Digital Commons Network^™

Using Education To Improve Timeliness And Efficiency Of Medication Administration In An Inpatient Hospital Setting: A Quality Improvement Project, Kevin Christopher Lane

Master's Theses and Capstones

Background: Timeliness of medication administration is important for optimal patient care. Technology, interdepartmental communication, and nursing workflow influence on-time delivery of medications. Improving knowledge through PowerPoint™ education and visual aids such as medication alert placards improves interdepartmental communication and positively influences nursing workflow leading to improved medication delivery times.

Local Problem: Nurses spend considerable time looking for and administering medications to patients on the unit. A goal was established to reduce the amount of time nurses spent looking for medications by 5% after implementing PowerPoint™ education to improve workflow.

Methods: This project used the Plan-Do-Study-Act (PDSA) strategy for implementation. …

Improving Nursing Intake And Output Documentation Utilizing Chart Audits And Staff Education: A Quality Improvement Initiative, Cayla Marie Barretto

Master's Theses and Capstones

Background: Inaccurate and unreliable fluid balance documentation has been a long-standing issue in nursing. Best practice for “strict intake and output monitoring” is real-time accurate documentation.

Local Problem: Within a medical-surgical microsystem, it was identified that intake and output documentation (I/O) was not being completed thoroughly. A brief chart audit was conducted to identify gaps in documentation. In total, forty charts were audited, and two charts (5%) passed the audit. Common areas where documentation was incomplete included daily weights, output entered as “unmeasured occurrence”, IV fluid administration not totaled, or no intake recorded at all. We aimed to see a …

Support Their Sleep: Enhancing Nurses' Knowledge And Implementation Of Non-Pharmacological Sleep Protocols To Improve Patient Rest, Recovery, And Reduce Cognitive Impairment., David C. Barry

Master's Theses and Capstones

Background: Sleep and rest play an influential role in promoting recovery and healing in humans. Hospitalized patients are at risk for altered sleep from hospitalization, illness, and stimulation from a hospital environment. Non-pharmacologic interventions preformed by nurses can help to improve sleep and sleep environment for patients.

Local problem: There was no protocol or available information regarding patient sleep promotion for nurses to references when caring for patients.

Methods: Nurses in the microsystem (n=8) were administered a pre/post questionnaire containing Likert scales and a short quiz containing knowledge-based questions. Questionnaires were distributed to nurses prior to and after …

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 …

Job Satisfaction Of New Hampshire Nursing Faculty, Patricia Marie Puglisi

Master's Theses and Capstones

The nursing shortage is a growing concern with the shortage of nurse faculty restricting entry of qualified students. A descriptive study of faculty from 11 New Hampshire nursing schools was conducted to determine nurse faculty satisfaction and factors contributing to satisfaction. A modified version, sent electronically of the Nurse Faculty Satisfaction Questionnaire measured faculty satisfaction. Of 159 faculty invited 74 (47%) participated. Overall, NH nurse faculty were highly satisfied as nurse educators with 78.4% rating overall satisfaction of 8 or higher on a 0 - 10 scale. The top three satisfiers were opportunity to work independently, sense of accomplishment from …

The Relationship Between Learning Styles And Nursing Students' Satisfaction With Online Education, Jamie L. Meyers

Master's Theses and Capstones

A descriptive correlation study was conducted to investigate the relationship between nursing students' satisfaction with online education and their preferred learning style. Eighty-nine nursing students from a Northeast university completed the Visual (V), Auditory (A), Read/Write (R), and Kinesthetic (K), (VARK) learning style inventory tool, Online Course Satisfaction Survey (OCSS) and demographic questionnaire. Findings revealed an overall 67% satisfaction rate with online education but dissatisfaction in the areas of communication and interaction. The study showed the majority of nursing students possess the combination of all four learning preferences, VARK. No statistical significant relationship between a student's learning style and satisfaction …

Validity And Reliability Of The Critical Care Pain Observation Tool: A Replication Study, Kathleen Marie Keane

Master's Theses and Capstones

Because critically ill patients are often not able to self report the presence of pain, an observer rating scale, the Critical Care Pain Observation Tool (CPOT) was developed for pain assessment of critically ill patients. This research examines the reliability and validity of the CPOT via replication of the original research study that developed the tool. Utilizing a repeated measures design, two nurse observers used the CPOT to score patient pain behaviors during rest, with repositioning and after repositioning. Results show fair to almost perfect interrater reliability and good discriminant validity of the instrument. The Critical Care Pain Observation Tool …

New Graduate Nurses' Perceptions Of Simulation Training, Karen S. Britt

Master's Theses and Capstones

New graduate nurses enter practice with basic critical thinking skills and have minimal experience applying learned concepts into clinical practice. Hiring institutions aim orientation programs at developing new graduate nurses' skills so that they are better prepared to meet patient needs. Human Patient Simulation is one tool employers have recently begun using. A qualitative study was conducted to gain insight into seven new graduate nurses' perceptions of utilizing simulated mock code training during the orientation process. Analysis of the focus group discussion identified four emerging themes: Developing Confidence, Developing Knowledge Base, Developing Critical Thinking, and Developing a Sense of Realism. …

The Effect Of Situation, Background, Assessment, Recommendation (Sbar) Education On The Quality Of Student Nurses Handoff Report, Kerri Goupil

Master's Theses and Capstones

Leaders in patient safety initiatives have promoted the use of standardized communication at the time of handoff as a means to decrease the margin for errors during the transmission of critical information. One means of standardizing handoff is by using the framework provided by the Situation, Background, Assessment, Recommendation (SBAR) communication technique. This framework provides specific guidelines for organizing and communicating relevant patient information at the time of handoff. To date there is a gap in training and education of handoff practices at the academic level of healthcare students. Potential interventions to address this gap include the positive benefits of …

The Impact Of High-Fidelity Human Patient Simulation On Clinical Judgment Of Nursing Students: A Pilot Study, Timothy L. Boyd Jr.

Master's Theses and Capstones

The American Association of Colleges of Nursing is encouraging their constituents to increase clinical judgment of nursing students to meet increased workplace demands and higher patient acuity. The literature suggests that human patient simulation (HPS) may be a teaching pedagogy to promote clinical judgment. However, few quantitative studies exist that measure clinical judgment as an outcome of HPS. A pilot study was conducted using a quasi-experimental design that randomly assigned subjects (n = 11) into one of three groups: control, traditional and experimental. Subjects completed pretests for three dimensions of clinical judgment: knowledge, confidence and skill. Following the intervention which …

Correlating Health Locus Of Control And Risk For Postpartum Depression, Alyssa Jane Abraham

Master's Theses and Capstones

The potential risk factors and the symptoms of postpartum depression have been identified in the healthcare literature. Literature shows that there is a relationship between perceived self-efficacy and risk for postpartum depression. The identification of health locus of control and self-efficacy in new mothers will allow nurses to create individualized patient care interventions for women at risk of developing postpartum depression, thus potentially improving outcomes. This study sought to determine if a correlation exists between risk for depression, as identified by the Edinburgh Postnatal Depression Scale, and health locus of control, as identified by the Multidimensional Health Locus of Control …

How Nurses Perceive Patient Suffering, Sandra J. Tanis

Master's Theses and Capstones

Suffering is a complex and multidimensional experience that is individual in nature and deeply personal. Effecting all aspects of being---physical, psychological/emotional, sociocultural, spiritual---suffering may impact all dimensions of a patient's life. The purpose of this study is to explore nurses' perception of patients who suffer. The study aims to raise the level of awareness of patient suffering for nurses, and thereby serve as a basis for reflecting on the impact of their nursing care on the health of the individual and patient outcomes. A qualitative study explores how a group of eight nurses described suffering in their patients. Themes, which …

The Relationship Between Autonomy And Job Satisfaction Among Registered Nurses, Morgan A. Taylor

Master's Theses and Capstones

With the state of health care today, it is essential to determine the level of job satisfaction among registered nurses as they are important members of the health care team. With the ongoing nursing shortage, identifying strategies to improve retention among nurses will help retain well qualified nurses and recruit the new generation of nurses. Autonomy is a factor that often plays a role in the quality of an individuals work environment, thus the current study was conducted to determine if a relationship exists between nursing job satisfaction and autonomy.

A quantitative, correlational study was conducted with 100 registered nurses …

The Effect Of Preoperative Stoma Site Marking On Quality Of Life In Patients Undergoing Ostomy Surgery, Susan L. Cantara

Master's Theses and Capstones

The purpose of this study was to determine if preoperative stoma site marking by a Wound, Ostomy, Continence (WOC) nurse affects patient quality of life. This study used a descriptive design with a convenience sample of 25 ostomy patients. Sixty-three surveys were mailed to study participants and the response rate was 40%.

Ten subjects (40%) had their stoma site marked by a WOC nurse preoperatively and fifteen subjects did not. Eleven participants reported that their ostomy was permanent (44%), while fourteen of the participants (56%) state they had a temporary stoma. Thirteen of the subjects had elective ostomy surgery (52%) …

Utilization Of Evidence Based Practice Principles To Implement Organizational Values, Catherine Z. Curtis

Master's Theses and Capstones

Nursing job satisfaction is related to nursing retention. During this current nursing shortage, nursing leaders need to investigate ways to improve work environments to increase nurse satisfaction. Research has shown nurse job satisfaction greatly impacts the quality of patient care and nurse retention. This research project implemented a nursing model of practice that included organizational values that could be linked to improved job satisfaction. A nursing model derived from The Whole-Person Caring Model (Thornton) and using principles of Shared Governance, Empowerment and Crucial Communication was the independent variable used to measure changes in nurses' perceptions of work environment and job …

Breastfeeding Attitudes Of Junior And Senior Nursing Students, Eileen Riley

Master's Theses and Capstones

The health benefits of a longer duration of breastfeeding for both mothers and infants have been identified in the literature. However, the breastfeeding rates for infants at six and twelve months old lag the Healthy People 2010 recommendations. Studies have shown that a nurse's attitude can influence breastfeeding duration rates yet nurses' attitudes and hospital practices do not always support breastfeeding mothers. Therefore it is vital that senior nursing their practice in order to support and encourage mothers. The Iowa Infant Feeding Attitude Scale was used in this study to collect data from junior nursing students before their maternal/child health …

Current Intrapartum Care Practices In India, Rizwana Rizwana

Master's Theses and Capstones

According to the annual report of the Government of India, 100,000 women annually continue to die because of childbirth related complications (Ministry of Health and Family Welfare (Government of India), 2000-2001). In India, over 90% of women become mothers and a majority of them deliver without skilled assistance during delivery. This translates to approximately 30 million women in India experiencing pregnancy every year, and 27 million having live births (Bakshi, 2006). Of these, 136,000 maternal deaths occur every year due to childbirth complications, most of which can be prevented. Literature reveals that lack of appropriate care during pregnancy and childbirth, …