Medicine and Health Sciences Commons^™

Evaluating Implementation And Barriers To Sustainability Of An Asthma Clinical Quality Improvement Project, Holly Uphold Phd, Ms, Diane Liu Md, Faap

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Purpose and Objectives

Asthma is an important public health issue in Utah and quality asthma care is essential to addressing the burden of asthma. The purpose of this initiative was to evaluate clinical asthma quality improvement (QI) program delivery formats and identify barriers to sustaining QI processes.

Intervention Approach

The focus of the intervention was to improve clinical asthma care through reducing variation in clinician knowledge about recommended asthma care and facilitating process improvements in asthma care delivery using Academic Detailing (AD) and Learning Collaboratives (LC) QI delivery formats.

Evaluation Methods

A pre/post-test design was used to compare improvements between …

An Examination Of Primary Health Care Nursing Service Evaluation Using The Donabedian Model: A Systematic Review, Kylie Mccullough, Lesley Andrew, Angela Genoni, Melissa Dunham, Lisa Whitehead, Davina Porock

Research outputs 2022 to 2026

Nurses are key to the delivery of global primary health care services. However, there appears to be a lack of evaluation of primary health care nursing delivery models in the published literature. This evaluation is vital to the improvement of patient experiences, national and global health outcomes, and the justification of future investment in primary health care nursing services. The purpose of this review was to explore and analyze the literature that reports on the evaluation of primary health care nursing services, to ascertain the nature and utility of these evaluation methods, and identify opportunities for future research in this …

Evaluating A Rapid Response Team Performance To Implement Best Practice In Rapid Response Team Protocol, Pansy Samuel

Doctor of Nursing Practice Projects

Background

Rapid Response Teams (RRT) provide clinical resources to improve patient safety outcomes at healthcare institutions. This team promptly responds to deteriorating patient conditions to prevent further deterioration and reduce mortality rates. Rapid response teams do not always perform optimally. Reasons for this performance failure include breakdowns in communication, team dynamics, or other variables that can often be adjusted when the team members understand the role these variables play in undermining the performance of the RRT. An understanding of the perceptions of the RRT members regarding their roles and potential areas of improvement did provide valuable data that was utilized …

Addressing Interprofessional Competence In Interpretation Of Electronic Fetal Monitor Tracings, Susan H. Hébert

Doctoral Dissertations

Interpretation of electronic fetal monitor (EFM) tracings is a critical clinical practice skill nurses and physicians perform during the intrapartum stage of pregnancy. However, if performed inaccurately can potentially jeopardize the well-being of the neonate. This risk is present because if concerning EFM tracings are not interpreted accurately, preventative care interventions to promote the well-being of the unborn child do not occur. The project was initiated by completing a scoping literature review on the methods for training and evaluating EFM interpretation competence, which revealed current EFM interpretation training and evaluation methods are lacking. A concept analysis defined nurse competence in …

Critical Thinking Development In Undergraduate Midwifery Students: An Australian Validation Study Using Rasch Analysis, Amanda G. Carter, Amanda Müller, Michelle Gray, Dianne Bloxsome, Kristen Graham, Dolores Dooley, Linda Sweet

Research outputs 2022 to 2026

Background: Well-developed critical thinking skills are required to provide midwifery care that is safe, evidence-based, and woman-centred. A valid, reliable tool to measure is required the application of critical thinking in midwifery practice. The Carter Assessment of Critical Thinking in Midwifery (CACTiM) has previously been psychometrically assessed using classical methods at a single site. This study aims to further evaluate the properties of CACTiM tools using Rasch analysis in a diverse group of midwifery students and preceptors. Methods: The CACTiM tools were completed by undergraduate midwifery students studying at three Australian universities and their preceptors. Midwifery students’ critical thinking was …

Health Services Survey, Doan (Delaney) Le, Hannah Gries, Cassandra Roy, Lesley Rabago, Franzelle Macaspac

Nursing Leadership in Community Engagement Projects

Health Services Survey

The agency we partnered with is a nonprofit organization committed to serving the needs of women and their families who are experiencing unstable or absent housing. They help to provide emergency shelter to families across five locations in the Seattle area and provide services surrounding housing, healthcare, employment, and community. They also have specialty programs aimed at providing services to children who are medically fragile and require specialized care, and families who have recently given birth and are still in the recovery and bonding stages. All this work is delivered with the values of love, equity, stewardship, …

Mental Illness As A Vulnerability For Sexual Assault: A Retrospective Study Of 7,455 Sexual Assault Forensic Medical Examinations, Leslie Miles, Julie L. Valentine, Linda Mabey, Nancy R. Downing

Faculty Publications

Background: Persons with severe mental illness (MI) are at a high risk of becoming victims of sexual assault (SA). Vulnerability for SA with any type of MI is unknown. This study aimed to identify the prevalence of preexisting MI and other significant factors in patients reporting preexisting MI at the time of their SA medical forensic examinations (SAMFEs).

Method: A retrospective SAMFE chart review of patients ( N = 7,455) from 2010 to 2020 was conducted. Sexual assault nurse examiners completed SAMFEs. Inclusion criteria included (a) aged 14 years and older, (b) completed SAMFE with SA kit evidence collection, and …

Evaluation Of A Comprehensive Diabetes Mellitus Protocol At A Rural, Federally Qualified Health Center In Southern West Virginia, Hannah D. Davis

Graduate Theses, Dissertations, and Problem Reports

Background: Diabetes mellitus is a chronic disease that affects nearly 34 million Americans. In rural Appalachia, the population is affected disproportionately at a rate of 14% compared to the national average of 10%. Diabetes is a lifelong, chronic condition managed best by a multidisciplinary team-based approach to achieve optimal disease control. Best practices in the care of diabetes support the use of evidenced based care protocols and leveraging technology to decrease the burden of disease. Type 2 diabetes mellitus (T2DM) is the most common type, making it the focal population for evaluation.

Purpose: The purpose of this project was to …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

Development, Implementation, And Evaluation Of A Professional Practice Model: A Scoping Review, Gemma Doleman, Di Twigg

Research outputs 2022 to 2026

Aim:

The aim of this study is to synthesize available literature describing the development, implementation and evaluation of a Professional Practice Model.

Background:

A Professional Practice Model is an overarching theory-based framework that depicts nursing values and defines the structure and process of nursing care. No research has synthesized available literature on this topic in recent times. Evaluation: A review of English language papers was published from 2015 to 2022. Fourteen studies met the inclusion criteria.

Key Issues:

All studies highlighted the importance of having a Professional Practice Model that reflects nursing care activities and resonates with nurses across an …

Objective Structured Clinical Evaluation For Supraclavicular And Femoral Nerve Blocks Utilizing Ultrasound Guidance For Student Nurse Anesthetists, Mitchell Fowler, Christopher Bond

Doctoral Projects

The purpose of this DNP project was to create a tool to teach and evaluate student registered nurse anesthetists (SRNAs) at TheUniversity of Southern Mississippi (USM) on supraclavicular and femoral nerve blocks to promote safety in the clinical setting. An objective structured clinical evaluation (OSCE) for ultrasound-guided supraclavicular and femoral nerve blocks was created as the basis for this project. Best-practice techniques as identified by the AANA’s 14^thstandard of nurse anesthesia practice were researched and used in the development of the OSCE to promote a culture of safety for SRNAs and patients (AANA, 2019).

A culture of safety …

"Program Evaluation On The Use Of The Screening, Brief Intervention And Referral To Treatment (Sbirt) Process In Primary Care Physician Offices", Lisa Sanchez-Navarro

Doctor of Nursing Practice (DNP) Manuscripts

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an early screening intervention tool for individuals with non-dependent substance use, which is employed to identify and provide care before a patient needs extensive specialized treatment. SBIRT can be used in primary care settings, to methodically screen individuals who might not seek help for a substance use issue (Centers for Medicare & Medicaid Services, [CMS], 2020). Gaps in using the SBIRT screening process were identified within the insurance organization’s PCP practices, therefore, a program evaluation was completed to: (a) determine whether Primary Care Physicians (PCPs) were using the SBIRT process, (b) …

Evaluation Of A Hypertension Bundle To Improve Maternal Outcomes, Jamie Jetton

Dissertations

Abstract

Problem: Hypertensive disorders of pregnancy continue to be on the rise in the United States, contributing to an increase in both maternal morbidity and mortality rates. These disorders not only have an effect on the pregnant women, but also the neonate. Early recognition and treatment of increased blood pressure findings can improve maternal and fetal outcomes.

Methods: This Quality Improvement (QI) project used a descriptive design and was comprised of a retrospective chart review, focused on the effectiveness of evaluating a hypertension bundle to improve maternal outcomes. The data collected for this project encompassed six months pre and post …

Program Evaluation Of Parent Engagement Activities In The Pediatric Cardiac Intensive Care Unit, Cheryl A. Bos

Doctoral Projects

Introduction: Leaders of a six-bed pediatric cardiac critical care unit identified the need to evaluate family engagement in patient care activities prior to implementing quality improvement initiatives. This program evaluation identified staff and family perception of barriers and facilitators to parent engagement in the Pediatric Cardiac Intensive Care Unit.

Methods: Data were collected through quantitative and qualitative methods. Surveys collected staff baseline and parent pre-/post-hospital perception of the role of family engagement in caring for the child.

Results: The Questionnaire of Factors That Influence Family Engagement survey of 58 registered nurses indicated the nurse workflow (τb = .579, p = …

Resilience In Practice: Adapting Faculty Practice During A Pandemic, Kelly Gonzales, Leann Holmes, Amelia P. Stoltman

Posters and Presentations: College of Nursing

No abstract provided.

Process Evaluation Of An Email-Based Walking Program With Extension Educators, Elizabeth Richards

School of Nursing Faculty Publications

This study evaluated the implementation process of an email-based walking program from the perspectives of program deliverers. Twenty-four Extension Educators participated in the process evaluation. We used an online survey to examine the perceptions of the implementation process of Get WalkIN’, a twelve-week email-based walking program. Educators agreed that the provided program training and recruitment materials were sufficient for successful program delivery. Program implementation involved sending emails to program participants at least weekly. Educators also agreed that the program was easy to deliver and took twenty minutes or less to implement each week. Strengths and areas for program improvement are …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

Program Evaluation Of A Bundled Educational Intervention To Enhance Implementation Of Professional Exchange Report, Luanne M. Shaw

Luanne Shaw, DNP, MSN, RN, CHSE, CEN

Communication handover is a source of potential error and risk to patient safety. Electronic-based tools may reduce errors and mitigate risks to patient safety. Electronic tools have been successfully implemented using multiple methods of education and training. Electronic tools vary in functionality and integration with the electronic health record (EHR). A large West Michigan Regional Health System (RHS) implemented a new EHR containing an embedded tool for communication handover called Professional Exchange Report (PER). There was inconsistency in the practice of bedside report by nurses. The RHS planned to use a bundled approach of educational interventions to implement the new …

Beyond Checklists: A Nursing Informatics Education Strategy For Undergraduate Nursing Students Appraising Health Information On Social Networking Sites (Sns) / Au-Delà Des Listes De Vérification : Une Stratégie De Formation Infirmière Au Numérique Pour L’Évaluation, Par Les Étudiantes De Premier Cycle, Des Informations Sur La Santé Présentes Sur Les Sites Des Réseaux Sociaux (Srs), Maggie J. Theron, Barbara Astle, Duncan Dixon, Anne Redmond

Quality Advancement in Nursing Education - Avancées en formation infirmière

Increasingly internet social networking sites are used in healthcare to support, communicate and offer information platforms between healthcare providers, users, and the public. Undergraduate nursing students draw on various sources of evidence to inform best-practice decisions in collaboration with patients and the healthcare team. Student or patient-initiated access of information from social networking sites necessitates high levels of informatics literacy. While students may reveal adept social networking site navigation skills, their capacity to appraise and apply information from these sites to their nursing practice, in ways that demonstrate informatics competence, requires further exploration. The purpose of this education project was …

Evaluation Of A Simulation-Based Nurse Residency Program, Cheri A. Van Wyngarden

Doctoral Projects

Upon completion of nursing school, new graduate nurses sit for licensure examination to demonstrate the minimal knowledge necessary to practice safely as an entry level nurse. Despite satisfactory completion of this examination, many new graduate nurses lack the competency and confidence to safely practice (Jung, Lee, Kang, & Kim, 2016 & Liaw, Palham, Chan, Wong & Lim, 2014). Traditional models of preceptorship with orientation are not adequately preparing new graduate nurses for practice. Nurse residency programs narrow the gap between demonstrated knowledge and competent practice. Varying types of nurse residency programs have successfully replaced traditional nursing orientation methods across the …

Psychometric Evaluation Of Lung Cancer Stigma Among Lung Cancer Survivors In South Carolina, Lisa A. Webb

Theses and Dissertations

Background: Despite the improved screening and treatment modalities, lung cancer is the second leading cause of cancer and accounts for 27% of all cancer deaths in the United States. Survivors of lung cancer experience physical, social, and particularly psychological challenges. Lung cancer stigma is a formidable challenge for survivors of lung cancer that complicates their physical, psychological and social well-being.

The Cataldo Lung Cancer Stigma Scale is the first instrument adapted to measure lung cancer stigma. This instrument was adapted from Berger’s HIV Stigma Scale. HIV stigma and lung cancer stigma share similarities. These health-related stigmas reflect behaviors that …

Evaluation Of A Postpartum Hemorrhage Protocol, Lori M. Davies

Walden Dissertations and Doctoral Studies

Postpartum hemorrhage is a leading cause of maternal death, yet many deaths related to hemorrhage might be prevented with early recognition and intervention. The birthing unit of a U.S. community hospital formed an interprofessional task force to plan and implement a postpartum hemorrhage protocol that would provide the obstetric team with the knowledge, skills, and tools needed for early identification and quick action when hemorrhage occurred. Lewin's model of change provided a framework for protocol implementation. The purpose of this doctoral project was to evaluate this quality improvement project. Secondary data internal to the organization were collected and analyzed to …

A New Approach For Scoring In Objective Structured Clinical Examination, Jomon C. U Mr, Roseminu Varghese Ms

Manipal Journal of Nursing and Health Sciences

The Objective Structured Clinical Examination (OSCE) is a useful multi-use assessment tool which may be used to evaluate health care providers of various disciplines in a clinical setting. It appraises proficiency, through direct observation based on objective or unbiased testing. It is accurate, objective and consistent letting uniform testing of clinical skills among an extensive range of students. OSCE software, developed at Manipal College of Nursing (MCON), a constituent unit of Manipal Academy of Higher Education (MAHE) is a windows-based platform which is integrated with student’s information system and is designed to access only through the intranet of MAHE. It …

Evaluation Of A Health System’S Community Targeted Program For Individual’S With Increased Risk For Cardiovascular Disease And Diabetes, Phallon Lovelady

Doctoral Projects

Introduction: Lack of a program evaluation plan for a community targeted primary prevention program poses a risk for undefined program effectiveness. Conducting a systemic program evaluation helps determine program effectiveness and value. The purpose of this paper is to discuss the process of implementing a program evaluation during a Doctorate of Nursing Practice (DNP) scholarly project.

Objectives: The objectives of this project were to apply a scholarly approach to program evaluation utilizing evidence-based practice tools, demonstrate DNP Essentials and health systems leader competencies, and describe the steps taken during the process.

Methods: The CDC Framework for Program Evaluation (2011) was …

Evaluation Of Clinical Growth And Nursing Student Motivation In The Traditional Clinical Learning Environment, Jessica Barkimer

Dissertations (1934 -)

Evaluation of students in the traditional clinical learning environment is difficult. There remains a lack of standard guidelines to evaluate students using valid and reliable instruments as well as inconsistent processes with lack of interrater reliability standards between educators. A need exists for fair and consistent evaluation of nursing students. When the clinical educator uses a standard evaluation process and understands students’ motivation for learning, adaptations in teaching strategies and education on self-regulatory strategies can be implemented to enhance learning and measure clinical growth. This research study used a prospective, correlational, pre-test/post-test design to examine the relationship between student motivation …

Refusing To Let The Dust Settle: Creative Evaluation Of A Concept-Based Curriculum, Jeannette Kates, Phd, Gnp-Bc, Rn, Mary Hanson-Zalot, Edd, Rn, Julia Ward, Phd, Rn, Jamie Smith, Msn, Rn, Ccrn, Valerie Clary-Muronda, Phd, Msn-Ed, Rn

College of Nursing Posters

Concept-based curricula are being implemented in nursing education as a means to shift the emphasis from content to an emphasis on concepts and conceptual learning (Giddens & Brady, 2007). This paradigm shift requires concomitant changes in how faculty teach and how students learn. In concept-based curricula, teachers use student-centered learning activities, such as case studies, questions, or problems to engage students in active learning (Giddens, Caputi, & Rodgers, 2015).

Improving The Care Of Patients With Urinary Catheters Through A Quality Improvement, Ashley Nicole Holmstrom

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infections (CAUTI) significantly increases patient morbidity and mortality, length of stay, and organizational cost. In the 2 years prior to project implementation, the incidence of CAUTI increased by 15% in the local acute care, inpatient facility that served as the project site. Nursing leaders at the project site linked the increase in CAUTIs to a nursing knowledge deficit related to CAUTI prevention principles. The clinical question focused on the impact of CAUTI prevention staff training on the incidence of CAUTI, length of stay, and cost to the local acute care organization. After a review and critical appraisal …

Program Evaluation Of A Bundled Educational Intervention To Enhance Implementation Of Professional Exchange Report, Luanne M. Shaw

Doctoral Projects

Communication handover is a source of potential error and risk to patient safety. Electronic-based tools may reduce errors and mitigate risks to patient safety. Electronic tools have been successfully implemented using multiple methods of education and training. Electronic tools vary in functionality and integration with the electronic health record (EHR). A large West Michigan Regional Health System (RHS) implemented a new EHR containing an embedded tool for communication handover called Professional Exchange Report (PER). There was inconsistency in the practice of bedside report by nurses. The RHS planned to use a bundled approach of educational interventions to implement the new …

Perceived Barriers To The Pre-Transplant Evaluation: A Patient Perspective, Linda K. Buck

Doctoral Dissertations

Patients who are afforded the opportunity for a kidney transplant tend to have better short and long-term outcomes, including improved physical health, quality of life, and long-term survival over those who are treated with prolonged dialysis (Landreneau, Lee, & Landreneau, 2010; Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients (OPTN/SRTR), 2014; Wolfe et al., 1999). At the end of 2012, 402,514 people were being treated with hemodialysis while 40,605 were receiving peritoneal dialysis (USRDS, 2014). At this same time, only 92,885 people were listed on the OPTN national waitlist for kidney transplantation. The aim of this project …

Investigating Personality Traits Of Registered Nurses: Implications For Personnel Evaluation, Stephanie N. Means

Dissertations

The United States is currently facing a registered nurse (RN) shortage that is expected to reach the millions in the next few years. Since the beginning of the century, healthcare professionals and administrators have strived to develop and implement ways to increase recruitment and retention in the nursing field. It has been recognized that the key to recruitment and retention is to get the right nurse in the right place, which means focusing on clinical proficiencies as well as personality qualities and characteristics. Personality assessment has long been used to evaluate person-job (P-J) fit of applicants for positions across the …