Medicine and Health Sciences Commons^™

Emergency Department Workplace Violence Against Nurses, Adam Johnson

MSN Capstone Projects

Emergency room nurses are often thought of as the adrenaline junkies of the nursing world. Emergency nurses interact with a wide array of patients and visitors and are often the first clinician a patient may see upon arriving at an emergency department. With this wide array of patients and visitors, also comes a volatile environment with the increased risks of violence against nurses. This violence could include verbal, physical, and emotional violence from patients, visitors, and even fellow staff members. As violence increases, nursing longevity decreases and thus further increases the expense of nursing on a facility. Therefore, this has …

Increased Discharge Compliance Through Mental Health Follow-Up, Robert H. Kirby

MSN Capstone Projects

Emergency departments are being strained to their breaking points as a result of the recent COVID pandemic. These departments are in need of programs that can help to reduce stress on not only limited budgets but also reduce the strain on their overwhelmed staff. One such strain on emergency departments and their limited resources is the readmittance of mental health patients as a result of non-compliance of the discharge instructions. The change project looks to address whether following up 10 days post discharge can increase discharge instruction compliance and ultimately reduce readmissions. The aim of the project is through the …

Burnout And Fatigue: A Potential Downside Of The Critical Care Nursing Profession, Samantha L. Ford

MSN Capstone Projects

Studies show that burnout and fatigue increase healthcare cost and decreases organizational profit due to increased rates of employee turnover, decreased employee satisfaction, a decrease in the quality of care provided to patients, and the development of a toxic work environment. The three principal factors of job-related burnout and fatigue will be addressed within the context of this paper including emotional exhaustion, depersonalization, and personal accomplishment.

Critical care nurses suffer from feeling emotionally depleted to the point they feel as though they can no longer give anymore of themselves to the patients they care for, which is a result of …

Huddle And Safety, Jaelynn Hall Bsn, Rn

MSN Capstone Projects

The purposed evidence-based practice (EBP) project focuses on a nursing intervention (team huddles) to increase safety and reduce inpatient fall rates. Negative outcomes to consider from an inpatient fall are harm and injury to the patient along with increased health care cost for the patient as well as hospital facility. Accrued cost associated with an in-patient injury resulting from a fall is not reimbursed according to the Centers for Medicare and Medicaid Services. The additional cost for hospital-acquired falls is estimated to be $6,694 (95% CI: -$1,277 to $14,665) (Agency for Healthcare Research and Quality, 2017). This was only related …

Critical-Care Pain Observation Tool Benchmark Project, Rachel Lutz

MSN Capstone Projects

Background: Pain in the nonverbal adult patient is often misdiagnosed and undertreated. Patients who are unable to communicate pain does not indicate that pain is not present. With the majority of critical-care patients being hemodynamically unstable leaving pain untreated can have detrimental effects on already unstable hemodynamics thus affecting patient outcomes. Research has indicated that patients who have accurate pain management with appropriate analgesia and minimal sedation can help decrease ventilator days, improve patient’s mobility, and help decrease the rate of delirium and length of stay in the intensive care unit (ICU) (Bourbonnais et al., 2016).

Aim: This benchmark project …

Exploring The Mental Health Needs Of Intensive Care Unit Nurses Facing The Pandemic Of Covid-19, Bushra Salamah

The Eleanor Mann School of Nursing Student Works

Coronavirus disease (COVID-19) has spread domestically and internationally, with approximately 134 billion confirmed cases worldwide and over 2 million deaths attributed to the virus. Frontline healthcare workers are at a substantially higher risk of infection and death due to excessive COVID-19 exposure while also facing mental health challenges. Epidemiological data on the mental health statuses of frontline nurses is still limited. The aim of this study was to examine mental health (burnout, stress, emotional exhaustion, disengagement) and associated factors among Intensive Care Unit (ICU) Nurses who are caring for COVID-19 patients to support and maintain their psychological well-being.

New Graduate Nurses Experiences During Their Transition From Novice To Competent And How Mentorship Post Residency Affect Their Experiences, Kelsey N. Murphy

MSN Capstone Projects

Staffing competent nurses in specialized areas poses a unique challenge to hospitals across the country. Competent and experienced RNs are leaving the bedside for a multitude of reasons including dissatisfaction in workplace environment, retirement, and hospitals are facing a shortage of skilled nurses in acute care (Valdez, 2008). To address this growing concern and meet increasingly complex health care demands, hospitals are relying on nursing schools to produce competent graduate nurses (GNs) (Valdez, 2008). Hospitals recruit and hire GNs for highly specialized roles in acute care areas despite the stressors accompanied with these roles. Clinical educators have the opportunity to …

Increasing New Orienting Emergency Department Nurses' Awareness Of Mass Casualty Incident Emergency Preparedness And Disaster Response Core Competencies To Improve Mass Casualty Incident Response, Christopher C. Deramo Ii

Doctoral Dissertations and Projects

Mass casualty incidents (MCI) impose a substantial threat to healthcare. Despite the increasing frequency of MCIs many healthcare organizations and nursing programs do not adequately prepare nurses to be effective responders during an MCI. This evidence-based practice pilot project was purposed to increase new orienting emergency department nurses’ confidence and ability to effectively respond to an MCI. This project involved implementing an MCI educational program consisting of a disaster nursing framework to educate new orienting emergency department nurses on emergency preparedness and disaster response core competencies. The project leader utilized a quasi-experimental design to collect data pre- and post-intervention utilizing …

Family Behaviors As Unchanging Obstacles In End-Of-Life Care: 16-Year Comparative Data, Renea L. Beckstrand, Jasmine B. Jenkins, Karlen E. Luthy, Janelle L. B. Macintosh

Faculty Publications

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined.

Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time.

Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999.

Results Of the 2000 questionnaires …

Dnp Final Report: Sedation Protocol Compliance For Improved Outcomes In Intensive Care, Sonya M. Grigsby

DNP Final Reports

Background: Current evidence-based practice guidelines show that lighter sedation reduces mechanical ventilator days (MVD) and intensive care (ICU) length of stay (LOS). Guidelines (2018) for the management of pain, agitation, delirium, immobility, and sleep were released to direct appropriate high-quality care to achieve positive outcomes. However, studies demonstrated there were barriers to compliance of these guidelines.

Objective: To improve compliance with an existing evidence-based sedation protocol in an intensive care, and, thereby, improve patient outcomes (MVD and ICU LOS).

Methods: The three-month quality improvement (QI) project evaluated processes leading to compliance with the guideline. First, nurses were surveyed to determine …

Oral Care And Ventilator Associated Pneumonia Prevention, Rachel Baber

MSN Capstone Projects

With rising healthcare costs and increasing demands placed on healthcare workers, it is no wonder that decreasing hospital length of stay for patients is high priority for hospitals today. Hospital acquired infections are one of the culprits keeping so many patients hospitalized. Specifically, in intensive care units (ICU) and intermediate care (IMC) units that care for mechanically ventilated patients, ventilator associated pneumonia secondary to intubation is a complication and cost that is being sought to be avoided. Hospitals have been pro-active to prevent ventilator associated pneumonia from occurring by placing oral care bundles or protocols in place to care for …

A Compilation Of Written Instructional Practice Reflections On The Acue (Association Of College And University Educators) Course In Effective Teaching Practices, Sheryll Go

Q2S Enhancing Pedagogy

This is a compilation of written instructional practice reflections on The ACUE (Association of College and University Educators) Course in Effective Teaching Practices, from January – April 2020. This online course has prepared Nurse Educators like me in gaining a foundation in evidence-based teaching practices that increase student motivation, engagement, and learning. The attached assignment include reflections from completed modules.

Dying Well: Improving End-Of-Life For Those Affected By Life-Limiting Illness, Fawna R. Allen

MSN Capstone Projects

Healthcare at End-of-life (EoL) in the older adult with a life-limiting illness is often crisis-driven, incongruent with patient and family preferences, and futile. Advance care planning (ACP) is an effective means of aligning EoL goals of care to values and preferences. ACP near EoL in the United States healthcare system is frequently under-utilized and fragmented. Without timely communication and education regarding EoL care options patients and their families are susceptible to spending their last days consumed by ineffective and potentially painful treatments. Alignment of goals of care with patient and family preferences has been shown to reduce crisis-driven care and …

Qt Monitoring In The Icu: A Benchmark Project, Jeffrey S. Woodward

MSN Capstone Projects

In adult Intensive Care Unit (ICU) patients, does QT/QTc monitoring compared to no QT/QTc monitoring affect mortality or ventricular tachyarrhythmia rates during their ICU stay? Not monitoring changes in the QT interval can lead to poor outcomes since mortality rates are higher in patients with arrhythmias (Uvelin, Pejakovic, & Mijatovic, 2017). Approximately 300,000 sudden cardiac deaths occur in the United States each year with an estimated 15,000 because of a lethal ventricular tachyarrhythmia rhythm called Torsades de Pointes (TdP) that occurs when a QT interval is prolonged (Dave, Bessette, & Setnik, 2017). Some risk factors for developing prolonged QT intervals …

Controlled Donation After Circulatory Death: Benchmark Study, Marilyn R. Strait

MSN Capstone Projects

Abstract

In potential organ donors after circulatory death (P), does the utilization of an evidence-based critical pathway from identification of potential donor to organ donation (I) versus no utilization of an evidence-based critical pathway (C) increase the rate of organ procurement and the satisfaction of donor families with the donation process (O)? A benchmark study was conducted to answer this question, and in short, yes, it does. The utilization of a critical pathway, when individualized to a local population and hospital’s organization increases the organ procurement rate, the donor family satisfaction with the process, and increases staff satisfaction with the …

Molecular Genetic Cancer Screening: Role Of Prediction Of Colorectal Disease In The Clinic Setting, Samantha Spinks

DNP Research Projects

Colorectal Cancer is the third most common cancer in men and women and the second leading cause of cancer related deaths (ACS, 2019). Colonoscopy screening can prevent colon cancer by early detection and removal of adenomatous colon polyps. The ACS has been lowered from age 50 to 45 due to an increase in the prevalence of colon cancer in people below the age of 50 years of age. Molecular genetic screening is a tool that providers can use to identify patients who are at risk for premature adenomas. People who have a genetic variant are more likely to develop adenomas …

Predictors And Outcomes Of Invasive Mechanical Ventilation, Ailin Puckett

DNP Research Projects

Objective: Invasive mechanical ventilation (IMV) is lifesaving and one of the most common interventions implemented in the intensive care unit (ICU). More than half of the patients in the ICU require IMV within the first 24 hours after ICU admission. This project aimed to evaluate and predict the mortality rate of hospitalized patients on IMV by examining their risk factors, such as patient demographic characteristics, disease status, social environment, and discharge status.

Methods: The National Inpatient Sample (NIS) database 2016 was used to identify patients requiring IMV. Mortality was the dependent variable. Independent variables had four major categories. First, patients’ …

Barriers To Care Among Uninsured Patients With Chronic Disease In A Free Clinic: A Quantitative Study, Stephanie Jinright

DNP Research Projects

No abstract provided.

The Observational Investigation Of Vitamin D And The Effect On Hypertension (Oiveh) Study, Warren Burke

DNP Research Projects

Background

It is uncertain if vitamin D supplementation improves cardiovascular health, more specifically, the systolic and diastolic blood pressures, and the data from previous trials investigating supplementation and the effects on the blood pressure are limited.

Methods

The following scholarly project was a retrospective observational study, examining randomly selected participants with chronic kidney disease and hypertension from a local nephrology practice. The Student’s t-test, Pearson’s r correlation, and ANOVA statistical tests were utilized to determine if vitamin D supplementation improved the systolic and diastolic blood pressures.

Results

A total of 260 participants were examined. The mean systolic blood pressure …

Age And Functional Outcomes Post-Neurologic Insult In Patients Attending Inpatient Rehabilitation, Jonathan Bowman Spt, Elena Crooks Pt, Dpt, Phd, Doug Weeks Phd, Kimberly Honn Phd

2020 Symposium Posters

Introduction

Neurologic insults such as strokes and traumatic brain injuries (TBI) affect over 1 million Americans every year. The lack of current knowledge informing accurate prognoses causes victims and their loved ones distress, and is a focus of much research. The purpose of this study was to determine whether patient age at time of insult could predict change in functional outcomes during inpatient rehabilitation.

Methods

Subjects were patients of an inpatient rehabilitation facility (IRF) post-stroke or TBI. The Functional Independence Measure (FIM) assessed functional independence and cognitive status at admission and discharge from the IRF. The Montebello Rehabilitation Factor Score …