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Articles 31 - 60 of 485
Full-Text Articles in Medicine and Health Sciences
Combating Compassion Fatigue In The Emergency Department, Pam Packard
Combating Compassion Fatigue In The Emergency Department, Pam Packard
Doctor of Nursing Practice Projects
Combating compassion fatigue in the emergency department is vital to nurses’ well-being. Compassion fatigue is the result of negative physical, emotional, and spiritual strains that often burden nurses. The weight of compassion fatigue is explored throughout this conceptualization of Combating Compassion Fatigue. Two questions were explored: Does compassion fatigue affect compassion satisfaction? If so, is compassion fatigue a precursor to suboptimal compassion satisfaction?
Improving Intravenous Catheter Insertion Success In Difficult Access Patients, Heidi Berry
Improving Intravenous Catheter Insertion Success In Difficult Access Patients, Heidi Berry
Doctor of Nursing Practice Projects
Around one in every nine Emergency Department (ED) patients have Difficult Intravenous Access (DIVA) and 25% of ED patients will require more than one attempt (Fields et al., 2014a). Failed insertion attempts contribute to decreased patient satisfaction, care delays, and financial losses. The freestanding ED affiliated with a multi-state, not-for-profit healthcare system in an urban community had difficulty with first-attempt Peripheral IV (PIV) insertion success in identified patients. The target population was the clinical staff of the freestanding ED which included Registered Nurses and Paramedics. The objective outcome was to enhance personal knowledge of PIV catheter insertion in difficult-access patients …
The Impact Of Palliative Care Education On Acute Care Nurses, Heather Sadler
The Impact Of Palliative Care Education On Acute Care Nurses, Heather Sadler
Doctor of Nursing Practice Projects
The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to improve acute care nurses’ knowledge of evidence-based palliative care interventions utilizing the framework from the End-of-Life Nursing Education Consortium (ELNEC) training modules. Increasing the knowledge, comfort, and competence of acute care nurses has the potential to improve end-of-life care delivery in the acute care setting. A lack of access to specialized inpatient palliative care service teams was identified in a rural county in the Southeastern United States. This county is served by a small, criticalaccess hospital. The frontline nursing staff of this facility regularly provides end-of-life …
Connecting Simulation-Based Learning And Quality Improvement Among Student Nurses To Prevent Catheter-Associated Urinary Tract Infections, Jason Defreitas
Connecting Simulation-Based Learning And Quality Improvement Among Student Nurses To Prevent Catheter-Associated Urinary Tract Infections, Jason Defreitas
Doctor of Nursing Practice Projects
Hospital Acquired Infections (HAIs) are a form of infection a patient acquired during hospitalization. Whether through the application or implementation of medical devices, performing bedside procedures, or non-adherence to following aseptic techniques, healthcare providers are responsible to ensure patients remain safe throughout the course of their inpatient treatment. Over the past 2 years, the Centers for Disease Control and Prevention (CDC), has reported HAIs, specifically catheter-associated urinary tract infections (CAUTI) have increased above pre-pandemic reported cases (CDC, 2021). These types of infections can lead to many factors that affect the patient and their family such as, “increased length of stay …
Advanced Practice Registered Nurses And Healthcare Disparities: Understanding The Impact Of Implicit Bias, Marla Lepley-Starr
Advanced Practice Registered Nurses And Healthcare Disparities: Understanding The Impact Of Implicit Bias, Marla Lepley-Starr
Doctor of Nursing Practice Projects
Introduction: Disparities in healthcare have long been a challenge for physicians, advanced practice providers, nurses, and other interdisciplinary team members. More recently, population health-focused efforts have been implemented to manage everincreasing rates of diabetes, hypertension, and obesity, as well as lack of transportation, limited access to care, and poverty (North Carolina Department of Health and Human Services [NCDHHS], 2019). Racism, sexism, ageism, sizeism, etc., are present in the healthcare setting and manifests in implicit bias during care delivery. This can manifest as beliefs, behaviors/practices, and emotions of the provider (Paradies et al., 2014). Research is limited related to the …
Self-Advocacy Training To Support Self-Confidence In Transition To Practice, Debora Shingleton Allder
Self-Advocacy Training To Support Self-Confidence In Transition To Practice, Debora Shingleton Allder
Doctor of Nursing Practice Projects
Background: The crisis in the competency of newly licensed graduate nurses continues to grow despite the efforts of nursing academia. Transition to practice programs has improved new graduate attrition and narrowed the gap of practice readiness, but much of the responsibility to train graduate nurses falls on nurse preceptors. Many of these preceptors have minimal nursing experience and little to no training in fostering clinical judgment. Furthermore, nurse preceptors must balance providing care for their clients while also guiding novice nurses. They often do not have the time to provide the emotional support, real-time reflection, and timely feedback required to …
Using Unfolding Case Studies To Develop Critical Thinking In First-Semester Nursing Students, Carol Cook
Using Unfolding Case Studies To Develop Critical Thinking In First-Semester Nursing Students, Carol Cook
Doctor of Nursing Practice Projects
There is a crisis in competency among new nurses in the United States. Prelicensure nursing education prepares them to pass the NCLEX-RN, but it does not provide the necessary foundation for sound clinical decision-making. Mistakes in the clinical setting can lead to failure to rescue, resulting in the third leading cause of death: medical error. A radical change is needed to prepare nurses with the clinical judgment skills necessary for patient care. Educators must be mindful of the academic-practice gap and adopt evidence-based improvements, including active learning with unfolding case studies. This quality improvement project involved a four-part unfolding case …
Improving Handoff Communication In The Emergency Department, Amy Shepherd
Improving Handoff Communication In The Emergency Department, Amy Shepherd
Doctor of Nursing Practice Projects
Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …
Combating The Sedentary Lifestyle In A Rural North Carolina Community, Kelsey Toliver Watts
Combating The Sedentary Lifestyle In A Rural North Carolina Community, Kelsey Toliver Watts
Doctor of Nursing Practice Projects
A rural North Carolina community is experiencing an increase in inactivity, obesity, and comorbidities. The project leader collaborated with the local health department and recreation department to implement community walking events. The events aimed to promote physical activity while providing education to the residents as to why physical activity is important. The project leader used optional pre-walking event and post-walking event surveys to assess activity change and increased knowledge. Out of the 90 attendees, 68% completed the pre-event survey and 14% responded to the post-event survey. This created limited data available for follow-up. All participants who completed the follow-up plan …
How Essential Oils Help Prevent Against Healthcare Workers’ Burnout, Lauren Casey
How Essential Oils Help Prevent Against Healthcare Workers’ Burnout, Lauren Casey
Doctor of Nursing Practice Projects
This project set out to see if stress and anxiety (leading to burnout) could be combatted with the use of essential oils (EOs). Burnout is a common concern amongst the medical community and healthcare providers are leaving their jobs and field at unprecedented rates. While EOs have been used for patients, they are rarely used for the healthcare providers’ benefit. Because of that, this project wanted to focus on the employee for a change, which in turn would benefit the patient by having a mentally-present provider and the company by having less turnover. The project consisted of a pre-survey prior …
Using A Nurse Manager Prep Course To Spark Interest In Nurse Manager Succession Plan Participation, Sharon Pettiford
Using A Nurse Manager Prep Course To Spark Interest In Nurse Manager Succession Plan Participation, Sharon Pettiford
Doctor of Nursing Practice Projects
Hospitals strive to become Magnet-accredited facilities. Having Magnet status indicates an institution has high standards regarding nurse work environments and positive patient outcomes. The American Nurses Credentialing Center (ANCC) created the Magnet program criteria in 1994 (Dierkes et al., 2021). Obtaining Magnet accreditation is a coveted goal for hospitals. The target organization is currently not a Magnet-accredited hospital, nor does it have a nurse manager succession planning program. In preparation to achieve this accreditation, the target organization needed to implement a succession plan for nurse leaders. Institutions with successful succession planning programs pay careful attention when selecting participants for succession …
Increasing Future Health Care Providers’ Understanding Of The Complexity Of Endometriosis To Facilitate Early Diagnosis, Christina Alexander
Increasing Future Health Care Providers’ Understanding Of The Complexity Of Endometriosis To Facilitate Early Diagnosis, Christina Alexander
Doctor of Nursing Practice Projects
The DNP project was designed to improve future healthcare providers’ knowledge on the complexity of endometriosis by providing students with a lunch and learn session on endometriosis. The intent of the project implementation was to improve students’ knowledge on endometriosis to facilitate early diagnosis for patients. Improving provider knowledge of evidence-based endometriosis guidelines is imperative to achieve early diagnosis. The educational session provided students with information regarding symptoms, impact of delayed diagnosis, discerning differential diagnoses, associating timing of symptoms, and identifying endometriosis lesions. The impact of the project implementation was measured using pre/post-survey data evaluating overall knowledge, symptoms awareness, “best …
Integrating A Community Mental Health Resource Tool In A Rural Emergency Department Setting, Robert Rash
Integrating A Community Mental Health Resource Tool In A Rural Emergency Department Setting, Robert Rash
Doctor of Nursing Practice Projects
Providing effective discharge education to patients who are treated in the emergency department setting remains a very important component of a patient’s visit to an emergency department. Literature confirms although there are various governmental regulatory agencies that set forth regulations and guidelines, there remains a need to continually evaluate and critique the discharge education process to best meet the evolving needs of the patients, stakeholders, and community. Universally understood standards include appropriate reading levels and usability of the discharge education being provided. Discharge education can be very simple to complex creating higher demands on nursing staff to ensure they understand …
Increasing Cpr Awareness In School Staff, Savanna Parker
Increasing Cpr Awareness In School Staff, Savanna Parker
Doctor of Nursing Practice Projects
There are a limited number of staff members in Stokes County Schools that are CPR certified. A CPR workshop was conducted to provide an opportunity to allow more staff members to become certified, to gain knowledge and gain confidence in Cardiopulmonary Resuscitation, and to reduce delays in administering aid. Participants were asked to complete the Perceived Competence Scale (PCS) before and after participation in the CPR Workshop. The PCS is a 4-item questionnaire, based on a 7-point Likert scale. Answer choices range from Not True to Very True. Each question provides a lead-in statement, allowing for the concept being studied …
Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training, Carmen Mclamb
Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training, Carmen Mclamb
Doctor of Nursing Practice Projects
Achieving peripheral venous access in patients is one of the first steps in most treatment protocols. Delays or even failures to obtain peripheral venous access can delay lifesaving treatments, prolong hospital stays, and affect patient outcomes. Peripheral venous access can be difficult due to chronic disease processes, scarring of valves from frequent cannulation, limitation due to dialysis fistulas, or due to acute conditions such as hypovolemia and hypotension. Studies have found the use of ultrasound-guided techniques can achieve peripheral venous access quickly and prevent the need for more aggressive procedures (Skulec et al., 2020). However, there is a gap between …
Decreasing Nursing Burnout Post Covid-19 Pandemic Through Complementary Therapies, Linda Martiin
Decreasing Nursing Burnout Post Covid-19 Pandemic Through Complementary Therapies, Linda Martiin
Doctor of Nursing Practice Projects
This quality improvement project aimed to address the problem of nursing burnout post COVID-19 pandemic through complementary therapies. Nursing burnout can be mental, emotional, or physical exhaustion which an excessive amount of prolonged stress can cause. Nursing burnout has affected nursing staff worldwide, directly impacting the care provided to patients and the patient's satisfaction. The Nursing Worklife Model was utilized as the theoretical framework for this project (Appendix A). The literature review exhibits the prevalence of nursing burnout in nursing staff. A quantitative study was utilized for this project. The Oldenburg Burnout Inventory was utilized to establish the participant's level …
Increasing Nurses' Comfortability Using The Defibrillator, Mandy Whitaker
Increasing Nurses' Comfortability Using The Defibrillator, Mandy Whitaker
Doctor of Nursing Practice Projects
The educational needs of nurses vary depending on the practice setting in which he or she is employed. Some competencies are taught yearly or bi-yearly. The current process for registered nurses to learn how to use the defibrillator is through the advanced cardiovascular life support (ACLS) training they are required to take every 2 years. Although a certification proves a nurse is competent in a certain area, skills tend to be forgotten over time. It is often noted “if you don’t use your skills, you lose them.” Nelson and Aguirri (2020) reported even though there are many facets to the …
Increasing Clergy Members Awareness, Sensitivity, And Knowledge (Ask) Of The Lgbtqia+ Community Improves Health Outcomes, Claudette Green
Increasing Clergy Members Awareness, Sensitivity, And Knowledge (Ask) Of The Lgbtqia+ Community Improves Health Outcomes, Claudette Green
Doctor of Nursing Practice Projects
Introduction: Individuals who identify as belonging to the LGBTQIA+ community in the context of religion and faith often experience spiritual discrimination and are made to feel like an outcast (Cole & Harris, 2017). Often, spiritual leaders lack the training, knowledge, and skills necessary to understand and communicate in a way that offers solace and comfort to their LGBTQIA+ congregants (Yarhouse & Sadusky, 2020). Moreover, the church has been at the forefront of leading the discrimination and condemnation of LGBTQIA+ members. This discrimination has led many to leave the church and become involved in self-harming behavior, ongoing mental health struggles, …
Enhancing Emotional Intelligence In Prelicensure Nursing Students, Aimee G. Motley
Enhancing Emotional Intelligence In Prelicensure Nursing Students, Aimee G. Motley
Doctor of Nursing Practice Projects
Nursing programs are intended to prepare nursing students to become competent nurses, that can make decisions to promote positive patient outcomes. However, studies suggest that as students transition into clinical practice, they are still lacking decision-making skills. Emotional Intelligence (EI) has been suggested to improve communication skills, problem-solving, and resilience. The purpose of this project was to enhance the emotional intelligence of Baccalaureate prelicensure nursing students. The PICOT statement was: Can formal EI training combined with interactive EI training, influence EI awareness, knowledge, and skills of baccalaureate nursing students as evidenced by scoring 77% or higher on an EI posttest …
Accreditation Commission For Education In Nursing (Acen): A Mixed Methods Study To Determine Accreditation Readiness At A Non-Profit Organization Located In Western North Carolina, Leslie Queen
Doctor of Education Dissertations
The accreditation process allows programs to complete the reflection process of program evaluation, where they assess and measure themselves via preset standards and suggested outcomes. The theoretical framework of Getzels and Guba (1957) was used to determine if the people within the nonprofit organization studied could successfully fulfill the predetermined expectations of the organization. This study also examined the value of program evaluation, explained the process used by schools of nursing that wish to seek national accreditation, investigated the benefits and strengths of attaining accreditation, and uncovered possible barriers that may hinder accreditation efforts. By exploring these topics, conclusions were …
Increasing Patient Initial Visit Compliance In An Outpatient Setting, Zackery Cooper
Increasing Patient Initial Visit Compliance In An Outpatient Setting, Zackery Cooper
Master of Science in Nursing Theses and Projects
Outpatient healthcare clinics make revenue based on patient visits and productivity is based on the number of visits seen per provider. When patients do not attend their scheduled appointments, practices lose the revenue from the visit, plus have the added cost of a potentially unproductive provider. The current practice in the project facility is to send reminder text messages through the electronic health record scheduling system. The system sends reminder texts 48 and 24 hours prior to the appointment date. The proposed change to the practice is to add telephone calls to patients the morning of their scheduled visit. The …
Hand Hygiene Compliance In Nursing Staff Of Long-Term Care Facilities, Lindsay Clontz
Hand Hygiene Compliance In Nursing Staff Of Long-Term Care Facilities, Lindsay Clontz
Master of Science in Nursing Theses and Projects
Elderly residents of long-term care facilities are most at risk to acquire serious infections. Because of the relationship with nursing staff members, they are most likely to get an infection from a member of the nursing team. It is imperative that nursing staff members receive proper training related to hand hygiene in order to adhere to infection prevention and control guidelines. The goal of this project is to improve hand hygiene in nursing staff to reduce the number of resident infections recorded on the monthly infection surveillance report. This project utilizes a multi-faceted approach including a pre-test, presentation, post-test, return …
Prevention Of Infection During Hemodialysis Treatment Initiation, Jessica Stroupe
Prevention Of Infection During Hemodialysis Treatment Initiation, Jessica Stroupe
Master of Science in Nursing Theses and Projects
Infection in the dialysis access of a patient can be detrimental to the health of a dialysis patient. For this reason, infection control is extremely important in the outpatient hemodialysis setting. The goal of this project is to prevent infection during dialysis treatment initiation. This goal will be achieved during a 5-week project in which staff of an outpatient hemodialysis unit will be directly observed and then educated on the importance of infection control during treatment initiation. Staff will be given education on areas that need improvement regarding infection control during treatment initiation. The staff will be able to use …
The Importance Of Skin-To-Skin Initiated In The Operating Room, Katina Miller
The Importance Of Skin-To-Skin Initiated In The Operating Room, Katina Miller
Master of Science in Nursing Theses and Projects
The benefits of skin-to-skin contact has been well documented for both infants and mothers. Out of all the different modes of delivery a pregnant patient can have, skin-to-skin contact is performed the least amount for mothers who delivery via cesarean section compared to mothers who have a vaginal delivery. All mothers, should they choose, should be allowed to have skin-to-skin contact with their infant in the operating room. This project was designed to increase skin-to-skin contact between a mother and their infant shortly after birth via cesarean section at least 75% of the time. Education was conducted during team huddles …
Fluid State And Diet Control In Patients With Acute Kidney Injury On Hemodialysis, Carolyn Evans-Howard
Fluid State And Diet Control In Patients With Acute Kidney Injury On Hemodialysis, Carolyn Evans-Howard
Master of Science in Nursing Theses and Projects
Prolonged hospitalization, high number of readmissions, and high mortality rates are associated with patients diagnosed with Acute Kidney Injury (AKI). The purpose of this quality improvement proposal is to address the need for more education for nurses caring for these patients. If the kidneys shut down temporarily due to acute illness or medication taken, fluid and toxins will build up in the body with no way of being released. It is proposed that if dietary and fluid restrictions are followed it may help the patient recover faster. The method proposed is to have nurses learn the necessary dietary and fluid …
Patient Satisfaction, Amber Bowman
Patient Satisfaction, Amber Bowman
Master of Science in Nursing Theses and Projects
This thesis project reviews how nursing care, specifically that of nursing assistance, impacts patient satisfaction. Care provided to patients during hospitalization is scored by post-discharge surveys. For this project, the HCAHP survey is specifically referred to and discussed. The survey data obtained from the HCAHP survey is available to the public for review. This data can affect the population's outlook on healthcare organizations. Research has found that care provided by nursing assistants has an impact on the satisfaction of patients. Research in the area of improving patient satisfaction is lacking in data and tools for improvement.
Proposal For A Formal Pediatric Abuse Screening Tool For The Emergency Department, Christina Bolin
Proposal For A Formal Pediatric Abuse Screening Tool For The Emergency Department, Christina Bolin
Master of Science in Nursing Theses and Projects
Implementation of a quick, reliable pediatric child abuse assessment tool for use in the emergency department is of great importance. A thorough assessment of all pediatric patients presenting to the emergency department (ED), regardless of complaint, should become second nature in order to recognize the signs of child abuse. Because a tool of this nature is lacking in many ED's, the Escape Instrument is needed. This instrument is a successful, efficient screening tool that can be applied to all pediatric patients during triage in the emergency department. This tool will allow the emergency department staff to quickly identify children under …
Case Manager Discharge Planning For Safe Discharge Of Homeless Patients, Melody Jenkins
Case Manager Discharge Planning For Safe Discharge Of Homeless Patients, Melody Jenkins
Master of Science in Nursing Theses and Projects
Acute care case managers are continually challenged with the task of identifying discharge barriers and preparing a discharge plan that facilitates successful recovery and healing. Planning a discharge for a patient that is homeless can be extremely challenging. This MSN Nursing project addresses the complex discharge barriers involved in planning a safe discharge for homeless patients. The project goal was to create a Case Management Resource Algorithm that will organize available community resources to meet the social determinants of health deficits to prevent the progression of disease processes, prevent repeat visits to the emergency room, decrease inpatient admissions, as well …
Bedside Reporting, Morgan Sanford
Bedside Reporting, Morgan Sanford
Master of Science in Nursing Theses and Projects
Bedside reporting can directly correlate with preventing errors in the healthcare setting. The three main errors that occur are falls, medication errors, and sentinel events. These errors have a vast number of different outcomes, even resulting in death in some cases. Despite The Joint Commission directly stating that bedside reporting is best practice, this is not always what is conducted in many hospital organizations. Literature has suggested the problem that exists with implementation is the longevity of the implementation from staff. Identifying a feasible and conducive way to implement bedside reporting that is both favorable for the patient and staff …
Reducing The Number Of Patients Leaving Before Evaluation From The Emergency Department, Myranda Dills
Reducing The Number Of Patients Leaving Before Evaluation From The Emergency Department, Myranda Dills
Master of Science in Nursing Theses and Projects
Boarding patients in the emergency department (ED) can lead to several adverse events and errors that can prolong the patient’s hospitalization and delay discharges from the inpatient floors. These excessively long hospital stays decrease the number of bed available to patients being admitted from the ED, creating a bottleneck effect of patients backflowing in the ED. When this occurs, there are less available beds and resources for new ED patients, creating long wait times, and eventually an increase in the number of patients leaving before provider evaluation. This MSN project serves to create a new job role in the ED …