Medicine and Health Sciences Commons^™

Official Mentor Program Benchmark Project, Gabriela O'Hara

MSN Capstone Projects

Nursing shortage, turnover, and low job satisfaction are constant issues that often trouble healthcare organizations. These issues have led organizations to implement programs, such as externship, internship, and preceptor programs to strengthen new nurses’ professional practice and skills. However, these issues continue to be organizational challenges. Considering the need for new nurses to have a supportive foundation for their career and to further encourage workplace satisfaction and retention, the following PICOT question was developed: In a healthcare organization, how does an official mentor program, compared with not having a mentor program, influence nursing retention and nursing job satisfaction over 2 …

Mitigating Burnout In The Pediatric Intensive Care Unit, Katelyn O. Mcgaughy

MSN Capstone Projects

Burnout is defined as a “prolonged response to chronic emotional and interpersonal stressors on the job leading to a combination of physical and emotional exhaustion” (Lachman, 2016). The effects of burnout syndrome among nurses are well documented in the literature. Burnout is associated with an increased incidence of a variety of physical and psychological symptoms, including weight loss or gain, lethargy, headaches, sleep issues, anxiety, depression, and difficulty concentrating (Lachman, 2016). As a result of these symptoms, nurses experiencing burnout are more prone to provide poorer quality care to patients and are at heightened risk of commission of errors in …

Qt Monitoring In The Icu: A Benchmark Project, Jeffrey S. Woodward

MSN Capstone Projects

In adult Intensive Care Unit (ICU) patients, does QT/QTc monitoring compared to no QT/QTc monitoring affect mortality or ventricular tachyarrhythmia rates during their ICU stay? Not monitoring changes in the QT interval can lead to poor outcomes since mortality rates are higher in patients with arrhythmias (Uvelin, Pejakovic, & Mijatovic, 2017). Approximately 300,000 sudden cardiac deaths occur in the United States each year with an estimated 15,000 because of a lethal ventricular tachyarrhythmia rhythm called Torsades de Pointes (TdP) that occurs when a QT interval is prolonged (Dave, Bessette, & Setnik, 2017). Some risk factors for developing prolonged QT intervals …

Acuity-Based Staffing: Improving Patient Outcomes And Staff Satisfaction, Natalie Long

MSN Capstone Projects

Traditionally, nurse staffing practices have been based on a nurse-patient ratio model and have not incorporated patient acuity. More recent literature has shown that acuity-based staffing can improve patient outcomes and staff satisfaction. The Emergency Department (ED) is an area that has fluctuating patient acuity and volume. To incorporate acuity in to staffing in the ED, the acuity mix over the past year can be used to calculate required nursing hours, therefore providing the number of required nurses for that facility. The calculated number of staff can then be distributed over a 24 hour period. By incorporating acuity in to …

Continuous Glucose Monitors To Decrease Hypoglycemia, Sara B. Woodcock

MSN Capstone Projects

Diabetes is a disease that affects millions of people from children to older adults. There is no cure, although it can be managed to prevent complications. Education of student nurses is where they are born and raised to become nurses who save and change lives. Teaching student nurses in depth about diabetes as a disease and the treatments that best fit their specific needs is where educating patients begins. Learning about a secondary option for blood glucose checks can make all the difference for several patients. Multiple finger sticks daily has been the leading way to check blood sugar for …

Implementation Of A Fall Prevention Program, Hannah L. Gott

MSN Capstone Projects

Improving patient safety and outcomes are unequivocal goals of hospital organizations because the business of healthcare would not be possible without our patients. One of the most prevalent reasons patients can experience poor outcomes is due to falls. There are numerous interventions already in place in organizations to prevent and eliminate these patient events, but they still occur. This study aims to provide a practical and structural approach to eliminating patient falls by implementing a fall prevention program. This fall prevention curriculum includes utilization of bedside shift report, safety huddles, and code fall teams.

The Relationship Between Hand Washing And Hospital-Acquired Infections, Qian Gao

MSN Capstone Projects

Hand hygiene is a hot topic all the time since it is a simple yet effective way to prevent infection. For the staff who work in the hospital, they need to perform hand hygiene thousands of times. Hospital-acquired infections are caused by viral, bacterial, and fungal pathogens. The most common types of infections are bloodstream infections, pneumonia, urinary tract infections, and surgical site infections. There are many articles that emphasize the benefits of hand hygiene and the decreasing rates of hospital-acquired infections. However, few of these articles focus on the education aspect of hand washing. The author reviews the articles …

Emergency Department Homeless And At Risk Homeless Screening Benchmark Study, Emily Mulder

MSN Capstone Projects

Individuals experiencing homelessness drastically overutilize emergency department (ED) services compared to non-homeless individuals (Ku et al., 2014). Many unhoused individuals have serious medical and psychosocial needs, which are chronic in nature, and become exacerbated due to poor management while living on the streets (Ku et al., 2014). The health needs of such individuals would be best managed through primary care continuity. However, care coordination becomes complex when a patient does not have a physical address or knowledge of available community resources (Mitchell, León, Byrne, Lin, & Bharel, 2017). By understanding the unique barriers that homeless and at risk homeless patients …

Mindfulness Meditation For Nursing Students, Christine Cho

MSN Capstone Projects

This capstone project discusses an eight-week Mindfulness Meditation Program for nursing students. It can be implemented virtually or face-to-face in either the didactic or clinical portion of a course. This capstone project was implemented virtually. The purpose of the project is to introduce mindfulness meditation to nursing students to build resilience and reduce stress. The weekly topics include: Orientation, Being Fully Present, Responding Mindfully Without Judgment, Communication, Teamwork, Compassion, Balanced Life, and Closure. Pre- and post-assessments of anxiety, stress, and mindfulness are evaluated with the Burn Anxiety Inventory (BAI), Perceived Stress Scale (PSS-10), and Mindfulness Attention Awareness Scale (MAAS). Mindfulness …

Self-Engagement To Decrease Blood Pressure Readings And Decrease Non-Compliance., Teresa G. Townes

MSN Capstone Projects

Hypertensive patients are the patients that are seen in every aspect of health-care. They are seen in outpatient clinics, home health, in-patient settings, and in home health. Many times these patients have an abundance of education to absorb and many medications to take on a daily basis. The interest of how these patients are engaged in their own health-care and how it affects their blood pressure readings.

Many patients may know that they take a medication for their blood pressure, but they might not remember the name, dosage, or frequency of the medication. When a patient cannot recall their medications, …

Critical Incident Stress Debriefing For Nurses In Emergency And Critical Care Departments, Rachel A. Davis

MSN Capstone Projects

Front-line healthcare workers such as emergency department nurses, trauma nurses, and other nurses working within intensive care services are exposed to significant trauma on the job as they care for their critically wounded and dying patients. While trauma cannot be removed from the job descriptions of such staff members, individuals and their facilities can work together to try and ensure traumatic events do not have significant, lasting effects on the mental well-being of these nurses. Critical incident stress debriefing (CISD) after traumatic events in the workplace has been cited as a relatively inexpensive way to decrease the impact of negative …

Early Initiation Of Palliative Care, Ann R. Phillips

MSN Capstone Projects

The overall aim of this project, based upon the best available evidence, clinical experience of oncology nurses, and patient preferences for information about palliative care, is to propose the creation and initiation of a protocol which empowers oncology/palliative care nurses to be able to initiate early discussions about palliative care for patients with advanced stage cancer (III-IV) diagnoses.

By having frank conversations surrounding palliative care early on in the treatment process, patients are better able to make informed decisions about treatment, depending on the trajectory their disease takes. Such conversations provide patients with a clearer picture of what is likely …

Implementation Of A Patient Acuity Tool And The Impact On Nurse Satisfaction, Amber M. Denson

MSN Capstone Projects

Increased workloads contribute to nurse stress, affect nurse-patient relationships, and can ultimately lead to nurse turnover (O’Connell, Nettleton, Bunting, & Eichar, 2020). Nurse satisfaction can also be influenced by nurse-patient assignments (Allen, 2019). Implementation of a patient acuity tool (PAT) to balance workload and evenly distribute patient acuity in nurse-patient assignments can improve nurse job satisfaction, quality of care, and nurse retention (Firestone-Howard, Gonzalez, Dudjak, & Rader, 2017; Al-Dweik & Ahmad, 2019).

Discussions were held on a 20-bed medical-surgical unit in an acute care hospital with stakeholders that included the nurse manager, charge nurses and bedside nurses at staff meetings …

Controlled Donation After Circulatory Death: Benchmark Study, Marilyn R. Strait

MSN Capstone Projects

Abstract

In potential organ donors after circulatory death (P), does the utilization of an evidence-based critical pathway from identification of potential donor to organ donation (I) versus no utilization of an evidence-based critical pathway (C) increase the rate of organ procurement and the satisfaction of donor families with the donation process (O)? A benchmark study was conducted to answer this question, and in short, yes, it does. The utilization of a critical pathway, when individualized to a local population and hospital’s organization increases the organ procurement rate, the donor family satisfaction with the process, and increases staff satisfaction with the …

Enhancing Perceptions Of Labor Experiences Through Evidence-Based Education, Sherrie Fontenot

MSN Capstone Projects

The cesarean section (C-section) rate has risen dramatically in the past several decades both in the United States and throughout the world. Domestically, the C-section rate has risen from 4.5% in 1965 to 32.2% in 2014 (National Partnership for Women & Families [NPWF], 2016a). Worldwide, roughly 19% of births occur via C-Section (Betrán et al., 2016). Concurrently, the induction rate has also increased, doubling in the United States between 1990 – 1998 (Davey & King, 2016). As of 2014, about 23% of all women had their labors induced in the United States (NPWF, 2016b). Furthermore, the trend toward electively inducing …

Hourly Rounding: The Effects On Fall Rates In Adult Population In Acute Care Setting, Sheyla J. Pellicier Mercucci

MSN Capstone Projects

Falls are one of fourteen categories of hospital-acquired conditions (HACs) listed by the Centers for Medicare and Medicaid Services (2020). Falls are costly and stressful for everyone involved; patients, families, nursing staff and physicians. According to the United States Department of Health and Human Services (2019), about seven hundred thousand to one million hospital admitted patients fall every year. The estimated cost of a fall is about fourteen thousand fifty-six dollars if an injury occurs and can extend patient’s hospital length of stay (LOS) to up to 6.3 more days (Joint Commission Center for Transforming Healthcare, 2019).

When a patient …

Geriatric Medication Adherence, Heather Granados

MSN Capstone Projects

Improved patient education can lead to increased medication adherence in geriatric patients.

Venous Thromboembolism Prevention, Heidi K. Gibson

MSN Capstone Projects

Venous thromboembolism (VTE) prevention is important to patients, families, and healthcare institutions. Education is key in prevention VTE. This educational capstone project poses the question as to what type of educational material is most beneficial in decreasing VTE and also increasing VTE protocol compliance rates among nurses. The paper addresses the following PICOT question: In staff nurses (P) how does venous thromboembolism prevention education (I) compared to no venous thromboembolism prevention education (C) affect compliance with the established thromboembolism protocol (O) during the three months following completion of the required education for the intervention group (T)?

Home Telemonitoring In Heart Failure, William Huff

MSN Capstone Projects

Heart failure (HF) exacerbation is a major source of hospitalization, mortality, and healthcare cost to home health agencies. Unmonitored accumulative fluid retention between skilled nurse visits, base knowledge deficits in HF pathophysiology and dietary restrictions, and lack of basic monitoring equipment such weighing scales are primary contributors to HF related hospitalizations in the home health setting. It has been discovered that early recognition of decompensating HF can reduce or eliminate HF related hospitalization, mortality, and healthcare costs associated with the management of exacerbation. When a patient is sent to the emergency room (ER) for fluid overload secondary to HF, massive …

Nurse Residency Program: A Critical Care Benchmark Project, Dana Wagner

MSN Capstone Projects

Nursing school is arguably one of the most challenging degree plans in existence. The level of professionalism and intelligence of newly graduated nurses (GNs) is exceptional, and the expectation is that they will excel in whatever field of nursing they choose. That said, navigating the theory-practice gap between school and a GN’s first job can be extremely intense, especially in specialty areas such as critical care. According to Belvins (2016), both The Joint Commission and the Institute of Medicine recognize that many GNs are not prepared for fast-paced, high-acuity healthcare environments. The recommendation is the implementation of additional education and …

Prevent The Preventable: Children With Hypertension Due To High-Sodium Diets., Shana M. Cobb

MSN Capstone Projects

Heart disease in the United States is the number one cause of death and costs $317 billion annually (Centers for Disease Control, [CDCa], 2018). Heart disease is usually considered an adult disease, but today we are finding that more children are developing symptoms of high blood pressure and sodium consumption is the link (Webb, 2017). Health care spending for hypertension is at an all-time high and is expected to triple over the next 20 years (Bussenius, Zeck, Williams, & Haynes-Ferere, 2018). The American Heart Association (AHA) states if sodium consumption was decreased to around 1,500 milligrams (mg) a day, blood …

High-Risk Pregnant Patients In The Third Trimester: Comparing Mental And Physical Health, Megan Maxwell

MSN Capstone Projects

The purpose of the paper is to compare physical and mental health in high-risk pregnant patients in their third trimester who are managed in an inpatient setting compared to an outpatient setting. This paper looks at specific high-risk pregnancy diagnoses.

Community Cooking Course To Combat Nutritional Knowledge Deficit, Heather R. Bohman

MSN Capstone Projects

More than two-thirds of American adults and almost one-third of American children are overweight or obese. Not only are the statistics alarming, the cost of obesity is staggering. Obesity robs an individual of their quality of life and costs the U.S. healthcare system an estimated $147 billion a year in obesity-related illness (Finkelstein, Trogdon, Cohen, & Dietz, 2009). The need to find solutions to improve the health of Americans is clear and communities are called to respond. The Centers for Disease Control and Prevention (CDC, 2018) recommends partnership with local agencies to promote obesity prevention initiatives and create a healthier …