Medicine and Health Sciences Commons^™

The Impact Of Evidence-Based Diabetes Self-Management Education In A1c Levels In Adults With Type 2 Diabetes, Concepcion Fanous

MSN Capstone Projects

Diabetes Mellitus II is a leading cause of death in the United States, imposing a significant healthcare cost. According to the Centers for Disease Control and Prevention (CDC, 2020), one out of every ten Americans have been diagnosed with diabetes, with 90 to 95% of them having type 2 diabetes (T2d). Effective management T2d is crucial to prevent clinical complications, expensive medical care, and a diminished quality of life. Uncontrolled diabetes can lead to severe medical complications including atherosclerotic cardiac cardiovascular disease, renal disease, and microvascular disease (American Diabetes Association [ADA], 2021). The economic burden of diabetes complications amounted to …

Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis

MSN Capstone Projects

The significance of appropriate nurse staffing in enhancing patient outcomes and mitigating nurse burnout is well-documented. Inadequate nurse staffing can lead to negative consequences, including burnout, decreased nurse retention, and potential safety risks (Shin et al. 2018; Wynendaele et al. 2019) Research has also established a strong connection between nurse-to-patient ratios, well-being, and job dissatisfaction among nursing staff (Andel et al. 2021; Thompson-Munn et al. 2021).

Given this evidence, there is a compelling rationale for aligning nurse staffing ratios with proposed federal standards to address burnout, improve well-being, and enhance patient outcomes. Implementing these changes necessitates careful planning and assessment. …

Animal-Assisted Therapy In Mental Illness, Chanae Cypress

MSN Capstone Projects

Mental health disorders are a significant global health concern, with a growing need for alternative therapeutic approaches. Animal-assisted therapy has gained recognition for its potential to improve the emotional and psychological well-being of individuals struggling with these disorders.

This Capstone Benchmark proposed project explores the potential positive impact of animal-assisted therapy (AAT) on patients with mental health disorders during inpatient hospitalization. The project outlines a 4-week intervention program involving 45-60 minutes sessions with dogs, which patients receive 2-3 times per week. For this Capstone Benchmark project, the selected PICOT question is: In patients with mental health disorder (P) how does …

Continuity Of Care In The Post-Partum Period, Ashley Quezada

MSN Capstone Projects

Maternal mortality rates in the United States have been a growing concern over the past decade, with rates continuing to climb as recent studies have been published. The total maternal mortality rate in the United States in 2018 was 17.4 and has increased to 32.9 as of 2021, while other developed countries continue to decline (Hoyert, 2023). The maternal mortality rate is the number of deaths per 100,000 live births. More than 50% of pregnancy-related deaths in the United States occur after delivery, in the post-partum period (Melillo, 2020). The purpose of this report is to not only bring light …

Leadership Style And Nursing Retention, Brenae J. Reason

MSN Capstone Projects

Nursing is the heart of healthcare, for decades we have been the drivers of innovation and have contributed to so many advancements in the profession. Even with nursing being a sincere passion amongst many nurses, there is an alarming trend of nurses who are faced with burnout (Brusie, C., n.d.). It has been reported that 1 in 5 nurses left their position in one particular health system (Andreyeva et al., 2023). It is also noted that turnover can be costly for organizations (Zuniga et al., 2019). While there are a multitude of reasons nurses could be leaving their companies, one …

Organizational Methods Of Reducing Burnout: The Impact Of Self-Rostering On Work-Life-Integration, Cory Authement

MSN Capstone Projects

With burnout being at an all-time high, organizations must find new ways to prioritize staff wellbeing and promote work-life balance. According to the Emergency Nurses Association (ENA) turnover in emergency departments ranges from 15-30% within the first year of nursing, and 43% within the first three years (Roncallo et al., 2020). These turnover rates cost a 300-bed facility approximately four million dollars in annual expenditure (Hesse, 2016). This level of loss and expenditure is unsustainable for the future of nursing and diverts resources away from our patients.

In recent studies, it was shown that burnout leads to difficulties for nurses …

Benchmark: Reducing Surgical Plume Output With Smoke Evacuation, Kaitlynn Olano

MSN Capstone Projects

This project focuses on addressing the critical issue of surgical smoke exposure in operating rooms through the strategic implementation of smoke evacuation systems. The primary objective is twofold: to prioritize the safety and well-being of healthcare professionals and to ensure that patient care remains uncompromised. It strives to reshape the operating room environment, making surgical plume exposure a thing of the past.

Extensive research forms the core of this project. A comprehensive literature synthesis, including systematic reviews, randomized control trials, prospective and cohort studies, and qualitative research, underscores the occupational safety concerns related to surgical plume exposure. This synthesis strongly …

Improving Clinical Competence With Electronic Medical Record Training In Nursing Students: A Benchmark Study, Ashley Reddock

MSN Capstone Projects

Nursing students are required to do many clinical hours based on their program, the Board of Nursing and their accrediting body. During these clinicals, students are faced with challenges that cause safety concerns due to lack of exposure or knowledge regarding policies and procedures. What seems like a simple task, could be life altering because of inadequate competency.

Performing at an expected level of education and demonstrating integration of knowledge, skills, abilities, and judgement defines competency according to the American Nurses Association (ANA) (2018). Nursing programs are expected to produce competent students, and competent nurses upon graduation. Displaying competency in …

Evidence-Based Pain Management With Inclusion Of Music Therapy For Post-Surgical Patients: A Benchmark Study, Ashleigh Rowan

MSN Capstone Projects

Improper pain management in the postsurgical patient can delay proper healing, increase frustration for the patient, and prolong hospital stays (Córcoles-Jiménez et al., 2021). Moderate to severe pain can pose a greater risk for complications such as deep vein thrombosis, pneumonia, and delayed recovery (Kolaczko et al., 2019). Music therapy is an underutilized pain intervention in the PACU environment. Music therapy has been shown to lower pain and anxiety scores in many different clinical settings (Lee et al., 2017). Pain management can radically improve a patient’s outlook and recovery (Luo & Min, 2017). Patients who return to wakefulness and receive …

Perceptions And Awareness Of Operating Room Staff Regarding Surgical Smoke: Implications For Safety And Health, Karla Flores

MSN Capstone Projects

In the ever-evolving landscape of modern medicine, surgical procedures have become increasingly complex and reliant on energy-based devices, leading to the ubiquitous presence of surgical smoke in ORs. This phenomenon, while a byproduct of technological advancement, poses significant concerns regarding the health and safety of OR personnel, including surgeons, nurses, anesthesiologists, surgical technicians, and ancillary staff. This paper presents a meticulous examination of the multifaceted impacts of surgical smoke, emphasizing the urgency for comprehensive intervention and systemic change.

Cardio-Pulmonary Resuscitation Without The Pulmonary? A Benchmark Project, Fernando A. Rios

MSN Capstone Projects

Cardiac Arrest occurs outside of the hospital setting more than you think. According to MyCares.net, 15% of OHCA happened in a public setting in 2020. Even if you are a trained healthcare professional, it may not be accessible at times in these situations due to different factors such as equipment availability, trained assistance, etc... Having an alternative option to conventional mouth-to-mouth rescue breath CPR would encourage trained and untrained bystanders to perform life-saving interventions to patients until local EMS responders can arrive. The covid pandemic affected everyone inside and outside the medical world. The general population got a real …

Utilizing Mock Code Simulation To Enhance Nurses’ Confidence A Benchmark Project, Denecia Mark

MSN Capstone Projects

Each year, about 292,000 adult patients in the United States have an in-hospital cardiac arrest (IHCA), with substantial variance in their rate of survival (Merchant et al., 2020). Graduate nurses must be knowledgeable and prepared to respond to codes. Mock Codes or simulation-based teaching will allow nurses to practice skills, expand their knowledge, and gain self-confidence in a secure and controlled setting with no risk to patients, reducing nurses' anxiety. CPR certification is currently updated every two years, and research has shown that learned skills begin to deteriorate after three months. As a result, if simulated codes are introduced skills …

The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins

MSN Capstone Projects

In 2023, the National Council of State Boards of Nursing revealed that 100,000 nurses left the workforce during the COVID-19 pandemic and another 900,000 plan to leave by 2027 due to stress, burnout, and retirement. Identifying and implementing practical strategies to reduce voluntary turnover as a result of stress and burnout is a top priority for nursing leaders across the country. Work engagement and job satisfaction have well been documented in the literature as antidotes to occupational stress and burnout in the nursing profession (Schaufeli & Bakker, 2004; Pressley & Garside, 2022). Evidence suggests that implementing shared governance is a …

Effect Of Doula Care Education On Cesarean Section Rates: A Benchmark Study, Elena Rubio-Mcdonald

MSN Capstone Projects

A cesarean section (CS) is a vital maternal care intervention when necessary; however, the surgical procedure places childbearing women at direct risk for infection, hemorrhage, thromboembolism, injury to bladder or bowel, post-surgical pain, and complications from anesthesia. The risk of mortality associated with CS is four to five times more likely compared to vaginal delivery. Severe nursing shortages, high patient volumes, and patients with complex pregnancy related health concerns create barriers to the provision of continuous labor support (CLS) by labor and delivery (L&D) nurses. Partnering with certified doulas and implementing the CLS methods they employ may promote spontaneous vaginal …

A Provider In Triage To Decrease “Left Without Being Seen”: A Benchmark Project, Taylor B. Weathers

MSN Capstone Projects

As Emergency Departments (ED) continue to fill and become crowed, the attention to care of each patient can be delayed or missed. Back flow into the ED can cause a bottleneck effect for patients coming in, which can lead to an increase in the number of patients who leave without being seen (LWBS). In order to combat the challenges of patient throughput that result in patients leaving prior to care, I am proposing the implementation of a provider in triage (PIT). By placing a provider, either physician or mid-level practitioner, in the triage area will allow patients to been seen …

Green Tea Supplementation: An Effective Lifestyle Modification For Cholesterol Management, Samuel J. Nemati

MSN Capstone Projects

Hypercholesterolemia is an insidious disease and the leading factor to the deadliest killer in the United States – cardiovascular disease (Centers for Disease Control and Prevention, 2023a). Over 85 million American adults suffer from elevated cholesterol, and treatment can prove challenging and may require multiple modalities outside just pharmaceutical intervention – such as dietary and other lifestyle changes (Centers for Disease Control and Prevention, 2023b; Goldman, 2023). Green tea – among the most common teas consumed worldwide – exerts a uniquely antihyperlipidemic and cardioprotective effect that suggests its consideration as a potentially-viable nonpharmacological option for hypercholesterolemia (Harvard Health Publishing, 2012; …

Benchmark Study Of Early Palliative Care In End-Stage Liver Disease, Pebble Ward

MSN Capstone Projects

Patients with ESLD in general have high rates of healthcare utilization, resulting in more than 250,000 hospitalizations at $9.8 billion annually in the United States (Ufere et al., 2019). Liver disease is a rising cause of death worldwide, affecting younger people, but palliative care is largely absent for these patients (Kimball et al. 2018). Early readmissions are common for patients with ESLD and in the U.S. alone, over 25% of patients are readmitted within 30 days of their initial diagnosis, rates that now exceed those seen for patients with CHF and COPD (Ufere et al. 2019). Evidence shows that early …

Massive Transfusion And Shock Index, Kasey House

MSN Capstone Projects

Hemorrhagic shock is one of the leading causes of preventable death in military trauma patients. Literature shows that pre-hospital transfusions of blood products within the combat environment have shown to have a greater likelihood of survival. This has produced a challenge in the pre-hospital setting to have a standardized method of predicting the patient’s need for a massive transfusion. In the last few years, the development of a Massive Transfusion Protocol (MTP) has become the standard to quickly deliver blood products to actively bleeding patients. Every minute waiting to administer blood products increases mortality by 5%.

While initiating an MTP …

America Heart Association Guidelines On Telemetry Monitoring To Reduce Alarm Fatigue And Improve Patient Outcomes, Rekike Aster Ehrenberg

MSN Capstone Projects

The excessive use of telemetry monitoring in healthcare has become a widespread concern, leading to increased healthcare costs and alarm fatigue among providers. These issues threaten patient safety and negatively impact patient outcomes. To address these issues, the American Heart Association (AHA) has published guidelines for telemetry monitoring to reduce alarm fatigue and improve patient outcomes.

A three-month benchmark project was conducted using evidence-based methods to implement the AHA guidelines for telemetry monitoring in a medical-surgical unit. The project aimed to serve as a model for others with similar issues. By following the AHA guidelines, patient safety can be enhanced, …

The Effects Of Non-Pharmacological Interventions For Behavior And Psychological Symptoms Of Dementia: A Benchmark Study, Rachel R. Williams

MSN Capstone Projects

The management of behavioral and psychological symptoms of dementia (BPSD) in patients who reside in nursing homes can be challenging. These neuropsychiatric behaviors can include but are not limited to aggression, agitation, delirium, depression, and psychosis (Cloak & Al Khalili, 2022). Patients with BPSD often have difficulty expressing their needs due to the disease process, resulting in further complexity when managing behaviors. There are no psychotropic medications to treat BPSD specifically, but many are often prescribed to treat the symptoms or behaviors exhibited by patients. The use of psychotropics, especially long-term can cause a myriad of adverse effects and should …

Improving The Mental Health Of Nursing Students By Utilizing A Serenity Room: A Benchmark Study, Megan E. Taylor

MSN Capstone Projects

Research findings consistently show that even though improvements have been made through the years, there is much more work to be done concerning mental health nationwide, especially in nursing. Nurses are the front-line workers in healthcare and face challenging times daily. Mental health-related issues in nursing have increased on a national level since the COVID-19 pandemic (Xiong et al., 2022). A more significant nursing shortage will likely occur without drastic change and support for nurses’ well-being.

The purpose of this paper is to describe a benchmark Capstone project. This benchmark study was conducted with the goal of improving nursing students …

Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner

MSN Capstone Projects

Although a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.

The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, …

Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner

MSN Capstone Projects

Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …

The Effects Of Education On Influenza Vaccination Uptake, Jazzlyn Lawson

MSN Capstone Projects

Influenza is a viral illness that occurs internationally and peaks in prevalence during the months of October to May. There are several types of influenza viruses: Influenza A, B, C, and D (CDC, 2023). Vaccines are available in the United States as early as the start of the flu season to those who wish to receive it. The influenza virus types covered by the annual flu vaccine include Influenzas A and B types (CDC, 2023). The influenza vaccine is recommended by the CDC with the intent to limit the occurrence and spread of influenza each year. Symptoms of influenza consist …

Palliative Care And Quality Of Life Improvement: A Benchmark Study, Rebecca Daniels

MSN Capstone Projects

This project provides an overview of the standard and regular implementation of palliative care versus early implementation of palliative care in patients with chronic or terminal illnesses. Palliative care is an essential component of healthcare that focuses on improving the quality of life and providing support to patients through holistic elements to patients and their families facing chronic and terminal illnesses. With evidence-based research, many articles have been published with implementation of early palliative care showing improvement in patient and even caregiver quality of life. This project includes evidence gathered from mixed methods of systematic review of existing literature, randomized …

The Role Of Safety Interventions In Decreasing Unplanned Extubations In Pediatrics: A Benchmark Study, Wesley Bray

MSN Capstone Projects

Unplanned extubation (UE) is the removal of an endotracheal tube from a patient any time before their planned extubation. In layman’s terms it is when a patient loses their airway before they were ready. These events lead to longer hospital stays, cost hospitals thousands of dollars for each case and can cause severe complications for the patient including death. Pediatric patients are a population that are at risk of UEs more so than the general population due to their inability to understand what is going on in the hospital due to their age and development, as well as their ability …

Effects Of Chlorhexidine Products On Nosocomial Infections: A Benchmark Study, Sarah Withers

MSN Capstone Projects

Healthcare associated infections (HAI) are more than a burden as they can result in subsequent complications, prolonged patient stays in the hospital, as well as additional antibiotic treatment. The evidence-based change project will focus on ensuring that patients with any form of a central line who are admitted to the intensive care unit (ICU), receive a bath using chlorhexidine gluconate (CHG) products once daily as well as the use of antimicrobial intravenous (IV) caps.

Workplace Violence In Emergency Departments, Education And De-Escalation Training: A Benchmark Study, Summer Block

MSN Capstone Projects

Most people do not go to work and fear being assaulted or harassed daily. However, for emergency nurses in this county that is exactly what it has come to. Up to 96% of emergency department nurses state they have been verbally abused. This entails name calling, verbal threats, being shouted at and being sworn at. Anywhere from 25% to 60% of these nurses have had to face physical assaults while on the job. (Al-Aadi, 2020; Copeland & Henry, 2017; Grinberg, 2022; Li et al., 2019; McDermid et al., 2019). Physical assaults can include being spit on, slapped, punched, kicked, choked, …

Vaginal Preparation In Cesarean Delivery To Decrease Surgical Site Infections: A Benchmark Study, Angelica Ware

MSN Capstone Projects

This benchmark project intends to decrease the rate of surgical site infections related to cesarean procedures with vaginal preparation through an evidence-based approach. Vaginal preparation is a simple technique that cleanses the vaginal walls by removing microorganisms. The goal of the benchmark project is to promote the implementation of a vaginal preparation policy across any healthcare facility that performs cesarean procedures. Vaginal preparation is intended for scheduled cases, add-on cases, and urgent cases. The benchmark study does not include emergent cesarean deliveries, as vaginal preparation is at the discretion of the physician in those cases.

The topic of surgical site …

Body Dysmorphia Screening Tool For Aesthetic Treatments, Brandi Harper

MSN Capstone Projects

This evidence-based project includes a discussion of Body Dysmorphic Disorder (BDD) or body image disturbance as part of pre-treatment screening in medical facilities providing appearance-altering procedures and aesthetic treatments to adult patients. The information provided serves as the foundation for endorsing the adoption of a BDD screening tool into clinical practice to increase the identification of body dysmorphia, thereby facilitating proper referral, diagnosis, and treatment to aid in patient safety and satisfaction and limit medico-legal imputations. The discussion presented here is supported by evidence-based research. It focuses on BDD prevalence and significance amongst adult patients and highlights validated screening tools …