Medicine and Health Sciences Commons^™

Building Excellence Through Shared Governance And Continuous Process Improvement, Deborah Reitter

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Nursing shared governance in the hospital setting is a well-established structure for shared decision-making between staff nurses and nurse leaders to improve nursing practice, quality of care, and patient safety. Establishing effective, shared governance can take several years: new skills must be acquired, new behaviors accepted, and new professional commitments made. Newcomers to shared governance require support, education, and the opportunity to acquire requisite skills; otherwise, interest, commitment, and achievement of desired outcomes cannot be sustained.

Local Problem: A large hospital in California established a shared governance structure in 2018. Performance gaps between two high-performing Nursing Unit Councils …

Barriers Of Bronson School Of Nursing Program, Karla Kline

Honors Theses

Aside from the rigorous coursework of nursing school, nursing students experience various barriers that impact their academic success. Barriers to successful completion of traditional Bachelor of Science of Nursing (BSN) programs include isolation, lack of peer connections, lack of faculty connections, lack of family support, lack of financial support, and mental health struggles (Shaw, 2015) (Seal & Woods, 2021). This research will aim at assessing and exploring these barriers students are facing, along with the additional or exacerbated barriers the COVID-19 pandemic has surfaced.

This study will expand on the research conducted by Shaw (2015), in which she examined the …

Benchmark Study On The Impact Of Nurse Managers’ Leadership Style On Job Satisfaction And Retention Of Nurses, Khatrina Swarup

MSN Capstone Projects

Nurse managers play a crucial role in the healthcare system as they ensure that quality care is maintained and provide the necessary support for the nursing staff to perform their responsibilities well, amongst other duties. Nurses want patients to receive quality, cost-effective care, and these patients want the same. If nurses are happy with their jobs, they provide quality patient care, improving overall patient outcomes. Also, job dissatisfaction predicts how individuals perform at work and whether they intend to leave their position or not.

The current standard of practice does not specify what leadership styles nurse managers or leaders should …

Strategies To Prevent Hospital Acquired Pressure Injuries In The Intensive Care Unit, Theresa Ann Pomerleau

Doctor of Nursing Practice

Background. Despite prevention strategies, hospital acquired pressure injuries continue to occur, especially in intensive care units. This led to an impetus for nurses to have a robust knowledge of pressure injuries to promulgate prevention strategies in their practice. Significance of the Problem. The hospital acquired pressure injury rate in the medical surgical intensive care unit for the year 2019 at Hospital X was greater than the national benchmark. Purpose. The global aim statement was to improve the quality of patient care by developing an evidence based educational suite in collaboration with interdisciplinary team members for prevention of hospital acquired pressure …

The Influence Of Gender Bias On Male Nurses And Nursing Students In The Obstetric, Maternal, And Pediatric Nursing Profession., Julian Alvarez

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This literature review analyzes if gender bias influences the disproportionate number of male nurses and male nursing students in the pediatric, maternal, and obstetric nursing fields as compared to nursing as a whole. PubMed and CINAHL databases were utilized to find 15 research articles focused on the experiences of male nurses and male nursing students. These articles were compared amongst each other to find common themes of the male experience in the nursing fields of pediatrics, maternity, and obstetrics. The three common themes found were 1) Men tend to encounter situations where their professionalism will be monitored more closely when …

Impact Of Covid-19 Related Deaths On New Nurses In Rhode Island, Jessica Petonak

Senior Honors Projects

The purpose of this project was to identify the impact that COVID-19 related deaths have had on nurses with limited bedside experience in the state of Rhode Island. Exploring the level of preparedness that nurses felt to deal with death can provide insight into nursing and employer education. Hearing about nurses’ experiences during the pandemic helps illustrate the current state of nurses’ mental health. Gaining a better understanding of the amount and types of support that nurses on the frontlines are receiving can identify current gaps and potential areas of improvement. I found that the COVID-19 pandemic and related deaths …

Filling The Knowledge Gap For Nurse Leaders: Next Steps Following Covid-19, Mikel W. Hand, Catherine Alexander, Bret Lyman, Joy Parchment, M Lindell Joseph, Esther Chipps

Faculty Publications

The purpose of this article is to share gaps in knowledge and research related to pandemic management identified by nurse leaders during the COVID-19 pandemic. As part of a larger Delphi study, nurse leaders responded to an open-ended question about gaps in research they saw as important following the pandemic. Responses were analyzed using directed content analysis. Results are presented as 4 supercategories: Organizational leadership preparedness, adaptive leadership in crisis, innovations in care delivery, and health, well-being, and resilience.

Understanding The Lived Experience Of Health Through The Exploration Of Well-Being Of Women With Multiple Sclerosis In Southwestern Ontario, Jennifer Howard

Electronic Thesis and Dissertation Repository

The prevalence of Multiple Sclerosis (MS) is increasing globally with 2.8 million cases worldwide as of 2021, with Canada experiencing the highest incidence for this disease (Multiple Sclerosis International Foundation [MSIF], 2021; Multiple Sclerosis Society of Canada [MSSC], 2021). MS is an autoimmune disease that damages the myelin sheath in the central nervous system (spinal cord and brain) which may result in problematic symptoms such as cognitive dysfunction and lead to physical disability (MSSC, 2021). There are over 90,000 Canadians with MS, impacting women on a ratio of 3:1 compared to men (MSSC, 2021; Statistics Canada, 2013). Current literature suggests …

Aspects Of The Physical Work Environment And Nursing Work, Yolanda Keys

Nursing Theses and Dissertations

Objective: The purpose of this body of work is to inform nurse leaders and design professionals of opportunities to leverage the physical environment to enhance the overall work environment for nurses.

Background: The environments in which nursing work takes place need to support the staff who work within them. Healthy work environments have been shown to improve outcomes for patients, nurses, and organizations; however, the contribution of the built environment to the overall work environment for nurses is not fully understood.

Methods: Included in this portfolio are three studies: 1) a descriptive study exploring the experiences of …

The Influence Of Parental Obesity On Children And Adolescents, Seth Seward, Kaylee Eckert

Fall Showcase for Research and Creative Inquiry

Obesity in America is an epidemic, with a total of 42.4% of adults having a BMI over 30.0. In Healthy People 2030, America set the goal of decreasing childhood and adolescent obesity from 17.8% of our population to 15.5%. Obesity is directly related to a higher risk of developing hypertension, hypercholesterolemia, diabetes, asthma, anxiety, and depression. Through our literature review, we created the question 'During the ages of 2 to 18, are children and adolescents who have obese parents at an increased risk for obesity and related health diseases in comparison with children and adolescents who do not have obese …

The Impacts Of Consuming Peanuts During Pregnancy, Hannah Irons, Grace Jones

Fall Showcase for Research and Creative Inquiry

Peanut allergy accounts for the majority of severe food-related allergic reactions. Childhood allergies have increased in prevalence by 50% between 1997 to 2011 with peanut allergies almost tripling between 1997 and 2017 (Turke, 2017). It tends to present early in life and affected individuals usually do not outgrow it. Reactions to peanuts can range from mild to severe, such as anaphylaxis. The diagnosis of a peanut allergy is confirmed with the detection of peanut-specific IgE (Czolk R., 2021). The question remains "how does one develop a peanut allergy?" Our research project has used evidence-based practice and nursing research to determine …

Mandatory Nurse-To-Patient Ratios Impact On Nurse Satisfaction In California Icus, Emily Mcguire, Anna Schmied

Fall Showcase for Research and Creative Inquiry

The purpose of this research was to determine if nurse satisfaction was greater in California intensive care units (ICUs) where there is a mandatory nurse-to-patient ratio of 1:2, one registered nurse (RN) to two patients. Greater nurse satisfaction contributes to the overall improvement of both nurse and patient outcomes. Nurses who work in intensive care units experience high rates of mental distress and poor health due their job demands. Research shows that the mandatory nurse-to-patient ratios in California ICUs lead to fewer work injuries, greater nurse retention, and less burnout - all of which improves nurse satisfaction. This is compared …

Does Smoking Cessation Counseling Improve Success Rates In Adult Smokers Who Desire To Quit Compared To Both Pharmacologic Therapy For Cessation And No Therapy Or Counseling?, Madison Pribble, Trevor Leonard

Fall Showcase for Research and Creative Inquiry

This research is aimed to answer the question: does smoking cessation counseling improve success rates in adult smokers who desire to quit compared to pharmacologic therapy for cessation and no therapy or counseling? We looked at health-related literature to determine which method of smoking cessation had the highest success rates. In our research we expected to find that success rates were greatest when individuals had a combination of pharmacotherapy in conjunction with counseling. A report of the Surgeon General compiled results of studies reporting the efficacy of numerous cessation therapies and their success. Our research of these and other reports …

Policy Analysis Of The Illinois Nurse Practice Act (Aprn Title Section 65/65-50), Sara Kim

Doctor of Nursing Practice Projects

Background

Physician groups claim allowing nurses to use the title "doctor" confuses patients. Nurses assert that the title is common to many disciplines, and nurses should be trusted like other professionals to identify their specialty to patients. Currently, qualified nurses in Illinois using the title "doctor" in clinical areas must introduce themselves to each patient in the following way: "Hi, I'm Dr. Smith, the nurse practitioner taking care of you today. I do not have a degree in medicine, and I am not a physician or medical doctor” (225 ILCS § 65/65-50).

Purpose

This project aimed to evaluate Illinois Nurse …

Physical Assessment Skills Taught In Nursing Curricula: A Scoping Review., Sherry Morrell, Natalie Giannotti, Gina Pittman, Adam Mulcaster

Nursing Publications

OBJECTIVE: This scoping review sought to establish the current state of knowledge regarding physical assessment skills taught globally in undergraduate nursing curricula. Explicitly, the review aimed to determine which skills are being taught via curricula and which skills are performed by students in clinical placements, as well as what physical assessment skills are being used by registered nurses in practice.

INTRODUCTION: Nursing programs are expected to teach the physical assessment skills required for entry-level registered nurses to practice competently. The discrepancy lies in determining which skills are essential to teach entry-level nurses and which are unessential.

INCLUSION CRITERIA: Studies that …

Spiritually Influenced Health: Results Of A Health Promotion Initiative In Houses Of Worship, Crystal C. Shannon

International Journal of Faith Community Nursing

Promoting health within communities is a primary responsibility for nurses and other healthcare professionals. This involves the active incorporation of spiritual and faith-based approaches to health. Challenges remain in the delivery of effective health delivery that incorporates faith for at-risk communities. This is a retrospective descriptive study designed to explore the effects of faith-based health promotion sessions on existing health habits within local faith organizations from 2015-2018. The protocol utilized nursing students as project developers in collaboration with faith leaders and subject matter experts in the delivery of health education on nutrition, cardiac health, and physical activity. Findings suggest positive …

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 …

Perceptions And Nursing Demands And Experiences In The Midst Of An International Crisis (Pandemic): A Qualitative Study Of Nurse Educators’ Experiences, Lorelli Nowell, Swati Dhingra, Kimberley Andrews, Jennifer Jackson

Quality Advancement in Nursing Education - Avancées en formation infirmière

The COVID-19 pandemic caused widespread disruption to nurse educators’ work, both within higher educational institutions and in clinical practice learning environments. In this study, we explored the experiences of nurse educators in academic and clinical settings during COVID-19 and the impact the pandemic has had on their work. We conducted semi-structured interviews with 15 nurse educators from six different countries and used thematic analysis to gain a comprehensive understanding of nurse educators experiences during the pandemic. The participants’ experiences were classified into stages that reflected the intensity of the pandemic and resulted in four themes: (a) the calm before the …

Burnout In The Nursing Profession: Extant Knowledge And Future Directions For Research And Practice, Sara Labelle

Nursing Communication

Burnout is a psychological state resulting from prolonged psychological or emotional job stress, and is a culmination of three factors: emotional exhaustion, depersonalization, and reduced personal accomplishment. Due to the nature of the “people-work” they must constantly perform, along with a highly stressful and unpredictable work environment, nurses have alarmingly high rates of burnout among members of their profession. Given the importance of research on burnout to understanding the context-specific stressors and challenges of nursing, this review offers a synthesis of research published in the last decade in both nursing and communication journals, with an emphasis on discussing opportunities for …

Burnout In The Nursing Profession: Extant Knowledge And Future Directions For Research And Practice, Sara Labelle

Communication Faculty Articles and Research

Burnout is a psychological state resulting from prolonged psychological or emotional job stress, and is a culmination of three factors: emotional exhaustion, depersonalization, and reduced personal accomplishment. Due to the nature of the “people-work” they must constantly perform, along with a highly stressful and unpredictable work environment, nurses have alarmingly high rates of burnout among members of their profession. Given the importance of research on burnout to understanding the context-specific stressors and challenges of nursing, this review offers a synthesis of research published in the last decade in both nursing and communication journals, with an emphasis on discussing opportunities for …

Shifting Taxonomies In Home Care Nursing Information Behavior: Patients, Pandemic, Community, Richard P. Smiraglia, Edmund Pajarillo, Elizabeth Milonas, Sergey Zherebchevsky

Publications and Research

IKOS has continued to monitor the nursing information behavior (NIB) of home care nurses. In earlier reports we described how we developed an online taxonomy of NIB. We then took on a qualitative analysis of video representations of home care nursing in the pandemic. Merging the codes from two rounds of open coding yielded a set of categories (or axes) that could be used to construct a narrative analysis. Contextual quotations from the video transcripts further reveal the intensity of the potential taxonomic extension. The importance of this research for knowledge organization is the understanding we develop concerning shifting taxonomies …

The Effects Of Debriefing On Nurse Distress After Perinatal Loss, Russin Marie Kelly

Doctor of Nursing Practice Scholarly Projects

Labor and delivery nurses are the first-line caregivers for women suffering a perinatal loss which involves miscarriage, stillbirth, and infant death. This loss of life can cause nurses’ distress. This project proposes using the PEARLS healthcare debriefing tool as an intervention to decrease distress and improve nurse satisfaction. Before and after the debriefing intervention, a survey allowed the nurse to rate their distress from zero to ten using the distress thermometer and answer questions about job satisfaction. The data analyzed shows that the debriefing intervention decreased nurse distress after perinatal loss compared to the prior practice of no debriefing after …

Shifting Employabilities: Skilling Migrants In The Nation Of Emigration, Yasmin Y. Ortiga

Research Collection School of Social Sciences

This paper examines how Philippine state agencies sustain its labour-exporting strategies by encouraging aspiring migrants to invest in their own training and education, taking on the responsibility of turning themselves into desirable workers for employers overseas. Based on a document analysis of newspaper articles and Philippine government reports, this paper uses the case of Philippine nursing education to show how the Philippine state alters these discourses of skill when overseas opportunities decline, channelling aspiring migrants sideways to other sectors of the labour market. Discourses of employability justified these career detours to aspiring migrants by assuring them that such experiences will …

Code Gray Response Team, Charlie A. Brizzee

IPS/BAS 495 Undergraduate Capstone Projects

This video presentation addresses the declining feeling of safety by frontline clinical staff due to the recent escalation of combative patients and workplace violence in the healthcare setting, identified through Emotional intelligence and the approach created to address it. This project was crafted as an innovative and creative approach to addressing the issue in the clinical setting without adding additional staff or additional expense to the organization. Additionally, the approach had to be innovative and creative as the author does not own the current process, and knowing to receive stakeholder acceptance, the ownership had to remain with the current stakeholder. …

Development Of An On-Job Mentorship Programme To Improve Nursing Experience For Enhanced Patient Experience Of Compassionate Care, Alma Arshad Hookmani, Naureen Lalani, Noureen Sultan, Aly Zubairi, Ayesha Hussain, Babar Hasan, Muneera A. Rasheed

Department of Paediatrics and Child Health

Background: Evidence suggests improvement in nursing staff satisfaction, competence, and retention after implementation of evidence-based mentorship programmes. When guided by a framework of compassion, mentoring as a caring action can not only build healthy, transformative relationships but a similar behavior is reciprocated to patients which subsequently can drive patient experience of care. However, examples of on-job mentorship programs for nurses in low- and middle-income countries (LMIC) are limited.
Objective: The objective of the study was to develop an on-job nursing mentorship programme using a compassionate framework aimed at improving nurses' experience and thus enhancing patient experience in a tertiary care …

Telesimulation Innovation On The Teaching Of Spikes Model On Sharing Bad News, Zohra Kurji, Azaina Aijaz, Amina Aijaz Khowaja, Zohra Asif Jetha, Shanaz Hussein Cassum

School of Nursing & Midwifery

Coronavirus disease 2019 (COVID-19) brought to the world, an unprecedented emergency, which dramatically affected the face-to-face teaching in higher education academia. University faculty and students had to shift overnight to an online and remote course instruction. They were neither trained nor prepared and had limited resources and infrastructure. Palliative Care and Oncology Stream Faculty at Aga Khan University, School of Nursing and Midwifery, Pakistan, piloted an innovative academic project using telesimulation (TS). Trainee nurse interns were taught communication skills and the art of breaking bad news to palliative clients using the SPIKES model through TS. To incorporate best practices for …

By Utilizing Technology Can Nursing Students Gain More Confidence And Decrease Anxiety When Communicating With Chronically Ill Patients About Their Sexual Relationship?, Sheri Rickman Patrick, Alice Butzlaff

Faculty Research, Scholarly, and Creative Activity

Introduction
Effective communication is an essential part of nursing care. Nurses need to effectively communicate with patients, families, providers and staff. The purpose of this study was to show how the use of technology (i.e., video conferencing on an electronic device) could assist nursing students to gain more confidence and reduce anxiety when discussing difficult topics such as sexual intimacy.
Methods
Pre-licensure nursing students were recruited to participate as part of regular class activities. A pre- and post-survey asking about their confidence and anxiety in communicating with patients was completed; then subjects were randomly placed into groups of 4 to …

Setting The Research Agenda For Nursing Administration And Leadership Science: A Delphi Study, Esther Maria Chipps, M Lindell Joseph, Catherine Alexander, Bret Lyman, Logan Mcginty, Heather Nelson-Brantley, Joy Parchment, Reynaldo R. Rivera, Mary Anne Schultz, Danielle M. Ward, Susan Weaver

Faculty Publications

Objective: The aim of this study was to identify and prioritize research topics for nursing administration and leadership science.

Background: Nursing administration and leadership research priorities should provide a framework for building the science needed to inform practice.

Methods: The Association for Leadership Science in Nursing (ALSN) and American Organization for Nursing Leadership (AONL) Foundation (AONL-F) for Nursing Leadership and Education collaborated on a Delphi study. Initial input on research priority items were received from ALSN and AONL members. National experts participated in a 3-round Delphi study.

Results: Top-ranked priorities included: 1) nurses' health, well-being, resiliency, and safety in the …

The Discursive Construction Of Substance Use And Harm Reduction In Canadian Health Policy, Sibel Kusdemir

Electronic Thesis and Dissertation Repository

Harm reduction as a philosophy has been widely recognized by healthcare professionals in Canada, yet the topic remains controversial in both political and public discourses. Understanding these discourses will allow health care providers to better respond to political and public concerns, as well as ensuring that services are aligned well with public health needs. This study explored the discursive use of the term “harm reduction” in Canadian health care and nursing policy documents’ contexts by using a Foucauldian framework and Bacchi’s ‘what’s the problem represented to be?’ approach. I propose three discursive themes: self-responsible citizen, evidenced-based practice, and what nurses …

“I Can’T Be The Nurse I Want To Be”: Stories Of Moral Distress In Pediatric Oncology Nurses’ Caregiving Narratives, Monica L. Molinaro

Electronic Thesis and Dissertation Repository

This thesis presents the caregiving narratives of nine pediatric oncology nurses that illustrate the embeddedness of their caregiving and moral distress within institutional contexts that limit their capacity to be the nurses they want to be. Informed by the concepts of moral distress, bearing witness, and narrative repair, a critical narrative methodology was employed to examine the nurses’ caregiving experiences in relation to broader discourses and neoliberal, corporatized health care settings. The nurses’ stories were marked by ambivalence and moral distress and are presented in four narrative themes, which illustrate: the nurses’ struggles to complete their tasks and address multiple …