC approach in general acute care settings. This quality improvement initiative is a mixed method and pretest and posttest design, which aims to create and deliver an evidence-based and theory-guided teaching plan for newly employed nursing staff to promote the nurses' knowledge, attitudes, and practice of providing TIC to acutely ill patients …

An Exploration Of The Lived Experience Of Novice Adjunct Nursing Faculty As They Transition From Clinical Expert To Novice Educator, Angelique Tolentino-Martin

Doctoral Dissertations and Projects

This transcendental phenomenological study aimed to describe and understand the lived experiences of novice adjunct nursing faculty teaching in the United States in undergraduate nursing programs as they transition from clinical practice to academia. The theories that guided this study are Meleis’ transition theory and Schoening’s nurse educator transition model which provide a framework for the transition experiences for novice adjunct nursing faculty. The central research question is: What are the lived experiences of novice undergraduate adjunct nursing faculty transitioning from clinical expert to novice nurse faculty? Purposive sampling and snowball sampling were used to recruit participants who were novice …

Clinician Education Program: Promoting The Use Of Care Bundles In Reducing The Hospital Length Of Stay And Readmission Rates Of Adult Copd Patients, Nordita R. Bascon

MSN Capstone Projects

Management of COPD patients can cost hospitals approximately $308,502 per month. This is based on a single COPD readmission encounter costing $7,500 and estimated daily expenses of $2,883 (Davis, 2023; Hegwer, 2018). This executive summary outlines a clinician education program held at a community hospital in West Texas to promote patient quality care by encouraging healthcare professionals to use evidence-based chronic obstructive pulmonary disease (COPD) care bundles. Eighteen physicians and nurse practitioners attended the program. Then, a survey was conducted to assess the impact of the proposed program. Most attendees said they would incorporate care bundles in COPD care.

Internal …

Investigating The Impact Of Outpatient Mental Health Follow-Up Care On Continued Adolescent Suicidality: An Evidence-Based Change Project Proposal, Kimberly Feifel

MSN Capstone Projects

The escalating rates of adolescent suicide globally, coupled with the surge in pediatric hospitalization rates, underscore the urgent need for effective intervention strategies. Despite hospitalization, many patients persist in experiencing suicidal ideation and behaviors, often leading to readmissions. A significant portion of these individuals do not receive adequate outpatient mental health follow-up care post-discharge. As a leading pediatric healthcare institution committed to delivering exemplary care, particularly to those struggling with mental health challenges, the organization’s commitment demands proactive measures.

The attached proposal aims to establish an organizational policy to reduce 30-day readmission rates among adolescents with persistent suicidal thoughts and …

Optimizing Digital Proficiency To Improve Perceived Self-Efficacy In Telehealth Nurses, Serena Young

Doctor of Nursing Practice Projects

The use of telehealth to provide care management services has increased as healthcare continues to evolve. Seven million Americans were predicted to use telehealth in 2020, which increased to over 35 million through the pandemic. These services have been shown to decrease healthcare disparities and promote positive health outcomes. Education and training for nurses providing telehealth services have not kept up with the increased demand. Nurses providing care management telehealth services in a large tertiary health system have low perceived self-efficacy for technology. Leaders in the organization believe this is causing a lack of digital proficiency in their workforce. This …

Implementation Of A Standardized Handoff Reference Tool From The Intensive Care Unit To The Operating Room, Sophia Agbomah, Stacie Summers

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: This quality improvement (QI) intervention evaluated the effectiveness of a standardized handoff reference tool for patients transferring from the Surgical Intensive Care Unit (SICU) to the operating room (OR) in a large metropolitan level I trauma center. There was minimal data to assess the quality of this sequence of patient transfer as no systematic ICU-OR handoff content practices were currently employed at the hospital. This project aimed to help fill the practice-knowledge gap that could impact some of the most vulnerable patients during ICU-OR transfer. Methods: Pre- and post-implementation staff surveys, live observations, and chart …

The Clinical Inquiry Process Diagram (V. 5), Roy E. Brown

VCU Libraries Faculty and Staff Publications

This updated edition of The Clinical Inquiry Process Diagram improves on the 2023 version. It provides a depiction of the steps involved in the clinical inquiry process, covering research, performance improvement, and evidence-based practice. The revisions in this version emphasize the importance of alerting users to the iterative nature of clinical inquiry and the ongoing need to assess the situation or patient based on evolving evidence. It's crucial to recognize that the clinical inquiry process does not follow a linear, sequential progression. Instead, individuals may find themselves concurrently addressing different aspects of the process or revisiting prior steps as they …

Camera Assisted Monitoring Device As A Tool To Reduce Falls In Inpatient Adults: An Integrative Review, Pamela Oriaifo

Doctoral Dissertations and Projects

Background: Adult inpatient falls remain a significant challenge in many hospitals, resulting in poor quality of life and severe financial burden. There have been tremendous efforts to curb the number of falls ranging from environmental modification, clinician education, review of medications, and use of assistive devices. One such assistive device is the use of camera monitoring systems. This systemic review scopes camera/video-assisted fall prevention programs in hospitals. It was hypothesized that camera/video-assisted fall prevention programs would reduce adult inpatient fall and costs significantly. The outcomes of camera or video-assisted fall prevention programs were considered in some hospital settings. Method: The …

Discrimination Against Hispanic And African American Women And Interventions To Improve Patient Outcome: An Integrative Review, Sandi Daneri Cruz Rivera

Doctoral Dissertations and Projects

Racial discrimination in health care has been a heavy topic of discussion on social media. Discrimination against women of color such as those of African American and Hispanic descent has been found to have negative health effects. The aim of this project was to identify how racial discrimination influenced African-American and Hispanic women’s health and current interventions that have been implemented to help address these issues. The findings showed that women who experienced discrimination not only in health care but in everyday life did experience negative health outcomes including cardiovascular disparities, obesity, increasing inflammatory markers, and mental health disparities. Implementations …

Doctor Of Nursing Practice Transformative Leadership Ai Assignment, Elizabeth Gotay

AI Assignment Library

Assignment Overview: In this assignment, students will delve into the complex realm of transformative leadership in nursing practice through a comprehensive case study analysis. Students will examine real-world scenarios and apply their knowledge of leadership theories, ethical considerations, and advanced nursing concepts to critically analyze the role of transformative leadership in achieving positive patient outcomes and fostering organizational change.

Impact Of Fall Education To Nursing Staff On Oncology Patient Fall Rates, Danni Nina Sloane

Doctoral Dissertations and Projects

Falls and fall-related injuries impact patients' health outcomes and are the most commonly reported adverse event in hospitals for patients over 65 years of age. This scholarly project was conducted to evaluate the effect of evidence-based education to the Registered Nurses and Certified Nursing Assistance in the medical and surgical oncology inpatient on reducing the number of patients falling. Retrospective reviews of patient fall rates, were conducted two months before the fall educational sessions, and prospective reviews were conducted after implementing fall education. Patient falls also affect reimbursement rates and, on average, increase a patient’s length of stay by about …

Nursing Faculty Experiences Of An Academic Merger: A Transcendental Phenomenological Study, Sherry Michelle Boone

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to describe the experience of undergoing a merger of two or more academic institutions within the United States for nursing faculty who chose to voluntarily depart the organization following the merger. The theoretical framework guiding this study was social capital theory as it discusses the importance of relationships and the resources those relationships provide. While assets may be acquired during a merger, social capital must be developed over time and is important for building a new combined healthy organizational culture. The study included nine participants who departed the institution in the timeframe …

Naloxone Education To Improve Distribution In Primary Care: A Quality Improvement Project, Joanna Boback

DNP Projects

Significance and Background: Opioid overdose is a major public health problem in the United States. The Centers for Disease Control and Prevention (CDC) developed guidelines for prescribing opioids which have not been widely integrated into practice. These guidelines specify co-prescribing naloxone with opioids as a form of harm reduction. A policy to reflect these recommendations was needed to guide prescribing at a Federally Qualified Health Center (FQHC) in Connecticut to increase low naloxone prescribing rates. Evidence supported the use of provider education to increase prescribing rates.

Purpose: Deliver education to providers across the health system on best practices related to …

Improving Pediatric Medical Nurses’ Confidence In Caring For Pediatric Mental Health Patients: A Pilot Project Large Academic Pediatric Health System In The Pacific Northwest, Lauren Kalember

Doctor of Nursing Practice Projects

Problem Description

Pediatric mental and behavioral health care needs continue to increase across the nation. Approximately ten percent of pediatric hospitalizations are for a primary mental or behavioral health condition (Canvara & Johnson, 2020). With the increase in hospitalizations for mental health (MH) needs, pediatric psychiatric units are at capacity, and MH patients are admitted to pediatric general medical/surgical units for care. Most of the nurses that work on these units have not received pediatric mental health education outside of nursing school curricula and report a lack of confidence in their ability to care for pediatric MH patients. With the …

Toward An Evidence-Based Framework To Guide Health Care Responses For Patients Impacted By Human Trafficking: Evaluation Of The Heal Trafficking Protocol Toolkit, Susie B. Baldwin, Cathy L. Miller, Beth J. Maclin, Sacha Williams, Hanni Stoklosa

Nursing Faculty Publications and Presentations

Trafficked persons seek health care during exploitation, but few health professionals know how to respond appropriately, and few institutions have protocols to guide this response. Currently, no empirically tested framework exists to guide protocol development for human trafficking response protocols in health care settings. Our aim was to empirically evaluate the HEAL Trafficking Protocol Toolkit's usability and effectiveness through cross-sectional survey methodology. We invited users who downloaded the free Toolkit from January 2017 through January 2018 to participate in an electronic survey and conducted descriptive quantitative and qualitative thematic analyses. Survey respondents were professionally and geographically diverse. Eighty-four percent who …

Patient-Mediated Interventions In Hospital: A Systematic Review, Georgia Tobiano, Shelley Roberts, Rachel Muir, Teresa Jerofke-Owen, Christine Ting, Sarah Thorning, Daren K. Heyland, Andrea P. Marshall

College of Nursing Faculty Research and Publications

Aims

To describe the characteristics of hospital-based, patient-mediated interventions and their impact on patient, clinician and organization outcomes.

Design

Systematic review.

Data Sources

Health literature databases (MEDLINE, CINAHL and EMBASE) were searched in August 2021. Backward and forward citation searching was conducted.

Review Methods

Studies investigating patient-mediated interventions, targeted at adult hospitalized patients were eligible. Data were extracted related to study and intervention characteristics. Narrative synthesis was used to understand intervention impact on patient, clinician and organization outcomes (as per a framework). Methodological quality was assessed using the Mixed Methods Assessment Tool.

Results

Thirty-three studies, reporting 18 interventions, were included. …

Dnp Final Report: Vascular Access In Burn Patients: An Evidence-Based Practice Project, Amanda Venable

DNP Final Reports

Vascular access in burn patients is a challenging aspect of care that affects the healthcare team and patients daily. The goal in this evidence-based practice project at a southern United States burn center was to improve the quality of the vascular access process by reducing the use of Central Venous Lines (CVL) and unsuccessful venipuncture attempts. The following practice question was formed: In hospitalized burn patients (P), how does a vascular access team with ultrasound-guided peripheral IV capability (I) compared with no vascular access team and standard IV insertion (C) affect central line days (O1) or patient experience (O2) during …

The Clinical Inquiry Process Diagram (Version 4), Roy E. Brown

VCU Libraries Faculty and Staff Publications

The purpose of the diagram is to provide a clear understanding of the clinical inquiry process and to highlight the similarities and differences between research, performance improvement, and evidence-based practice. While it is not meant to be comprehensive, it serves as a tool to facilitate a shared understanding of when a particular question may lead to one of these three areas of clinical inquiry.

The author would like to acknowledge the following for their ideas and willingness to provide feedback to improve this latest version of the diagram.

• Kady Martini, DNP, RN, EBP-CH, NEA-BC (The Ohio State University School of …

Women's Power In Hospital-Based Nursing: A Critical Qualitative Study, Kaitlyn C. George, Bret Lyman, Andy Pilarte Alcantara, Maya Stephenson

Faculty Publications

Aim: To understand the factors that affect power in hospital-based nursing and reveal how the female gender affects an individual's ability to feel empowered.

Design: Critical qualitative research design.

Method: Semi-structured interviews were conducted with nurses working in inpatient hospital settings in Utah and New Mexico. Data were collected from February to March 2022. Interviews were analysed using thematic analysis.

Results: Sixteen participants were interviewed. Six themes were identified from the data, four of which related to nurses' power at work, and two of which specifically related to how gender affects a nurse's ability to use power and feel empowered. …

Implementation Of A Medical Emergency Chain Of Command Protocol In The School Setting, Vikki Shannon Brannon

Doctoral Dissertations and Projects

Medical emergencies occur every day in school settings across America. School nurses have a vital role in providing care for individuals experiencing a medical emergency and leading a multidisciplinary team during a medical emergency event. Since incidences of medical emergencies are commonplace, it is standard to have protocols and guidelines for these events. To address this concern, an evidence-based practice project was implemented in a rural school district in North Georgia. The pilot project was developed and implemented to assess the effectiveness of implementing a “Medical Emergency Chain of Command Protocol.” The protocol was developed to improve the effectiveness and …

Best Strategies To Address Burnout Among Healthcare Professionals: An Integrative Review, Kimberly Ann Delbo

Doctoral Dissertations and Projects

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy …

Iris Nursing Strong Program: Benchmark Study, Sonia Bunyard, Keviesha Lacy

MSN Capstone Projects

The change project we are presenting is the IRIS-Nursing Strong program. IRIS stands for: Increasing, Reason & Relaxation, Implementation, Strategies all aimed to prevent nursing burnout. The Iris flower symbolizes hope and strength as nurses are healthcare providers who constantly provide that hope and strength to their patients. We plan to develop this program in the workplace to infuse that hope and strength back into the nurses who spend so much time taking care of others. The goal is to offer a non-judgmental environment, recognize early signs of distress in ourselves and our peers, provide …

Inspiring Excellence In Doctoral Nursing Education Through Partnership: Incorporating An Innovative Change Model To Improve Dnp Project Outcomes, Melanie Brewer, Debbie Conner, Transition Management Partners, Llc

All Faculty and Staff Scholarship

Background/Introduction

Franklin University, a leader in educating working adults, formed an academic practice partnership with OhioHealth. Integrating the OhioHealth Change Management Model (CM) into the Doctor of Nursing Practice (DNP) program marks a deviation from a theory-based project to a more theory-to-practice model for managing organizational change. The CM provides leadership-driven DNP students with access to an innovative, real-world approach to prepare to transform organizations, systems, and healthcare through evidence-based interventions.

Purpose

The CM is a novel, goals-focused, data-driven approach used to manage people while implementing evidence-based practice, policy, or business change in an organization. The model includes Identifying executive …

Dnp Final Report: Skilled Nursing Facility Readmissions: An Evidence-Based Telemedicine Innovation Project, Debra B. Graham

DNP Final Reports

Background: Nationally, 20% of patient readmissions occur within the first 48 hours after arrival to a skilled nurse facility (SNF), and 40-68% of these readmissions are potentially avoidable. Since 2016, the Centers for Medicare and Medicaid penalized SNFs when their return to hospital (RTH) percentages was above national benchmarks. The four SNFs in this project experienced rising transfer rates and diminished RTH percentages since 2017, despite using in-house providers Monday through Friday. Furthermore, there was no provision to address patients’ changes in conditions after hours.

Purpose: This evidence-based practice (EBP) project aimed to standardize the care provided to …

Implementation Of A Polypharmacy Deprescribing Protocol Among Older Adults In A Community-Based Care Organization, Johanne Cazeau

Doctor of Nursing Practice Scholarly Projects

Background: Polypharmacy, defined as the use of five or more medications, has the potential to increase morbidity, mortality and decrease quality of life. Older adults are disproportionately affected by polypharmacy. Decreasing polypharmacy could prevent morbidity and mortality while saving millions of dollars annually. The use of the ARMOR tool has been shown to decrease polypharmacy and the prescribing of inappropriate medications among the elderly.

Local problem: There is a high prevalence of polypharmacy among older adult patients at the managed care organization where this quality improvement project was implemented. Among a panel of 30 members, almost all (n=29) were taking …

Dnp Final Report: Seal The Deal In Dementia Care, Christian D. Garrett

DNP Final Reports

Background: Individuals with dementia are often burdened with behavioral problems, which augment health care costs and burden of disease. Treatment of behavioral symptoms with pet therapy is acknowledged to be emotionally beneficial. Robotic pets have demonstrated similar promising effects without the undesirable outcomes of traditional pet therapy. Robotic pet therapy offers an effective replacement to traditional pet therapy.

Objective: The DNP scholarly project rigorously appraises the effectiveness of the SAR, PARO, an FDA approved biofeedback device, for non-pharmacological treatment of dementia-related symptoms.

Methods: An experimental design with repeated measures guided the study. Pre- and post- measures included reliable, valid tools …

Dnp Final Report: Mission Cyborg: An Ebp Project Integrating Hybrid Learning In An Undergraduate Nursing Course, Mary A. Thomas

DNP Final Reports

In modern times it is an expectation of students that technology be incorporated into how they receive their education. The COVID-19 pandemic brought to light how pure reliance on traditional face-to-face (F2F) learning can be detrimental to student learning. Many institutes of higher education had already implemented hybrid/blended learning prior to the pandemic and saw no difference in their NCLEX-RN pass rates. This evidence-based practice project gathered, reviewed, and synthesized evidence in order to determine if implementing different teaching strategies would maintain or improve student performance on both unit exams and end of course exit exams.

Improving Access And Delivery Of Mental Health Care To Veterans Through A Care Coordination Pilot At A Texas Department Of Veterans Affairs Hospital, Jacqueline Buval

Doctor of Nursing Practice Projects

Background: Mental health (MH) disorders are among the leading cause of disabilities in adults, with an even greater prevalence among Veterans who served in combat. Forty percent of troops returning from combat zones report suffering from post-traumatic stress disorder (PTSD) or depression and 33% report trouble accessing MH care. Access to care is directly influenced by care coordination procedures in health care systems. If care coordination is poor or lacking, patients remain in settings that are inappropriate for their level of care. Implementing a care coordination program can improve care transitions, provide the necessary support for patients to successfully …

Implementation Of A Zone Of Silence During Administration Of Breastmilk To Decrease Nurses’ Distractions In A Neonatal Intensive Care Unit: Quality Improvement Project, Lauren Crociata

DNP Projects

Introduction: In the NICU, breastmilk is handled and administered as safely and carefully as a medication. Administration errors occur when incorrect breastmilk is administered to the wrong patient. This can lead to the transmission of infectious disease and create the loss of trust between families and the healthcare team during a neonate’s NICU stay. Nurses are often faced with interruptions and distractions during administration, and evidence shows that interventions to reduce nurses’ distractions lead to reduction of administration errors in inpatient settings. This quality improvement project took place in a level III NICU. It implemented an evidence-based zone of silence …

“This Isn’T Just Busy, This Is Scary”: Stress, Social Support, And Coping Experiences Of Frontline Nurses During The Covid-19 Pandemic, Erin S. Craw, Tess M. Buckley, Michelle Miller-Day

Communication Faculty Articles and Research

Despite having previous experience and extensive trauma training, the COVID-19 pandemic presented unprecedented challenges for nurses working in hospital settings. During the pandemic, nurses struggle to care for patients and protect themselves from infection, while navigating ongoing organizational changes. Guided by prior literature on social support and coping, this study explores nurses’ experiences of coping with stress while treating COVID-19 patients during the pandemic. In-depth semi-structured interviews were conducted with 14 active staff nurses working in hospitals and one licensed practical nurse (LPN) at a rehabilitation center who treated COVID-19 patients during the pandemic. An inductive thematic analysis was employed …