Nursing Administration Commons^™

Promoting Empowerment And Innovation: A Technology Initiative, Theresa Marcotte

Doctor of Nursing Practice Projects

Improving empowerment through a supportive organizational culture can lead to innovation in practice and promote positive outcomes. Supporting employee empowerment, through a supportive organizational culture and environment, provides opportunities to innovate and creatively meet desired outcomes. Using these concepts, an Associate Degree Nursing Program empowered faculty to address a strategic planning opportunity to improve practice. The innovation, a Technology Initiative, provides opportunities for evidence-based testing practices, leading to improved, first-time pass rates on the National Council Licensure Exam (NCLEX). Technology use in the classroom can improve dissemination of nursing knowledge and retention strategies and therefore improve program retention. The utilization …

Evaluating Transfer Of Continuing Education To Practice: A Retrospective Mixed-Methods Study, Tiffany Bryant, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Continuing education (CE) is an essential component of building and maintaining the competence and performance of health professionals. Evidence of its impact on practice is lacking. Organizations need evidence of CE transfer to the practice setting to demonstrate its value and inform CE practice.

Objectives: The purpose of this study was to provide evidence of CE’s impact on practice by analyzing nurses’ reports of intent to change practice, actual practice change, and examples of practice change. Research assessing the effects of CE on nursing practice across multiple courses involving different topics, levels of nursing practice and location supports generalizability. …

Missed Nursing Care Reported By Medical-Surgical Rns In A Community Hospital, Anne Schmidt, Dnp, Msn, Rn, Aprn-Bc, Cenp

Doctor of Nursing Practice Projects

Background: Missed nursing care is defined as any lapse in essential patient care. It is a previously studied, persistent phenomenon. If unrecognized, it can compromise patients’ recoveries, trigger adverse events, and increase healthcare costs.

Objectives: To examine the prevalence of missed nursing care reported by medical-surgical registered nurses (RNs) and contributing factors for its occurrence.

Methods: The project used a cross-sectional, correlational design. A convenience sample of 96 RNs, recruited from three medical-surgical units, completed the MISSCARE Survey between September and October 2017. An analysis of survey responses quantified the frequency, nature, and common contributing factors for care omissions. The …

Transitioning Experienced General Care Float Pool Nurses To A Critical Care Float Pool, Troy T. Betts, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: A nationwide nursing shortage has resulted in a significant reduction in the number of qualified nurse applicants for critical care positions. Additional recruitment solutions for critical care staffing needed to be explored.

Purpose: The purpose of this project was to evaluate the effectiveness of an orientation program designed to transition experienced general care trained float pool nurses to a critical care float pool.

Methods: This descriptive study measured participants’ pre and post critical care orientation knowledge, and completion of core computerized competencies. Critical thinking questions, unit-based competencies, and measurement of participants’ individual perception of competence were also completed. Pre …

Peer To Peer Review: Professional Development To Improve Feedback Skills And Self-Efficacy, Brittany H. Gnilka, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Peer to peer review is the most essential form of peer review as it encourages nurses to evaluate the quality, safety, and effectiveness of nursing care amongst peers. Poor communication skills for providing feedback during peer review is a barrier identified in the literature, which can be addressed in professional development training.

Objectives: The purpose of this study was to evaluate the effect of communication-focused professional development sessions on the ambulatory care nurses’ perceived self-efficacy to successfully provide meaningful feedback during peer to peer review.

Results: The results showed a statistical significance difference between the mean pre and postGSES …

Measuring Nursing Students’ Perceptions Of Teamwork In A Multiple Patient Simulation, Christine Seaton, Dnp, Msn

Doctor of Nursing Practice Projects

Background: Simulation based education offers safe, reflective learning opportunities. However, data had not been obtained of nursing students’ perceptions of teamwork performed during Virtual Hospital (VH), a multiple patient simulation.

Objectives: This evaluation gap was addressed using the Agency for Healthcare Research and Quality’s (AHRQ) TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ). The validated survey measures self-reported perceptions of teamwork in communication, mutual support, and situational awareness on a Likert scale from 1 to 5 (AHRQ, 2014).

Methods: A pre-and post, one group design was used to measure perceptions of teamwork. Twenty participants were recruited from students, enrolled in a second-degree undergraduate …

Nurse Managers And Hospital Nurse Educators’ Views Related To The Knowledge, Skill And Attitude Requirements Of Newly Licensed Nurses In The Las Vegas And Salt Lake Valleys, Delos Jones, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: In 2017, approximately 230,569 new Registered Nurses (RNs) were licensed in the United States. Of these, over a quarter will leave their first position in less than a year. While 90% of academic leaders feel nursing graduates are ready for practice, only 10% of clinical leaders agree. Recent changes in health care, and an intensifying theory-practice gap hint that newly licensed nurses (NLNs) may not be equipped for today’s workplace.

Objective: This qualitative project asked, “What do nurse managers and hospital educators perceive as required knowledge, skills and attitudes (KSAs) for NLNs to ensure successful and safe orientation or …

Assessing Employee Needs To Enhance A Workplace Wellness Program, Paige Herschend, Dnp, Msn, Bsn, Ba

Doctor of Nursing Practice Projects

Background: Workplace wellness programs are increasingly prevalent, but their designs vary dramatically. While successful programs differ, those that are coordinated, comprehensive, and planned intentionally to address specific workplace needs have been found most beneficial.

Objective: This project assessed the perceived health status and wellness needs of employees at one company to determine whether its workplace wellness program could be enhanced.

Methods: This project focused on one site of a large, multi-state company. A retrospective review of data from an employees’ health and wellness survey was performed. Univariate and bivariate statistics were used to analyze the relationships among …

Evaluating Patient Outcomes When Adding Licensed Practical Nurses To The Staffing Mix, Isabel C.M. Shephard, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: An incorporation of licensed practical nurses (LPNs) in the RN staffing mix was made in a small community hospital. Research shows that RNs at the bedside equates to less adverse patient outcomes such as falls, pressure ulcers and an increase on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

Objectives: To evaluate the effects of incorporating LPNs in the staffing mix on the number of patient falls, pressure ulcers and HCAHPS survey results.

Methods: A Pre and Post study design was used to compare baseline data obtained four months prior to implementing and four months during …

Identification Of Risk Factors Associated With Falls In The Long Term Care Setting, Jacqueline L. Patel, Dnp, Ms, Anp-Bc

Doctor of Nursing Practice Projects

Background: Falls threaten the safety of older adults in long term care (LTC).

Objectives: To assess environmental, clinical and pharmacological causes of falls as well as compare Fall Risk Assessment Score, Brief Interview of Mental Status (BIMS) score, Activities of Daily Living (ADL) scores, age and gender of residents with one fall, recurrent falls, and no falls.

Methods: Using a descriptive-comparative design, we included a convenience sample of 290 adults ≥50 years old at our LTC facility. Fall and recurrent fall groups were matched to those with no falls. We assessed environmental, clinical and pharmacological variables, Fall Risk Assessment Scores, …

Referral Patterns From Long-Term Care Services To Palliative Care: Perceptions Of Directors Of Nursing, Karen S. Sharrah, Dnp, Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: Palliative care referrals are important in long-term care facilities because they are the first step in generating the services that the patient may need. This study looked at the phenomena of how Directors of Nursing in long-term care facilities that had access to palliative care services determined if a referral was needed.

Objectives: The purpose of this study was to gain a deeper understanding of the decision- making process used by Directors of Nursing for referrals. The study’s aims were to determine what factors prompt a referral in long-term care settings. The primary research question was: How …

An Evidence-Based Practice Assessment And Quality Improvement Initiative In Idaho's Critical Access Hospitals, Deena R. Rauch

Doctor of Nursing Practice Projects

Background: Health care providers and systems have been challenged to discard tradition-based care and outdated practices in lieu of evidence-based practice (EBP). Yet, little is known about the state of EBP, barriers and facilitators to EBP, and organizational readiness for EBP in Idaho’s Critical Access Hospitals (CAH). To affect positive change, it was necessary to understand whether providers in Idaho’s CAHs were using evidence as a foundation for practice—and, if not, what challenges existed in implementing EBP. Mitigating barriers and providing EBP education by way of webinar-based online technology has been proven to be practical and feasible. Providing EBP education, …

Use Of The Coleman Transition Model To Reduce Copd Readmissions, Sara Briggs

Doctor of Nursing Practice Projects

This paper explores the use of the Coleman Transition Model as an evidenced based intervention to reduce 30-day readmissions of Chronic Obstructive Pulmonary Disease (COPD) patients on a pulmonary unit. Nearly 20% of Medicare beneficiaries are re-hospitalized within 30 days after discharge, resulting in an annual cost of approximately $17 billion. Hospitals can engage in activities to lower their rate of readmissions. The evidenced based intervention includes robust case management using The Coleman Transition Model in hospitalized COPD patients to reduce readmissions. COPD is a prevalent, complex, and costly condition to manage. COPD is now the third leading cause of …

A Nurse Mentor Program In A Long Term Acute Care Hospital, Regina Masters

Doctor of Nursing Practice Projects

Nurse turnover is a national problem with the potential to affect quality of care and patient outcomes. A Long Term Acute Care Hospital (LTACH) with nurse turnover rates above the national average as high as 28% sought to address this problem. A review of the literature identified nurse mentor programs increasing registered nurse (RN) satisfaction and decreasing turnover. Therefore, the purpose of this project was to implement a mentor program for newly hired RNs. Mentors were paired with new RNs for a four-week program. Pre and post intervention data were collected via the McCloskey Mueller Nurse Satisfaction Survey (MMSS) and …