Medicine and Health Sciences Commons^™

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Psychological Safety And Conflict Management Among Nurse Practitioners In Interprofessional Teams, Scott Faust

Electronic Theses and Dissertations

This quantitative correlational study explored the relationships between perceived psychological safety, conflict management styles, and perceived conflict management success among nurse practitioners (NPs) operating in interprofessional acute or critical care teams in the United States. Despite existing literature on conflict management and psychological safety, there is a noticeable gap concerning the interplay of these factors, specifically among NPs. A multi-item survey was developed from validated measures to assess psychological safety, conflict management success, and conflict management style. The final sample included 944 NPs. The findings revealed a statistically significant difference in the scores of perceived psychological safety, depending on the …

Post-Graduate Integration Programs For Recently Graduated Nurse Practitioners: A Rapid Review, Li-Anne Audet, Amale Ghandour, Irene Sarasua

Quality Advancement in Nursing Education - Avancées en formation infirmière

Aim

The purpose of this paper is to present a rapid review of the literature that describes and evaluates post-graduate professional integration programs for recently graduated nurse practitioners.

Background

Recently graduated nurse practitioners face numerous challenges upon entry to practice, these include high patient caseloads, lack of confidence and difficulty integrating into the interprofessional team. In response to these challenges, numerous post-graduate professional integration programs have emerged to support the transition of recently graduated nurse practitioners into practice.

Design

A rapid review was conducted following McMaster University Rapid Review Guidebook’s Guidelines.

Method

Studies describing and evaluating post-graduate professional integration programs …

Advocating For Nurse Practitioner Independent Practice, Tamara Troyer Denlinger

Doctor of Nursing Practice Final Manuscripts

This project was an anonymous qualitative/quantitative survey of nurse practitioners in California to determine if passage of AB 890, which provides a pathway to independent practice, will result in more NPs choosing to practice independently after clinical hour requirements are met. Access to primary health care in California is projected to worsen over the next 10-15 years, particularly in rural areas, and an average of 44% of residents may be without enough access to care. Some areas in the state will be harder hit than others with Alpine, Calaveras, Glenn, and San Benito counties likely to be hardest hit by …

Tele-Sim For Nurse Practitioner Clinical Education: An Online, Real-Time, Educational Innovation Using Simulation And Telehealth For Learning Physical Assessment Skills, Kat Tremblay

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: Increasing numbers of nurse practitioner (NP) educational programs are being offered online, with little or no face-to-face contact among students and instructors. Students express lack of confidence in their physical examination skills and want live instructor demonstrations, observed practice, and real-time feedback from their clinical instructors.

Significance: NP students need to acquire physical examination skills to increase competency in assessing patients for enhanced clinical judgment and improved patient outcomes.

Purpose/Aims: to improve and measure the competency and confidence in the performance of advanced physical assessment skills of NP students in an advanced health assessment (AHA) clinical course with an …

Nurse Practitioner-Led Hepatitis C Virus Education In A Central Valley Opioid Treatment Program, Nikiesha Thomas Redus

Doctoral Projects

Introduction Viral hepatitis has been classified as a worldwide public health threat and it is estimated that 130-150 million people worldwide are infected with viral hepatitis. In the United States, increases in hepatitis C infections can be attributed to intravenous drug use and associated behaviors. Many people who inject drugs are unaware of their serostatus and access to accurate hepatitis C virus (HCV) information and education is limited. However, opioid treatment programs are well positioned to fill hepatitis C services gap among people who inject drugs by providing education, to raise hepatitis C awareness and lead to services and treatment …

Implementation Of A Peer Mentoring-Network Initiative In Outpatient Psychiatry To Improve Psychiatric Advanced Practice Nurses' Job Satisfaction, Maria Romanoff Rand

Doctor of Nursing Practice Scholarly Projects

Background: Post-pandemic rates of mental illness have increased, resulting in a rise in demand for psychiatric services. At the same time, a growing shortage of psychiatric providers is occurring. This combination has given rise to an expanding mental health crisis where strengthening and stabilizing the psychiatric workforce is paramount. Psychiatric Advanced Practice Nurses are uniquely qualified to staff this shortage. Therefore, positive job satisfaction for Psychiatric Advanced Practice Nurses is vital to increase and retain psychiatric healthcare providers available to address this critical need for mental health services.

Methods: At the project site, the shift to telehealth, changing leadership, and …

Advanced Practice Nursing Initiatives In Africa, Moving Towards The Nurse Practitioner Role: Experiences From The Field, Deborah C. Gray, Melanie Rogers, Minna K. Miller

Nursing Faculty Publications

AIM: This paper discusses the development and progression of the advanced practice nurse practitioner role in Africa.

BACKGROUND: Providing adequate primary health care is problematic in Africa. The World Health Organization and International Council of Nurses proposed that nurses, specifically advanced practice nurse practitioners with the requisite skills in disease prevention, diagnosis and management, can be key to solving the primary care issue.

SOURCES OF EVIDENCE: This paper utilized publications from PUBMED, CINAHL, policy papers, websites, workgroups, conferences, and the experiences and knowledge of authors involved in leading and moving forward key events and projects.

DISCUSSION: Four African countries have …

The Role Of Telehealth In Reducing Hospital Readmissions For Heart Failure Patients, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Heart failure affects over six million people annually, and is expected to increase to over eight million by 2030. Over 60 million people live in the rural United States. Telehealth is a tool to improve access to care, provide early intervention, and follow up with patients within 48 hours of a hospital discharge. Utilizing Telehealth to conduct a medication reconciliation within 48 hours of discharge to address any medication errors or admission, and reinforce adherence is a way to improve access to care to those living in rural areas.

Telehealth And Hospital Readmissions For Heart Failure Patients: A Literature Review, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Currently heart failure affects over six million people and is expected to increase to over eight million people by 20230. The US Census Bureau estimates over 60 million people live in a rural setting. This literature review seeks to determine the state of the science regarding the utilization of Telehealth to reduce heart failure readmissions in rural areas.

Implementing Hand Hygiene Protocol For Direct Care Staff In An Inpatient Psychiatric Facility To Improve Hand Hygiene Compliance, Juliet Mkpuechina

Doctor of Nursing Practice Projects

Background: Handwashing with soap and running water is one of the most effective ways to prevent diseases and infections spread through touch. Hand hygiene refers to handwashing with soap, water, and other disinfecting agents to prevent infection. According to Chassin et al. (2017), hand hygiene compliance reduces healthcare-associated infections (HAI). Studies show that an increase in handwashing compliance can be correlated to a decrease in healthcare-associated infections. Studies have proven that though it is challenging to link hand hygiene to a reduction in healthcare-associated infections directly to improved hand hygiene compliance, many hospitals have seen a decline in HAIs as …

Utilization Of Remap Conversation Tool To Improve Advance Care Completion In The Home-Based Palliative Care Community Setting, Gwendolyn Starkey

Doctor of Nursing Practice Projects

Background: The World Health Organization and the American Society of Clinical Oncology guidelines endorses mandatory communication skills training in care goals for seriously ill patients (Back et al., 2019). In one survey of primary care providers (PCP), 68% reported no formal training to discuss advance care planning (Comer et al., 2020). Advance care planning is essential to manage chronic conditions in our growing aging population to provide the best patient care. This manuscript aimed to discuss best practices and techniques in advance care planning and optimize skills to provide patient-centered care conversations that honor patient wishes, reduce unwanted hospitalizations, and …

Development And Implementation Of A Standardized Protocol For Nurse Practitioners Working In An Aud Treatment Telehealth Program, Cj Dea

Doctor of Nursing Practice (DNP) Projects

Background

Alcohol Use Disorder (AUD) is a major public health concern in the United States. Ria Health is a growing telehealth provider delivering AUD treatment through pharmacotherapy combined with behavioral health counseling.

Local Problem

Ria Health employs six California licensed nurse practitioners, but two of them have not yet met all the California provisions to practice independently without protocols. Ria Health has not put any standardized protocols in place.

Methods

This DNP project involved the creation of an evidence-based standardized protocol for AUD. The Student Satisfaction and Self-Confidence in Learning questionnaire was disseminated to participating nurse practitioners to measure student …

Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland

Doctor of Nursing Practice (DNP) Projects

BACKGROUND: Millions of nurse practitioners (NP), physician assistants (PA), and registered nurses (RN) are optimistic that their current employers will help them reach their full potential. One area that can add value to the hospital and empower employees to work to the full scope of their practice, and utilize the skillsets like that of an NP, is to train these providers to support medical device equipment in the operating room instead of relying on medical device representatives (MDRs) of medical device companies.

METHODS: Training NPs, PAs, or RNs how to support neurological medical device equipment will better utilize the skillset …

Nurse Practitioners' Adjustment To The Hospitalist Position: A Grounded Theory Study, Donna Tanzi

Dissertations, Theses, and Capstone Projects

Hospital based medicine is the fastest growing medical specialty in the United States. While most hospitalists are internal medicine residency graduates, most of these new internal medicine medical graduates are choosing not to enter hospital medicine, resulting in a growing hospitalist workforce shortage. To fill this staffing gap, nurse practitioners (NPs), some with no previous NP experience, are assuming hospitalist positions. As more NPs assume hospitalist positions, they face challenges adapting to the prevailing physician-based hospitalist model, such as attaining requisite medical knowledge and skills and establishing credibility and rapport with other care team members. Through a series of semi-structured …

Improving Healthcare Provider Knowledge Of Hospice And Palliative Medicine, Ashleigh T. Flora

DNP Projects

By addressing the diseases symptoms directly, palliative care improves patients feel and can participate in their life by providing indispensable holistic health management and support for patients and families. Hospice is the focused service of palliative care, provided by specially trained healthcare professionals. Evidence suggests that patients are poorly educated on chronic illnesses, providers are failing to have end of life discussions with patients, and providers are poorly educated as to services available to patients at end of life. This quality improvement project was designed to assess provider knowledge of hospice and palliative care utilization. Convenience sampling was used to …

Job Satisfaction Among Nurse Practitioners Who Work At Retail Health Care Centers, Karen Morrissey

Walden Dissertations and Doctoral Studies

Retail health care clinics (RHCCs) were designed to ease the shortage of access to primary care by having nurse practitioners (NPs) provide quality care to patients on a walk-in approach. RHCCs can be stressful work environments and when NPs become dissatisfied, they may leave RHCCs which creates a shortage of primary care access. The purpose of this descriptive study, guided by Herzberg’s dual-factor theory, was to determine if there was a relationship between: (a) challenge/autonomy, and professional growth and job satisfaction among NPs who work at RHCCs and (b) intrapractice partnership/collegiality, professional, social and community interaction, time and benefits and …

Advanced Practice Nursing Roles, Regulation, Education, And Practice: A Global Study, Kathy J. Wheeler, Minna Miller, Joyce Pulcini, Deborah Gray, Elissa Ladd, Mary Kay Rayens

Nursing Faculty Publications

Background and Objectives: Several subgroups of the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network (ICN NP/APNN) have periodically analyzed APN (nurse practitioner and clinical nurse specialist) development around the world. The primary objective of this study was to describe the global status of APN practice regarding scope of practice, education, regulation, and practice climate. An additional objective was to look for gaps in these same areas of role development in order to recommend future initiatives.

Methods: An online survey was developed by the research team, and included questions on APN practice roles, education, regulation/credentialing, and practice climate. The …

A Translational Research Framework For Nurse Practitioners, Mary Ryder, Elisabeth Jacob

Research outputs 2022 to 2026

Aims This study aims to explore a proposed translational research continuum for nurse practitioners. Background Nurse practitioners are acknowledged as clinical leaders responsible for transforming health care delivery. It is important that nurse practitioners contribute to health care knowledge using scientific processes for the implementation of evidence-based practice and evaluation of outcomes of interventions for their patient groups. Evaluation This paper provides a review of translational research literature including implementation science to align nurse practitioner activities to a modified translational research framework. Key Issues A translational research framework has the potential to strengthen nursing research in the nurse practitioner role. …

Factors Influencing The Development And Implementation Of Nurse Practitioner Candidacy Programs: A Scoping Review, Lisa Whitehead, Diane E. Twigg, Rebecca Carman, Courtney Glass, Helena Halton, Christine M. Duffield

Research outputs 2014 to 2021

Background

To meet the growing needs of a diverse population, it is critical that healthcare service provision is underpinned by innovative, cost-effective, and sustainable services and solutions. The role of the nurse practitioner creates an opportunity to meet the increasing demands of complex care and enables greater access to high quality care. Understanding how best to support nurse practitioner candidates to develop into the nurse practitioner role will create greater opportunities to transform service delivery and improve healthcare outcomes.

Aim

To identify key factors that support and positively impact the implementation of nurse practitioner candidacy programs and candidate experiences.

Methods …

Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar

Walden Dissertations and Doctoral Studies

Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …

Chronic Disease Management In A Nurse Practitioner Led Clinic: An Interpretive Description Study, Natalie Floriancic

Electronic Thesis and Dissertation Repository

Statement of research problem: Nurse practitioner led clinics (NPLC) in Ontario (ON) represent a model of care that is potentially well-situated to improve primary healthcare delivery. There is currently limited knowledge about this model of cares impact on patients with chronic disease. This study explored current chronic disease management practices implemented by Nurse Practitioners (NP) within NPLCs across ON.

Methods: Using a qualitative interpretive description methodology, eleven in-depth semi-structured interviews were conducted with nurse practitioners practicing within NPLCs in Ontario.

Results: Results indicate NPLCs successfully support patients with chronic disease through provision of on-site multidisciplinary care, continuity in service provision …

Promotion Of Heart Failure Self-Care In The Outpatient Setting, Meredith C. Lubas

Seton Hall University Dissertations and Theses (ETDs)

Medical management of chronic heart failure consists of a closely managed medication regimen, cardiovascular testing, interventions, and lifestyle modification, including self-care practices. While medication management, testing, and interventions have concrete guidelines, heart failure self-care education lacks solid guidelines and thus is often poorly defined and variable in practice. Outpatient heart failure treatment typically focuses on medication management more than self-care practices. This project addresses the current lack of heart failure self-care education in the outpatient setting.

For this project, a total of seven patients with heart failure with a reduced ejection fraction received a patient survey in order to assess …

Acute Care Pediatric Nurse Practitioners As Leaders: Perceptions, Self-Identity, And Role Congruity, Katie Mcdermott, Christine A. Schindler, Krisjon R. Olson, Tara L. Petersen

College of Nursing Faculty Research and Publications

Introduction

This study aimed to gain an understanding of practicing acute care pediatric nurse practitioners’ (AC-PNPs’) perceptions of themselves as leaders in both clinical and professional contexts.

Method

This qualitative study was conducted at a midwestern quaternary care children's hospital. Cultural domain analysis, semistructured interviews, and free listing techniques were employed to identify areas of consensus and variation among a convenience sample of AC-PNPs.

Results

Findings demonstrated the AC-PNPs have a limited self-view of leadership.

Discussion

Nurse practitioners need additional leadership capacity and capability building during graduate education, the transition to practice, and throughout their careers.

Nurse Practitioner Opioid Prescribing And Safety Measure Utilization Patterns In Ontario: An Explanatory Sequential Mixed Methods Study, Gina Pittman

Electronic Theses and Dissertations

Background. There has been a rise in opioid-related hospitalizations, emergency department visits, and mortality due to opioid poisoning across Canada. There is a gap in research related to Nurse practitioner (NP) opioid prescribing and safety measure utilization patterns and sparse literature related to physician opioid prescribing (Pittman et al., 2020). Purpose. A mixed methods approach, specifically an explanatory sequential three-phase study, was undertaken to explore this topic. The initial phase was development of the quantitative survey, followed by collection and analysis of the quantitative data. A final qualitative phase added insight into the quantitative results. There were four objectives for …

Methods To Stop Caffeine Use And Minimize Caffeine Withdrawal Symptoms In The State Of Caffeine Dependence: A Literature Review, Morgan Behling, Blaine Winters

Student Works

Caffeine is the most consumed psychoactive drug in the world and those who consume it frequently become dependent. Even if individuals desire to quit caffeine, they may not be able to due to withdrawal side effects, or a lack of knowledge of how to quit. Harmful effects of long-term caffeine consumption include fatigue, irritability, headaches, nausea, and depression. The goal of this literature review was to explore current evidence on different methods to quit or reduce caffeine use and minimize caffeine withdrawal effects in those who are dependent. A literature review of studies from 2014 to 2020 was conducted using …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

Balancing Provider Stress And Resilience In The Time Of Covid, Zachary Love

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice project is to improve secondary traumatic stress (STS), compassion satisfaction, and burnout amongst providers—physicians, residents, and nurse practitioners—within the acute psychiatry units of the La Jolla Veterans Health Administration (VHA) through a one-time educational training session.

Background: Mental health providers at the VHA acute psychiatry units experience one of the highest risks for the development of STS, CF, and burnout amongst all professions due to a number of individual and institutional factors. STS is characterized by secondhand traumatization with symptoms similar to that of Post-Traumatic Stress Disorder—difficulty sleeping, mood changes, upsetting images appearing …

Assessing The Perceptions And Attitudes Of Burnout Syndrome In Nurse Practitioners In Primary Care Settings, Keisha D. Mckinsey

Electronic Theses and Dissertations

The implications of workload and personal and patient-related burnout have been identified in numerous physicians’ studies. While burnout syndrome has become a subject of great interest for examining provider burnout to assess successful solutions, there is minimal research unique to nurse practitioners in primary care settings. This project was intended to determine the prevalence and effect of nurse practitioners’ burnout in primary care settings and make recommendations for improving nurse practitioners’ overall health and well-being. The key outcomes of concern for this project were, first, improvement in burnout scores on the Copenhagen Burnout Inventory tool pre- and posteducational intervention, and …

Can The Role Of The Nurse As Surgical Assistant Add Value In The Australian Public Health Care Sector?, Toni Hains, Anojan Navaratnam Dr, Andrew O'Brien, Karen Walsh, Jane Neilsen, Susan Firth

Journal of Perioperative Nursing

While the role of the Registered Nurse/Nurse Practitioner as surgical assistant has been underutilised in the Australian public health care sector, this role adds value by enhancing learning opportunities for medical and nursing staff. This extended practice role also provides a mechanism for increasing nurses’ job satisfaction leading to nursing workforce retention and workforce capacity building. Additionally, a consistent and experienced nurse in the role of table-side assistant for robotic-assisted surgery can improve patient safety, communication and enhance surgical flow.