Nursing Administration Commons^™

Dnp Final Report: Effects Of Open-Access Scheduling On Patient No-Show Rates In An Outpatient Clinic, Maria Aileen A. Wilkinson Msn, Mba, Rn

DNP Final Reports

No-show rates in a South Texas outpatient clinic have been as high as 16% to 20% which increases wait times to be seen in the clinic and decreases patient access to outpatient care. This no-show rate data has continued despite multiple interventions that have been implemented in an academic health science center. Physical, socio-economic, geographic, and health/lifestyle factors affecting no show or missed appointments are crucial to determining the most appropriate interventions to alleviate this issue. No-show rates are important metrics to improve because it directly affects the organization's revenue, access to care, and appointment wait times. Research evidence regarding …

Clinician Education Program: Promoting The Use Of Care Bundles In Reducing The Hospital Length Of Stay And Readmission Rates Of Adult Copd Patients, Nordita R. Bascon

MSN Capstone Projects

Management of COPD patients can cost hospitals approximately $308,502 per month. This is based on a single COPD readmission encounter costing $7,500 and estimated daily expenses of $2,883 (Davis, 2023; Hegwer, 2018). This executive summary outlines a clinician education program held at a community hospital in West Texas to promote patient quality care by encouraging healthcare professionals to use evidence-based chronic obstructive pulmonary disease (COPD) care bundles. Eighteen physicians and nurse practitioners attended the program. Then, a survey was conducted to assess the impact of the proposed program. Most attendees said they would incorporate care bundles in COPD care.

Internal …

Dnp Final Report: Executive Rounding And How It Affects The Completion Of A Quality Checklist And Quality Indicators: An Evidence-Based Practice Project, Ruben P. Castillo

DNP Final Reports

A question of inquiring led to the development of PICOT questions and a systematic search that recognized an executive leadership rounding process healthcare initiative need to improve the quality of care for patients, QI (quality improvement) initiatives such as reducing CAUTI (community-acquired urinary tract infections) and CLABSI (central-line associated bloodstream infections) in the medical floor population project was developed. The compelling internal and external evidence makes it vital to examine the following question, In acute care inpatients (P), how does an executive leaderships (manager &/or director), quality-indicator rounding plan (I) compare to no rounding plan (C) affect consistent completion of …

To Use Or Not To Use Oxygen For Mi Benchmark Study, Alexia Celaya

MSN Capstone Projects

It is a common practice for emergency personnel to administer oxygen for a patient diagnosed with a myocardial infarction. It is a well-known practice to place the patient on supplemental oxygen even if they are not hypoxic. The use of supplemental oxygen has been a cornerstone in the treatment of myocardial infarction. The rationale behind the administration of oxygen therapy is to increase oxygen delivery to the myocardium, therefore limiting the infarct size and future complications (Hofmann et al., 2017). The use of supplemental oxygen on normoxic patients has been challenged due to the possibility of causing further injury to …

Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport

Senior Honors Theses

The average emergency room patient is not receiving the compassionate nurse-patient communication that patients experience on other hospital floors. Fewer positive nurse-patient interactions prompt patients to state that they feel uncomforted and dissatisfied on hospital exit surveys, inciting hospital management to investigate how to reverse this trend to retain their federal funding. Emergency room nurses cite multiple barriers inherent in their work environment that prevent them from building rapport with their patients, including a layout not conducive to private conversations, strict time constraints, and a fluctuating workload. Working for a prolonged period under these conditions is driving many nurses to …

Nursing Annual Report: 2022, Centracare Health

Nursing Annual Report

Message from the CNO

Message from Central Operations, SVP - St. Cloud Hospital President

St. Cloud Hospital Statistics

Magnet Program Director Message, Nursing Strategic Plan FY 2022

Patient Experience

Nursing Care Delivery

Exemplary Professional Practice

Shared Governance

Working Relationships

Professional Development

Nursing Makes a Difference

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

Dnp Final Report: Cultivating A Culture Of Civility In A Baccalaureate Nursing Program: A Doctor Of Nursing Practice Evidencebased Practice Project, Monica Sowell

DNP Final Reports

Incivility is a well-known issue in nursing, negatively impacting every aspect of the profession. In response to high incivility levels within a baccalaureate nursing program in central Texas, an incivility education module was created for use in adult medical-surgical courses. The module incorporated online preparatory learning followed by active classroom learning, roleplay practice, and faculty modeling to teach students to define, identify, and respond to incivility using evidence-based cognitive-behavioral strategies. Data was collected pre-education implementation and at three post-education time points to evaluate student self-efficacy changes in recognizing and responding to incivility. The COVID-19 pandemic necessitated changing the education delivery …

Improving The Nurse Patient Assignment Process On A Medical Surgical Unit, Kevin K. Mcewan

Doctor of Nursing Practice Projects

Background: Nurse patient assignments on an adult medical surgical unit at a community hospital are often accomplished with inconsistent processes and rationales. Each charge nurse utilizes individualized processes to determine which patients will be best teamed-up and assigned to the available nurses. There are frequently no acuity measurements system or set criteria by which the number or types of patients can or should be assigned to any given nurse, nor are staff skill or competency considered in the assignment process.

Project Design: A pilot project was conducted on a medical/surgical unit. The project utilized the American Association of Critical Care …

Nursing Fatigue In Intensive Care Units: A Clinical Inquiry, Elizabeth A. Gambill

The Eleanor Mann School of Nursing Student Works

Registered Nurses (RN) working in Intensive Care Units (ICU) report increased physical and emotional fatigue from a combination of various environmental factors. Fatigue is suspected as contributing to low retention rates of ICU RNs. A meeting was arranged with an ICU nursing director in an acute care facility in Northern Arkansas revealing the need for a clinical inquiry into the prevalence of fatigue. A review of literature further analyzed the impact of fatigue, management practices, safety culture in the workplace, the Occupational Fatigue/Exhaustion and Recovery (OFER) scale, the Copenhagen Burnout Inventory (CBI), and the Moral Distress Scale- Revised (MDS-R). The …

Exploring The Phenomenological Experience Of Precepting, Erica Fowler

The Eleanor Mann School of Nursing Student Works

Nurse practitioners and physicians are increasingly sought to volunteer as preceptors for nurse practitioner students. Preceptors serve a crucial role in student education in providing mentorship, instruction, and supervision in the clinical setting. However, preceptors are often difficult to come by, leaving a shortage of available clinicians willing to participate in preceptorships. There is a paucity of information related to exploring the experiences of precepting among clinicians who have served as preceptors. Insight into these experiences are imperative in identifying the impetuses that drive or dissuade clinicians to commit to the preceptor role. This DNP project implemented a survey designed …

Nursing Annual Report: 2021, Centracare Health

Nursing Annual Report

Message from the CNO

Message from Central Operations, SVP - St. Cloud Hospital President

St. Cloud Hospital Statistics

New Magnet Program Director, Nursing Strategic Plan FY 2021

Patient Experience

Nursing Care Delivery

Exemplary Professional Practice

Shared Governance

Working Relationships

Professional Development

Nursing Makes a Difference

Exploring Therapeutic Nurse-Patient Communication: Techniques And Barriers, Pierina Rossini

Senior Honors Theses

Effective nurse-patient communication, also described as therapeutic communication, is essential for providing high quality nursing care. It increases patient satisfaction and health, decreases patient anxiety and disease symptoms, and increases patient cooperation and compliance to treatment. Some therapeutic communication techniques include attentive listening, empathy, silence, focusing, open-ended questions, clarification, exploring, clarifying, and summarizing. Unfortunately, there are barriers to therapeutic communication that have been identified. Research regarding nurse-patient therapeutic communication, consisting of secondary, qualitative, descriptive data, points to several barriers to therapeutic communication. Some of the barriers to therapeutic communication include nurse-patient gender difference; patient physical discomfort; nurse-patient language, culture, and …

Heart Failure 30-Day Readmission Frequency, Rates, And Hf Classification, Yolanda R. Brown, Twonia M. Goyer, Margaret C. Harvey

Doctor of Nursing Practice Projects

30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure

Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who …

Increasing Nurse Knowledge Using A Formal Lung Transplant Education Program, Amy M. Stoddard, Donna Lynch-Smith, Kate Carlson Wrammert, Bobby Bellflower

Doctor of Nursing Practice Projects

This quality improvement project was completed to show that a formal lung transplant education course for nurses caring for lung transplant patients increased their knowledge. An eight-hour education course was developed by experts in the field of lung transplantation. A pretest was administered before the education course. A posttest was administered to determine if knowledge was improved. A three-month follow-up test was administered to determine knowledge retention. Based on the data analysis, nurse knowledge improved after formal education. Item analysis determined what areas of educational content need to be the focus of quarterly education. The education course was adopted as …

Official Mentor Program Benchmark Project, Gabriela O'Hara

MSN Capstone Projects

Nursing shortage, turnover, and low job satisfaction are constant issues that often trouble healthcare organizations. These issues have led organizations to implement programs, such as externship, internship, and preceptor programs to strengthen new nurses’ professional practice and skills. However, these issues continue to be organizational challenges. Considering the need for new nurses to have a supportive foundation for their career and to further encourage workplace satisfaction and retention, the following PICOT question was developed: In a healthcare organization, how does an official mentor program, compared with not having a mentor program, influence nursing retention and nursing job satisfaction over 2 …

Dnp Final Report: Changing Admission Criteria In A Vocational Nursing Program To Decrease Attrition, Gabrielle O. Davis

DNP Final Reports

By the year 2030 Texas will have a shortage of 33,500 Licensed Vocational Nurses (LVN). The LVN is responsible for providing safe, compassionate and focused nursing care to assigned patients with predictable health care needs. Most LVNS work in settings caring for our ever increasing and aged population. To combat the coming shortage VN programs need to graduate safe, competent, and compassionate nurses, but programs across the state are experiencing high student attrition rates. Admission criteria is a common method to determine student success in nursing programs. This evidence-based practice improvement project synthesized evidence and integrated best practices along with …

Implementation Of A Patient Acuity Tool And The Impact On Nurse Satisfaction, Amber M. Denson

MSN Capstone Projects

Increased workloads contribute to nurse stress, affect nurse-patient relationships, and can ultimately lead to nurse turnover (O’Connell, Nettleton, Bunting, & Eichar, 2020). Nurse satisfaction can also be influenced by nurse-patient assignments (Allen, 2019). Implementation of a patient acuity tool (PAT) to balance workload and evenly distribute patient acuity in nurse-patient assignments can improve nurse job satisfaction, quality of care, and nurse retention (Firestone-Howard, Gonzalez, Dudjak, & Rader, 2017; Al-Dweik & Ahmad, 2019).

Discussions were held on a 20-bed medical-surgical unit in an acute care hospital with stakeholders that included the nurse manager, charge nurses and bedside nurses at staff meetings …

Controlled Donation After Circulatory Death: Benchmark Study, Marilyn R. Strait

MSN Capstone Projects

Abstract

In potential organ donors after circulatory death (P), does the utilization of an evidence-based critical pathway from identification of potential donor to organ donation (I) versus no utilization of an evidence-based critical pathway (C) increase the rate of organ procurement and the satisfaction of donor families with the donation process (O)? A benchmark study was conducted to answer this question, and in short, yes, it does. The utilization of a critical pathway, when individualized to a local population and hospital’s organization increases the organ procurement rate, the donor family satisfaction with the process, and increases staff satisfaction with the …

Disruptive Innovation: Impact For Practice, Policy, And Academia, Heather V. Nelson-Brantley, K. David Bailey, Joyce Batcheller, Laura Caramanica, Bret Lyman, Francine Snow

Faculty Publications

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US States, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.

Nursing Annual Report: 2020, Centracare Health

Nursing Annual Report

Message from the CNO

St. Cloud Hospital Statistics

Message from Craig Broman, St. Cloud Hospital President/CEO

Nursing Strategic Plan FY 2020

Message from Tom Schrup, MD/CPO

Education & Certification

Patient Experience

Nursing Care Delivery

Exemplary Professional Practice

Shared Governance

Working Relationships

Professional Development

Nursing Makes a Difference

Increasing Health Literacy Through Noteaid Translational Tool In Nursing, Liz Catherine S. Cory

Doctor of Nursing Practice (DNP) Projects

Background: Many adults in the United States lack health literacy necessary to understand patient education materials given to them, such as discharge summary. Re-hospitalization rates are higher due to poor transition of care planning. Older adults may only be provided with written instruction for their complex chronic conditions with multiple changes in medical or treatment plan, or uncommon surgical procedures. Nurses are instrumental in bridging the gap, as they often educate, advocate, and use health technology.

Purpose: To educate nurses on the availability of NoteAid as a natural language translation system that can help increase their comprehension of electronic health …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Improving Communication To Reduce Patient Falls In A 48-Bed Medical-Surgical Unit, Christian Gella

Nursing and Health Professions Faculty Research and Publications

Abstract

Problem: Patient falls has been associated with increased morbidity, mortality and decreased quality of life. The increase in total patient falls for 2018 relative to 2017, and a spike of 10 patient falls for the month of June 2018 from a baseline of 5.3 falls per month has gained greater attention to reduce patient harm from falls while hospitalized. Prevention of falls minimizes patient exposure to the possibility of being injured. Despite efforts to curtail patient falls, improvement in communication is essential to address the safety issues surrounding improving quality of care practices, and consequentially reduce un-reimbursable hospital costs …

Pain Management: A Flowsheet For Providers, Lisa Swezey

Doctoral Dissertations and Projects

Many different factors led to the trend of providers prescribing opioids for chronic pain. However, the misuse of and many deaths related to opioid prescriptions have caused the trend to reverse its direction. National organizations call for providers to stay clear of opioid medication and increase the use of nonpharmacological pain management, but also to treat pain adequately. There are still many barriers to decreasing the use of opioids and increasing the use of nonpharmacological methods. This scholarly project hoped to use an educational flowsheet to assist providers in meeting the demands from national organizations to decrease the use of …

Impact Of Utilizing The Nurse Practitioner Role In Trauma, And The Effect It Has On Healthcare Utilization And Patient Satisfaction, Jason Pilkerton

Doctoral Dissertations and Scholarly Projects

The addition of Nurse Practitioners (NPs) on the trauma service at night was examined to see if it has positively impacted healthcare utilization and satisfaction in trauma patients. This four-month evidence-based, quasi-experimental project took place on the Trauma Medical Surgical Unit (TMSU) at a level II trauma center in California. Retrospective analysis of medical records and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) satisfaction surveys were performed for those trauma patients located on the TMSU 60-days prior to NPs starting at night and 60-days after. The measured outcomes were LOS, readmissions within 30-days of discharge, LOS after readmission, …

Pots: Educating School Nurses, Stephanie Sherwood

Doctoral Dissertations and Scholarly Projects

The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident …

A Causal-Comparative Inquiry Into The Significance Of Implementing A Flipped Classroom Strategy In Nursing Education, Rhonda Faretta

Doctoral Dissertations and Projects

The purpose of this causal-comparative design study was to examine the application of the theory of Vygotsky’s social constructivism (1978) and McMillan and Chavis’s (1986) definition of sense of classroom community in the context of a flipped classroom. The researcher aimed to determine if a pathophysiology course taught with the flipped classroom method would result in a statistically-significant difference in nursing students’ academic performance and sense of classroom community when compared to a pathophysiology course taught with the lecture classroom method. Two questions were addressed during this study: (a) Is there a statistically-significant difference in nursing students’ academic performance (as …

Educating Nursing Students For Practice In The 21st Century, Jennifer Emilie Mannino Ph.D., R.N., Elizabeth Cotter Ph.D, R.N.

Faculty Works: NUR (2010-2023)

Nurses face a number of challenges in the 21st century. One major challenge pertains to nursing education, specifically to the entry into practice preparation of undergraduate nursing students. Not only do nurses need to be adequately prepared to care for an ever increasing complex patient population, but they are called upon to be leaders in healthcare. The ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of health care today; and having a baccalaureate degree alone does not always prepare new graduate nurses for the complexities of today’s health care …