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Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …

Feasibility And Measurement Of Bedside Pumping In The Nicu: A Mixed Methods Study, Jessica Gomez

Dissertations & Theses (Open Access)

Abstract

Background: Supporting preterm infants with mother’s own milk (MOM) can improve health outcomes and decrease mortality.¹ Freshly pumped MOM, within four hours of expression, has the highest availability of bioactive components versus stored MOM. However, fresh milk is often not readily available due to the disconnected process of breastfeeding that occurs with preterm infants in the NICU. One convenient solution to improve access to fresh MOM is for the mother to pump at the infant's bedside. This intervention could improve the mother's pumping experience and provide the infant access to fresh MOM.

Purpose: This study aimed to evaluate …

Surgical Fire Prevention And Management: An Objective Structured Clinical Examination For Nurse Anesthesia, Tate Fazio, Kaleb Killens

Doctoral Projects

Sentinel events in health care are rare events, often corresponding with permanent injury or death. Fires in the operating room (OR) are one type of sentinel event. Although rare due to possible life-threatening injuries to patients and staff, appropriate surgical fire education is critical in nurse anesthesia education, as anesthesia providers play a significant role in surgical fires (Wunder et al., 2020). The development of simulation exercises has the potential for students to experience and become competent in managing high-acuity, low-frequency events, such as surgical fires (Wunder et al., 2020). The Nurse Anesthesia Program (NAP) at The University of Southern …

Moral Distress As A Predictive Variable Of Perceived Job Retention In Senior Nursing Students, Rebekah L. Barber

Honors College Theses

New Bachelor of Science in Nursing (BSN) graduate nurses are leaving careers within inpatient healthcare facilities presumably because of moral distress related to the anticipated workload of registered nurses (RN). BSN curriculums are responsible for providing practical education through clinical instruction; however, many students experience inconsistencies in best practice recommendations. The inconsistencies predominantly originate between didactic nursing instruction and clinical learning within inpatient healthcare facilities. Using a cross-sectional descriptive research design, this thesis utilized the validated Moral Distress Scale-Revised (MDS-R), a 21-item instrument that assesses the frequency and intensity of moral distress experienced by healthcare workers. Student responses to the …

Attention-Deficit/Hyperactivity Disorder And Teachers, Samantha Ann Tierney, Samantha Ann Tierney

Honors College Theses

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common disorder, estimated to affect 5% of all children and adolescents. The current rate of diagnosis is steadily increasing. This increase in the number of students with ADHD affects educators, who have a large role in the success of students with ADHD. Despite this, many teachers are not prepared to deal with the extra challenges that come with teaching students with ADHD. Teachers may not be properly taught how to deal with children who have ADHD in their classrooms or the role they have in these children’s lives. The purpose of this study is to …

Postpartum Visitation Policies, Jenna B. Holderman, Morgan E. Matthews

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Continual support for the birthing person during labor improves delivery outcomes and overall childbirth experiences. How many support people are present and their relation to the birthing person varies based on individual preference, family dynamics, and sociocultural expectations. During the Covid-19 pandemic, many hospitals implemented a one-visitor policy for deliveries. With these new guidelines in place, the length of hospital stays significantly decreased, and there were a variety of opinions towards these restrictions.

Purpose: The purpose of this study was to explore birthing persons’ overall sentiment towards visitors in the immediate postpartum period.

Methods: The current study analyzed …

Moral Distress In Critical Care Nursing: A Literature Review, Anna Tindell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Moral distress is a pressing concern in the healthcare field with significant implications for all areas of nursing and patient outcomes. However, those within the specialty of critical care nursing experience moral distress more frequently than those in other specialties. It arises from the complex ethical dilemmas nurses in critical intensive care units face as they work in these high-pressure environments. The purpose of this literature review is to discuss moral distress in critical care nursing and how it affects a nurse’s ability to provide quality care. Furthermore, this review will determine factors contributing to moral distress and potential interventions …

Development Of Nursing Clinical Judgment Using Lasater’S Clinical Judgment Rubric, Hollyanne Heaton Springer

Dissertations

Nursing clinical judgment is evident when multiple complex decisions are made quickly resulting in positive patient health outcomes (Lasater, 2007; Tanner, 2006). Patient safety is dependent on effective nursing clinical judgment but this skill has been declining among new graduate nurses, resulting in only 9% demonstrating entry-level competency in 2020 (Kavanagh & Sharpnack, 2021). To mitigate this decline, nurse educators need to develop methods to teach this skill with increased effectiveness. Tanner’s (2006) clinical judgment model described four cognitions of clinical judgment. Lasater’s (2007) clinical judgment rubric (LCJR) was developed to build on this model and provide leveled language in …

Designing A Culturally Relevant Lifestyle Modification Guide For Primary Care Providers To Improve Diabetes Management In The Hispanic Population., Jesusita Elvira Tafoya

Capstones & Scholarly Projects

Diabetes mellitus type II (DMT2) affects the Hispanic population in the United States at an alarming rate, contributing to elevated morbidity and mortality. This growing ethnic group is also disproportionately at risk for obesity and being at a lower socioeconomic status, both of which contribute to DMT2 severity and prevalence. The provision of culturally competent care in the primary care setting using evidence-based lifestyle modifications has the potential to improve DMT2 outcomes among this socioeconomically disadvantaged population. Thus, the expert opinions of eight primary care providers in the Pueblo, Colorado community were sought where half of the patient population identified …

Student Desire To Stay In A Program: The Influence Of Faculty Caring And Cultural Identification With Faculty, Elizabeth Ann Cunniff

Dissertations

The Future of Nursing 2020-2030 report (National Academies of Sciences, Engineering, and Medicine, 2021) stated nurses should reflect the characteristics of the people they serve to ensure individuals receive culturally competent and equitable health care. Over the next decade and beyond, the U.S. population will become more racially and ethnically diverse, but the nursing workforce has not kept pace with the changing demographics (American Association of Colleges of Nursing, 2023). To increase diversity among nurses, nursing schools need more diverse graduates from prelicensure nursing programs, but attrition is greater among students with diverse racial, ethnic, and cultural backgrounds (Barbé et …

Exploring Moral Distress And Reflective Debriefing As A Potential Intervention Among Intensive Care Unit Nurses, Tegan Camille Jones

Capstones & Scholarly Projects

Moral distress is recognized in the literature as a significant problem for nurses working in the intensive care unit (ICU). Moral distress occurs when one knows the right course of action but is unable to follow it due to team or organizational constraints. Moral distress may lead to physical and psychological symptoms resulting in burnout, job attrition, and a negative impact on patient care. While interventions for reducing moral distress among ICU nurses are limited in the literature, one potentially promising approach is reflective debriefing. This Doctor of Nursing Practice (DNP) scholarly project aimed to explore the intensity, frequency, and …

Fostering Resilience In Nurse Practitioner Practice: Development And Validation Of A Guide, Robyn L. Heiser

Capstones & Scholarly Projects

Nurse practitioners (NPs) are a significant part of the U.S. healthcare system providing high quality, safe, consistent care often in low access and rural settings. Nurse practitioners are increasing in demand due to a growing physician shortage and a changing patient demographic of aging patients and patients with increasing complex, chronic illnesses. Nurse practitioners experience chronic work stress from layered demands of their work and role. This challenges their resilience and, if not appropriately managed, could lead to negative consequences for patient outcomes, the well-being of the NP, and overall healthcare system. Applying interventions that could effectively and efficiently foster …

Exploring The Relationship Among Clinical Judgment, Academic Resiliency, Student Predictors, And Exam Remediation In Prelicensure Nursing Students Preparing For Next Generation National Council Licensure Examination [For] Registered Nurses, James Franklin Oberlander

Dissertations

As the field of nursing becomes increasingly more complex, nursing students are psychologically challenged as they progress through a program of study, prepare for the licensure examination, and enter professional practice. Identifying factors that influence student outcomes is necessary for faculty to effectively guide students toward successful completion of nursing school and passing the National Council Licensure Exam for Registered Nurses (NCLEX-RN). Along with academic and nonacademic demographic variables, the main objective of this exploratory, quantitative research study was to investigate the relationship between clinical judgement, academic resiliency, exam remediation, and NCLEX-RN first attempt pass rates. One hundred six senior, …

Transformational Leadership Training For Leaders, Kristie Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Exploring The Lived Experience Of Significant Other Caregivers Providing Care To Partners Surviving A Spinal Cord Injury, Lisa Ann Lumley

Theses & Dissertations

According to the World Health Organization, 250,000 to 500,000 people worldwide have suffered a spinal cord injury. Significant others may become caregivers responsible for meeting the needs of the dependent partner. The focus of this study is on significant other caregivers’ experiences providing care for partners after a spinal cord injury. The effects of stress from providing care may be detrimental to caregivers' psychological and physical well-being. Psychological distress, such as anxiety and depression in caregivers, is a significant public health issue that affects the quality of life for millions of individuals. There is a lack of studies focusing on …

The Effects Of Postpartum Hemorrhage Simulation, Kera Olson

Doctor of Nursing Practice Projects

Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. Evidence supports the importance and impact simulation has had on preparation for postpartum hemorrhage. Preparation with hands-on education is imperative for a safe outcome during a real-life hemorrhage situation. Lack of frequent education and simulation can equate to negative outcomes for all involved. The purpose of this project was to increase exposure to a safe environment to explore knowledge and skills during a postpartum hemorrhage event. This quality improvement project surveyed postpartum nurses pre and post-mock postpartum hemorrhage simulation. The setting allowed for mistakes, discussion, and open …

Evaluating The Benefits Of Mindfulness Based Practices In The Hospital Setting: A Case For Mindful Communication Interventions For Nurses, Annie Kaplon

Mindfulness Studies Theses

Recent stressors, such as COVID-19, have provided new challenges for healthcare workers, especially nurses, and have contributed to the increase in burnout rates in the hospital setting. Therefore, relief in this space is critical. Ample research demonstrates that mindfulness-based interventions (MBIs) may help to improve well-being among healthcare providers more broadly. Literature supports that the practice of mindful communication, in particular, is helpful, not only in improving patient outcomes, but also in decreasing interpersonal stress among healthcare workers. This paper analyzes and synthesizes relevant studies, both qualitative and quantitative, and argues that mindful communication training improves the workplace environment for …

Nursing Perspectives On Intimate Partner Violence Screening In The Emergency Department, Justin Cabrera

Dissertations, Theses, and Capstone Projects

Using descriptive and quality descriptive (QD) analysis, emergency department nurses from around the country completed a modified version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool to gain insight on their attitudes, knowledge, and preparedness about working with patient survivors of intimate partner violence (IPV) regarding their willingness to and comfort in engaging in IPV screening practices. In total, 1,523 responses were received from emergency department nurses currently or formerly in practice.

Findings show that there was no correlation between emergency department nurses’ education and training on IPV and willingness and comfort with IPV screening with …

Mandatory Child Abuse And Neglect Reporting Behaviors Among Registered Nurses In New Mexico: A Statewide Comparative Study, Ingrid Ann Wilson

Nursing ETDs

Child abuse and/or neglect (CAN) is a global problem. Although nurses are mandated CAN reporters, a lack of reporting has been an issue. New Mexico (NM) is faced with higher child poverty and CAN-related substance-abuse compared to other U.S. states. This quantitative study aimed to explore factors influencing intended/actual CAN reporting behaviors among NM registered nurses (RN)s, examine relationships of these factors, and compare differences in reporting behaviors between rural and urban locations. A survey to a sample of RNs (N=146) showed factors associated with CAN reporting intended behaviors were work status (r=.21, p < .05), cues to action (r=.20, …

Perspectives Of Home Care Nurses On Frailty And Resilience In Older Adults Living At Home, Lisa Foley

Seton Hall University Dissertations and Theses (ETDs)

The population of older adults is growing rapidly in the United States. As more people are living to an advanced age, they are often managing a multitude of chronic illnesses and disabilities while continuing to live at home. Frailty is a common condition that affects how one ages and the condition is associated with dependency and poor health outcomes. Resilience is considered to be a protective factor against health stressors that lead to frailty in older adults. Perspectives of home care nurses were obtained by semi-structured interviews which described how older adults live at home with frailty and demonstrate resilience. …

Undergraduate Faculty Expectations Of New Graduate Nurses’ Entry-Level Competencies, Bridgette Lynn Bochner

Dissertations

This qualitative descriptive study sought to describe undergraduate faculty expectations of new graduate nurses’ entry-level competencies. By gaining valuable insight from nursing faculty, essential knowledge gained from this faculty perspective will benefit nursing students, nursing education, and all stakeholders in providing safe, quality care and establishing congruent entry-level competencies for new graduate nurses. Eleven faculty from the central and eastern portions of the United States participated in this study. In-depth interviews using open-ended questions were conducted, recorded, and transcribed by the researcher. A thematic analysis was conducted to identify recurring themes. The themes were validated by the participants using a …

Utilizing A Reminder Tool To Improve Post-Hypoglycemia Recheck Rates On A Medical Surgical Unit., Laken Heitz

Doctor of Nursing Practice Papers

Diabetes is a growing epidemic with profound implications on the healthcare system. One of many possible complications is hypoglycemia, which is any value below 70 mg/dL. Inpatient hypoglycemia is a patient safety concern, and its treatment requires nursing adherence to strict protocols including a recheck within 15 to 30 minutes after treatment. However, evidence from the literature and project site demonstrated low rates of timely post-hypoglycemia rechecks. The purpose of this project was to provide education to all MIPS nurses regarding the utilization of a reminder tool for post-hypoglycemia rechecks. The intervention plan included reviewing the current hospital-wide hypoglycemia policy, …

Balancing Nurture And Rigour: Seeking Effective Support For Nursing Students In Distress, Marti Harder

The Dissertation in Practice at Western University

As higher educational institutions face a growing demand to graduate more nurses, and mental health and life stresses are recognized as increasing obstacles to student success, the timing is right for nursing programs to evaluate their traditionally rigorous program cultures. At Sunrise University in Western Canada, nursing students make up a large population seeking support services, and there is an increasing need for capacity building in faculty to support learners who are in distress. In this organizational improvement plan (OIP), I explore what can be enhanced or further developed to create more effective support for students who are in distress …

Shared Governance And Transition Into Practice: Impact On Work Engagement, Gudrun M. Reiter-Hiltebrand

Student Scholarly Projects

Practice Problem: High turnover rates, particularly in new graduate nurses, and poor organizational commitment and engagement negatively affect staffing, operational performance, and patient outcomes. A negative trend for nurse engagement indicators was noted in previous staff engagement surveys of this organization.

PICOT: The PICOT question that guided this project was: In transition-into-practice (TIP) nurses (P), how does the implementation of shared governance (I) compared with no shared governance participation (C), affect their engagement with the hospital (O) within eight weeks (T)?

Evidence: Literature has shown that nurse engagement is one of the nurse indicators positively affected by shared governance …

Evaluation Of Simulation On Medication Errors In The Pediatric Intensive Care Unit, Carrie Clark

Dissertations

Problem: Medical errors are the third leading cause of death in the United States, the most common medical error being medication error. Pediatric patients are at an increased risk of medication error due to medication dosage calculation and the use of frequent high hazardous drugs.

Methods: The quality improvement (QI) project implemented the use of descriptive observational design using retro and prospective data. The data was collected over a 4-week and 4-week period by gathering data via safety and environmental management survey (SEMS).

Results: The data gathered consisted of an increase in medication errors of 150%. The data collected yielded …

Improving The Mental Health Nursing Competencies Of Nurses Caring For Patients With History Of Substance Use Disorder In Long-Term Care Settings, Nancyver Lafleur-Omeler

Doctor of Nursing Practice Projects

Background

While nurses are often on the front lines of working with patients with a history of substance use disorders (SUD), most have limited training in this area. Nurses who work in Long Term Care (LTC) settings are often challenged to resolve the practical issue of needing more competency in caring for SUD patients. Horner et al. (2019) agreed that the deficiency of mental health knowledge and skills in healthcare workers is linked to decreased quality of care, which can diminish patient outcomes. This lack of competency must be addressed (Margoliese & Vandyck, 2019).

Purpose

The goal of this project …

Factors Influencing High Nurse Turnover In A Midwestern U.S.A. Community Hospital And A Proposal For Change, Deborah Mokeira Omagwa

Doctor of Nursing Practice Projects

Nurse turnover has become a universal problem in recent years, causing nurses to bear the burden of higher patient loads, working overtime hours, and dealing with unfavorable working conditions. Nurses sometimes feel they have no voice to fight for them while they struggle at the bedside to improve patient outcomes. The purpose of this project was to be a voice for the nurses to inform the hospital administration on data driven results on how nurse turnover can be reduced, with the goal that the proposed nurse retention strategies will be implemented in this community hospital.

This was a qualitative project …

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart

Doctor of Nursing Practice Final Manuscripts

Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .

Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …