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Bridging Policy-Curriculum-Accommodations: A Nursing Education Initiative, Ketsa Maceus

The Dissertation in Practice at Western University

Supporting student academic accommodations (AAs) is an increasingly prevalent challenge for post-secondary nursing instructors in Ontario, with the growing number of students in nursing programs with mental health or medical disabilities. Historically, nursing programs have denied access to potential students with disabilities; today, the rigorous nursing program structure and the lack of support for instructors remain realities, even with the Ontario Human Rights Code and administrators' policies. The nursing faculty team (NFT) at Top College (TC) (pseudonym) must uphold educational and clinical expectations while assuring student competencies and curriculum integrity. In this comprehensive dissertation-in-practice (DiP), I explore bridging gaps in …

Quality Improvement Project: Evaluating The Impact Of An Intrapreneurial Skill Enhancement Program On Enhancing Innovation Perspectives And Overcoming Obstacles Among Nurse Practitioners At A Midwestern Academic Medical Center, Michael Thorn

Doctor of Nursing Practice Projects

Nurse practitioners (NPs) face barriers to being innovative in healthcare because of a need for more resources, education, and cultural inclusion compared to physicians and researchers (Joseph et al., 2019). NPs are often disregarded from involvement in the innovation ecosystem and seen as solely end-users of new products and services (Davis & Glasgow, 2020). This Doctor of Nursing Practice project aimed to assess the impact of a 5-week innovation and intrapreneurship course on NPs' perceptions of their ability to innovate at a Midwest academic hospital. The aim was to address the known innovation education gap that NPs rarely receive. Using …

Reducing Inpatient Falls Utilizing Multimodal Standardized Patient Education: An Evidence-Based Practice Project, Sheryl Almandrez

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: This project aims to utilize multimodal standardized patient education as an evidence-based practice intervention to reduce inpatient falls.

Background: In 2022, Kaiser Foundation Hospital (KFH) San Diego had 116 falls. Inpatient falls with injury account for the second-highest Joint Commission (TJC) sentinel event and California Department of Public Health (CDPH) adverse events. These injuries include lacerations, subdural hematoma, subdural hemorrhage, hip fractures, and wrist fractures. The Centers for Medicare and Medicaid Services (CMS) have also stopped reimbursing hospitals for the care provided after patients have sustained a fall with injury.

The project was implemented at KFH-San Diego …

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 …

Transformational Leadership Training For Leaders, Kristie M. 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 …

Development And Implementation Of A Nursing Shared Governance Toolkit, Heather Wagner

Nursing Research & Professional Development Conference

Background: NSG is a well-established structure for nurses and leaders to collaboratively work to improve nurse satisfaction, patient experience, and patient outcomes. Development of structures to support NSG may take several years. It requires cultural change, professional commitment, and the acquisition of new skills by both the nursing leaders and clinical nurses.

Local Problem: Nursing shared governance (NSG) at an acute care Midwestern hospital has been significantly impacted by the COVID-19 pandemic and nurse turnover. Nursing engagement and clinical excellence are heavily driven by professional shared governance structures.

Method: The purpose of this project was to develop and implement an …

Improving Nursing Communication By Implementing Communication Tools In A Bsn Undergraduate Program To Improve Patient Outcomes In Practice, Christopher Jackson

Doctor of Nursing Practice Projects

Communication deficiencies were identified among baccalaureate nursing students at South College in Nashville, TN, necessitating changes needing to be made in the nursing curricula. To address the flaws, the quality improvement project proposed implementing changes in clinical assignments during clinical rotations in medical-surgical nursing courses. The project manager discussed the purpose and usage of the SBAR tool, and the students then demonstrated the use of the tool. The clinical faculty rated the students using an eight-question Likert survey to assess the students’ confidence and competency three times; the first assessment at the end of the shift without guidance from their …

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 …

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 …

Implementation Of An Outpatient Protocol For Children And Adolescents With Food Allergy Anxiety: A Quality Improvement Project, Rochelle Bradley

Nicole Wertheim College of Nursing Student Projects

Background: Food allergies are a growing health concern in the United States. Ige-mediated food allergy is an anxiety provoking diagnosis due to the possibility of anaphylactic reactions, epinephrine use and life limitations. Providers who do not use a validated, condition-specific food allergy anxiety assessment tool in their practice have difficulty identifying patients at risk for moderate-severe food allergy anxiety. The literature has shown that providers also lack the knowledge of when to refer patients exhibiting food allergy anxiety to mental health services. This quality improvement project focused on improving providers' identification and education of food allergy anxiety after implementing …

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Examining The Role Of Authentic Leadership In Job Embeddedness And Turnover Intent, Abigail J. Jamison

Doctoral Dissertations and Projects

Hospital turnover has increased at alarming rates, particularly since the onset and in the aftermath of the COVID-19 pandemic. While traditional theories of turnover look at why employees leave, job embeddedness is both a theory and a framework that examines why people stay. Authentic leadership is a relational leadership style comprised of components of self-awareness, internalized moral perspective, relational transparency, balanced processing, and caring. This quantitative correlational research investigated the relationship of authentic leadership as mediator between job embeddedness and turnover intent, as well as the relationships between the five constructs of authentic leadership, to determine which, if any, caused …

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Assessing Palliative Care Knowledge Among Medicine/Pulmonary Intensive Care Unit Staff To Identify Barriers And Increase Palliative Care Referrals, Ryan Mckendrick

DNP Projects

Background: To conduct a needs assessment to identify areas of opportunity for increased awareness of the interdisciplinary medicine/pulmonary intensive care unit (MICU) staffs’ knowledge of palliative care and identify potential barriers to initiating referrals for palliative care consultations. Then provide an educational intervention and assess effectiveness with a post interventions assessment of referrals. The goal of this project is to increase referrals for palliative care consults.

Methods: A pre-/post-survey design will be utilized to assess palliative care knowledge to identify barriers to palliative care consultation referrals. An educational intervention that addresses palliative care knowledge deficits and addresses barriers will be …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Establishing A Protocol To Address Workplace Violence And Increase The Perceptions Of Safety Among Emergency Department Nurses: A Quality Improvement Initiative, Devan M. Robidoux

Master's Theses and Capstones

Background: Violence against emergency department nurses has become a widespread phenomenon that can greatly impact a nurse's job satisfaction and performance. Research has been scarce in examining the relationship between workplace violence and its underlying consequences. There remains a disconnect between precursors of violence against nurses perpetrated by patients and the cultural expectation that violence is a part of the nurses job and, subsequently, what they signed up for when going into the field. Nurses learn that having a greater understanding of the value in the lived experience of their patients leads to better quality delivery of care. However, culturally …

United States Pharmacopeia (Usp) <800> Standards: Increasing Compliance Of Safe Handling And Proper Administration Of Usp General Chapter <800> Drugs, Katelyn N. Sinclair

Master's Projects and Capstones

Problem: United States Pharmacopeia (USP) developed a set of standards to minimize exposure risks to patients, healthcare workers, and the environment when preparing, handling, and administering hazardous drugs (HDs) known as USP <800> HDs. The guidelines became effective December 1, 2019, but additional information is needed to ensure healthcare personnel are complying with the standards.

Context: Two medical surgical units from Hospital A were included in this project. Currently mandatory online modules about USP <800> standards are provided annually to every healthcare worker, but it is unknown if the policies and procedures are being followed appropriately.

Interventions: Active and passive observations as …

Conducting A Needs Assessment To Inform The Development Of A Burnout Mitigation Program For Critical Care Nurses, Leighann Marie Brock

Capstones & Scholarly Projects

Burnout among nurses is at monumental levels, contributing to high levels of job dissatisfaction and turnover. Some interventions existed in the literature to support burnout reduction programming among nurses; however, the literature failed to identify effective burnout reduction interventions based upon the specific needs of critical care nurses who face unique stressors related to high patient acuity and other environmental considerations. This project aimed to explore critical care nurses' needs and strategies designed to mitigate burnout in the clinical setting. Outcomes from this assessment would inform future interventions for the early identification and prevention of burnout among critical care nurses. …

Conducting A Needs Assessment To Inform The Development Of A Burnout Mitigation Program For Critical Care Nurses, Leighann Marie Brock

Dissertations

Burnout among nurses is at monumental levels, contributing to high levels of job dissatisfaction and turnover. Some interventions existed in the literature to support burnout reduction programming among nurses; however, the literature failed to identify effective burnout reduction interventions based upon the specific needs of critical care nurses who face unique stressors related to high patient acuity and other environmental considerations. This project aimed to explore critical care nurses' needs and strategies designed to mitigate burnout in the clinical setting. Outcomes from this assessment would inform future interventions for the early identification and prevention of burnout among critical care nurses. …

It’S More Than Nursing: The Experiences Of Psychological Safety Of Pre-Licensure Nursing Students Who Identify As Black, Indigenous, And People Of Color, Melissa Marie Anozie

Dissertations

The healthcare environment mandates its staff are able to communicate freely and openly to provide high quality patient care leading to positive patient outcomes. As the largest healthcare profession and those who are at the bedside most often with patients, registered nurses play a vital role in ensuring these outcomes. As advocates for the most vulnerable, nurses must communicate often but before doing so, they must feel psychologically safe. Psychological safety is how one perceives the benefits, risks, and consequences of asking a question, sharing an opinion, reporting an error, or revealing one’s true self to others. It is a …

Academic Allyship In Nursing: Deconstructing A Successful Community-Academic Collaboration, Jason Hickey, Mike Crawford, Patsy Mckinney

Quality Advancement in Nursing Education - Avancées en formation infirmière

Public health and social care systems in Canada are frequently racist and discriminatory towards Indigenous people and exacerbates health inequities that Indigenous people experience. In New Brunswick, there are a range of culturally informed health and social services being offered within First Nations communities and by Indigenous organization that operate outside of reserves. Some of these services and organizations rely on support from non-Indigenous allies to meet the needs of their community members.

However, it can be challenging for non-Indigenous people to engage in allyship due to unconscious bias, false assumptions, and lack of cross-cultural understanding. Effective allyship can also …

Predictors Of Engagement In Nursing Professional Practice: Transforming Organizational Culture In The Post-Covid Healthcare Environment, Jennifer Garnand

Dissertations

Cultivating the shared belief that individuals matter within an organization enhances the empowerment of staff and supports enthusiastic engagement in organizational efforts aimed toward a common mission, vision, and goals (McShane & Von Glinow, 2019). The nursing profession has been plagued by an unprecedented decrease in engagement and diminished job satisfaction, particularly following the prolonged tenure of the COVID-19 pandemic, leading to subsequent attrition amidst a staffing crisis. This quantitative predictive correlational study seeks to determine whether proactive and persevering characteristics, professional identity, and passion of nurses are predictors of engagement in a post-COVID healthcare environment. The research was based …

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.

The Transformational Leader In Nursing Practice – An Approach To Retain Nursing Staff, Anita C. Reinhardt, Teresa G. Leon, Linda Ochart Summers

Administrative Issues Journal

Transformational leaders have been shown to influence positive work environments and support the retention of nursing staff. While exemplars have been found in upper-level management, the implementation of these characteristics in unit-based leaders is less explained. The elements of the transformational leader on followers and the organization—individual consideration, individual stimulation, inspirational motivation, and idealized influence—can engage nursing staff to remain in an organization which will promote positive patient outcomes. This article will review the elements of the transformational leader and share two exemplars of the transformational metanarrative as demonstrated in nursing care units. Both exemplars demonstrate how the transformational leader …

Retention Strategies For The Current Nursing Workforce, Jennifer Higgins

Walden Dissertations and Doctoral Studies

Retaining a robust nursing workforce is essential to care delivery. As the generation gap in the nursing field widens, retention strategies that align with the current nursing workforce must be considered. Rapid turnover is a looming concern as baby boomers retire and millennials become the leading generation in the nursing workforce. Nurse leaders must identify and deploy strategies that will provide a meaningful work environment to retain nurses in this majority group. The purpose of this project was to address the gap in practice of rising turnover, low nurse engagement, and reliance on premium labor to deliver care. The sources …

Nurse Manager’S Leadership And Communication Skills And A Registered Nurse’S Organizational Citizenship Behavior, Satisfaction, And Intent To Leave, Emmitte J. Hall

Walden Dissertations and Doctoral Studies

The Veteran’s Health Administration (VHA) is the largest employer of registered nurses in the United States. The American Association of Colleges of Nursing predicts there will be a nursing shortage through the year 2030 and replacing and training each nurse is expensive and negatively impacts patient care. A review of the literature showed organizations with high levels of organizational citizenship behavior (OCB) had high levels of job satisfaction, which reduces turnover, but there was no research on the existence and impact of OCB in a federal health care facility, specifically the VHA. The purpose of this quantitative, correlational research was …

Promoting A Culture Of Self-Care: Application Of A Caring Science Framework To Prevent Nursing Faculty Burnout, Angela M. Braswell

DNP Scholarly Projects

BACKGROUND: Threats to nurses’ well-being from chronic workplace stress often leads to burnout. Lack of self-care contributes to nursing faculty burnout due to the inability to maintain well-being. Emerging evidence points to theory guided self-caring practices as effective coping strategies to manage the negative effects of workplace environments on well-being.

METHODS: This quality improvement project aimed to provide nursing faculty and staff in the academic workplace with opportunities to cultivate and enhance self-care practices to promote overall health and well-being following principles of Caring Science and Jean Watson’s 10 Caritas Processes^®. A multifaceted set of interventions were provided: …