Implementation And Program Evaluation Pilot Study: Educating Health Care Providers About Protecting Population Health During Climate Change., Christine Fasching Maphis

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Recommendations regarding the need to prepare nurses and other health care providers (HCPs) for the health impacts of climate change (CC) have grown ubiquitous in the literature. Timely, efficient and sustainable strategies by the health care industry are necessary. Failure to act is predicted to result in catastrophic and lethal population health consequences. A growing body of research identifies related knowledge gaps and supports HCP competencies and best practice interventions to mitigate adverse population health impacts of CC. A social ecological framework and the PRECEDE-PROCEED approach were employed to develop and evaluate a series of online webinars designed to equip …

Reducing Hospital Acquired Pressure Injuries Through A Standardized Prevention Bundle, Austin Lee Stoker

Master's Projects and Capstones

Abstract PROBLEM: Currently healthcare acquired pressure injuries (HAPIs) in the United States result in significant and unnecessary costs along with lost revenue for healthcare facilities. These costs are estimated to be between 9.1 and 11.6 billion dollars annually. Pressure Injuries (PIs) are directly associated with decreases in patient outcomes and are deemed preventable incidents. HAPI prevention can mitigate this clinical and financial problem for patients and organizations. CONTEXT: Unnecessary patient harm related to four HAPI occurrences in the last quarter on the 2B Medical Surgical Telemetry Unit in an integrated managed care delivery system continue to be of concern. Adherence …

Implementing Simulation In Icu New Graduate Nursing Orientation: Introducing Two Practice Innovations, Aiza Quinday Msn

Master's Projects and Capstones

A change project involving the use of innovative wearable simulation technology was integrated into the 12-week new graduate nurse ICU training program at one community hospital in Northern California. Project implementation was interrupted by the Covid-19 pandemic, so only the first pilot training session was conducted. Initial results from this training session suggest that the simulation training had a positive impact on the nurses’ ability to assess patient breath sounds and to recognize and treat a rapidly deteriorating patient. This training session also allowed the project team to identify additional areas of skill assessment and opportunities for improvement for the …

An Online Self-Directed Learning Module For Regional Stroke Survey Success, Winchell Rodriguez Kuttner

Doctor of Nursing Practice (DNP) Projects

The lack of a standardized education for stroke coordinators focusing on The Joint Commission (TJC) standards and requirements in preparation for the stroke program disease-specific care (DSC) certification survey every two years has led to undue added stress prior to survey. The development of tools and resources has been identified to address the current educational gap in stroke coordinator orientation. This project addressed the gap by creating an online, self-directed learning module to assist the stroke coordinators in knowledge acquisition of the stroke standards and requirements.

A stroke coordinator plays a critical role in stroke care delivery. An educational module …

Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario

Doctor of Nursing Practice (DNP) Projects

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …

The Effect Of Asynchronous Versus Synchronous Online Course Delivery On Hesi Scores And Student Engagement For Rural Pre-Licensure Nursing Students, Susan Luke Belliston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since nurses are the primary providers of direct patient care in the United States, a shortage in any community can impact the quality of health care available. Rural areas were among the first to be affected by the current nursing shortage. Further challenges to the rural nurse supply include a lack of access to nursing education, particularly baccalaureate education.Both distance and online education options allow for the increased reach of higher education to rural areas. Existing nursing education literature focuses on graduate nurse education and baccalaureate completion education. The pre-licensure nursing student is mostly absent from the existing literature concerning …

Fluctuating Cohesion: A Grounded Theory Study Of Nursing Students Engaged In A Hybrid Debriefing Format, Carol Lynn Senette

UNLV Theses, Dissertations, Professional Papers, and Capstones

Debriefing is a key component of simulation that promotes development of students’ reflective processes. Instructor-led debriefing (ILD) is considered the gold standard; however, research conducted over the past decade demonstrates the negative effects of anxiety on student reflection during ILD. Nursing students’ experiences with ILDs have been substantially investigated; yet scant research explores students’ perceptions and experiences of more learner-centered debriefing formats that deemphasize the instructor role.

The purpose of this grounded theory study was to explore undergraduate nursing students’ perceptions and experiences of a hybrid debriefing format consisting of peer-led debriefing followed immediately by ILD. Specifically, I aimed to …

The Contributing Factors To Student Nurse Medication Administration Errors And Near Misses In The Clinical Setting As Identified By Clinical Instructors, Kristen M. Selig

Theses and Dissertations

The report, To Err is Human, by the Institutes of Medicine (IOM, 2000) brought attention to medication safety in the United States healthcare system. While advances have been made in patient safety, including electronic medication dispensing systems, electronic medication administration records, and scanning systems, it is estimated that 7,000 to 9,000 people die each year due to medication errors (Tariq et al., 2019). The medication administration process involves steps from prescribing to administration. However, nurses administering the medications are the final check point. James Reasons’ Swiss Cheese Model of Accident Causation illustrates the role that systems play in medical errors. …

A Program Evaluation Of A Rural Nursing Academic Partnership, Meagan A. Spencer

Electronic Theses and Dissertations

As the American Association of Colleges of Nursing and Commission on Collegiate Nursing Education continue to promote the implementation and creation of literature on academic partnerships, a Christian university, sought to evaluate its academic partnership with a for-profit hospital for the first time in regard to student perspectives. The purpose of this mixed-methods program evaluation was to describe the student perceptions of the academic partnership in trusting, collaborating, and engaging nursing students and recruiting and retaining nursing graduates to rural hospitals and health care facilities. Measurable impacts included both qualitative and quantitative coding of the levels of trust, collaboration, and …

An Exploration Of The Numeracy Skills Required For Safe, Quality Nursing Practice, Anna Wendel

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the numeracy skills required for safe, quality nursing practice. Using a descriptive mixed methods design, this study answered two research questions: 1) What numeracy skills do nurses perceive as important for providing safe, quality nursing care in the first three years of practice? 2) How do nurses incorporate numeracy skills into daily patient care during the first three years of practice? Early career nurses from a not-for-profit health care organization in the mid-Atlantic region of the United States (n=109) responded to an online survey tool developed by the student investigator that ranked …

Academic Leaders And The Regulatory Orientation: New And Improved!, Annmarie Munana

DNP Qualifying Manuscripts

The purpose of this article is to describe the challenges and regulatory knowledge gaps present in academic nursing leaders, explore orientation as an evidence-based approach to support leadership transition, recommend guiding frameworks, and report on the usefulness of orientations to facilitate academic regulatory compliance knowledge.

During this time of yet another nursing shortage, and considering the aging population and nursing workforce, professional organizations and nurse leaders strive to develop innovative solutions to attract individuals to nursing. The shortage is also present amongst the ranks of nursing faculty and academic nurse leaders and the profession needs strong leaders at the helm …

Community Health Nurse Educators And Disaster Nursing Education, Jody Spiess

Dissertations

Abstract

The world is struggling with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and the need for disaster nursing education has never been more clear. Recently, the American Nurses Association reported that of the over 32,000 nurses surveyed; only 11% felt well prepared to care for a COVID-19 patient (ANA, 2020). Community health nurse educators are tasked with educating future nurses on disasters, yet, little is known about this population’s perceived competence in disaster preparedness. The purpose of this study is to describe community health nurse educators' perceived competence in disaster preparedness.

The study is a descriptive, correlational …

Social Network Centrality, Social Construction Of Knowledge, And Nurse Practitioner Competency In Asynchronous Online Discussions Among Adult Gerontology Acute Care Nurse Practitioner Students, Sharon Schaaf

Organization, Information and Learning Sciences ETDs

The relationships between social network centrality, social construction of knowledge, and nurse practitioner competency among adult gerontology acute care nurse practitioner students participating in asynchronous online discussions were explored. Social network centralities (betweenness, in-degree, out-degree, closeness, and eigenvector) were determined through social network analysis. Social construction of knowledge was assessed by the Interaction Analysis Model (IAM). Nurse practitioner competency was evaluated using the Novice to Expert model. A retrospective exploration of an online discussion board from the College of Nursing at the University of New Mexico was conducted. The centralities of betweenness, closeness, and eigenvector demonstrated a significant relationship with …

Diet Behaviors, Physical Activity, And Sociodemographic Factors In A Sample Of Racially Diverse Adults: A Secondary Analysis Of Nhanes (2017-2018) Data, Fatemeh Choupani

Dissertations

Background: The prevalence of obesity is increasing among adults in the United States and is related to a high risk to health. Obesity has been linked to lifestyle behaviors such as diet behaviors and physical activity.

Purpose: This study aimed to determine if an association exits between foods prepared outside of the home, walking or biking, vigorous/moderate recreational activities, sociodemographic factors and the outcomes, body mass index, percentage of body fat, and waist circumference.

Method: A secondary analysis was conducted using data from 3942 adults from the U.S. aged 20 years, as recorded in the National Health …

Lowering Perceived Stress Levels In Undergraduate Nursing Students, Caitlin Dodd

Electronic Theses and Dissertations

This project analyzed the effects of guided meditations and a stress management class on undergraduate, prelicensure nursing students’ perceived stress levels. College students and professional nurses are both susceptible to having high stress levels. Mindfulness activities have been shown to lower stress levels. Undergraduate, prelicensure nursing students participated in this project determining the effects of guided meditations and a stress management class on perceived stress levels in a quantitative, pre- and postinterventional study. Participants in the project completed a stress management class and 18 guided meditation sessions in an undergraduate classroom setting. The researcher used the Perceived Stress Scale-10 (PSS-10) …

Reducing The Incidence Of Pressure Injuries In Adult Icu Patients At Mcallen Medical Center With The Implementation Of A Pressure Injury Preventive Bundle: A Quality Improvement Project, Cheryl Cruz

Student Scholarly Projects

Practice Problem: Pressure injuries (PIs) are a significant healthcare problem globally. Adult patients in the intensive care setting are especially vulnerable to the development of PIs given the acuity of their diagnoses requiring extensive treatments, procedures and the use of multiple medical devices.

PICOT: The PICOT question that guided this project was, “In adult intensive care unit (ICU) patients, how does the effect of implementing a pressure injury prevention bundle compare in patients who received the bundle, and patients receiving standard pressure injury prevention in reducing the incidence of pressure injuries after two months?”

Evidence: Evidence exist that bundle implementation …

Development Of An Academic-Service Alliance To Address New Graduate Registered Nurses’ Practice Readiness, M. Dianne Norman

The Dissertation-in-Practice at Western University

New Graduate Registered Nurses’ (NGRN) lack of practice readiness is a Problem of Practice (PoP) impacting hospitals. Stemming from the evolving complexity of today’s healthcare environment and the generalist nature of the baccalaureate nursing program, the lack of NGRN practice readiness increases hospital-based orientation costs, patient safety risks, and NGRN attrition. There is currently no formal structure in which key stakeholders can address the NGRN lack of knowledge, skills and judgment and the associated implications for the safety and quality of patient care. This Organizational Improvement Plan (OIP) examines NGRN practice readiness within the organizational context of the Health Centre …

Improving Care Experience Of Total Joint Home Recovery Patients Through Nursing Education, Earvin Ledi

Master's Projects and Capstones

Problem: At a Northern California hospital (NCH), there is a current effort to ensure the perioperative patients are satisfied with their care. These patients receive the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey after surgery. The scores regarding discharge process and patient knowledge over the last five quarters have fluctuated between the 10th percentile and the 36th percentile. NCH relies on patient satisfaction scores to better serve their members.

Context: NCH understands the higher the scores, the more members they will retain and the higher the overall income. Based on the low OAS …

Assessing College Students’ Perceived Risk For Developing Type 2 Diabetes Mellitus, Carletta Weatherspoon

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

This study assesses the effectiveness of an evidence-based educational intervention affecting the perception of the risk for developing type 2 diabetes (T2DM) in college students and examined relationships between demographic factors and perception of risk for T2DM. Seventy-seven students from the Georgia College Association of Nursing Students (GCANS) and the Personal Health and Fitness Class participated. Of these, 43 participants completed the post-educational email survey. Instruments measured demographic characteristics, perception of risk for developing diabetes, and diabetes risk. The Risk Perception Survey for Developing Diabetes (RPS-DD) assessed students’ perception of risk at baseline and one week post intervention. There was …

Core Content Items And Constructs To Inform Student Nurse Handoff Communication, Kelley Mcafee

Doctoral Dissertations

This study describes nurse educators’ perceptions of content items for a high-risk, high frequency process essential for entry as a nurse generalist into clinical practice. The process of interest is student nurse handoff communication. Research Questions:

1. What do nurse educators identify as core content for successful student nurse handoff communication?
2. Do nurse educators identify with one handoff communication tool for student use?
3. Are student nurses expected to engage in nurse handoff communication during simulation experiences and/or clinical experiences?
4. What educator characteristics are associated with his/her perceptions of the core content?

A Strategic Plan To Thread Genomics Competencies Into Undergraduate Curriculum, Holly Mathis

Dissertations

Problem: Genomics in undergraduate nursing education has experienced slow adoption in the United States. Various approaches have been proposed but do not address barriers to successful implementation.

Methods: A strategic plan was developed to increase the amount of genetics and genomic content in the curriculum of an undergraduate nursing program. A gap analysis was performed on the curriculum revealing a paucity of content. A SWOT analysis informed the strategic plan, which included a faculty education program using the ANA/ISONG’s Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines and Outcome Indicators (2^nd ed.) (2009) as a foundation.

Results: Faculty …

A Case Study Of Factors That Influence The Implementation Of Full Spectrum Contraceptive Care In A University Student Health Center, Cecile Dahlquist

Electronic Theses, Projects, and Dissertations

Large, prospective cohort studies such as The Contraceptive Choice Project have been conducted regarding safety, efficacy, satisfaction, and usage of Long-Acting Reversible Contraception (LARC) such as the Contraceptive Implant (Nexplanon) and Intrauterine Contraception (Winner, Peipert, Zhao, Buckel, Madden, Allsworth & Secura (2012). Despite these findings, access and financial barriers remain for many women, and less than 7 percent of women utilize the most effective methods of contraception in the United States (Winner et al., 2012). Barriers to effective LARC methods exist at a higher rate with our young, poor, and non-white marginalized populations (Finer & Zolna, 2016).

Unplanned pregnancies have …

Exploring Resiliency During The Nursing Student Clinical Experience, Natalie N. Mcmullin

The Dissertation-in-Practice at Western University

In nursing programs, it is common for students to not complete their degree (Van Hoek et al., 2019). This problem is perpetuated as students who experience high stress and lack resiliency are more likely to be unsuccessful or take longer to complete their nursing degree (Van Hoek et al., 2019). Resiliency is not only important for students during their degree, it is essential to continuously strengthen it throughout their nursing career (Turner & Kaylor, 2015). The aims of this organizational improvement plan will be to empower nursing students to be more resilient in the clinical setting so that they are …

Assessing The Need For Standardized Pre-Chemotherapy Education: An Outpatient Oncology Clinic Initiative, Spana Patel

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: In a diverse southern California outpatient oncology clinic, assess the need for standardized pre-chemotherapy education for newly diagnosed cancer patients to aid in the improvement of health literacy, self-management of side effects, satisfaction, and reduction of anxiety.

Background: Cancer patients often feel anxious, overwhelmed, and confused by the abundance of information and medical jargon that they must digest. One southern California outpatient oncology clinic identified the need for consistent, standardized procedure in providing chemotherapy education and assessing treatment knowledge in newly-diagnosed cancer patients as evidenced by: inconsistent attendance in educational classes and or appointments, inability to articulate treatment …

Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd

Doctor of Nursing Practice Final Manuscripts

Background and Evidence Problem: As the population ages, there is an increase in the incidents of falls. Falls are the predominant cause of both nonfatal and fatal injuries among adults aged 65 years and older (Bergen et al., 2016). Extensive research has been conducted in fall prevention in hospitals, skilled nursing, and rehabilitation units. End-of-life care in a hospice setting presents a greater challenge in risk identification and prevention of falls. A local hospice had 457 falls between July 2018 to mid-March 2019 with a lack of consistent, detailed, fall education and documentation.

Evidence-Based Practice Intervention: Utilizing the American Geriatrics …

Fall Prevention Assessment In The Intermediate Care Patient Population, Dawn Rose

Doctor of Nursing Practice Final Manuscripts

Fall Prevention Assessment in the Intermediate Care Patient Population

Falls cause greater than 600,000 deaths per year and are the most common injury in people over 65 years of age. Fall prevention in the acute care setting has been identified as key goal in the most recent JCAHO review process. Falls on an intermediary care unit lead to an increased rate of morbidity, delayed discharge, and excess cost expenditure.

Even with appropriate evidence-based tools in place, Hospital A’s intermediate care unit, recorded an increased rate of falls; the highest rate in its health care system. An investigation identified factors contributing …

Implemented Nurse Education To Improve The Effective Use Of The Sapphire Pca Pump: Achievement Of Quality Pain Control, Fanta Keita Zable

Master's Projects and Capstones

The Sapphire ™ Infusion System Patient-Controlled-Analgesia (PCA) pump is a device that is used to administer high pain medication to manage a patient’s pain level after an invasive procedure such as surgery. In order to achieve this goal, nurses must be able to use the sapphire equipment efficiently to prevent medication overdose and underdose, as well as to preserve safety for both the patients and the nurses themselves. In addition, nurses must be able to document accurately on EPIC. The purpose of this project, led by the team of Clinical Nurse Leader (CNL) students from the University of San Francisco, …

Competency-Based Practicum Evaluation Tools For Family Nurse Practitioner Programs, Angelica Renteria

Doctor of Nursing Practice (DNP) Projects

Problem: Training family nurse practitioners (FNPs) was identified as a concern within a university MSN FNP program. A major gap identified was that student practicum evaluation tools needed to be competency-based.

Context: The paradigm shift from content-focused curriculum to competency-based curriculum has led to a refinement in program accreditation and increased national certification requirements.

Interventions: Revision (aligned with NONPF core competencies and AACN Master’s essentials), adoption, implementation, and evaluation of competency-based FNP practicum evaluation tools and training of faculty and preceptors to use the revised tools and one-minute preceptor model were the interventions in this project.

Measures: …

The Impact Of Perinatal Palliative Care Simulation On Undergraduate Nursing Students, Erin Anderson

Nursing (graduate) Student Scholarship

Background: Nurses who have limited exposure to perinatal palliative care often avoid interactions with patients, limiting the quality of care provided. Undergraduate nursing students are often not afforded opportunities for experiencing perinatal palliative care during direct patient care clinicals. Simulation may provide an opportunity for students to have these experiences.

Methods: A review of the literature was conducted resulting in six articles addressing the evidence-based education question, do undergraduate nursing students report feeling more prepared to provided perinatal palliative care to patient and families after receiving didactic instruction along with simulation-based learning experiences, compared with nursing students who receive …

The Effect Of Perioperative Education In Undergraduate Nursing, Elizabeth Biddle-Zabawa

Nursing (graduate) Student Scholarship

Educational institutions have modified their curriculum and as a result perioperative education in undergraduate nursing programs has decreased to where it is nonexistent in some institutions (Byrne, Root, & Culbertson, 2016). The decrease of perioperative education in nursing programs has led to a lack of new graduate nurses choosing to work in the perioperative setting and creating a nursing shortage (Castelluccio, 2011). The purpose of this evidence-synthesizing capstone project was to explore and determine how best practices to incorporate perioperative concepts into undergraduate nursing education curricula influence new graduate employment in perioperative nursing.

Methods: A total of 12 articles fit …