Digital Commons Network^™

Catheter-Associated Urinary Tract Infection Reduction: A Quality Improvement Project, Wallace Kramm

Master's Projects and Capstones

Abstract

Problem: Hospital-acquired infections are preventable harm that occurs to patients while in the hospital. Catheter-associated urinary tract infection (CAUTI) is a preventable hospital-acquired infection that continues to plague hospitals nationwide. The Centers for Disease Control and Prevention estimates that there are more than 13,000 CAUTI related deaths in the United States annually (Scanlon, 2017). In addition to the harm caused to patients by CAUTIs, the estimated $500 million yearly cost for CAUTI treatment has created a fiscal burden on healthcare systems (Scanlon, 2017). Decreasing the rate of CAUTI by decreasing overall number of catheters is the goal of this …

Raising Oas Cahps Scores: Using Patient Education, Katrina Pangilinan

Master's Projects and Capstones

At the Golden Gate Endoscopy Center (GGEC), the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery (OAS CAHPS) survey results on patient satisfaction have been below the 50th percentile for the last three quarters of 2018. Patient satisfaction scores are a quality measure for the patient care experience and important for the success of the organization and its providers. Based on patient comments from previous surveys, patients feel that the center does not explain the possible side effects of the anesthesia in a way they can understand. Other patient comments and concerns included confusion regarding dietary restrictions …

An Innovative Discharge Intervention: A Quality Improvement Project, Yvonne Swain

Master's Projects and Capstones

Abstract

Problem: This project aims to decrease the discharge time of a patient from the hospital once the discharge order has been written. Current discharge times are averaging over 3 hours, leading to a breakdown in the patient throughput process. A patient survey was conducted to determine the reason for prolonged discharge times. The survey revealed that patients are not aware of their day of discharge, which may lead them to being discharged without transportation home. Many studies conclude that there are improvement opportunities around discharge planning and communication.

Context: This quality improvement initiative takes place in a 26-bed, medical-surgical/telemetry …

Improving Knowledge And Attitude Of Primary Healthcare Givers Towards Vulnerable Populations: A Quality Improvement Project, Kimberly Shankel

Master's Projects and Capstones

Improving Knowledge and Attitude of Primary Healthcare

Givers Towards Vulnerable Populations

Kimberly Shankel

University of San Francisco

Abstract

Problem

This project aims to improve patient satisfaction for vulnerable population patients while in hospital, namely transgender and gender non-conforming people. A major roadblock for this population in seeking medical care is their fear of discrimination when accessing healthcare, resulting in a delay, or avoidance of medical care. Multiple studies agree there is a need for nursing education on cultural competence to improve care and satisfaction for vulnerable populations.

Context

The site for this quality improvement project is a small suburban hospital …

Transforming Nursing Preceptors By Developing Emotional Intelligence, Michael Francis

Doctor of Nursing Practice (DNP) Projects

Changing the process of professionally developing nursing preceptors to meet the growing and changing needs of the nursing profession is critical. This evidence-based project leveraged an advanced preceptor education program for inclusion of basic emotional intelligence tenets and transitioning them into preceptor self-awareness, leadership recognition, and return on human capital investment. A large integrated healthcare system in Northern California identified a strategic need for preceptor development and within the system two acute care hospitals and one home health/hospice agency were selected to participate. The intervention included the development of a six-hour curriculum delivered through an interactive and innovative in-person learning …

When Care Becomes Futile: Perspectives Of Acute Care Medical-Surgical Nurses, Angela Mulcahy

Nursing Theses and Dissertations

Caring for patients at end-of-life is a difficult patient assignment for a nurse. Possessing the knowledge, skills, and means to communicate with and advocate for patients is key to providing quality care. A concept analysis of death literacy identified one specific challenge for nurses, futile care. Futile care has been linked to increased patient suffering, increased health care costs, use of scarce resources, and moral distress. Futile care exists in the medical-surgical acute care setting, but the concept has not been explored within this population. More knowledge from bedside nurses was needed to explore the concept and identify ways to …

Reducing Stress And Anxiety In Nursing Students Using Music Therapy, Teagan N. Duvall

Honors Capstones

No abstract provided.

Workflow Interruptions: Risk Factors And Outcomes In Nursing, Chandaniben Maniya

Honors Capstones

Introduction: Workflow interruptions in nursing are defined as the disruption of a nursing task. Workflow interruptions are a common stressor in nurses’ work, leading to deviations in their focus that can result in medication errors and missed nursing tasks. Thus, they can compromise patient safety, health outcomes, and satisfaction. Moreover, interruptions can cause stress, burnout, and reduce job satisfaction among nurses. It is important to recognize that there are solutions that would prepare nurses for reducing workflow interruptions and improving their work patterns. The purpose of this literature review was to identify the causes of interruptions, their effects on patients …

Fighting Fatigue With Caffeine: Exploring Perceptions On Patient Safety, Camille Quitangon

Honors Theses

Objective: To examine the association between fatigue and caffeine consumption, and explore nurses’ perceptions of the impact of these factors on patient safety.

Background: Many people consume caffeine for its benefits, such as stimulating the central nervous system to feel more awake. Health professionals, such as nurses, commonly experience fatigue and often will drink coffee to get through their long shifts.

Methods: A comprehensive literature review was conducted. Studies were split into two categories – fatigue and patient safety or caffeine's effect on human performance.

Results: Fatigue causes nurses to be impaired; it affects their ability to be alert, vigilant, …

Fostering Compassionate Care For Persons With Alzheimer's Disease In Nursing Facilities., Sam Gilbert Cotton

Electronic Theses and Dissertations

The aim of this dissertation study was to examine the impact of the implementation of a new Compassionate Care (CC) curriculum on the quality of care provided by Certified Nursing Assistants (CNAs) to residents with Alzheimer’s disease (AD). More specifically, this dissertation used Kirkpatrick’s model of evaluation to assess the reactions, learning, and behavior change of the CNAs exposed to the curriculum, and ultimately the impact of the curriculum on the stress levels of residents with AD. To accomplish this, we had two studies that aligned with the Kirkpatrick model of evaluation. For Study #1, the evaluation of the compassionate …

Developing Cultural Competency In Anesthesia Through Student Registered Nurse Anesthetists, Emma To

Doctoral Projects

Certified Registered Nurse Anesthetists (CRNAs) are the main anesthesia providers in over 70% of rural hospitals providing anesthesia. Each year, over 2,000 student registered nurse anesthetists (SRNAs) graduate and continue as licensed CRNAs. This Doctor of Nurse Practice (DNP) project emphasizes the importance of developing culturally competent providers in anesthesia by promoting early outreach in cultural competence education of SRNAs. Cultural competence is described as possessing characteristics of congruent attitudes, awareness, and conduct that provides and enables effective skills in cross-cultural encounters. Encompassing cultural competency education early in the SRNAs profession may provide valuable lifelong cultural skills that will benefit …

Implementating A Transitional Care Program To Reduce Hospital Readmissions In Medicare Recipients: A Research Translation Pilot Project, Gail Rattigan

Capstones & Scholarly Projects

Patients discharged from hospital to home, especially the chronically ill and older adults, are too frequently readmitted within 30 days. The Centers for Medicare and Medicaid Services (n.d.; 2017) along with other interdisciplinary researchers have proposed, studied, and implemented strategies to decrease this excessive and expensive phenomenon. After the implementation of the Hospital Readmission Reduction Program in 2009, preventable readmissions have decreased but remain at unacceptable levels. Care transitions from hospital to home have been implicated as perilous and fraught with communication breakdown and lack of patient support and follow up. Strategies aimed at both the hospitalization phase and the …

Interprofessional Education: How Curriculum Influences And Develops Future Healthcare Professionals, Karen Keune

CUP Ed.D. Dissertations

The value of higher education is a topic of great consideration and discussion, not only for current and future students, but also for legislators, educators, and employers. A college degree is more than a pathway toward advanced knowledge in a given subject; it is a component of a larger outcome beyond a diploma, it's a job. While the scale of employment opportunities appears to rise for those with a college degree, it is not enough to guarantee security for new graduates, no matter their topic of study. More than a competency in the field of study is required to prove …

Dental Hygiene Protocol Used By Nurses In The Hospital Setting A Pilot Survey, Tsenre M. Vigil

Dental Hygiene ETDs

Oral care is often dismissed or undervalued in the overall health and wellness of individuals and can be detrimental to patients in hospital-like settings. Although dental hygienists are educated to practice in alternative practice settings like pediatric offices, hospitals, nursing homes, schools and federally qualified health centers they are underutilized in such arenas. The purpose of this study is to learn about the University of New Mexico Hospital’s (UNMH) current oral hygiene care practices and protocols, nurses’ values and interests in inter-professional collaboration with a dental hygienist.

A feedback survey was created and intended recipients included all UNMH nurses regardless …

Intraoperative Ketamine Administration: An Adjunctive Therapy That Reduces Postoperative Pain For Patients Undergoing Spinal Surgery, Brittany Pierce

Doctoral Projects

In 2017, the United States Department of Health and Human Services declared that the country was experiencing an opioid crisis (U.S. Department of Health and Human Services, 2018). As a result of this phenomenon, healthcare providers are examining how they are managing pain and researching new avenues for the treatment of pain. Anesthesia providers are in a unique position to help reduce postoperative pain and ultimately the development of chronic pain. This doctoral project was conducted in order to write an evidence-based policy that directs and educates anesthesia providers in the administration of intraoperative ketamine to reduce postoperative pain in …

Student Nurses’ Perception Of Sleep Quality, Nicole Wall

Electronic Theses and Dissertations

Sleep health is an underrepresented topic in the literature. Poor quality of sleep can lead to sleep deprivation, which has serious health and social consequences. The first year of university encompasses new demands and challenges to learning. Nursing students and nurses who suffer from poor sleep quality are at risk of providing unsafe patient care. The purpose of this pilot study was to explore the perceived level of sleep quality of first year nursing students. This was a descriptive, cross-sectional study that was guided by Rosenstock’s Health Belief Model. The participants completed an online survey that included the Pittsburgh Sleep …

The Lived Experience Of Traumatic Amputation For Haitian Adults, Margarett Alexandre

Dissertations, Theses, and Capstone Projects

Amputation of a limb is a traumatic and disabling condition that impacts the lives of people worldwide. Trauma remains the leading cause of major limb amputation, second only to Diabetes Mellitus and dysvascular complications (Ziegler-Graham, MacKenzie, Ephraim, Travison, & Bookmeyer, 2008). Little is known about the experience of traumatic amputation for Haitian Adults, therefore this study was to understand the lived experience of traumatic amputation in Haiti. The purpose of this descriptive phenomenological study was to investigate the lived experience of traumatic amputations as talked about by adults who suffered an amputation because of the 2010 earthquake in Haiti. Eight …

Nutrition Education To Improve Health Outcomes In Community Dwelling Older Adults, Sara Giessinger

Master's Projects and Capstones

Abstract

The proportion of people age 60 and over is growing faster than other age group, and will double by 2050 from approximately 605 million to 2 billion worldwide, in addition to the 80 and over population quadrupling by the same time. Non-communicable diseases such as obesity, cancer, coronary heart and lung disease, diabetes, hypertension, insulin resistance, and hyperlipidemia,represent 63% of deaths annually worldwide. Due to the immense contact nurses have with clients, they play a key role in screening, referrals and education to guide this demographic to improved health outcomes through nutrition and physical activity interventions (Xiaoyue, Parker, Ferguson, …

Health Professional Students' Understanding Of Oral Health In Traumatic Brain Injury, Samira Omar

Electronic Thesis and Dissertation Repository

Oral health is a significant consideration in recovery following severe traumatic brain injury (TBI) as it is associated with overall health. Health-care providers play an essential role in rehabilitation following TBI. Thus, using qualitative descriptive research and focus groups, this thesis examined the experiences and perceptions of eight final-year health-professional students in nursing, occupational therapy, and speech-language pathology with respect to oral health in TBI. Results suggest that health-professional students lack a deep understanding of i) what constitutes oral health, ii) common oral health challenges that may be faced by persons with TBI, and iii) optimal oral care in persons …

The Effects Of Authentic Leadership And Organizational Commitment On Job Turnover Intentions Of Experienced Nurses, Alexis E. Smith

Electronic Thesis and Dissertation Repository

High levels of turnover continue to pose a challenge to the nursing workforce amidst growing patient acuity and budget constraints. The presence of strong nursing leadership may address the need for healthy work environments that contribute to retention outcomes. The purpose of this study was to examine the effect of authentic leadership of managers, on experienced nurses’ affective, normative, and continuance organizational commitment, and ultimately job turnover intentions. This study used secondary analysis of data collected in a non-experimental survey of 478 registered nurses in Canada. Hayes’ PROCESS version 3 SPSS macro for mediation analysis was used to test the …

Nursing Student Confidence And Self-Efficacy In Simulation: Evidence Synthesis Project, Serena Shirey

Nursing (graduate) Student Scholarship

The use of simulation-based activities is a growing trend in nursing pedagogy and requires evaluation to assess and improve outcomes. This project completed a review of multiple research studies and reviews to evaluate the effects of simulation and simulation methods on students’ sense of self-efficacy and confidence. The findings support the use of simulation and found that simulation does increase students’ perception of confidence and self-efficacy. The data collected included both qualitative and quantitative data. A few studies lacked generalizability due to small sample size and scenario selection. However, multiple methods were noted to improve the simulation experience and they …

The Impact Of Reflection On The Development Of Critical Thinking For Novice Nurses, Katherine D. Taylor

Nursing (graduate) Student Scholarship

This capstone project explores the use of intentional reflection as and educational intervention during the orientation process and the development of critical thinking skills in new graduate nurses. Nurse educators in the clinical practice setting could potentially impact one aspect of the transition to practice for the novice nurse through the development of critical thinking through by facilitating the incorporation of reflection during the onboarding of a novice nurse. Further investigation in the form of an evidence syntheses specifically related to the impact of reflection on the development of critical thinking in the new graduate nurse was necessary. The results …

The Impact Of Cross-Cultural Experiences On The Expression Of Cultural Humility, Teri L. Witter

Nursing (graduate) Student Scholarship

Cultural humility is a process in understanding and accepting differences between diverse groups of people. Nurses are challenged to develop cultural humility to care for the changing population in the United States. Nurse educators are tasked with the challenge of facilitating students’ awareness and expression of cultural humility. Immersion experiences are one approach to helping students grow in their cultural humility. Along with teaching cultural humility, educators must evaluate a student’s level of cultural humility. Measuring an abstract concept such as cultural humility can be a difficult. Limited instruments have been developed and used to measure the concept of cultural …

A Preliminary Evaluation Of An Academic Support Program, James Colin Bumby

Theses and Dissertations

The responsibility for graduating students is a school responsibility. A large urban Midwestern research university created the Nursing Endeavor Program (NEP) to ensure that students from underserved minorities, first generation, and/or low income are enabled to graduate successfully. There is a 100% retention rate for the period from admission to the nursing major in the junior year; however, in the pre-nursing years, the retention rate is only 50%. The role transition from pre-nursing student to student nurse can be challenging and stressful. A qualitative phenomenographic research approach was utilized to identify the factors facilitating and the factors hindering this transition. …

The Impact Of A Poverty Simulation On Practical Nursing Students’ Attitudes Towards Poverty, Jaime Crabb

DNP Scholarly Projects

Poverty is a multi-faceted global problem. Nurses and providers are front-line caregivers for this vulnerable population. In order to provide effective care, individuals must understand their own attitudes towards poverty. The purpose of this study was to evaluate for changes in Practical Nursing students’ attitudes towards poverty with the use of a poverty simulation based upon the Experiential Learning Theory. Participants were surveyed using the Short Form Attitudes towards Poverty (SFATP) tool. The ELT espouses that the best learning occurs when students actively engage in an experience, reflect upon it, and then apply that learning to future experiences. Statistical significance …

The Lived Experience Of Nurse Practitioner Role Transition: A Phenomenology Study, Anthony Michael Angelow

Dissertations

This qualitative, descriptive phenomenology study sought to answer the following question: What experiences do nurse practitioners identify as being associated with their transition to the nurse practitioner (NP) role? Using purposive sampling and snowball techniques, eight nurse practitioners participated in this study. The study included participants from across the United States. Data from this study were developed from unstructured interviews with participants using audio-recorded open-ended questions, which were then transcribed by the principal investigator. The data were analyzed using Colaizzi’s (cited in Creswell, 2013) method for qualitative data analysis to identify common themes. Four central themes were generated from these …

Lived Experiences Of New Nurse Graduates In Critical Access Hospitals, Lesa Ann Hoppe

Dissertations

The purpose of this descriptive, phenomenological study was to explore and uncover the phenomenon of the lived experiences of new nurse graduates in the first year of employment in critical access hospitals. One-on-one interviews were completed with 13 participants working in critical access hospitals in three Midwestern states. The nurses had between 1 and 12 months’ experience in their registered nurse position. Six themes were identified in the study using Colaizzi’s (1978) seven-step process for analysis: (a) Always a Professional, (b) Personal Connections, (c) Pride in Work and Community, (d) Always on Your Toes, (e) Everyone Works as a Team, …

Expressions Of Emancipatory Knowing In Undergraduate Nursing Service- Learning, Heather Corinn Voss

Dissertations

Emancipatory nurses recognize social and political problems of injustice or inequity and participate in social and political change to improve people’s lives. The recent spotlight on relationships among health, health inequity, social determinants of health, and structural institutional barriers, has led to demands that nurse educators integrate innovative curricular and pedagogical strategies to analyze and address social justice issues in today’s healthcare system. A mixed-method, qualitative study was conducted to elicit expressions of emancipatory knowing during and after a service- learning experience. Interpretive description was used to analyze data from 15 written reflections and eight semi-structured interviews. Nine expressions of …

It Starts With Us: A Plant-Based Experiential Education Program For Healthcare Providers In Northern Colorado, Alexandra Lessem

Capstones & Scholarly Projects

A wealth of evidence shows whole-food, plant-based diets are beneficial for disease risk reduction and treatment. Specific conditions positively impacted by plant based diets include cardiovascular disease, diabetes, obesity, many cancers, autoimmune and inflammatory diseases, and depression. Even m odest increases in intake of plant based foods can have positive effects but the diets of most Americans consist primarily sugars, fats, and processed foods with little to no intake of fresh, plant-based foods, which contributes to the poor health of many people across the nation. Few of these people are routinely counseled to eat a plant-based diet partly because few …

Sepsis, John Bell

Nursing Student Class Projects (Formerly MSN)

The pathophysiology of sepsis is related to the patient’s immune response. It involves an imbalance between pro-inflammatory and antiinflammatory responses, causing damage by a variety of mechanisms (Keegan & Wira, 2014).