Nursing Administration Commons^™

A Cross-Sectional Study Of Nurses’ Perception Toward Utilization And Barriers Of Electronic Health Record, Mohammad Alboliteeh

Makara Journal of Health Research

Background: The utilization of electronic health records (EHRs) is crucial. This study aimed to determine the perception of nurses on the utilization and barriers to the use of EHRs.

Methods: This descriptive cross-sectional study on 327 participants was conducted at the government hospitals of Hail City that use EHRs. Data collection was conducted between March and April 2022. The adapted questionnaire was used to collect the data.

Results: Nurses perceived EHRs as useful (5.76 ± 1.71), easy to use (4.74 ± 1.56), and intend to use (5.85 ± 1.81). Sex had no effect on perceived usefulness ( …

The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter

Master's Projects and Capstones

Problem: The assistant nurse manager (ANM) role is considered an entry-level management position and is not intended as a permanent career role. The unintended consequence is that there is a high rate of organizational turnover, making it challenging to build and retain a solid, cohesive, and productive team.

Context: A new manager of a float pool team in a 166-bed community hospital found that with little financial investment, a significant impact is made by holding a safe space for listening to the ANM team and designing education and training around what is most important to frontline managers.

Interventions: A baseline …

A Process Evaluation On The Health Care Transition Process For Youth With Osteogenesis Imperfecta With Special Health Care Needs, Janet Amirkhanian

Doctor of Nursing Practice (DNP) Manuscripts

With medical, surgical, and technological advances, children with childhood diseases with special health care needs (SHCNs) are surviving and living into adulthood (Cohen et al., 2014). Health care transition (HCT) should be a process through which youth are expected to achieve the skills necessary to manage their health as adults (Sawicki et al., 2017). HCT should be a purposeful, organized, and coordinated process involving the youth, family, and health care team (Stringer et al., 2015; Gabriel et al., 2017; White et al., 2018). Evidence supports that adolescents and young adults with SHCNs are often unprepared for transition (Jensen et al., …

Reducing Risk Factors Of Diabetes Mellitus Type Ii Development In Veterans Post Military Discharge Through The Patient Aligned Care Team Model And The Utilization Of Preventive Programs Involving Lifestyle Changes., Jeni Grundy

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes Type II (T2DM) prevalence is rising in America, becoming a focus for disease prevention. The American Diabetes Association (ADA) has highlighted the need to tackle the increased T2DM precursor, prediabetes, which ultimately leads to T2DM if risk factors remain unaddressed. One group of the American population with a high rate of prediabetes is the 9/11 Veteran cohort. The Veterans Affairs (VA) system has numerous health promotion missions. This system has highlighted its initiatives to address the development of T2DM. Specific to the 9/11 group, their primary T2DM contributory risk factor is obesity paired with the low utilization of already …

Advance Care Planning In Faith Communities: A Quality Improvement Project, Lorie Hacker, Jan Gaddis, Jessica Grimm, Catherine Chung

International Journal of Faith Community Nursing

This quality improvement project examined the impact of providing an advance care planning training tool to faith community nurses in the community setting on advance care planning knowledge, self-efficacy, and implementation of advance care planning outreach and advance directive completion. The pre- and post-intervention frequencies measure and paired-t test survey design resulted in clinically significant improvements in knowledge, and self-efficacy of advance care planning among faith community nurses. A fifty-fold increase was seen in advance care planning outreach activities among the group from pre- to post-intervention. The limitations of the project included small sample size and short implementation timing. However, …

Home Health Workplace Safety During The Covid-19 Pandemic: A Cross-Sectional Descriptive Analysis Of Home Health Agencies In Arkansas, Kelly M. Neal Taylor

ATU Theses and Dissertations 2021 - Present

Abstract

Workplace safety is a continual concern for home healthcare workers that provide medical care in a patient’s home environment. Healthcare workers, such as registered nurses, licensed practical nurses, and nursing aides, make up the largest group of home care providers. Before the COVID-19 Pandemic, home healthcare providers had to navigate job safety issues related to clutter in the home, unsanitary conditions, pest infestations, fumes, pets, and aggressive family members (Gershon et al., 2008). The pandemic brought about additional safety concerns, such as the implementation of isolation policies and limited supplies of personal protective equipment, to name a few. This …

Creating Rural Nurse Retention Strategies For Nursing Administrators, Susan Lesser

Doctoral Projects

Rural area nurse retention has been referred to as a crisis for decades; this crisis has been exacerbated by several factors including the COVID-19 pandemic, resources being directed towards larger hospitals, the inability to recruit and retain healthcare providers to rural areas, and the aging workforce (Rossetter, 2020). The researcher in this Doctor of Nursing Practice (DNP) Project investigated the elements that encourage rural nurse retention and sought to develop retention strategies that are rooted in the literature and anchored in the concerns of rural nurses. Retention strategy recommendations were drawn from results from the Revised Casey Fink Nurse Retention …

Reducing Readmission (And Mortality) For Older Patients & Survivors Of Life-Threatening Conditions: A Study Using The Staarr Protocol, Akhenaten Amun

Symposium of Student Scholars

Readmission rates for patients admitted for heart failure, pneumonia, chronic obstructive pulmonary disorder, a myocardial infarction, a hip or knee arthroplasty, or coronary artery bypass surgery tend to have high readmission and mortality rates within 30 days of their discharge from a hospital. Starting in October 2012, the Healthcare Reimbursement Reduction Program enforced penalties on Medicare reimbursements for hospitals with readmission rates, for patients with the conditions above, were higher than averages based on facilities with similar characteristics and patient populations. Teach-back and verify (Klingbeil & Gibson, 2018), interdisciplinary teams that engage in patient care and support (Reiter-Palmon et al., …

Does Triage Education Reduce Classification Errors In The Ed?, Rachel Abukhdeir

Symposium of Student Scholars

IN A METRO ATLANTA LEVEL TWO EMERGENCY DEPARTMENT, DOES THE APPLICATION OF TRIAGE EDUCATION REDUCE TRIAGE CLASSIFICATION ERRORS?

Abstract

Incorrect triage of patients leads to excessive wait times, an increase in length of stay, and escalating medical conditions. One of the most common triage systems in the United States is the Emergency Severity Index (ESI), a five-level triage system that focuses on prioritizing patient care based on the urgency of the patient’s illness. An assessment is performed by nurses to determine patients’ level of acuity. This method is subjective to the nurse performing triage. Currently, nurses have no or minimal …

Evidence-Based Best Practice For Transitions Of Care: A Policy Review On Medication Reconciliation Standards, Lovelyn Chizoba Ogbennah

Student Scholarly Projects

Practice Problem: Medication reconciliation (MR) is crucial in care transitions among healthcare facilities. Developing evidence-based discharge planning strategies, improving communication, optimizing electronic health record intelligence interoperability, and stakeholder engagement will promote a better transition process for patients and healthcare providers.

PICOT: The PICOT question that guided this project was: In an urban-based adult skilled nursing facility, how does an evidence-based structured review, and revision of current MR policy and procedures, compared to the existing MR policy, affect the clarity of the process for communication between clinicians during transitions of care over a 10-week review cycle?

Evidence: Fifteen …

Reducing Burnout In Nursing: Implementation Of A Mindfulness-Based Intervention, Melanie Holland King, Katherine Newnam, Mandy Gay

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective: To decrease nursing burnout in a rural hospital setting. Background: Burnout increases the rate of turnover, lowers patient satisfaction scores, and increases costs. An estimated 15.6% of nurses are experiencing burnout at an annual cost of 9 billion dollars for hospitals. Local Problem: A rural hospital in Tennessee without a burnout reduction program available to staff. Methods: The Iowa Model Revised was utilized to implement a mindfulness-based stress reduction program. Invention/Measurements: The Palouse mindfulness-based stress reduction program was utilized for this evidence-based practice project. The online course spans eight weeks and includes videos, reading materials, and worksheets. The program …

Bedside Nurse Shift Length: Evidence-Based Intervention On Nursing Burnout, Natalie Suzanne Medina Bsn, Kristen Morreale Bsn, Bryanna Whitehurst Bsn

MSN Capstone Projects

With the aging baby boomer population, employee burnout, and lack of quality medical training, the United States is facing one of the most detrimental nursing shortages in history. Before the COVID-19 pandemic, the United States Health and Human Services projected the demand for nurses to be much higher than the actual number of employed registered nurses through 2030. Since 2016 the nursing population was widely composed of nurses between 25 to 34 years old. After the global pandemic hit, the number of nurses in that age group declined by 5.2 percent, and nurses aged 35 to 44 have reduced by …

Substance Use Among Nurses As A Result Of Covid-19, And The Impact Of Rehabilitative Programs On Nurses, Gerome Macaspac

Nursing | Senior Theses

Background: The incidence of substance use among nurses has been a persistent issue for decades. The effects associated with substance misuse depend on what is used, the amount, how often, and how they are taken. Regardless of the substance used, any nurse who enters the workplace using substances puts the lives of others at risk. Due to the widespread effects of the COVID-19 pandemic, there is a risk that the number of nurses resorting to the use of substances may have increased. Therefore, an investigation into drug use among nurses during the pandemic is particularly important.

Objective: To explore the …

Nurse Satisfaction And Interprofessional Interactions: The Impact Of Nurses’ Professional Relationships On Job Satisfaction, Katrina Robinson

Master of Science in Nursing Final Projects

Purpose: The purpose of this study was to identify the relationship between nurses’ interprofessional interactions and nurses’ job satisfaction.

Methods: The study design utilized was a cross sectional retrospective analysis of survey results within a healthcare system. The Job Enjoyment Scale (JES) was used to measure job satisfaction and the Interprofessional Scale was used to measure interactions between nurses and specific disciplines (nursing, physicians, Advanced Practice Registered Nurses [APRN’s], pharmacists, therapists, and social workers). Pearson correlation coefficient analysis was computed to assess the relationship between JES and interprofessional variables at the unit level.

Results: Results suggested a significant positive correlation …

Nurse-Initiated Treatment Reduces Costs For Acute Asthma In A Pediatric Emergency Department, Michael D. Johnson Md, Ms, Minkyoung Yoo Phd, Richard E. Nelson Phd, Amanda K. Nielson Md, Lauren Allen Mas, Nanette Dudley Md, Brandon Andersen Rrt, Amanda Orme Dnp, Cpnp-Ac, Cameron Mcfarland Np-C, Michael Mundorff Mba, Mhsa

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Standardized emergency department (ED) pathways can improve care delivery to children with acute asthma, though their impact on hospitalization and costs is unclear. An Acute Asthma Care Pathway (AACP) that facilitates nurse initiation of treatment was implemented at a tertiary care pediatric ED using standard quality improvement methodology. The impact of implementation was assessed using process control methodology and multivariable time series analyses between pre- and post-implementation periods. Provision of a steroid within 30 minutes and 60 minutes of arrival increased by 21 and 22 percentage points respectively, IV magnesium sulfate administration increased by 30 percentage points, the proportion hospitalized …

Outcomes Of Asthma Quality Improvement In Pediatric Patients, Kathryn M. Murray Md, Faap

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. The Utah Pediatric Partnership to Improve Healthcare Quality (UPIQ) and Utah Department of Health (UDOH) Asthma Program Learning Collaborative is a quality improvement initiative designed to standardize asthma care in pediatric patients and improve the overall assessment and patient education process for both healthcare providers and patients. The aim of the Asthma QI Project was to improve the diagnosis and management of asthma for patients in the state of Utah by implementing a standardized approach to the identification and treatment of patients with asthma.

Methods. Patients scheduled to see a healthcare provider at our pediatric clinic were screened for …

Screening For Social Determinants Of Health To Improve Care In Pediatric Patients With Recurrent Urinary Tract Infections: A Scoping Review, Emily Gray Msn, Fnp-C, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose: To describe what is known about how SDoH screening impacts adherence to treatment in pediatric patients with recurrent UTIs.

Transient Ischemic Attack And Admission To A Dedicated Unit, Bandi Davini

Student Scholarly Projects

Transient ischemic attacks account for admissions of approximately 70% of patients who present to the emergency department with transient vascular symptoms, with an average length of stay of one to seven days, costing, on average, $22,087 (Qureshi et al., 2013). A hospital organization's bed efficiency directly affects quality metrics. Reducing the length of stay in TIA patients by having them admitted to a dedicated unit with whom the staff has experience managing stroke patients and the understanding of specific criteria needing to be met before discharge can directly impact quality metrics and provide cost-effective delivery of care. The PICOT question …

Preventing And Reducing Nurse Burnout In An Outpatient Military Facility, Lisa Haik

Student Scholarly Projects

Practice Problem: Nurse burnout adversely affects nurses, patients, and healthcare organizations. Implementing changes to address key contributors to burnout can effectively reduce and prevent burnout.

PICOT: The PICOT question that guided this project was: In outpatient clinic nurses (P), how does implementing a bundled strategy (I) compared to not providing interventions (C) affect nurse burnout (O) within eight weeks (T)?

Evidence: Evidence from an extensive literature review showed that there is no single cause for burnout and therefore no single intervention to reduce or prevent it. The primary themes in the literature to address burnout include practicing mindfulness, …

Reducing Central Venous Infections, Desiree Banton

Student Scholarly Projects

Practice Problem: Patients in the hospital are 36.6% more likely to die after a diagnosis of a Central Line-Associated Bloodstream Infection (CLABSI) (Chovanec et al., 2021). The purpose of this evidence-based practice implementation is to reduce CLABSI rates in the Neurological ICU (Neuro ICU) at a private medical center through use of a CLABSI prevention bundle checklist each shift.

PICOT: In the adult neuro-ICU (P), how does implementing a CLABSI prevention bundle checklist each shift (I), compared to current practice (C), affect CLABSI rates (O) within eight weeks (T)?

Evidence: Evidence-based research supports that if clinical staff completed each part …

Depression Awareness Programs For Adolescents: A Scoping Review, Kincharska N. Freeman Msn, Aprn, Fnp-C, Cnor, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

The purpose of this DNP project is to determine if receiving school-based depression awareness education affects the depression scores of adolescents between 10 and 19 years of age.

Implementing The Practice Of Rns And Uaps Receiving "Hand-Off" Report Conjointly, Gabby Pack, Cora Moll

Scholars Week

This is an informational presentation about ineffective communication within the nursing practice. This presentation outlines the benefits of RNs and UAPs giving/receiving "hand-off" report together.

From The First Encounter: A Communication Program For High Volume, High Acuity Patient Care Locations, Shazam Bacchus

Student Scholarly Projects

Effective communication is a true value to healthcare organizations. Far too many communication sessions are detrimental to patient health outcomes. National data and hospital records are proven information to suggest communication is a major barrier to overall patient satisfaction. Organizations struggle to increase market share and patient satisfaction with a likelihood to recommend because of poor communication by physician and nurses. The use of a strategic communication tool like AIDET plus the Promise can influence the improvement of an organization’s quality of care.

This paper examines the use of AIDET plus the Promise as a strategic communication tool. High volume, …

Analyzing Concept Mapping Integration Into A Bsn Curriculum Using The H-Pepss Survey, Tina Michelle Mathers

Electronic Theses and Dissertations

Background: This project’s foundational focus was on improving nursing students’ preparedness for their profession and patient care. Data supports that nursing graduates face challenges at the patient bedside, which often cause injury or harm. These deficits are known as preparation-to-practice, failure-to-rescue, and transition-to-practice gaps that occur despite the integration of preceptorship and residency programs. Through the integration of concept mapping into an established curriculum, an analysis of student patient safety perceptions in a pre- and postsurvey was completed. Method: This quality improvement project received approval from the institutional review board. The project was a quasi-experimental, nonrandomized, single-blinded design measuring first-semester …

Prioritizing Training Needs For Nurses In The Government Hospitals Of The Ha’Il Region, Saudi Arabia: Future Directions For Educational Developers, Eddieson Pasay-An, Hatem Homoud Alsrour

Makara Journal of Health Research

Background: The assessment of training needs can help establish the current performance or knowledge levels related to certain essential nursing activities. The purpose of this study is to determine the training needs of the staff nurses of the government hospitals in Ha’il Region, Saudi Arabia.

Methods: This study employed a cross-sectional–correlational approach with 230 staff nurses of the government hospitals in the City of Ha’il. Random sampling was used to ensure the representativeness of the sample.

Results: The nurses perceived training activities as very important (6.22 ± 1.09) in their work but performed the necessary activities only …

Impact Of Self-Care Techniques On Nurse Burnout, Macie Mayrell

MSN Capstone Projects

Nurse burnout is a serious, widespread problem in the healthcare arena. Registered nurses need to understand the importance of self-care to prevent or alleviate nurse burnout. An Evidence-Based Practice Benchmark Study implements a relaxation room on a nursing unit to encourage and promote self-care among acute care nurses.

Improving Nurse Leaders' Transformational Leadership Skills In The Online Environment, Tanya Haight

2022 Southern California Nursing Research Conference

Leadership is critical to the success of most organizations, and the achievement of an organization's goals is largely dependent on the leaders' ability to engage, motivate, and influence their teams—often referred to as Transformational Leadership. This is especially true for healthcare organizations wherein the morbidity and mortality of patients may be affected by the quality of leadership. At the start of the COVID-19 pandemic, in-person meetings transitioned to the online format without nurse leaders' formal training. Leaders cited this lack of orientation as impeding their ability to sustain an online-virtual transformational leadership presence with their teams. They reported varying degrees …

Improved Data Communication With Frontline Staff, David Sprecher

Master's Projects and Capstones

Problem: Frequently, communication from the Quality Department (QD) needs to be filtered through several organizational layers without first-hand knowledge of what message was given to frontline staff. Current mechanisms of communication between the QD and front-line microsystem teams have barriers preventing them from being consistent and reliable.

Context: Research has found that collaborating with and supporting frontline staff was key to establishing a culture that supports change and a focus on safety. Establishing open communication and effective teamwork with individuals on the frontline leads to shared values within a team and better collaboration which drives performance improvement.

Interventions: For trended …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

Intervention To Increase Home Preparation For Colonoscopies, Joshua Victor Stone

Master's Projects and Capstones

Abstract

Problem: Inpatient colonoscopies are costly to healthcare systems and inconvenient for eligible patients. The cost for a two-night inpatient bed is currently $4800.00 currently. The department manager led a five-month quality improvement project that was initiated in one 180-bed community medical center in Northern California to increase outpatient options, reduce the census and decrease the admission rate.

Context: Overburdened medical facilities often miss the opportunity to utilize ambulatory procedures due to competing operational priorities. In this setting, the Care Without Delay (CWD) department microsystem addresses barriers that impact operational throughput, efficiency, and unnecessary admissions.

Intervention: A …