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 …

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 …

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 …

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 …

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 …

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 …

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 …

A Mixed-Methods Approach To Investigating The Influence Of Education On Nurses’ Attitudes Toward Sex Trafficking Victims, Tabitha Mcdaniel

Nursing Theses and Dissertations

Significance of problem: Sex trafficking (ST) impacts victims of all ages, genders, races, and ethnicities. It is a significant public health issue which is shrouded in secrecy. Although victims are typically isolated by their trafficker, they will still seek out health care services. Nurses are frontline staff with rare access to victims in a setting where help can be given.

Purpose: The primary purpose of this mixed-methods study is to explore targeted education about sex trafficking and its influence on nursing attitudes and knowledge about sex trafficking and its victims. This study also analyzes demographic information and how those variables …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

Student Nurse Knowledge And Confidence Regarding Childhood Immunizations, Heather Westergard

Theses and Dissertations

Background: Immunization training is essential for nursing students. However, Brigham Young University's (BYU) Nursing Program lacks data regarding the current curriculum's effect on vaccination knowledge and confidence. Purpose: The purpose of the study is to explore BYU nursing students' knowledge and confidence regarding vaccinations. Methods: Nursing students at BYU in the second and fourth semesters were surveyed using pre-and post-test questionnaires designed to measure student nurses' knowledge of and confidence about immunizations. To help evaluate current curricula established immunization content was taught during both the public health course and pediatric course via direct instruction, assigned reading, quizzes, exams, lab, and …

Technological Change And The Practice Of Healthcare Communication: Implications For Patient-Centered Care, From A Communication Ethics Perspective, Emmalee Torisk

Electronic Theses and Dissertations

Written in a historical moment marked in many ways by the COVID-19 pandemic and the changes it has wrought, including the increased availability and use of telehealth services, this project attempts to consider the implications of the continued integration of technology into health care, centering on the following essential question: How do technological changes affect the contemporary practice of healthcare communication, particularly that which occurs between the patient—the consumer of health care—and their provider? This dissertation thus considers the ways in which such linkages of technology and health care seem to fit into a larger shift within health care …

Relationships Between Mindfulness, Nonacademic Factors, Stress, And Test Performance: A Cross-Sectional Study, Rebecca A. Baumeister

UNLV Theses, Dissertations, Professional Papers, and Capstones

Successful test performance is essential to nursing students. Poor performance comes with consequences such as inability to progress or removal from the program, leading to attrition. The influence of academic factors on test performance have been widely researched and stress is known to hinder it, yet other factors may also impact test performance.

Dispositional mindfulness has the potential to support test performance, but no known studies have focused on these two variables among undergraduate nursing students. A gap also exists in relation to the influence of nonacademic factors on undergraduate nursing students’ test performance. Due to the ongoing nursing shortage, …

Perioperative Management Of The Patient With Diabetes Mellitus, Alexa High

Nursing Student Class Projects (Formerly MSN)

Diabetes Mellitus is one of the most prevalent co-morbidities seen in hospitals today. As such, it is extremely important for healthcare providers to be well informed in order to care for their patients properly. This poster will adequately inform healthcare providers on key signs and symptoms, pathophysiology, diagnosis, and treatment for diabetes mellitus. This poster will also include significant information on how to care for the patient with diabetes mellitus during the perioperative period.

The Transgender Individual's Experience With Healthcare Interactions, Amy Roach

Doctorate of Nursing Science Dissertations

Previous research has identified that transgender individuals have difficulty accessing qualified and educated healthcare from health professionals. Therefore, this dissertation research study aimed to explore the transgender healthcare experience through a phenomenological lens. Additionally, the purpose of the study was to provide a transgender narrative on healthcare interactions to increase visibility and awareness of transgender-identified issues in accessing care. Specifically, aims of this study were to: (a) examine how transgender individuals perceive and experience interactions with trained healthcare professionals, such as nurses, physicians, and mental health professionals and (b) identify common issues related to transgender individuals’ barriers to care and …

Reducing Incidence Of Contrast-Induced Acute Kidney Injury Through Nursing Education, Hilarie Rankin

Doctor of Nursing Practice Projects

Contrast-induced acute kidney injury (CI-AKI) occurs commonly in patients following percutaneous coronary intervention (PCI) and has been linked to increased patient morbidity, higher risk for cardiovascular mortality, and a large burden of annual healthcare costs. The implementation of evidence-based care standards by nursing staff has been shown to reduce incidence of CI-AKI. Current discrepancies in nursing care have been linked to increased incidence of CI-AKI; therefore, the need for enhanced nurse buy-in with evidence-based protocols is paramount. The primary investigator sought to increase knowledge of CI-AKI and nursing compliance with an established evidence-based protocol at a single center hospital. After …

Improving Suicide Risk Assessment Through Educational Program Implementation, Timothy Booth

Doctor of Nursing Practice Projects

Background: Unsustainable behavioral health education focused on comprehensive suicide risk assessment performance contributes to decreased registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients.

Purpose: To educate medical-surgical and progressive care registered nurses in assessing patients for suicide risk factors and warning signs comprehensively.

Design Method: A quasi-experimental designed quality improvement project with evidence-based suicide educational program implementation. Project results yielded a 56.7% increase in registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients. Future DNP work will focus on sampling a larger population (N) to decrease opportunities for the skewness of project results …

Type I And Type Ii Diabetes Mellitus: Pathophysiology And Nursing Anesthesia Considerations, Megan Przybysz

Nursing Student Class Projects (Formerly MSN)

Diabetes Mellitus is prevalent across the globe, affecting more than 400 million people worldwide (Ogurtsova, 2017). Due to the high incidence of those affected, all healthcare providers will be responsible for the care of a diabetic patient, making it imperative that providers have a working knowledge of the pathophysiology of diabetes. This poster discusses the pathophysiology of type I and type II diabetes mellitus, as well as diabetes signs and symptoms and diagnostic criteria. There is also an examination of comorbidities associated with diabetes and how the pathophysiology of diabetes assists in the development of conditions such as autonomic neuropathy, …

Takotsubo Cardiomyopathy, Aimee Baker

Nursing Student Class Projects (Formerly MSN)

This poster evaluates the current understanding of Takotsubo Cardiomyopathy (TTC) and describes current treatment recommendations, long-term prognosis, and advanced practice nursing implications. TTC is a relatively rare disease and is present in about 2% of suspected ST-segment myocardial infarctions in women. (Sattar et al., 2017) TTC is not well understood and has several current hypotheses regarding cellular pathology. This poster explores the current understanding of pathophysiologicderangements from an organ system and two pathologic hypotheses at the cellular level. Current treatment recommendations include subclasses of treatments stratified by types of complications. Also, this poster introduces a new subclass of heart failure …

Disseminated Intravascular Coagulation (Dic), Kahl Knapke

Nursing Student Class Projects (Formerly MSN)

Disseminated intravascular coagulation (DIC) is a rare medical emergency that can have profound and potentially life-threatening conditions. DIC has a hypercoagulability phase that simultaneously leads to a hypocoagulability phase due to depletion of clotting factors. DIC is secondary complication stemming from an underlying condition. Trauma, malignancy, severe infection, reaction to a transfusion, obstetric complications, etc. are a few conditions that are commonly linked to DIC. The primary method of treatment is early identification and resolving the underlying medical condition. The management of DIC requires nursing and medical staff with keen knowledge and understanding of precursor signs of DIC and the …

Disseminated Intravascular Coagulation, Kahl Knapke

Nursing Student Class Projects (Formerly MSN)

Disseminated intravascular coagulation (DIC) is a rare medical emergency that can have profound and potentially life-threatening conditions. DIC has a hypercoagulability phase that simultaneously leads to a hypocoagulability phase due to depletion of clotting factors. DIC is a secondary complication stemming from an underlying condition. Trauma, malignancy, severe infection, reaction to a transfusion, obstetric complications, etc. are a few conditions that are commonly linked to DIC. The primary method of treatment is early identification and resolving the underlying medical condition. The management of DIC requires nursing and medical staff with keen knowledge and understanding of precursor signs of DIC and …

Diversity In Community College Registered Nursing Education, Sergio Hernández Del Cid

Ed.D. Dissertations in Practice

The United States is currently facing a shortage of trained professionals in many fields such as Science, Technology, Engineering, and Nursing (Allen-Ramdial & Campbell, 2014; Georgetown University, 2020). As a result, current U.S. nursing student demographics do not mirror the populations they serve (Gooden, Porter, Gonzalez, & Mims, 2001). Research has shown the positive impact a diverse nursing staff has on patient care (Gooden, Porter, Gonzalez, & Mims, 2001). Representative care and cultural awareness translate to better patient outcomes especially for patients from marginalized and underrepresented communities (Woods-Giscombe, Rowsey, Kneipp, Lackey, & Bravo, 2019). Community colleges play a critical role …

Examining Provider-Related Factors Associated With Role Competence In Shared Decision Making In Oncology Nurses, Alexandria Tarvainis

College of Science and Health Theses and Dissertations

Abstract

Purpose: To examine provider-related factors associated with higher levels of competence in shared decision-making (SDM) in oncology nurses.

Design: This study is a retrospective secondary data analysis of SDM survey data collected from 230 participants (oncology nurses that are active members of the Oncology Nursing Society) during February 2017 to September 2017.

Methods: Data collected from oncology nurses who actively provide direct care to patients from inpatient and outpatient oncology units in the Midwest and Pacific Northwest. Participants completed an online or mail survey on the following: knowledge, attitudes, communication, and adaptability which scores were derived from a 5-point …

Establishment Of Best Practice Skills For Advanced Practice Nurses, Leslie Kendrick, Tara Hughes, Joseph Burkard Dnsc, Crna

Doctor of Nursing Practice Final Manuscripts

Over the past two decades, nursing researchers have defined nurses’ perceptions of evidence-based practice as well as facilitators and barriers to its implementation . This project seeks to take the next step through a current assessment of registered and advanced-practice nurses’ assimilation of evidence-based practice as well as a current literature review of the research to clinical use gap. This is a cross-sectional, retrospective project. Through analysis of two self-administered questionnaires to both registered and advanced-practice clinical nurses as well as literature review findings, five recommendations for advanced-practice nurses were created. Ultimately, the goal of this project seeks to establish …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

It’S Their Lifeline: Preventing Central Line Associated Blood Stream Infection In An Adult Intensive Care Unit, Jacenda Lee Rangel

Master's Projects and Capstones

Problem description: Central line associated blood stream infection (CLABSI) is one of the deadliest types of hospital acquired infection and blood stream infection, raising patient mortality by 12-25% and accounting for 28,000 deaths annually in the United States. CLABSI also increases morbidity, length of stay, and costs hospitals an average of $48,000 per case. Effective measures for CLABSI prevention are needed for an adult intensive care unit (ICU) of an urban hospital to decrease the financial burden of CLABSI, improve quality of care, and prevent patient harm.

Setting: The microsystem of focus is a 36-bed high acuity ICU. Patients of …

Introduction Of Incivility Strategies In The Empowerment Of Nursing Faculty And Students, Angela Wolf

Nursing Capstones

Incivility in nursing education is a growing occurrence that is shown to have profound negative effects on the entire nursing profession. This is a cycle that starts in nursing school and left unchecked carries forward into the workplace. Uncivil behavior is experienced by students, faculty, and peers. A thorough literature review was conducted to describe incivility that occurs in the classroom and possible interventions that allow for improved conditions for nurse educators and nursing students. One study conducted in the university setting using a mixed study design indicated various possible causes including students pay for their education, so this gives …