Medicine and Health Sciences Commons^™

Early Home Visits By A Registered Nurse Care Manager With Heart Failure Patients, Dana Davis Blake

Nursing Theses and Capstone Projects

Strategies focused on 30 days in the life of a patient with heart failure will have limited impact on the burden that heart failure will have nationally or individually. The broader landscape of readmission risk underscores the need for a more comprehensive approach to heart failure management. Care management with a registered nurse demonstrated efficiently coordinate care. Home visits address the peaks of risk in the post-discharge transition and palliative phase while providing longitudinal support. The purpose of this study is to substantiate that early home visits and telephone followup with a registered nurse after discharge from the hospital will …

Patient Education And Coumadin (Warfarin) Therapy: Readmission Rates Pre/Post Coumadin Team Initiation, Rebecca L. Barber

Nursing Theses and Capstone Projects

As a response to the 2011 National Patient Safety Goals (NPSG), a Coumadin Team, consisting of a Physician Chair, Pharmacists, and Registered Nurses, was formed at Mission Health System to focus on International Normalized Ratio (INR) testing, Coumadin dosing, and patient education. The goal of this team has been to identify and eliminate barriers that prevent the stabilization of INRs within the prescribed goal range, and to ensure that all patients receive education about Coumadin therapy in order to prevent harm and reduce readmission rates related to Coumadin therapy. The purpose of this study is to compare readmission rates within …

Relationship Between Psychotropic Drugs And Falls In The Geriatric Population, Lauren E. Fletcher Crotts

Nursing Theses and Capstone Projects

Falls in the geriatric population are extremely common and the risk for falls continues to increase with age. Falls are a leading cause of mortality in the geriatric population, and it is the number one reason for institutionalization in the United States. The purpose of this study was to explore the relationship of the prescribing effects of psychotropic medications such as antidepressants, benzodiazepines, and antipsychotics on falls in the geriatric population who live in a long term care community with a diagnosis of depression, dementia, anxiety, delirium, and Alzheimer's disease. The literature provided mixed conclusions on the effects of psychotropic …

Examining Nursing Students' Retention Of Taught Content By Repeat Study And Repeat Testing: A Replicated Study, Rebecca Oglesby

Nursing Theses and Capstone Projects

This project was a replication of a previous study conducted with medical residents to determine if repeat testing produced higher scores as compared to repeat study. Current literature reports that repeated testing produces higher scores than repeated studying. This project was conducted with first semester nursing students who were provided a learning session on two topics, followed by a multiple-choice test and review sheet for each topic. Two groups were randomly assigned. Each group tested on either Topic A or Topic B (Asepsis and Oxygenation) and studied the other topic. Testing sessions were held on the teaching day, at two …

Academic Incivility In Nursing Education, Sherrie Marlow

Nursing Theses and Capstone Projects

A well-documented and growing problem impacting the nursing shortage in the United States is the increasing shortage of qualified nursing faculty. Many factors contribute to the nursing faculty shortage such as retirement, dissatisfaction with the nursing faculty role and low salary compensation (American Association of Colleges of Nursing (AACN), 2005; Allen, 2008; National League of Nursing (NLN), 2010; American Association of Colleges of Nursing (AACN), 2011). Academic incivility has been identified as contributing to nursing faculty role dissatisfaction (Clark & Springer 2010). Academic incivility diminishes the presence of a caring environment, lowers an individual's self-esteem, and negatively impacts the formation …

Patient Comfort And Multimodal Analgesia: Effects Of Preoperative Ibuprofen, Rodney Nash

Nursing Theses and Capstone Projects

Multimodal therapy for surgical patients is explified by use of a combination of a non-steroidal anti-inflammatory and an opioid to control visceral pain by decreasing both inflammation and pain transmission. Perioperative or postoperative use of multimodal therapy has been shown to provide adequate surgical pain relief while decreasing the total dose of opioids required. This project demonstrated that preoperative use of ibuprofen for women undergoing total laparoscopic hysterectomy decreased the total dose of opioids consumed in a 24-hour period, and increased the likelihood of the patient reaching her pain goal target at discharge. This finding adds to the literature support …

Assessment Of Nurses' Knowledge And Attitudes Toward Pain Management: Novice To Expert, Robin J. Sherrill

Nursing Theses and Capstone Projects

Despite 20 years of work by educators, clinicians, and professional organizations and the publication of clinical practice guidelines, there have been, at best, modest improvements in pain management practices (Berry & Dahl, 2000). Literature review asserts, nurses' continue to have knowledge deficits and ongoing negative attitudes toward pain management. Nurses are at the forefront in patient care and the appropriate skills, knowledge, and attitudes in pain assessment and management is essential in order to provide optimal patient care. The purpose of this study was to assess the current level of nursing knowledge and attitudes toward pain management from Benner's continuum …

A Descriptive Study Of Second Year Adn Students On The Use Of Study Groups Outside The Classroom, Francine Hebert Sheppard

Nursing Theses and Capstone Projects

Study groups formed independently by students outside the classroom environment have been reported to provide some positive assistance to the learning process. This study was conducted to define the frequency that students use such study groups, to establish any relationship between using study groups and academic outcome, and to identify any themes common to the participants when describing their perceptions and experiences with study groups. The study utilized a previously-published survey tool acquired from the public domain. Forty-five ADN students enrolled at a private, Christian university participated in this study. Sample mean age of participants was 25.7 years of age. …

Development Of A Lateral Workplace Incivility Nurse Liaison Position In The Psychiatric Healthcare Setting, Christopher L. Brown

Nursing Theses and Capstone Projects

Workplace incivility is becoming commonplace in all work environments including health care. Research highlights the dangerous, distressing, and costly side effects of lateral workplace incivility (LWPI) including nursing staff's overall health, organizational commitment, and intent to stay. Historically, organizations have been considered safe work environments but LWPI has increased over the last several decades. There has also been limited research related to LWPI as it affects psychiatric healthcare staff and no study recommending a needs assessment or developing a position to educate and assist victims. The purpose of this project was to assess psychiatric healthcare staff's understanding and exposure to …

Improving Patient Flow Through The Implementation Of A Results Pending Treatment Area, Heather L. Bryant

Nursing Theses and Capstone Projects

Abstract

The purpose of this research study is to retrospectively evaluate whether the implementation of a Results Pending Treatment Area (RPTA) altered patient flow patterns and therefore reduced patient length of stay (LOS) for ambulatory patients in a Level One Trauma Center Emergency Department. The research is justified because a reduction in the length of stay for patients is shown to decrease overcrowding, ED wait times, loss of revenue, and diversion while improving patient safety and patient satisfaction. The Roy Adaptation Model was the overarching theoretical conceptual framework utilized to support the research, with a more detailed emphasis on Swanson's …

Medication Safety: Improving Faculty Knowledge And Confidence, Sharon S. Cherry

Nursing Theses and Capstone Projects

The purpose of this capstone project was to increase knowledge and confidence among nursing faculty assisting pre-licensure nursing students with the medication administration process. The project administrator designed a one day Safe Medication Practices seminar that included a Medication Administration Toolkit to increase knowledge and confidence in faculty members about safety and efficiency in giving medications with multiple students on any clinical day. This toolkit included high-fidelity simulation medication scenario case examples as a teaching pedagogy, as well as other teaching strategies to utilize in the clinical environment. Bandura's Social Learning theory provided the framework for this capstone project. The …

The Effects Of A Care Delivery Model Change On Nursing Staff And Patient Satisfaction, Kathleen Gier

Nursing Theses and Capstone Projects

Hospitals across the nation are faced with the challenge of providing high-quality, cost-effective patient care. The purpose of the research study, The Effects of a Care Delivery Model Change on Nursing Staff and Patient Satisfaction, was to examine the impact of implementing a team-approach care delivery model on defined outcomes of staff satisfaction and patient satisfaction. A quasi-experimental design study was utilized to examine the effects of implementing a team-approach care delivery model on a 33-bed Medical-Surgical unit. Prior to and after implementation of the new care delivery model, data were collected regarding patient and staff satisfaction. All nursing and …

Floating Nurses To Specialty Areas, Deborah S. Hickman

Nursing Theses and Capstone Projects

As the largest group of health care providers, nurses play a vital role in the safety and satisfaction of patients. Despite this vital role, the nursing shortage continues to grow. As a result of this shortage and to fix staffing insufficiencies, nurses are frequently assigned to work in an area that they are not familiar with. This reassignment of a nurse to a different unit from their normally assigned unit is referred to as "floating." Nurses that are reassigned to a different unit from their normally assigned unit are referred to as "float nurses." Some healthcare professionals believe the use …

The Late Preterm Infant: How Much Transition Time Is Needed To Prevent Hypothermia?, Sandi Lane

Nursing Theses and Capstone Projects

Late preterm infants are those infants born between 34 weeks and 36 and 6/7 weeks gestation. They are generally the same weight and appearance of full term infants and are treated in level 1 or well baby nurseries the same as full term infants. Late preterm infants are not as physiologically mature as full term infants and have problems that may go overlooked. Late preterm infants experience complications such as hypothermia, hypoglycemia, respiratory difficulties, and feeding problems that lead to hyperbilirubinemia. These complications can lead to longer hospital stays or readmissions and higher healthcare costs. It is the purpose of …

Registered Nurses Perceptions Of Patient Advocacy Behaviors In The Clinical Setting, Irma Laney

Nursing Theses and Capstone Projects

Healthcare is becoming more complex and advanced; there is an increase in patient's awareness and safety, higher educational levels of the public, internet access, improved medical technology, development of the Patient's Bill of Rights, and distrust of experts. Patients are often left vulnerable and helpless in the healthcare setting due to limited knowledge about medicine, healthcare, illnesses, and their rights. The purpose of this thesis was to provide an understanding of the RN's perceptions of patient advocacy behaviors in the clinical settings. King's Interacting Systems Framework and middle range Theory of Goal Attainment provided the framework used to identify the …

Evidence Based Practice: Patient Discharge Education Barriers To Patient Education, Catherine Lyerly Lingle

Nursing Theses and Capstone Projects

Evidence-based guidelines for discharge instructions, when successfully administered, reduce readmission rates in patients, leading to improved quality of life and economic savings. Unfortunately, effective delivery is complex and time consuming, placing a high demand on already overworked bedside nurses. Failure to provide complete discharge instructions can result in non adherence to patient treatment regimens and lack of essential follow-up, the most commonly identified reasons for readmissions. To improve quality of care, hospitals need to adopt a new model that incorporates delivery of intensive, one on one education to patients during the hospital stay with continuing support, guidance, and education throughout …

The Effect Of A Simulation Experience On Student Perception Of Self Confidence, Ginny N. Little

Nursing Theses and Capstone Projects

The aim is to determine if participation in a high-fidelity simulation increases student levels of self-confidence. Thirty-eight first year associate degree nursing students enrolled in a medical-surgical course in a southeastern community college participated in a diabetes simulation as part of their course. Students then voluntarily completed a survey indicating self-confidence following the simulation. Descriptive statistics were used to determine the overall mean of student responses to each question on the National League for Nursing (NLN) Student Satisfaction and Self Confidence in Learning Tool. Students rated the teaching helpful and effective with a mean score of 4.47 (sd = .951). …

A Structured Orientation Development System For Nursing Faculty, Dana R. Mangum

Nursing Theses and Capstone Projects

A national nursing shortage is nearing its crest. The Baby Boomer generation is beginning to retire in record numbers. Healthcare technology is continually evolving and the topography of nursing education is changing. In order to acquire, develop, and retain excellent nursing faculty to meet the ever changing demands, nursing faculty need to be streamlined into the world of academia. A Structured Orientation Development System (SODS) was developed to aid nursing faculty into the transition from expert bedside nurse to expert nursing faculty. A literature review found no evidence of a structured type nursing faculty orientation system. The purpose of this …

Nurses' Perceptions Of Shared Medical Appointments, Kristin Monza

Nursing Theses and Capstone Projects

With the increased economic burdens placed on Americans in recent years, the topic of healthcare has been in the forefront. As healthcare reform embraces the country, healthcare organizations are forced to re-examine their business structure more accurately to reflect the changing culture and patient population. The Shared Medical Appointment (SMA) is a model in the chronic disease setting, and many of the benefits and proficiencies have been studied but no studies have assessed nurse experiences or perceptions of SMAs. The purpose of this study was to determine the Registered Nurses's experience with and perception of SMAs. A descriptive exploratory design …

The Effect Of Diabetes Education On Self-Efficacy And Readmission Rates Of Diabetic Patients, Angela M. Rasheed

Nursing Theses and Capstone Projects

The purpose of this study was to determine the effect of a diabetes education program on self-efficacy and readmission rates of diabetic patients. All participants were recruited based on their current enrollment with one of the largest primary care physician's practices in the Southeastern United States. Qualifying criteria included the diagnosis of being either diabetic type I or II and commitment to attend a five-week diabetes educational workshop. Participants were given the Diabetes Self-Efficacy Survey at the initial start of the diabetes educational program and also at the end of the five-week workshop to evaluate the effectiveness of the diabetes …

Compassion Fatigue Among Emergency Department Nurses, Tracy Ann Petleski

Nursing Theses and Capstone Projects

Aim: The purpose of this capstone project was to determine the prevalence of compassion fatigue among emergency department nurses. Background: Healthcare workers especially nurses working in high acuity areas are at high risk for developing compassion fatigue, burnout, and secondary stress. A concern is nurses working in the emergency department are at risk for developing compassion fatigue and should be aware of the concept, self-care activities, and available resources to improve compassion satisfaction scores and to reduce the effects of compassion fatigue burnout, and secondary stress on nurses' working in stressful environments. Method: The project was carried out at a …

The Effect Of Emotional Freedom Technique On Stress And Anxiety In Nursing Students, Susan L. Patterson

Nursing Theses and Capstone Projects

Stress and anxiety have been identified as significant issues experienced by student nurses during their education. In fact, some studies have suggested that the stress experienced by nursing students is greater than that experienced by medical students, other non-nursing healthcare students, degreed nurses, and the female population in general. A recently introduced energy type therapy, Emotional Freedom Technique (EFT), combines the tapping of meridian points with a focus on the feared object or negative emotion to provide desensitization to the fear. In addition, there is repetition of a statement of self-acceptance suggested to contribute to cognitive restructuring. The purpose of …

Pregnancy Resolution Counseling With Adolescents, Michelle Taylor Skipper

Nursing Theses and Capstone Projects

The results of a positive pregnancy test for an adolescent female mandate a time-sensitive decision to be chosen on the outcome of that pregnancy--whether to continue to pregnancy or terminate. Ambivalence regarding the pregnancy in adolescence is typically high as the rate of unplanned pregnancies has been reported as high as eighty-six percent. In this project, Allanson's Abortion Decision Balance Sheet (ADBS) was modified to an age-appropriate literacy level and completed by nine adolescents in a public health department setting in the project "Pregnancy Resolution Counseling with Adolescents" (PRCA). Providing objective questions related to emotions regarding the pregnancy was proposed …

Awareness Of Academic Incivility: Comparison Utilizing Second Year Associate Degree Nursing Students, Myra T. Thompson

Nursing Theses and Capstone Projects

Academic incivility is a growing concern on college campuses ranging from rude behaviors, offensive language, and cheating, to hostile violent behaviors. A quantitative descriptive design was used to compare the awareness of perceptions regarding academic incivility among fourth semester nursing students currently enrolled in a private, Christian, Baptist-related university, and a rural public community college. As evidenced in the literature, uncivil behaviors in the classroom negatively impact the teaching-learning environment. Research is limited regarding academic incivility in the private institution. An identifiable gap in research is found when comparing awareness of academic incivility among students who attend a private institution …

Improving Faculty Perceptions Of And Intent To Use Simulation: An Intervention Project, Charles Tucker

Nursing Theses and Capstone Projects

Human patient simulation is an innovative teaching strategy that can facilitate practice development and preparation for entry into today's healthcare environment for nursing students. Unfortunately, the use of human patient simulation has been limited due to the perceptions of nursing faculty members. This project sought to explore those perceptions using the Theory of Planned Behavior attributes of attitude, subjective norm, and perceived behavioral controls. A two phase project explored the use of an educational workshop intervention to change faculty perceptions and potentially improve intent to use human patient simulation by the nursing faculty. While the educational workshop intervention demonstrated statistically …

Registered Nurses Experience With And Perceived Effects Of Horizontal Violence, Reba B. Williams

Nursing Theses and Capstone Projects

The prevalence of horizontal violence in nursing has been well documented in the past 20 years. Recently the focus of the literature has been on developing strategies to prevent horizontal violence from occurring. The purpose of this exploratory descriptive study was to ascertain how Registered Nurses at one rural North Carolina hospital experienced and perceived horizontal violence. A "zero" tolerance policy was in place at the time of the study. The Nursing 2011 horizontal violence survey was used to examine a convenience sample of 40 nurses in this facility. The subjects were employed in seven different units throughout the hospital. …

Cultural Bias Education Of Nursing Faculty, Frank Castelblanco

Nursing Theses and Capstone Projects

A cultural bias education seminar was presented to nursing faculty at a private university in Western North Carolina in an attempt to increase the level of cultural competence. Leininger's "Culture Care and Universality"; a nursing theory was used as the theoretical framework for the project and Campinha-Bacote's Inventory for Assessing the Process of Cultural Competency Among Healthcare Professionals, Revised (IAPCC-R) was employed to measure the pre- and post-cultural competence levels of the nursing faculty. The faculty voluntarily completed the pre-assessment, the seminar was completed and 17 participants completed the post assessment. The statistical findings illustrated an increase in total cultural …