Medicine and Health Sciences Commons^™

Detection And Management Of Post Intensive Care Syndrome, Ann Tomy

Nursing | Student Research Posters

Post Intensive Care Syndrome (PICS) is a collection of symptoms that more than half of patients who survive a critical illness experience after discharge.Those symptoms include weakness, fatigue, sleep disturbances, cognitive dysfunction, post-traumatic stress disorder, mental health conditions, and a lack of effective coping strategies. PICS can significantly impact an individual's quality of life, complicating the recovery process and posing challenges for reintegration into daily activities and societal roles. The etiology of PICS is multifactorial, with the severity and duration of the illness, the nature of medical interventions in the ICU, and the pre-existing health condition of the patient all …

Assessing Lung Cancer Screening Protocols And Outcomes: A Comparative Analysis Between Indonesia And The United States, Priscilla Sitorus

Nursing | Student Research Posters

After losing a loved one to lung cancer, it can be difficult to process, especially when the diagnosis could have been made earlier. However, some may struggle to trust a healthcare system when screening protocols and care vary significantly, to the extent that it may seem unclear. Amongst both men and women, lung cancer is the worldwide leading cause of cancer-related mortality (World Health Organization, 2023), thus further creating a considerable amount of challenges that not only takes part in communities, but the overall healthcare system. Despite the increasing rate of lung cancer, Indonesia has limited screening programs available for …

Post-Discharge Follow-Up Call To Impact Heart Failure Re-Admission Rates, Regina Mitchell

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The clinical setting for this project, a 321-bed southeastern hospital in South Carolina, has an elevated re-admission rate for CHF patients of 22.67% (Ferguson, B. V.P. Quality, personal communication, October 21st, 2022), 1.57% above the Centers for Medicare Services (CMS) benchmark of 21.1% for payment reduction penalties. Purpose: Determine if post-discharge interview phone calls decrease CHF re-admission rates. Methods: A two-group pretest-posttest design will be used. Data will be collected during retrospective unit chart review, weekly chart review of patient participants, and structured post-discharge phone interviews. Inclusion Criteria: English-speaking, adult (>18 years of age) patients with …

Clinical Experiences Of Rn To Bscn Nursing Students In Kenyan Universities, Gladys Mbuthia, Gisela Rensburg Rensburg, Sheila Shaibu

School of Nursing & Midwifery, East Africa

Introduction and objective: Clinical learning environments play a great role in nursing training as they allow nursing students to develop their clinical skills by combining cognitive, psychomotor and affective skills. Consequently, clinical learning environments enable nursing students to bridge the theory-practice gap. Fewer studies have examined the clinical experiences of RN to BScN students in Kenya. This paper is part of analytical memo of a larger PhD study that sought to explore and describe the support needs of RN to BScN students in Kenyan universities. The paper focuses on clinical experiences of RN to BScN students.

Methods: Using a qualitative …

Enhanced Recovery After Surgery (Eras) Protocol For Bariatric Surgery, Krista Bunch

Doctor of Nursing Practice Projects

Bariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). …

Improvement In Patient Compliance For Gynecological Care, Tracee Williams

Doctor of Nursing Practice Projects

This quality improvement project implemented the patient-initiated follow-up (PIFU) pathway in a gynecology clinic setting. PIFU has potential to lead to decreased no-show appointments and increased patient autonomy in outpatient healthcare practices. Barriers that influence compliance with plans of care include lower socioeconomic status, racial and ethnic minorities, and unmet social needs such as food insecurity, healthcare travel and cost, and child/adult care needs. In addition to higher rates of no-show appointments, individuals facing these barriers have increased comorbidities. Prior to implementing the PIFU model, patients between the ages of 18 and 42 completed a patient satisfaction survey to better …

Anesthesia Management For The Preeclampsia Or Hypertensive Parturient, Britanie Sumpter

Doctor of Nursing Practice Projects

Preeclampsia is a placental disease characterized by abnormal maternoplacental blood vessels and placental dysfunction resulting in fetoplacental hypoperfusion and maternal multi-system organ dysfunction (Wang et al., 2019). Expectant management of a hypertensive or preeclamptic parturient includes antihypertensive medications, magnesium sulfate for seizure prophylaxis, and early delivery of the fetus (ACOG, 2020). Neuraxial anesthetic-induced sympathectomy combined with circulating antihypertensives, magnesium sulfate therapy, and intravascular volume depletion in preeclampsia is thought to contribute to exaggerated hypotension.

Persistent refractory hypotension after neuraxial anesthesia in parturients with preeclampsia or hypertension has been an ongoing issue affecting obstetric providers at the host facility. This project …

Integrating Psychotherapy In A Psychiatric Outpatient Clinic, Ayesha Baluch

Doctor of Nursing Practice Projects

Mental illness is common in the United States, affecting millions of people. Although there are effective medications for mental illness, psychotherapy in addition to pharmacotherapy provides the best outcomes. This project aimed to improve providers' psychotherapy screening and education of patients about psychotherapy utilization. A pre-implementation survey was conducted to evaluate psychotherapy screening and the barriers faced by providers to utilize psychotherapy screening. An education session was provided to the providers about the importance of psychotherapy screening and education. Data showed that the providers discussed psychotherapy with eight patients (40%) and educated four patients (20%) pre-implementation. Data showed that the …

Nurses' Experience Implementating Weighted Blankets In Inpatient Psychiatric Unit, Michael Ragen

Doctor of Nursing Practice Projects

The complexity of treating sleep difficulties in patients with concurrent psychiatric disorders continues to be a struggle for the medical community. The mechanism that causes psychiatric disorders can induce insomnia or hypersomnia (Khurshid, 2018). There is also a growing interest in disturbed sleep ability to induce psychiatric episodes (Verkhratsky et al., 2020). This classic “Chicken or Egg Scenario” meets the modern focus on creating the best outcome for patients with the least medication, spurring interest in the holistic management of sleep disorders. The literature has little information on the use of weighted modalities for sleep management and anxiety in an …

Lung Cancer Screening In A Primary Care Clinic For Coal Mine, Glenda Mills, Sarah Cobb

Doctor of Nursing Practice Projects

Lung cancer is the leading cause of mortality for both men and women in the United States. Guidelines are set by the American Cancer Society for annual screenings of at-risk patients. Early identification of lung cancer risk and screening with low-dose CT scans can increase detection and treatment thereby reducing risk of death or disability. Coal miners are exposed to numerous cancer-causing agents, such as toxic chemicals, dust pollution from coal, and diesel exhaust fumes. However, primary care clinics serving coal miners lack lung cancer screenings despite the increased risk miners face. Patients were screened using criteria set forth by …

Healthcare Professional Awareness Of Climate Health And An Evidence-Based Environmental Stewardship Framework, Patricia Joubert, Rosemary Timmerman, Angie Shemwell, Barbara Ngyuen, Teresa Rangel

Articles, Abstracts, and Reports

No abstract provided.

Primary Care Organizational Readiness And Implementation Climate For Task Sharing Of Tele-Mental Health Interventions, Frances Chu, Brenna Renn, Erin Abu-Rish Blakeney, Sean Munson, Oleg Zaslavsky

Articles, Abstracts, and Reports

Primary Care Organizational Readiness and Implementation Climate for Task Sharing of Tele-Mental Health Interventions

Chu, F.; Renn, B.; Blakeney, E.; Munson, S.; Zaskavsky, O. Providence Swedish/University of Washington, Seattle, WA

Purpose: To examine perceptions of organizational readiness and implementation climate for task sharing of telemental health (TMH) interventions from primary care healthcare professionals by levels of behavioral health integration (BHI) and roles. Background/Significance: BHI clinics have positive impact on patient outcomes. Task sharing, a strategy used to address shortages of behavioral/mental health (BMH) specialists, with TMH interventions adds complexity. Method: The mixed methods study surveyed 151 healthcare professionals with Organizational …

Learning Circles: Promoting Inclusive Care Starting In The Classroom, April Graham, Kindsey Gattman, Tobias Johnson

Articles, Abstracts, and Reports

No abstract provided.

Developing A Health Equity-Minded Curriculum: The Impacts Of Cancer Care, Leanna Ross, Camille Ashley, Julianne Luttrell, Krismae Jimenez

Articles, Abstracts, and Reports

No abstract provided.

Perceived Moral Distress Among Patient-Facing Healthcare Professionals During The Covid-19 Pandemic, Sarah Sumner, Karen Colorafi, Teresa Rangel

Articles, Abstracts, and Reports

No abstract provided.

Improving Depression Screening In Primary Care, Grace Wilson, Annmarie O'Connor

Doctor of Nursing Practice Projects

Depression remains an increasingly prevalent and underdiagnosed disorder affecting approximately 21 million adults in the United States with only 66% seeking treatment (NIMH, 2022). Untreated depression can lead to worsening mental and physical health which negatively impacts a person’s quality of life. The implementation of routine depression screening in primary care is recommended by the US Preventive Services Task Force (USPSTF) to improve early detection leading to improved outcomes (USPSTF, 2023). Despite increased depression prevalence and USPSTF recommendation, there remained an absence of routine depression screening in a primary care practice in Midwest Illinois which led to the development of …

Implementing Distress Screening And Hospital Management Of Oncology Patients With Distress, Rhezarie Mae Agtarap

Doctor of Nursing Practice Projects

Of the nearly 2 million new cancer cases projected to occur in the United States in 2022, up to 65% of patients may be hospitalized in the first year of their diagnosis. Hospitalized oncology patients have been documented to experience psychological distress during their hospitalization related to physical and emotional challenges related to their disease. In ***, a tertiary hospital located in ***, Oregon, hospitalized cancer patients with hematologic malignancies and aggressive or advanced solid cancers have verbalized distress, including depression, anxiety, feelings of isolation, and fatigue during prolonged hospital stays. According to the National Comprehensive Cancer Network (NCCN), distress …

Diversity, Equity, & Inclusion In Nurse Anesthesia: Bridging The Gap, Aminat Yusuff-Akinbo

Doctor of Nursing Practice Projects

The nurse anesthetist plays a crucial role in the healthcare system. Through intensive training, they provide safe and effective anesthesia care to patients across various healthcare settings. Currently, the nurse anesthesia field lacks diversity, with underrepresentation of minority groups such as Black, Hispanic, and Indigenous individuals. The United States Census revealed that there are more than 325 million residents. Yet only 10.9% of nurse anesthetists are of diverse racial backgrounds. This lack of diversity limits the cultural perspectives and experiences brought to patient care and perpetuates disparities in healthcare outcomes. An increase in diversity can improve care for individuals and …

Establishing Routine Multiple Micronutrient Supplementation During Pregnancy In An Impoverished Guatemalan Community, Marissa Schuette, Erin Brueggemann

Doctor of Nursing Practice Projects

Pregnant and breastfeeding women in impoverished settings face heightened nutritional demands, placing them and their children at increased risk of inadequate nutrition's detrimental effects. Existing literature suggests that supplementing with multiple micronutrients (MMS) may offer superior protection against morbidity and mortality compared to traditional iron and folic acid (IFA) formulations. This research is set in the Land of Hope (LOH) clinic, located in Escuintla, Guatemala, a community served by the non-profit organization ER Abroad. The study aims to assess the feasibility of standardizing MMS provision to pregnant women at LOH, coupled with supplementary education on pregnancy and nutrition. The team …

Shivering In Postpartum Women: Development Of A Perioperative Protocol For Women Undergoing Cesarean Section, Lindsay Dawson, Kara Peters

Doctor of Nursing Practice Projects

In obstetric patients undergoing a cesarean section, a spinal anesthetic is the most common form of anesthesia (Hannallah, 2016). An intrathecal (or spinal) block is not benign. Postpartum shivering is a potential risk with any neuraxial procedure, with an incidence of 40-80% specifically following a spinal anesthetic (Feng et al., 2021). Patients who experience shivering are at a greater risk for postoperative complications, impaired mother-newborn bonding, and decreased patient satisfaction. Both nonpharmacological and pharmacological treatment options exist for prevention and treatment of postpartum shivering. The objective of this project was to introduce a standardized, evidence-based protocol to decrease the incidence …

Recommendations For Sugammadex Administration In Standard And Special Populations, Kristen E. Mattson, Alexa Brummund

Doctor of Nursing Practice Projects

The purpose of this project was to collect evidence-based information regarding sugammadex administration in both standard and selected special populations. Special populations included renal failure, breastfeeding, pregnancy, and pediatrics. The objectives of the project were to collect and present current research to the host facility, define barriers to the use of sugammadex, and assess the participants’ knowledge of sugammadex use in special populations. A guideline for sugammdex administration was created and presented to the host facility through a poster presentation and quick reference guide. A voluntary post-implementation survey was implemented, and the results were recorded, analyzed, and displayed in the …

The Effect Of A Positive Work Culture In Emergency Service Nurses: An Ebp Proposal, Brianna M. Fitzgerald

MSN Capstone Projects

This paper aims to address the spirit of inquiry of the effect a safe work environment has on compassion fatigue in nurses in the emergency department (ED). The World Health Organization promotes an eager approach to the battle of compassion fatigue in frontline healthcare workers, stating, "Unless this is addressed, it will further add to the global nursing workforce shortage." (Stafford et al., 2022, p. 1853). Unfortunately, 69% of nurses under the age of 25 report burnout from working conditions (American Nurses Association, 2022). Improving nurses' job satisfaction and motivation levels is necessary to increase the effectiveness of nursing services …

Improving Emergency Department Nurses Communication Self-Efficacy With Underrepresented Populations Through Cultural Humility Training, Nikki L. Graham

Doctor of Nursing Practice Projects

Problem Description: The chasm of health inequality for underrepresented populations in the United States is growing, despite advances in healthcare and increased life expectancy. Disparities span the age and healthcare continuum for underrepresented populations, with increased mortality and morbidity rates in nearly every category. Non-white residents in Cook County face the same challenges. Historical lack of trust creates a reluctance to seek healthcare among Black populations, but when they do, they are disproportionately dissatisfied with their care, receive less aggressive treatment, and report higher levels of uncontrolled pain. Nurses, as the largest body of healthcare professionals, are uniquely positioned …

Optimizing Digital Proficiency To Improve Perceived Self-Efficacy In Telehealth Nurses, Serena Young

Doctor of Nursing Practice Projects

The use of telehealth to provide care management services has increased as healthcare continues to evolve. Seven million Americans were predicted to use telehealth in 2020, which increased to over 35 million through the pandemic. These services have been shown to decrease healthcare disparities and promote positive health outcomes. Education and training for nurses providing telehealth services have not kept up with the increased demand. Nurses providing care management telehealth services in a large tertiary health system have low perceived self-efficacy for technology. Leaders in the organization believe this is causing a lack of digital proficiency in their workforce. This …

A Quality Improvement Project To Promote Awareness And Knowledge Of Nutrition As An Adjunctive Treatment Option For Chronic Insomnia, Sara J. Weelborg

Doctor of Nursing Practice Projects

Background

Insomnia is difficult to treat resulting in adverse outcomes. Traditional treatments are not always safe or accessible. Evidence, not readily available to providers, supports the adjunctive use of nutrition to ease symptoms.

Problem

Literature recommends the Mediterranean Diet for insomnia. A nutrition education module for psychiatric nurse practitioners (n=4) was created by a multidisciplinary committee to increase knowledge and comfort. Pre-post Likert-scale tool, multiple choice test, and interview questions were used to measure educational benefits.

Outcomes

All participants demonstrated knowledge acquisition (range 11% to 100%), increased intention to use information (range 9% to 43%), and positive feedback about nutrition …

A Pilot Project To Improve The Well-Being Of Inpatient Nurse Managers At An Academic Medical Center Through A Mindfulness-Based Intervention, Nancy Wiederhold

Doctor of Nursing Practice Projects

Purpose: To decrease inpatient nurse managers' burnout, stress, and compassion fatigue through attendance at a mindful, self-compassion intensive program.

Background/Significance: Nurse leaders and managers are indispensable pillars of the healthcare team, carrying the responsibility of shaping organizational success and ensuring quality patient care. Unfortunately, the current landscape of nursing leadership is clouded by sentiments of powerlessness, hopelessness, and guilt.

Description: Recognizing the practical challenges faced by nurse managers, a targeted intervention was implemented – a four-week, in-person mindfulness-based, self-compassion program. This initiative aimed to equip them with the tools to mitigate stress, burnout, and compassion fatigue. Led by a trained …

Implementation Of An Advanced Practice Provider Fellowship To Improve Transition To Practice, Breanne Hosford

Doctor of Nursing Practice Projects

Problem

Retention of advanced practice providers (APPs) is needed for ongoing high quality comprehensive care. Administrators at a large urban pediatric institute in the Midwest identified turnover and retention as an issue for APPs in the first one to two years of service. Even in years when turnover rates were not as high, the greatest number of APPs leaving the institution where those in their first five years of tenure. Without strategies aimed at improving transition to practice, new hire APPs will continue to be unprepared for their new role, therefore endangering job satisfaction, leading to continued turnover, and threatening …

A Patient Centered Quality Improvement Education Program Designed To Improve The Health Of Patients Living With Uncontrolled Hypertension In A Primary Care Setting, Alia Jamison-Dinowitz

Doctor of Nursing Practice Projects

Cardiovascular disease is the leading cause of death in the United States and it negatively contributes to poor health outcomes (Martinez-Garcia et al., 2018). Within the Antelope Valley in Lancaster California, 30.3 % of city residents have a hypertension diagnosis (Los Angeles County of Public Health, 2017). Much like the city at large, hypertension is a critical issue at AV Pediatrics and Family Medicine (AV Peds). This issue is driven by a variety of factors including a lack of understanding about hypertension and medication compliance, and a lack of understanding about healthy lifestyle choices. Providers at AV Peds have seen …

Situation Awareness Preparation And Prebriefing: Fostering The Cognitve Processes Of Thinking Like A Nurse In Simulation, Amanda Lynn Potter

Dissertations (1934 -)

Situation awareness (SA) is linked with actionable decision-making and clinical judgment in nursing practice. The cognitive processes used in developing SA, outlined in Endsley’s (1995) model, is the framework underpinning this study and are interwoven into the National Council of State Boards of Nursing Clinical Judgment Measurement Model (NCJMM). Cultivating these cognitive processes through prebriefing and simulation designed to intentionally develop SA, is a recommended practice currently seen in aviation and military training. There is a lack of vigorous research testing whether a specific intervention during clinical simulation can develop SA in nursing students. In addition, fostering SA in the …

I Changed My Mind After My Placement: The Influence Of Clinical Placement Environment On Career Choices Of Final-Year Pre-Registration Nurses, Edah Anyango, Irene I.Ngune@Ecu.Edu.Au Ngune, Janie Brown, Esther Adama

Research outputs 2022 to 2026

Background: Clinical placements (CPs) in the final year of nursing education largely impact nursing students’ professional development by exposing them to nursing realities. Nursing students also use placement exposure to identify suitable career opportunities for their upcoming professional life. However, there is limited evidence on how final-year CPs may attract pre-registration nursing students into different nursing specialties, including hospital and non-hospital settings. Aim: To explore the influence of CPs in the final year of nursing education on pre-registration student nurses’ career decisions. Method: A narrative inquiry approach was utilised. A purposeful sample of 12 final-year students from two Western Australian …