Medicine and Health Sciences Commons^™

Oral Sucrose And The Relation To Neonatal Pain Perception, Meagan L. Burns

MSN Capstone Projects

Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (Treede, 2018). The phenomenon of pain is a personal and unique experience that many of the world’s population has experienced in some form or fashion throughout their lifetime. Neonates are exposed to many painful procedures and/or situations due to various medical ailments that may require a neonatal intensive care unit (NICU) admission. Infants have a special place in the hearts of adults all over the world, and any interventions that would increase the likelihood of diminishing or removing perceived pain in this population are likely …

Patient-Defined Plan Of Care Goals To Increase Patient Satisfaction And Communication: A Benchmark Study, Kyle D. Groce

MSN Capstone Projects

Over the last two decades, patient-centered care has been identified as a core principle for healthcare (McKeown et al., 2023). Patient-centered care has been shown to reduce overall healthcare costs, improve patient outcomes, and increase patient satisfaction (Figueroa et al., 2016; Köberich et al., 2016; McKeown et al., 2023; Araki, 2019; Morgan & Yoder, 2012). Although patient-centered care is universally recognized as an essential aspect of healthcare, there is no universally defined definition of it or how to implement it (Rassouli, et al., 2020).

Studies have shown that most patients, if given the opportunity, overwhelmingly want to be involved in …

The Effect Of Obesity On Comorbidities: A Benchmark Study, Kaley Nolen

MSN Capstone Projects

Obesity is distinguished by a body mass index (BMI) greater than 30. Tremmel et al. (2017) reports obese individuals are at a greater risk for developing cardiovascular disease, diabetes, and cancer. In 2014, approximately 641 million adults were classified as obese (Zhang et al., 2018). This epidemic has drastically worsened over the last two decades resulting in obesity ranking as the fifth most common cause of death globally (Safaei et al., 2021). Okunogbe et al. (2021) states, slowing the incidence rate of obesity by 5% will save approximately $3.3 billion annually between 2020-2060. The pathophysiology and cause of obesity is …

The Importance Of Family Presence At The Bedside Of Critically Ill Patients, Brenda K. Ramsey

MSN Capstone Projects

The purpose of this paper is to discuss the visitor restrictions on patients and their families during the COVID-19 pandemic. At the beginning of the pandemic, visitation was highly restricted with only telecommunication as a means of “visiting” with your loved one who were hospitalized, especially in the ICU settings. During my research of keeper studies for my capstone project, the articles discussed different forms of communication. The articles discussed interventions such as electronic (e-visits) for physician offices and diaries kept in the ICU for communication between family and staff. Some discussed the effects of visitor restrictions and how it …

Role Of Hand Hygiene In The Prevention Of Central Line-Associated Bloodstream Infection In Intensive Care Unit Patients: A Benchmark Project, Meliana Amazan

MSN Capstone Projects

CLABSI (Central Line Associated Blood Stream Infection) is one of the most common hospital-acquired infections in the ICUs (Intensive Care Unit). Not only it is cost prohibitive, but it also prolongs hospitalization. However, it is avoidable. This condition needs to be reviewed to improve patients’ outcomes in the ICUs. This project aims to decrease or eliminate the incidence of CLABSI among ICU patients through proper and mindful hand hygiene. Healthcare providers should be aware of the different care bundles that contribute to decreasing CLABSI and be able to apply them correctly. Articles were searched on different databases such as Cochrane …

Shift Change: Minimizing The Covid-19 Nursing Shortage And Decreasing Nursing Burnout, Suzanne R. Baker

MSN Capstone Projects

Burnout and the nursing shortage of the healthcare system is not a new issue for nurses, but the COVID-19 pandemic caused this problem to only get worse (Young, 2021). Most healthcare facilities are severely understaffed. The nursing shortage and symptoms of burnout among nurses working in the Intensive Care Units (ICU) and other high-demand COVID-19 nursing units have been magnified by the COVID-19 pandemic. Inferior working conditions such as increased work times, increased workload, and decreased training in the care of COVID-19 patients magnified nursing burnout and the ongoing nursing shortage (Galanis et al., 2021). Discovering ways to reduce the …

Early Mobilization In Critical Care: A Benchmark Study, Monica Paige Voelkel

MSN Capstone Projects

Critically ill patients often have complex injuries to multiple organ systems creating barriers to mobilization and a decrease in functional status (Bergbower et al., 2020). Early mobilization (EM) in hospitalized patients has shown to improve patient outcomes and decrease length of stay (LOS) (Bergbower et al., 2020). The link between EM and LOS is one that warrants further investigation with the PICOT question: In critically ill patients (P), how does early mobilization (I), compared to standard mobility (C) improve patient outcomes (O) over a three-month period (T)? The purpose of this paper is to discuss the rationale for the benchmark …

Implementation Of An Evidence-Base Hospital Acquired Pressure Injury Prevention Program, Brenda Miner

MSN Capstone Projects

Covid-19 hindered many quality improvement projects. As the stressors from the pandemic began to disappear the healthcare industry was struck with new struggles. These new struggles were ensuring quality care was being provided to all patients. The decline in quality care also led to a decline in reimbursement from payor sources, such as Medicare. During the pandemic the healthcare industry was at their most vulnerable state and now that the dust is settling the ramifications of just surviving are staring the industry right in the eyes. Change is difficult, but it is even more difficult following traumatic events such as …

Assessing The Impact Of Daily Chlorhexidine Baths In Prevention Of Central Line Associated Bloodstream Infections: An Evidence Based Project, Brooke Rea

MSN Capstone Projects

Background: The rates of central line associated bloodstream infections (CLABSI) is a major concern in the healthcare industry. It is imperative that healthcare professionals take every precaution to prevent these life-threatening infections to the already critically ill patient.

Objective: The reason for this paper is to assess the effectiveness of the use of daily chlorhexidine baths in patients with central lines in the prevention of CLABSIs.

Narrative Review: A narrative review of evidence was conducted to assess the effectiveness of daily chlorhexidine bathing in patients with central lines. Twelve studies were moved forward in the project. Each of the twelve …

Preventing Deep Vein Thrombosis In Surgical Patients, Ariel D. Roberson

MSN Capstone Projects

Deep vein thrombosis (DVT) is a significant medical issue that incurs thrombi formation in the venous system which can result in major medical problems. DVT’s often occur because of complications after orthopedic surgery. Common risks factors for DVT are vein injury, slow blood movement, increase estrogen, and chronic medical illness (Centers for Disease Control and Prevention [CDC], 2018). As many as 900,000 individuals are impacted by DVT each year (CDC, 2020). Consequently, recent estimates show that 60,000 to 100,000 Americans die each year because of DVT. Even more alarming, 10 to 30% of individuals will die of DVT within a …

Robot Revolution: Impacting Adoption Of The Technology, Cece Noland

MSN Capstone Projects

The author examined the value of robotic guidance platforms in spine surgery, and then implemented an improvement project to positively impact internal (Medtronic employee) adoption of the technology. By promoting adoption, robotics will continue to advance the standard of care for spine surgery patients. This paper is to meet fulfillment of requirements for NURS5382 Capstone.

Improving Safety In The Emergency Department: Utilizing Metal Detectors To Mitigate Weapon Possession, Jonathan Garcia

MSN Capstone Projects

Today’s high risk-healthcare environment has prioritized patient safety with great initiatives and, unfortunately, placed staff safety second. However, safety for both groups should be equal priorities. Evidence suggests that Emergency Departments (ED) often care for patients with a history of crime and mental health diagnoses, creating an environment where the threat of violence and weapons is increasingly prevalent compared to other clinical settings. (Erlyana, 2019) Risk mitigation is possible if we consider studies by Malka et al. (2015) and Laidlaw et al. (2017) that indicate the efficacy of metal detectors in accurately identifying concealed weapons. To improve clinician and patient …

Safe Staffing, Safe Patients Benchmark Project, Sarah Barton

MSN Capstone Projects

With the most recent pandemic, nurses have been overworked, overwhelmed, and understaffed at dangerous levels. Nurses are leaving full time employment at this facility in droves to seek better wages through traveling. In turn, our patient outcomes have taken a large hit, with an increase in falls, pressure ulcers, and catheter-acquired urinary tract infections, to name a few. This is costly for the hospital, not to mention the damper it puts on the hospital’s vision and goals. With the implementation of a nursing incentive program, the hospital could cut overall spending in half within 2 years with an investment of …

Early Mobilization For Adult Mechanically Ventilated Patients, Stephanie Miller

MSN Capstone Projects

Approximately 13 million people worldwide receive treatment in intensive care units (ICUs) annually. Many patients admitted to the intensive care unit require mechanical ventilation for their survival and attempts to mobilize these critically ill patients is frequently restricted for their own safety. It has been suggested that this lack of mobility may have a significant negative impact on the recovery process and lengthen the time of the patient’s overall hospital stay and recovery. Additionally, survivors report significant physical impairments and deconditioning that present obstacles towards their recovery and well-being after prolonged ventilation.

Pain In The Dying Patient, Shanna Selph

MSN Capstone Projects

This benchmark aims to educate nurses, doctors, and families on the importance of proper pain management in dying patients. The evidence in this benchmark will be appraised to improve practice, improve outcomes, and reduce healthcare costs (Melnyk, 2018). Feelings of being overwhelmed, fatigue, confusion, and guilt can occur in healthcare professionals without the proper knowledge of pain in the dying patient. Health professionals are responsible for ensuring proper care of patients is taken during the most difficult time of their lives to ensure they have the best quality of life through the end of their lives. The question to be …

Mindfulness Meditation To Reduce Nurse Burnout: An Ebp Implementation Project, Lester Denson Jr

MSN Capstone Projects

Hospitals across the United States are suffering from poor staffing (American Nurses Foundation, 2021). A common thread throughout those facilities is that nurses are leaving their jobs due to self-reported burnout, contributing to the staffing shortage and low morale (Shah et al., 2021).

Mindfulness training plays a part in decreasing emotional exhaustion for staff nurses. A reduction of emotional exhaustion has been discovered after the implementation of mindfulness-based intervention programs, with continued improvement after completion of the program (Sarazine et al., 2021; Bianchini & Copeland, 2021). The benefit of this implementation would be a reduction of nurse burnout which ultimately …

Alarm Fatigue Prevention Benchmark Project, Lauren James

MSN Capstone Projects

Healthcare technology is constantly evolving to find ways to help provide better outcomes for patients. Clinical monitoring is technology that helps healthcare staff recognize deterioration of the patient which allows them to intervene earlier, which increases the patient’s chance for survival. The monitors are connected to the patients to monitor vital signs such as heart rate, oxygen saturation, respirations, and blood pressures. They allow staff to get real time feedback of the patient’s condition and determine if the patient is getting better or any interventions need to be done due to clinical deterioration.

However, all technology has setbacks and downfalls. …

Group B Streptococcus: A New Perspective, Susan Harris

MSN Capstone Projects

Group B streptococcus (GBS) is a major cause of illness and death in young infants across the nation. Current guidelines suggest pregnant women should be screened from thirty-five-to- thirty-seven-weeks gestation. Although screening may be negative at that time, the expectant mother could become colonized with GBS before delivery. GBS is a pathogen that lives in the gastrointestinal and genitourinary tract of fifteen to twenty percent of women of childbearing age (Moorhead et al., 2019). GBS does not become a problem until it is passed from colonized mothers to the neonate during delivery (Virranniemi et al., 2019). When GBS is passed …

The Use Of Mindfulness-Based Stress Reduction To Reduce Stress And Burnout In Nurses, Sherri Foreman

MSN Capstone Projects

The Mindfulness-Based Stress Reduction Program (MBSR) has been used effectively in multiple clinical settings to reduce workplace stress and burnout in nurses. The MBSR’s cost-effective approach to stress management can be implemented into any healthcare facility’s policy. The topic of MBSR’s effect on stress and burnout has been identified as essential due to nurses working in fast-paced, stressful work environments. These work environments lead to increased stress and burnout. The International Council of Nurses surveyed nurses before and after the pandemic. There were 40% of nurses that reported symptoms of burnout before the pandemic compared to 70% of nurses after …

Evidence-Based Change To Address Newborn Pain During Painful Procedures, Amy M. Hines

MSN Capstone Projects

This evidenced-based practice project sought to provide evidence to change a hospital policy on addressing pain during painful procedures on newborns with the use of nonpharmacological interventions. A literature search was conducted on three databases: PubMed, Cumulated Index to Nursing and Allied Health Literature, and Cochrane. Twelve pieces of literature were included: nine randomized control trials, one systemic review, one meta-analysis, and one correlational study. The literature reviewed showed a strong positive correlation between using nonpharmacological interventions and lower pain scores of newborns during painful procedures.

Implementing Nurse-Specialist-Delivered-Education To Improve Application Compliance Of Ordered Intermittent Pneumatic Compression, Mitchel R. Perry

MSN Capstone Projects

Healthcare-associated (HA) venous thromboembolism (VTE) is the formation of a potentially deadly blood clot that can occur in patients as a result of hospitalization, surgery, procedures, etc. (Centers for Disease Control and Prevention, 2022a). HA-VTE is the number one most preventable cause of death in hospitals. The organization at which this author is associated experienced 48 VTE events during the first six months of 2020 (Mainer, 2020). Over 50% of these events demonstrate a lack of appropriate physical or mechanical VTE prophylaxis application per provider order, including sequential compression devices (SCD). The use of intermittent pneumatic compression devices (IPCD) (i.e., …

Type 2 Diabetes Treatment Plan, Kylie N. Laird

MSN Capstone Projects

Diabetes affects more than 34 million Americans, with approximately 90-95 percent of them having type 2 diabetes. Diabetes is primarily managed by the patient with assistance from their healthcare team (Centers for Disease Control and Prevention, 2021). Diabetes is a costly disease that affects individuals, healthcare systems, economies, and entire societies globally. Based on the knowledge, lifestyle interventions have shown to be effective in the management of type 2 diabetes (Garcia, 2020), a more holistic approach to disease management was pursued. Garcia (2020) conducted a study in which lifestyle intervention data for treatment of diabetes was compared to pharmaceutical management …

Postpartum Education On Maternal Morbidity And Mortality, Ashley Veasley

MSN Capstone Projects

Postpartum education, or lack thereof, is the most overlooked cause of maternal morbidity and mortality. The lack of thorough postpartum education with patient understanding is often the reason warning signs are overlooked as normal and seeking care is delayed, or not pursued at all. This narrative review aims to find research to enhance awareness of maternal morbidity/mortality and improve patient outcomes through education, including ways to intervene beforehand. The literature review began in August 2021, suitable peer-reviewed studies were retrieved from CINAHL, Cochrane, and PubMed databases. Evidence from the reviewed studies found supporting evidence indicating insufficient postpartum education related to …

Importance In Decreasing Blood Culture Contaminations, Jannery Valdelamar

MSN Capstone Projects

Blood culture collection was a skill introduced while in nursing school. We are all human and make mistakes, and sometimes errors are made. Blood culture contamination happens. It happens even more in hectic departments like Emergency Department and Intense Care Unit. The American Society for Microbiology and Clinical Laboratory Standard have recommended that the %3 should be the overall rate for blood contamination rate (Center for Disease Control, 2023). In the current facility that I am in, blood culture contamination is an enormous issue. The facility rate is 9.3%, the Emergency Department was 11.3%, and the Phlebotomy was 5.2%. Multiple …

Benchmark Study: Impact Of Electronic Health Records Vs. Paper-Based Records, Erin Emmerich

MSN Capstone Projects

Medical documentation is an essential part of healthcare and conducted at the highest standard; documentation ensures the delivery of safe and high-quality healthcare services (Noureldin et al., 2014). Performance Improvement team reports the same poor outcomes each quarter that may be a result of the paper-based documentation system. These outcomes include patient safety, patient satisfaction and cost-effectiveness. This narrative review’s purpose is to determine whether the implementation of an electronic health record (EHR) system could improve outcomes. Evidence-based guidelines for the implementation of an EHR need special consideration to have a successful transition. Further studies may need to be reviewed …

Targeted Temperature Management Following Cardiac Arrest, Kylie Carimi

MSN Capstone Projects

Cardiac arrest is often associated with the death of brain tissue resulting from the lack of oxygen supply caused by the interruption of blood circulation. For this reason, good neurological outcome following cardiac arrest is difficult to achieve. Targeted temperature management, formerly known as therapeutic hypothermia, is the maintenance of specific body temperature parameters after the return of spontaneous circulation (ROSC) following cardiac arrest (Donnino et al., 2015). The goal of therapy is to improve neurological status and facilitate healing by reducing the metabolic requirement of the brain. (Saigal et al., 2015). Therefore, the question arose, in adult patients who …

Teach-Back Education In Heart Failure Patients Benchmark Study, Bethany N. Johnson

MSN Capstone Projects

Heart failure exasperation is one of the most common causes of hospital readmission in the United States (Breathett et al., 2018). It is estimated that greater than half of all heart failure patients will be readmitted to the hospital within six months of discharge (Caluya, 2021). Additionally, one in four individuals with heart failure are readmitted within thirty days of discharge (Rahmani et al., 2020). This data shows a large area of improvement for hospitals in order to improve patient outcomes. Due to the lack of standardized discharge teaching, heart failure patients are often admitted to the hospital for the …

Evidence Based Change To Improve Outcomes In Cardiac Patients, Amy L. Callahan

MSN Capstone Projects

According to the Centers for Disease Control and Prevention, “heart disease is the leading cause of death in the United States” (CDC, 2022). Modern healthcare has made numerous advances in changing the prevalence of heart disease and has shifted resources to promoting prevention. When a patient requires admission to an acute care facility for heart disease exacerbation, the focus is more of treating the acute process and how to manage the condition moving forward.

Although there have been a substantial number of resources that have been allocated to prevention in the primary care and outpatient setting, there is a need …

Palliative Care In The Neonatal Population, Raegan Miller

MSN Capstone Projects

In more than 90% of cases of neonate deaths, terminal comfort care was provided in a Neonatal Intensive Care Unit (NICU) (Soni et al., 2011). Palliative care teams are increasing, but not enough organizations have embraced the need for better palliative care guidelines. Nor do many organizations know when, how, or if palliative care should even be introduced. These events lead to comfort care measures being underutilized in the NICU for most newborn infants with life-limiting and life-threatening conditions. Neonatal palliative care is discussed more than in years past, but little research has been dedicated to how early palliative care …

Combination Thromboembolism Prevention Prophylaxis, Karma Davis

MSN Capstone Projects

Venous thromboembolism (VTE) is a leading cause of preventable hospital death in the United States (Centers for Disease Control and Prevention, 2022). The correct selection of VTE prophylaxis in hospitalized patients is critical in stopping increased length of stays, incurring extra costs, and preventing deaths. Currently, the single modality of pneumatic compression sleeves (ICD) are often utilized for inpatient deep vein thrombosis prevention. ICDs are an easy, quick way for physicians to meet the requirement for VTE prevention in both general medical patients and those in the critical care unit. However, patients may remove or refuse this type of prevention …