Digital Commons Network^™

Exploring Incivility Among Nursing And Health Science Students: A Descriptive Study, Diane Louise Smith

Student Theses, Dissertations and Capstones

Incivility has infiltrated our institutions of higher learning as well as the world of nursing. All too familiar in nursing is the phrase “eating their young,” which aptly describes how nurses treat other nurses, even though they should be nurturing and caring professionals.

The investigator explored nursing and health science students’ perceptions of student and faculty uncivil behaviors within the academic environment, seeking the levels and frequency of the problem. Bandura’s social learning theory presents a sound theoretical framework for this dissertation. The research methodology consisted of a quantitative descriptive approach. The Incivility in Higher Education-Revised (IHE-R) Survey was used …

The Applicability Of The Decisional Conflict Scale In Nursing Home Placement Decision Among Chinese Family Caregivers: A Mixed Methods Approach, Yu-Ping Chang, Loralee Sessanna, Joanne Kraenzle Schneider

Asian/Pacific Island Nursing Journal

This study aimed to 1) examine relationships between uncertainty, perceived information, personal values, social support, and filial obligation among Chinese family caregivers faced with nursing home placement of an older adult family member with dementia; and 2) describe the applicability of the Decisional Conflict Scale in nursing home placement decision making among Chinese family caregivers through the integration of quantitative and qualitative data.

We used a mixed-methods approach. Quantitative data analysis consisted of descriptive and correlational statistics. We utilized a thematic analysis for the qualitative data. Data transformation and data comparison techniques were used to combine qualitative and quantitative data. …

An Investigation Of Factors Predicting The Type Of Bladder Antimuscarinics Initiated In Medicare Nursing Homes Residents, Daniela C. Moga, Qishan Wu, Pratik Doshi, Amie J. Goodin

Pharmacy Practice and Science Faculty Publications

Background: To examine factors predicting type of bladder antimuscarinics (BAM) initiated in nursing home (NH) residents.

Methods: Incident BAM initiators following NH admission were identified by constructing a retrospective cohort from Medicare files and Minimum Data Set (MDS). Participants included all residents 65 years and older admitted in Medicare-certified NH between January 1, 2007 and December 31, 2008 who were prescribed BAM and had continuous Medicare (Part A, B, and D) enrollment. Patient characteristics, medications, and comorbidities were derived from Medicare enrollment and claims. NH characteristics and health status were derived from MDS assessments. The outcome was defined as type …

Lived Experience In Patients With Recurrent Glioblastoma In Japan: A Narrative Study, Ai Chikada, Asako Takekuma Katsumata, Mariko Asase, Sayaka Takenouchi, Yoshiki Arakawa, Kazuko Nin

Asian/Pacific Island Nursing Journal

Glioblastoma (GBM) is well known to have one of the poorest prognoses among all cancers. Patients with GBM in progression-free survival (PFS) may be relatively stable and can often maintain their quality of life. Thus, PFS is a desirable goal. In Japan, the median PFS is 11 months. It is difficult to grasp a patient's thoughts and hopes when, after PFS, they are readmitted due to recurrence or acute deterioration. Therefore, this study aimed to describe the lived experience of illness in patients with recurrent GBM, focusing on PFS. We enrolled five patients into the study; however, only four patients …

The Horns Of Dilemma: Life Or Sovereignty, Farida Bibi Mughal, Bibi Hajira Irshad Ali

School of Nursing & Midwifery

Death and dying are the bitter truth that is faced by every person inevitably. Paying respect to the decision of a patient in a hospital setting is always a challenging task. In eastern countries, family plays an important role in decision making. But it always overrides the preferences and wishes of the patient and this leads to violation of ethical principles such as autonomy, informed consent and veracity. Looking a situation from different paradigms and deciding the best solution on the ground of ethical principles should be the utmost priority of the healthcare provider.

Implementation Of An Opioid Risk Assessment Tool, Stacey Cuomo

Seton Hall University DNP Final Projects

The increased prevalence of opioid use in society has led to an increase in surgical patients with a history of such use. Patients who use or are addicted to opioids have different tolerances and responses to anesthesia than non-opioid users, and will require different care than non-users both pre- and post-operatively. The means to identify this population prior to a surgical procedure is needed as a way to organize, plan and manage patient care during the perioperative period. An Opioid Risk Assessment Tool (ORAT) was used as a way to streamline the process of identifying these patients. This paper addresses …

Debriefing With Reflection: Best Practice For Learning In Simulation In Pre-Licensure Nursing Education, Mary Mcdermott

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was intended to transform the outdated method of conducting debrief after simulation by implementing a good judgment model and integrating the concept of “advocacy-inquiry.” This implementation was expected to reduce demoralizing and anxiety producing debrief experiences and improve student reflection and learning in order for students to more deliberately link theory with practice.

Significance: The debrief is often recognized as the component of simulation in which the most effective learning occurs. It is the time when students are provided opportunity to reflect on thoughts, actions and behaviors. Unfortunately, many nursing students often experience undue …

Effects Of An Alcohol Education Program On Improving Knowledge, Attitudes And Satisfaction Of Registered Nurses Caring For Patients Undergoing Alcohol Withdrawal, Luis Medina

Seton Hall University DNP Final Projects

Managing and caring for patients who are undergoing alcohol withdrawal presents challenges for nurses in an inpatient setting. These challenges are influenced by factors such as negative attitudes, lack of knowledge and poor satisfaction. The purpose of this quality improvement initiative was to determine whether the effects of implementing an alcohol educational program would improve knowledge and satisfaction while reducing negative attitudes. This program implemented education on alcoholism, alcohol withdrawal and the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) monitoring tool which would be incorporated into the everyday practice of nurses caring for patients undergoing alcohol withdrawal. The …

The Effectiveness Of Nurse-Driven Early Mobility Protocol, Viktoriya Fridman

Seton Hall University DNP Final Projects

Purpose: The purpose of this quality initiative is to introduce the nurse driven evidence-based practice change related to patient mobility in the hospital setting with the aim to improve nurse knowledge, attitude, and behavior on a medical-surgical unit.

Significance of Project: The proposed DNP quality project is devised from the American Academy of Nursing (AAN) Choosing Wisely campaign unique to the elements of “don’t let older adults lay in bed or only get up to a chair during their hospital stay” to achieve a practice change. A significant aspect of patient care in a hospital setting is patient …

Psychometric Testing Of The Healthy Eating And Physical Activity Self-Efficacy Questionnaire And The Healthy Eating And Physical Activity Behavior Recall Questionnaire For Children, Jane Lassetter Phd, Rn, Christopher I. Macintosh, Mary Williams, Martha Driessnack, Gaye Ray, Jonathan Wisco

Faculty Publications

Purpose: The purpose of this study was to develop and assess the psychometric properties for two related questionnaires: the Healthy Eating and Physical Activity Self-Efficacy Questionnaire for Children (HEPASEQ-C) and theHealthy Eating and PhysicalActivity Behavior RecallQuestionnaire for Children (HEPABRQ-C). Design andMethods: HEPASEQ-C and HEPABRQ-C were administered to 517 participating children with 492 completing. Data were analyzed to evaluate for reliability and validity of the questionnaires. Results: Content validity was established through a 10-person expert panel. For the HEPASEQC, item content validity index (CVI) ranged from 0.80 to 1.00. The CVI for the total questionnaire was 1.0. AllHEPASEQ-C items loaded on …

Reducing Rehospitalizations From One Skilled Nursing Facility: A Quality Improvement Project, Victoria Ann Phillips

Doctoral Dissertations and Scholarly Projects

The purpose of this quality improvement project initiated by a core project team in a large medical center was to investigate possible causes for increased hospital readmissions from one specific skilled nursing facility. The conceptual framework utilized was the Define, Measure, Analyze, Improve, Control (DMAIC) model from the Lean Six Sigma methodology. Data collection from chart audits, a staff survey, a system probe, and a process mapping project assisted to narrow the focus of the plan to improve communication among facilities by standardizing documentation and coordination of care as patients transitioned from the skilled nursing facility to the medical center’s …

Out Of The Darkness And Into The Limelight: How Nurse Jackie Betters The Nursing Image, Shayla M. Holloway

Senior Honors Projects, 2010-2019

Due to the media’s portrayal of nurses, the nursing image has been

misconstrued over the past few years. Although nurses tend to be overlooked in the

media, there are television series out there that help promote the profession. This

essay considers how the television series Nurse Jackie is positively changing

society’s view of the modern day nurse. By analyzing some of the main protagonists

in season one of this controversial late night drama, one can see how Nurse Jackie

dispels popular nursing stereotypes and enhances the nursing image. Although

viewers may not grasp this shows impact on nursing, this show …

Assessing The Impact Of Simulation Role On Anxiety And Perceived Outcomes In Undergraduate Nursing Students, Teresa A. Bates

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: Due to large class sizes and limited resources, students participating in high-fidelity simulation experiences may be assigned to an observer role as opposed to an active, nursing role. It is important for educators to determine if anxiety levels and student learning outcomes are comparable regardless of role.

Methods: A quasi-experimental correlational study composed of 132 prelicensure baccalaureate students was conducted.

Results: There were no significant differences between simulation roles for anxiety levels and perceived outcomes for satisfaction, self-confidence in learning, clinical ability, problem solving, confidence in clinical practice, and collaboration.

Conclusions: These findings suggest that either role is an …

An Informatics Solution For Operating Room Efficiency, Richard A. Barrow

Doctor of Nursing Practice (DNP) Projects

Problem: For most hospitals, a major cost is the operating room. Inefficiency increases costs and risks for adverse events. An efficient operating room can also be a major revenue generator.

Context: This evidence-based performance improvement project was conducted in a small rural Veteran’s Hospital, which belongs to an integrated health network in Central California. The facility has four operating rooms and is expanding services provided to their patients.

Intervention: The intervention was the use of analytics and evaluations to improve the operating room efficiency by five percent. The use of 3 separate queries which were combined to generate reports and …

Using Social Narratives To Improve The Healthcare Experiences Of Children Diagnosed With Autism Spectrum Disorder, Margaret Spindel

Senior Honors Projects, 2010-2019

Children with Autism Spectrum Disorder (ASD) often experience significant emotional stress when they visit a healthcare provider. The focus of this research project was to explore the use of social narratives to help reduce stress associated with this environment. Social narratives are short stories designed to walk a child through a potential situation that they will encounter, that they may not be familiar with, or that they are not currently handling properly. As part of an initial literature review, evidence for the need for additional intervention in the healthcare setting for children with ASD was established. Continuing literature review then …

Burnout Syndrome In Hospital's Nurses: Causes And Consequences, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse, David P. Paul Iii

Harlan M. Smith

PURPOSE: The purpose of this research was to examine the causes and consequences of Burnout Syndrome among RNs in U.S. hospitals to identify solutions to this problem.

METHODS: The methodology was the review of the literature and a semi-structured interview. There were seven primary databases and two websites used in this research, and 35 articles were used for this literature review.

RESULTS: Causes and risk factors of burnout syndrome among RNs have been categorized into four major areas: individual, management, organizational, and work characteristics. Burnout syndrome rate among RNs with age under 30 years was 43.6% higher …

Burnout Syndrome In Hospital's Nurses: Causes And Consequences, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse, David P. Paul Iii

Alberto Coustasse, DrPH, MD, MBA, MPH

PURPOSE: The purpose of this research was to examine the causes and consequences of Burnout Syndrome among RNs in U.S. hospitals to identify solutions to this problem. METHODS: The methodology was the review of the literature and a semi-structured interview. There were seven primary databases and two websites used in this research, and 35 articles were used for this literature review. RESULTS: Causes and risk factors of burnout syndrome among RNs have been categorized into four major areas: individual, management, organizational, and work characteristics. Burnout syndrome rate among RNs with age under 30 years was 43.6% higher than RNs over …

“These Classes Have Been My Happy Place”: Feasibility Study Of A Self-Care Program In Native Hawaiian Custodial Grandparents, Loriena Yancura, Heather Greenwood-Junkermeier, Christine A. Fruhauf

Asian/Pacific Island Nursing Journal

Native Hawaiian custodial grandparents have a distinctive set of strengths and challenges that may lead them to benefit from a structured self-care program. The purpose of this paper is to describe a feasibility study with nine Native Hawaiian custodial grandparents who participated in a 6-week self-care intervention. Based on open-ended questions during the post-questionnaire and at the 6-month follow-up focus group, grandparent participants noted that their grandchildren needed education and clothing. Most grandparents did not endorse statements that their grandchildren had any mental or physical health conditions. Grandparents reflected that the intervention provided them with skills to help cope with …

Sexual Health Education In New Mexico Public Secondary Schools, Elizabeth Dickson

Nursing ETDs

Previous research has shown that comprehensive sexual health education (SHE) can significantly reduce risky sexual behavior and can increase protective behavior in adolescents. While an important component for all adolescents, this is particularly important for adolescents at high risk for adverse health outcomes, such as unplanned adolescent pregnancy and sexually transmitted infections. The aims of this descriptive study were to explore the content and delivery of SHE in New Mexico and to describe influences on decisions pertaining to implementation of state SHE policy. The social ecological model (SEM) was used as a theoretical framework to better understand levels of influence …

Inpatient Hospice Home: A Needs Assessment And Business Plan, Stacey Middleton

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Middleton

There are two constants that every person can count on in life, being born and dying. No amount of research is required, and there is no need to challenge the inevitable. When a child is born, people celebrate and congratulate the new parents and their family. When a person dies, people are saddened by the loss of a friend and loved one. Death comes to all and is either, fast and unexpected or a slow drawn out process. Every dying patient deserves to die with dignity, be free from pain, and …

Improving Obesity Management In Primary Care, Jeffrey M. Waddell

Doctor of Nursing Practice Scholarly Project

This project examined how advanced practice nurses (APNs) manage overweight and obesity in primary care. Not only were their general attitudes and beliefs toward overweight and obesity explored, but their beliefs about the treatment and management of obesity were also examined. The APNs’ knowledge and current practice with managing obesity in the primary care setting were evaluated. This project went on to examine the APNs’ awareness and utilization of clinical practice guidelines in managing overweight and obesity. Finally, the study asked about the perceived impact of a website designed to provide guidance managing obesity based on the American Association of …

Improving Adherence To Mental Health Treatment In A Low-Income Clinic, Janice G. Gandy

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The increasing prevalence of mental illness in the United States presents significant challenges for primary care providers in low-income settings. Integrated Behavioral Health (IBH) programs have resulted in improved general health for low-income participants; however, managing appointment adherence, in which the patient attends appointment as scheduled, is particularly challenging. The purpose of this pilot project was to implement bundled interventions at a low-income primary care clinic to improve patient adherence to behavioral health treatment. The bundle of interventions included: 1) educational interventions emphasizing the benefits of IBH care 2) warm patient handoffs between the primary care provider to a behavioral …

Quality Improvement In Provider Attitudes Towards Adherence To Comprehensive Diabetic Care Hedis Standards, Samantha Taylor

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Healthcare Effectiveness Data and Information Set (HEDIS) is a quality measurement for standard of care used to rate a health plan or provider's ability to demonstrate clinical effectiveness. Medicare Advantage healthcare plan utilizes HEDIS as a guide for standard of care. Adherence to HEDIS is useful in decreasing chronic disease burden through preventative measures. Diabetes, a disease with high burden, has Comprehensive Diabetes Care HEDIS standards that specifically target providers. Increasing adherence to HEDIS measures is shown to significantly improve health outcomes when used with evidence-based guidelines. The literature shows having high HEDIS scores are not an incentive to adhere …

Pilot Of A Randomized Trial Comparing Outcomes Of Three Types Of Peripheral Intravenous Catheters (Pivc): Utilizing The Plan, Do, Study, Act Cycle, Heather Galang

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Peripheral intravenous catheters (PIVC) are used in high volume in acute and ambulatory settings. Due to high volume of use in patient care, complications from a PIVC can significantly impact patient experience. Literature indicates complications such as blood exposure, phlebitis, unplanned removal, infiltration, occlusion, dwell time, pain, and cost have serious consequences in patient care, leading to potential delays in treatment, patient discomfort, patient dissatisfaction, safety concerns, nursing interruptions, increased length of stay, and added costs. Gap analysis indicates additional research can prove beneficial for evidence-based care improvement. The authors propose using the plan, do, study, act to conduct a …

The Effectiveness Of Education And Cognitive Rehearsal In Managing Nurse-To-Nurse Incivility, Deborah B. Kile

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

This project was designed to evaluate the effectiveness of education on nurse-to-nurse incivility and use of cognitive rehearsal techniques on registered nurses' perception of their ability to recognize and confront incivility, along with resulting job satisfaction. Nurse-to-nurse incivility negatively affects nurses, organizations and patients. The Tri-Council for Nursing's proclamation calls nurses to recognize incivility and take steps to eliminate this in practice ("Tri-Council" 2017). A mixed method, quality improvement pilot study was conducted. Participants, (registered nurses employed in a Post-Anesthesia Care Unit in a community hospital in Virginia), received education on incivility and cognitive rehearsal techniques. Data was collected through …

Exploring Perceptions And Experiences With Resources Among Rural Alzheimer's Dementia Family Caregivers In The Midwest, Rita M. Million

Theses & Dissertations

Exploring PERCEPTIONS AND EXPERIENCES WITH RESOURCES AMONG RURAL Alzheimer’s Dementia Family Caregivers in the Midwest

Rita M. Million

University of Nebraska, 2017

Supervisor: Karen Schumacher, Ph.D., RN

Background. Despite vast amounts of research on informal caregiving in the Alzheimer’s dementia (AD) population, research on the experience and perceptions of rural caregivers is limited. A better understanding of rural caregivers’ knowledge, use, and nonuse of resources is essential to offset the impact of caregiving. Purpose. This study explored Alzheimer’s dementia family caregivers’ experiences and perceptions with resources in rural Midwest communities. Design. A descriptive qualitative approach with one-time semi-structured interviews was …

Coping With Labor Education For Nurses, Donna Vo

Master's Projects and Capstones

The “Coping With Labor Education for Nurses” education plan is substantiated by data from the California Maternal Quality Care Collaborative (CMQCC) vaginal birth initiative toolkit and other research. Evidence-based data from multiple sources indicates that improving how labor support is offered at the bedside for the laboring patient can potentially decrease cesarean rates, reduce expenses, and increase savings. The objectives of this plan are to improve patient advocacy and the level of labor support interventions labor and delivery nurses will provide for patients to improve patient satisfaction score above 80%, decrease or maintain cesarean rates below 24.9%, and improve patient …

Aim High, Win Big: Optimizing The Or Nurse's Skills To Improve Surgical Outcomes, Ammie Rose Agbuya-Gates

Master's Projects and Capstones

Abstract

Operating room nurses are constantly challenged with new surgical procedures and technology that affect the delivery of safe patient care. A deficiency in skill sets was identified among 50% of OR nurses in this microsystem. A structured scrub training program will improve the performance of novice and advanced beginner nurses to prevent the occurrence of adverse events. This program includes 320 hours of exposure to scrub the top ten procedures of two specialty services after the nurse learns how to circulate. The ability to circulate and scrub is an indication of high performance. It is expected that the OR …

Reducing Intraventricuar Hemorrhage, Nakia Green

Master's Projects and Capstones

Abstract

Global Aim:

Between September 2017 and September 2018 we aim to reduce the rate of grade III and grade IV intraventricular hemorrhage (IVH) in infants less than or equal to 32 weeks gestation, or less than or equal to 1500 grams from 11% to 5%.

Project Aim:

Develop a best practice bundle for the Prevention of Intraventricular Hemorrhage with implementation of best practice of midline head positioning for infants less than or equal to 32 weeks gestation or less than or equal to 1500 grams by October 2017.

Setting:

Level III, 64 bed Neonatal Intensive Care Unit

Quality …

Surgical Site Infection Reduction Through Nasal Decolonization Prior To Surgery, Melissa S. Schmidt

Master's Projects and Capstones

Surgical site infections (SSIs) are the most common and expensive healthcare-acquired infection. The objective of this nurse-driven process improvement project was to implement a cost-effective and practical decolonization protocol to improve outcomes for high-risk veteran populations undergoing surgery at a large veteran’s hospital in the Pacific Northwest. Prior to the implementation, a decolonization protocol was used for cardiac and orthopedic preoperative patients. The process involved screening for methicillin-resistant Staphylococcus aureus (MRSA) colonization via nasal swab preoperatively and treating positive patients with mupirocin ointment to nares BID and chlorhexidine showers for five days prior to surgery. Adherence to the protocol was …