Nursing Administration Commons^™

Development And Implementation Of An Evidence-Based Practice Mentor Fellowship, Stacy L. Alves

Doctor of Nursing Practice (DNP) Projects

Background: The Institute of Medicine (2008) set a goal that 90% of healthcare decisions would be based on the best evidence possible by 2020, yet many challenges remain. Common barriers include clinicians’ beliefs about the value of evidence-based practices, their competency to implement it, and systems issues such as time, resources, and organizational value and preparedness (Melnyk et al., 2017).

Local Problem: A hospital within an integrated health care system sought to increase the use of EBP for clinical decision making. A gap analysis revealed a lack of sufficient EBP mentors to lead efforts to promote system-wide EBP implementation.

Context: …

Qualifications Of Executive Nurses For Service On Hospital Boards, Michelle Lee Foxx

Electronic Theses and Dissertations

Abstract Healthcare governing boards have responsibility for the legal and financial stability of the organization. They are assuming more responsibility for quality care and outcomes. Nurse leaders have valuable insights into key shared governance issues such as quality of care, financial performance, legal requirements, and regulatory oversight. Yet, only 5% of the 3.2 million nurses in the U.S. health workforce hold a seat on hospital governing boards in the United States. The purpose of this study was to explore how nurses with executive experience perceive their own leadership qualities in the context of established requirements for executive hospital boards. Fifty …

Effects Of Incorporating Patient Acuity Into The Rn Assignment Process, Melissa L. Forton

Evidence-Based Practice Project Reports

As the largest sector of healthcare, nurses are the primary providers of patient care. By 2025, it is estimated that there will be a shortage of over 250,000 registered nurses (RNs) (American Association of Colleges of Nursing, 2011). Factors contributing to the nursing shortage include increased complexity of patients and decreased staffing that leads to decreased job satisfaction (Fox & Abrahamson, 2009). Over half of neonatal intensive care nurses reported missing at least one nursing task per shift when staffing was inadequate or patient acuity was high (TubbsCooley, Pickler, Younger, & Mark, 2015). The purpose of this evidence-based practice (EBP) …

Nursing Assignments Based On Patient Acuity: The Road To Nursing Job Satisfaction, Kristina Tomic

Evidence-Based Practice Project Reports

Challenges in the healthcare industry, including nursing shortages and low nursing retention, have resulted in nurses’ job dissatisfaction. Improving work environment and workload can lead to improved and equitable nursing shift assignments, which may improve nursing job satisfaction. The purpose of this EBP project was to (a) implement a patient acuity tool in the hospital unit, (b) assess its effectiveness in appropriating nursing shift assignments, and (c) evaluate its effect on nursing job satisfaction. The Evidence Based Medicine (EBM) Model was used as a guide to facilitate the transition of the best evidence into practice. As suggested within the evidence, …

Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano

Evidence-Based Practice Project Reports

Patient/visitor violence against healthcare (HC) employees is a type of workplace violence (WPV) and considered a dangerous hazard within HC occupations (Bureau of Labor Statistics, 2015). Lack of recognition of the true incidence and underreporting of WPV may contribute to a false sense of security within a HC facility (HCF). Therefore, fully addressing the problem may be met with administrative resistance, resulting in poor employee perceptions of support and commitment for a zero-violence environment. A retrospective analysis was conducted on the HCF’s online incident reports, security request calls, and data from a previously deployed WPV employee survey. The emergency department …

Implementation Of A Multifactorial Fall Prevention Protocol, Laura Wilkerson

Evidence-Based Practice Project Reports

According to the Joint Commission Center for Transforming Healthcare (2016), moderate to severe injuries from falls on average add 6.3 days to a hospital stay and cost approximately $14,056 per patient hospitalization. The purpose of this evidence-based practice (EBP) project was to implement a multifactorial approach to identify patients at risk for falls on admission to the orthopedic/neurosurgical unit and provide individualized interventions necessary to prevent falls. The Iowa Model of Evidence-Based Practice and Orlando’s Nursing Process Discipline facilitated the implementation of this project. A total of 45 staff members on the unit were educated on the multifactorial fall protocol …

Implementation Of A Standardized Handoff During Transition Of Care From The Emergency Department To The Intensive Care Unit, Melinda Abbring

Evidence-Based Practice Project Reports

Patient safety and nursing communication are crucial to the nursing handoff during transition of care from the emergency department (ED) to the intensive care unit (ICU). The Institute of Medicine published To Err is Human: Building a Safer Health System (1999) and Crossing the Quality Chasm (2001) highlighting ED handoffs as a safety measure. In 2006, the Joint Commission recognized handoffs with the National Patient Safety Goal 2E. The purpose of this evidence-based practice project was to determine if implementation of a standardized handoff would improve nursing communication and patient safety during transition of care from the ED to the …

Implementation Of A Nursing Workload Tool To Reduce Nurse Burnout, Nicole K. Greives

Evidence-Based Practice Project Reports

Nursing burnout and workload is a complicated issue with far-reaching effects. Nursing burnout and inappropriate nursing workload have been linked to increased risk of urinary tract infection, respiratory infections, decreased patient satisfaction, decreased quality and safety of care, and increased mortality. The purpose of the project was to decrease nursing burnout on a Medical Progressive Care Unit (MPCU) by moving patients with high workloads and medical instability to a higher level of care. Within this project, Rosabeth Kanter’s Theory of Structural Power was used for the theoretical framework, and the Stetler Model guided the implementation. The intervention consisted of a …

The Effect Of A Multifaceted Reminder Intervention On Nursing Documentation Completeness, Meredith A. White

Evidence-Based Practice Project Reports

Nationwide, nurses must withstand growing patient assignments and increased workloads. The consistency between nursing documentation and technical nursing interventions performed indicates that registered nurses provide much more care than they record. This incongruence has the potential to impact patient safety, but also has significant financial implications, since reimbursement is linked to documented services. The purpose of this EBP project was to implement a multifaceted reminder intervention (including a 10-minute PowerPoint and visual reminder) in an IMCU setting to assist the nursing staff (n = 38) in completing the HAPU documentation components. John Kotter’s Eight-Stage Process and the Iowa Model of …

The Effects Of Implementing Best Practices On 30-Day Readmission Rates In Adults Following Cabg Surgery, Linda Elaine Kline

Evidence-Based Practice Project Reports

Coronary artery bypass graft (CABG) surgery is one of the most frequent and expensive cardiac surgical procedures in the U.S. today. Complications from CABG surgery are one of the top causes of 30-day hospital readmissions. Readmissions after CABG surgery are often preventable and add to health care costs. Recent government legislation mandates penalties for hospitals with excess readmission rates. The purpose of this evidence-based practice project was to determine if implementation of best practice recommendations effected 30-day readmission rates following CABG surgery. A critical appraisal of the literature was conducted to identify best practice recommendations. The Iowa model and Lewin’s …

The Effect Of Education On Compassion Fatigue As Experienced By Staff Nurses, Kathryn L. Zehr

Evidence-Based Practice Project Reports

Historically, nursing has been perceived as a highly rewarding profession. Yet, due to the increasing complexity of today’s healthcare, nurses are faced with greater challenges in their work environments. Registered nurses who work in tertiary care settings are exposed to disturbing patient situations including trauma, death, abuse, or chronic disease. Joinson (1992) described this experience as compassion fatigue and symptoms include headaches, short attention span, or fatigue. A review of literature has identified that nurses should be educated about risk factors and coping strategies to combat compassion fatigue. Guided by the Model for Evidence-Based Practice Change and Jean Watson’s Theory …