Medicine and Health Sciences Commons^™

Bedside Handoff In The Emergency Department, Sheila Pochron

MSN Capstone Projects

Background

A standardized approach to bedside handoff improves nurse and patient satisfaction as well as quality outcomes.

Objectives

To compare the preference for bedside handoff in the emergency department post implementation by analyzing nursing surveys and Press Ganey data.

Design

A mixed method pilot study.

Settings

A not-for-profit community-based safety net hospital which is Magnet designated. ED is a level 3 trauma center with 60,000 visits annually.

Participants

ED nurses (n=52) and adult patients (n=86)

Methods

A pre and post implementation survey that utilized the 5-point Likert scale was given to nursing staff in the emergency department. Questions were asked …

Deterring Delirium In The Intensive Care Unit, Kimberly Allen

MSN Capstone Projects

There is growing concern about the increase in cases of delirium associated with a critical care hospitalization encounter. Discovery of different types of research that can eliminate or at least minimize occurrences of delirium including early recognition, eye masks and earplug usage, and environmental changes have show promise in reducing the risk of ICU delirium.

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Burnout Among Intensive Care Nurses, Julia Brown

MSN Capstone Projects

At a time when the healthcare system is experiencing strain due to the current health crisis and nursing shortages, talking about, and addressing nursing mental health is of the utmost importance. Nurses who work in the pediatric intensive care unit (PICU) often face more stress due to the patient population they work with. These stresses can lead to burnout and moral distress if not addressed appropriately. Nurses should have a system in place at their workplace and tools readily available to support their mental health while on the job. Through a literature search, it is proposed that an initiation of …

Impact Of Central Line Bundle Care On Reduction Of Central Line Associated-Infections: A Scoping Review, Alisha James-Scott Msn, Fnp-C, Rachel Savoy Msn, Fnp-Bc, Donna Lynch-Smith Dnp, Acnp-Bc, Apn, Ne-Bc, Cnl, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Apn

Doctor of Nursing Practice Projects

Purpose/Background Central venous catheters (CVC) are typical for critically ill patients in the intensive care unit (ICU). Due to the invasiveness of this procedure, there is a high risk for central line-associated bloodstream infection (CLABSI). These infections have been known to increase mortality and morbidity, medical costs, and reduce hospital reimbursements. Evidenced-based interventions were grouped to assemble a central line bundle to decrease the number of CLABSIs and improve patient outcomes. This scoping review will evaluate the literature and examine the association between reduced CLABSI rates and central line bundle care implementation or current use.

Methods A literature review was …

Reducing Burnout Through Guaranteed Breaks In Nurses In The Acute Care Setting: A Benchmark Study, Stefan D. Arias

MSN Capstone Projects

This benchmark study attempts to promulgate the issue of burnout and the importance of addressing at least one way to mitigate further damage to the profession of nursing.

The Need For A Sepsis Screening Tool In An Outpatient Facility, Michael C. Ciccarone

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Sepsis is an exaggerated inflammatory response generated by the immune system secondary to the presence of septicemia, or pathogens within the bloodstream. An average of 270,000 individuals die from sepsis each year, while a total of 1.7 million cases occur annually. Research has shown that the early identification of sepsis prior to hospital admission is associated with decreased lengths of stay, hospital-associated costs, and overall mortality. To demonstrate this research, 26 healthcare staff members in an outpatient clinic were provided with a pre-survey, qSOFA sepsis screening tool, and a post survey to determine if these materials
increased participant confidence when …

Implementation Of A National Telestroke Program: A Unit-Based Staff Education Inititative, Leigh Ann Raymond

Master of Science in Nursing Scholarly Project

Abstract

A national telestroke program (NTSP) was implemented at a medical center in the latter half of 2020. Following two inpatient strokes, it was discovered that only 67 members of the 370-member inpatient nursing staff had been assigned the required online learning modules. A unit-based nursing educational initiative was developed utilizing available online learning modules to address the gaps in knowledge in recognizing acute stroke signs, symptoms and providing timely care. The educational initiative, however, supplemented and complimented the online learning modules by incorporating an in-person poster presentation on inpatient strokes that included a small group discussion of an inpatient …

Nursing Assignment: Understanding Covid-19 Vaccines: Specific Strategies To Encourage And Educate Your Patients, Regina G. Lama

Open Educational Resources

Understanding Covid-19 Vaccines: Specific Strategies to Encourage and Educate Your Patients

This assignment focuses on the difference in Covid-19 vaccinations. The nursing student will discuss the different vaccinations and form a teaching plan for the patient in order to encourage the vaccination process. The student will then explore the patients expectations concerning vaccination.

As a presentation the students will be able to evaluate, share and reflect on teaching method.

Education To Prevent Psychological Distress In Icu Patients, Casey Robinson

Master of Science in Nursing Scholarly Project

Admission to an intensive care unit can become a traumatic event for some patients and can cause them to experience psychological distress. Psychological distress is when patients experience anxiety, depression or post-traumatic stress disorder related to ICU admission. With the introduction of the COVID-19 pandemic, this psychological distress has become more of a problem with patients and current nursing practices are falling short in providing quality psychological care. Surgery ICU nurses at the University of Cincinnati Medical Center were given a pre-test on preventing psychological distress in ICU patients to facilitate practice change. A short educational offering was provided to …

Workplace Violence Interventions: A Benchmark Project, Madison Orwosky

MSN Capstone Projects

Workplace violence incidence rates are increasing in the medical field. The staff in the emergency department (ED) is especially prone to these workplace violence events due to patients arriving in such unpredictable states. Alarmingly, most medical staff members report experiencing some type of workplace violence, whether that is verbal, physical, or sexual violence. The former director of the Parkland ED sent out a survey to the ED staff regarding workplace violence. Out of 145 participants that completed this survey, 121 participants reported that they had personally experienced a workplace violence event. This survey data illuminates that a change is warranted …

Effects Of Palliative Care On Nurses’ Knowledge And Attitudes, Daniel Kerr

MSN Capstone Projects

Heart failure (HF) is a chronic, progressive disease that affects 6 million Americans (Ng & Wong, 2017). During the course of the disease, patients have worsening symptoms and need increasing levels of care from both medical staff and home caregivers. Often, these caregivers are family members or friends who spend a significant amount of their free time assisting the patient, leading to significant stress and burden on the caregivers. Recent changes in recommendations from the American Heart Association (AHA) include Palliative Care (PC) consultation for patients diagnosed with advanced stage heart failure, but many physicians have not included a PC …

Implementation Of A Postdischarge Virtual Visit And Nurse Follow-Up Protocol To Decrease 30-Day Readmission Rates For Patients With Pulmonary Arterial Hypertension, Kimberly Thompson

The Eleanor Mann School of Nursing Student Works

Pulmonary arterial hypertension (PAH) is a rare, chronic disease with no cure. Patients with this disease have high mortality and morbidity, experience frequent hospitalizations, readmissions, and psychosocial burdens, and require a high degree of self-care management skills (Doyle-Cox et al., 2016; Lattimer et al., 2016; McDevitt & Walter, 2019). More than half of PAH patients are hospitalized within the first year following diagnosis, and about 20% are readmitted to the hospital within thirty days of discharge (Bhattacharya et al., 2019: Tonelli, 2020). These patients also have a high symptom burden, and these symptoms significantly affect their physical and mental quality …

The Lost “Doe”: A Quality Improvement Project For Unidentified Patients, Brendi Gale

The Eleanor Mann School of Nursing Student Works

A Mass Casualty Incident (MCI) describes any natural or manmade disaster that stresses a community beyond their normal resources (CMS, 2019). Across the globe, populations have grappled with an increased frequency of natural disasters and a surge of critically ill secondary to pandemic SARs-CoV-2 (Cavallo, Donoho, & Forman, 2020; Smith, 2020; US Global Change Research Program, 2018). In addition, the incidence and severity of mass shootings has risen in the United States with a reported 277 active shooter events between the years of 2000-2018 (Federal Bureau of Investigation, 2018; Smith et al., 2019). An Emergency Department (ED) in Northwest Arkansas …

Improving Sepsis Bundle Compliance In The Emergency Department, Meredith Burkhart

The Eleanor Mann School of Nursing Student Works

Sepsis is one of the leading causes of death in hospitals across the nation. It is also the costliest condition a patient can be admitted to the hospital for. This proposal discussed the significance of sepsis in the local, national, and international level. It also covered the SEP-1 guidelines given by the Centers for Medicare and Medicaid. Prior to project implementation, the clinical site had at least one sepsis bundle fall out every month, meaning that a portion of the SEP-1 guideline was not met. This project introduced an alert system for the emergency department to respond to patients with …

The Efficacy Of A Communication Guide On Stress Experienced By Family Members Of Patients Admitted In The Intensive Care Unit With Covid-19, Kandace Williams

The Eleanor Mann School of Nursing Student Works

Coronavirus disease (COVID-19), first introduced in the United States on January 20, 2020, has created worldwide panic due insufficient research and understanding of the nature of this new disease. Patients suffering from COVID-19 often require intensive care unit (ICU) admissions, resulting in stress and confusion amongst patients and their families. The high transmissibility of the disease has caused hospitals to adopt firm visitor restrictions to protect the public from exposure and spread. Families experience increased anxiety and stress due to ineffective communication with staff and restricted access to their hospitalized loved ones. A needs assessment revealed a gap in care …

The Effects Of A Survivorship Care Plan On Hospital Readmission Rates In Allogenic Stem Cell Transplant Patients, Chantaney Williams

The Eleanor Mann School of Nursing Student Works

Stem cell transplants (SCTs) are complicated treatments utilized to treat hematologic malignancies and other disorders, such as multiple myeloma, non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, acute myeloid leukemia, neuroblastomas, germ cell tumors, amyloidosis, and autoimmune disorders such as systemic lupus erythematosus and systemic sclerosis. The complex care of patients undergoing SCTs place them at high risk for adverse outcomes, including infection, cytomegalovirus, graft vs host disease, secondary new cancers, infertility, and sexual dysfunction (American Cancer Society, 2020). Survivorship care plans (SCPs) are a vital part of the discharge process to educate allogenic SCT patients about post-transplantation care. SCPs are implemented to reduce …

Improving The Nurse Patient Assignment Process On A Medical Surgical Unit, Kevin K. Mcewan

Doctor of Nursing Practice Projects

Background: Nurse patient assignments on an adult medical surgical unit at a community hospital are often accomplished with inconsistent processes and rationales. Each charge nurse utilizes individualized processes to determine which patients will be best teamed-up and assigned to the available nurses. There are frequently no acuity measurements system or set criteria by which the number or types of patients can or should be assigned to any given nurse, nor are staff skill or competency considered in the assignment process.

Project Design: A pilot project was conducted on a medical/surgical unit. The project utilized the American Association of Critical Care …

Implementation Of Same Day Discharge Following Elective Percutaneous Coronary Intervention, Kaitlyn Miller Jeffcoat

The Eleanor Mann School of Nursing Student Works

High rates of Cardiovascular disease (CVD) and ischemic heart disease (IHD) have led to ever-increasing numbers of percutaneous coronary interventions (PCI) performed. The prevalence of IHD and subsequent PCI has been found to limit bed availability and access to cardiovascular care. Historically, the standard of care following elective PCI has included overnight observation (OO) though clinical advances to PCI procedures have made it possible for same day discharge (SDD) following elective PCI. There are many benefits of SDD following elective PCI that include increased access to cardiovascular care, hospital cost savings, and patient satisfaction without compromising patient safety. The DNP …

Nursing Fatigue In Intensive Care Units: A Clinical Inquiry, Elizabeth A. Gambill

The Eleanor Mann School of Nursing Student Works

Registered Nurses (RN) working in Intensive Care Units (ICU) report increased physical and emotional fatigue from a combination of various environmental factors. Fatigue is suspected as contributing to low retention rates of ICU RNs. A meeting was arranged with an ICU nursing director in an acute care facility in Northern Arkansas revealing the need for a clinical inquiry into the prevalence of fatigue. A review of literature further analyzed the impact of fatigue, management practices, safety culture in the workplace, the Occupational Fatigue/Exhaustion and Recovery (OFER) scale, the Copenhagen Burnout Inventory (CBI), and the Moral Distress Scale- Revised (MDS-R). The …

Implementation Of Telephone-Based Medication Adherence Conferences To Improve Health Outcomes Of Heart Failure Patients, Diana Marie Broadway

The Eleanor Mann School of Nursing Student Works

Cardiovascular disease (CVD) has been a significant health problem worldwide and is the leading cause of death globally. Heart failure (HF) is a chronic progressive form of CVD that affects millions of adults in the United States. The treatment for heart failure is very complex and requires an ongoing regimen of medications. In heart failure, many patients report nonadherence to their medication regimens, which leads to a magnitude of preventable deaths annually. With frequent medication nonadherence of the HF patients, there must be an intervention used to combat this problem. The use of telephone-based interventions (TBI) can modify nonadherent medication-taking …

Generating Evidence Of Critical Care Nurses' Perceptions, Knowledge, Beliefs, And Use Of Music Therapy, Aromatherapy, And Guided Imagery, Annie Heiderscheit, Shawna Vernisie, Wendy L. Magee, Helen Shoemark

Faculty Authored Articles

No abstract provided.

Atrial Fibrillation In Covid-19: A Descriptive Study Of Incidence, Mortality And Related Factors, Diana L. Taylor

DNP Research Projects

Abstract

This scholarly project determined the relationship of atrial fibrillation (AF) occurrences in COVID-19, as it is the most frequent arrhythmia in the U.S. and is driven by inflammatory pathology. In COVID-19 positive patients with AF occurrences understanding the relationship between these conditions could help identify patients with poor prognosis, higher morality, and other factors earlier in the hospital course.

This single-center scholarly project was a retrospective descriptive chart review to determine the relationship between AF and COVID-19 over a 6-month timeline in Chattanooga, TN. Of the 565 hospitalized COVID-19 positive patients included, 82 (14.5%) had AF occurrences. A higher …

Lyme Disease Essentials For Healthcare Workers, Donita Blanken-Little

DNP Research Projects

No abstract provided.

Elearning Module For Nursing Students To Improve Delirium Identification, Prevention, And Management, Shannon Baker

Doctor of Nursing Practice (DNP) Projects

Background and Review of Literature: Delirium is a serious, acute alteration in cognition and consciousness, which is common amongst older hospitalized patients and has an overwhelmingly negative impact on patient outcomes. Under-recognition by healthcare providers poses a barrier and contributes to poor patient outcomes, including increased morbidity and mortality.

Purpose: To reduce the incidence of delirium amongst acutely ill patients via internet-based education for student nurses on delirium prevention, assessment, and management.

Methods: An eLearning intervention consisting of a virtual lecture with an unfolding case study for undergraduate nursing students. This project utilized the Nurses’ Delirium Knowledge Assessment (NDKA) …

A Lesson Involving Nursing Management Of Diabetes Care: Incorporating Simulation In Didactic Instruction To Prepare Students For Entry-Level Practice, Elizabeth Moxley, Larry Maturin Jr., Desale Habtzghi

Faculty Peer-Reviewed Publications

Background: Diabetes is a global health problem requiring nursing students demonstrate a thorough understanding for NCLEX^® and entry-level practice, although clinical opportunities are increasingly limited, especially for Associate Degree Programs.

Method: A Simulation-based Education was incorporated in a didactic lesson to improve diabetes nursing care. Knowledge, confidence, application and relevance were measured using Wilcoxon signed-rank, Chi-square and Kruskal-Wallis analyses.

Results: Student (n=46, 85% female) perceived knowledge of glycemic management (post > pre, p < 0.0001), confidence administering insulin (post > pre, p < 0.0001), and clinical relevance improved. Confidence increased among three cohorts per Kruskal Wallis H test (² = 7.76, p = 0.021). Increased confidence correlated with relevance (² = 30.965, p = 0.009) and prior understanding of therapy ( …