Other Nursing Commons^™

Promoting Parental Comfort To Facilitate Conversations On Adolescent Sexual Health And Behaviors, Angelina Jolie Banes, Lauren Liddell

Nursing | Senior Theses

This thesis proposal will investigate the impact of a comprehensive digital sexual health education program on the comfort levels of parents and teens when discussing sensitive topics such as pregnancy and sexually transmitted infections (STIs). The research is guided by Orem’s Self-Care Deficit Nursing Theory, which emphasizes the need to assess and address individuals’ self-care deficits, including the ability to engage in safe and informed sexual behaviors. The research design is a quantitative, quasi-experimental study with a one-group pre and post-test design. The sample consists of 50 parents and 50 teens from Marin County, who will participate in an online …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez

Master's Projects and Capstones

Abstract

Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Interfacility Transfer Of Pediatric Patients To A Comprehensive Children's Hospital, Kim Zaky

Student Scholarly Projects

Practice Problem: Secondary transfers to pediatric centers have increased by 25% due to the regionalization of specialty care. Low pediatric volume and the lack of access to pediatric subspecialty confounds the need for transfer requests to comprehensive children’s hospitals. Referring hospitals rely on pediatric teams to determine the level of service and mode of transportation decisions due to a lack of comfort in caring for and managing pediatric patients.

PICOT: This project was guided by the following question. In pediatric patients transferring from other healthcare facilities to a comprehensive children’s hospital (P), does the implementation of a nurse-led pediatric illness …

Type 1 Diabetes In The Classroom, Ursula Herrell

Undergraduate Honors Theses

Type 1 diabetes [T1D] is an autoimmune disease that presents in a pathophysiological disorder as insulin deficiency. Managing this illness during childhood is a constant challenge of maintaining blood glucose levels within a healthy range, resulting in increased stress for children and caregivers. School attendance is one factor that may result in increased stress. Studies have highlighted the fact that teachers of students with T1D may receive little education regarding management of the disease and may be required to make accommodations which can result in confusion, miscommunication, and increased psychosocial stress. The goal of this research was to learn about …

Implementation Of A Code Lobby Surge And The Impact On Left Without Being Seen Rates, Nicole Plouffe

Student Scholarly Projects

Practice Problem: Crowding of emergency departments contribute to higher-than-average left without being seen (LWBS) rates. LWBS patients pose risks to the hospital as well as to one’s own health.

PICOT: The PICOT question that guided this project was in a pediatric emergency department (P), does implementation of a “Code Lobby Surge” (I), compared to standard care (C), decrease left without being seen rates (O) within eight weeks (T)?

Evidence: Surge interventions and decreasing the visual of crowding have shown to decrease LWBS rates.

Intervention: “Code Lobby Surge” was implemented to decrease LWBS rates and improve throughput within the …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

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 …

Asthma Care By Unlicensed Personnel In The Elementary School Setting: A Training Program, Teresa Eligio

Doctoral Projects

This Quality Improvement project (QI) aims to improve the competence and confidence of unlicensed school health staff in identifying asthma symptoms, reading an asthma action plan, asthma care, emergency response, medication delivery tools, and trigger reduction in the school setting. The QI project transpired in an Elementary School District in Los Angeles County, CA. The Project Manager, an asthma instructor trained by the American Lung Association, provided evidence-based Asthma-Basics training for health clerks (HCs), substitute health clerks (SHCs), licensed vocational nurse health clerks (LVN HCs), school office coordinators (SOCs), school office attendance clerks (SOAs), and substitute school office staff (SDO). …

Lunch And Learn: Addressing Needs And Resources Of Adolescent And Young Adult Cancer Patients, Philomina Bigelow

MSW Capstones

Historically adolescent and young adult (AYA) oncology patients have been an underserved population. Research indicates they are more likely to experience poorer treatment outcomes, which may result in part from unaddressed biopsychosocial stressors, poor treatment compliance, and poor provider rapport. Research also indicates that oncology providers do not have a formal standardized training they are required to attend on biopsychosocial needs and resources for the AYA population. Oncology care providers need knowledge of the biopsychosocial needs and resources of their AYA patients in order to provide care and resources that remove the effects of biopsychosocial stressors. This project was designed …

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

School Nursing Practice And Experiences During School Closures, Susie E. Birden Brown

Electronic Theses and Dissertations

This evidence-based quality improvement project was to evaluate public school nurses’ relationships and reaction to their new work environment during the closure of schools in Northern California resulting from the COVID-19 pandemic. This project addressed the change in school nursing, especially the nurses’ working environment. A stress management program was offered to the school nurses as an intervention to give them information on perceived stress. The stress management program included mindfulness and stress-relieving techniques over a 1-month period. The research methodology used in the project was a pre- and postintervention using the Perceived Stress Scale-10 (PSS) to measure if the …

Evaluation Of Telemedicine As An Option For Providing Safe, Accessible, Care To Young Adults In A University Setting, Diane Lynch

Seton Hall University Dissertations and Theses (ETDs)

Previously underutilized, telemedicine has been implemented within a wide variety of health settings as a safe and efficient way of delivering healthcare during the COVID-19 pandemic. Maintaining operations during the pandemic made implementation of telemedicine an important aspect of college and university health center reopening plans. The purpose of this project was to evaluate the acceptance and quality of a telemedicine program implemented at the health center of a medium sized private university.

Data were collected via patient and staff surveys to measure satisfaction with the program and a retrospective review of electronic medical records was conducted to obtain data …

Implementing The Richmond Agitation-Sedation Scale To Assess Delirium In A Pediatric Icu, Leigh Paridy

Dissertations

Purpose: The purpose of this quality improvement project was to establish early identification of delirium in the intensive care setting to reduce the impact of long-term patient outcomes. Description of project: A retrospective-prospective medical chart review was completed. The retrospective chart review looked at fifty-two patients admitted to the pediatric intensive care unit (PICU) between October 1, 2020 and December 1, 2020 for patient demographics and State Behavior Scale (SBS) and the Cornell Assessment for Pediatric Delirium (CAPD) charting compliance especially with children with developmental delay and those with a high susceptibility to delirium. The prospective chart review looked at …

Pediatric Health Literacy, Morgan E. Sapper, Grace G. Lloyd

Senior Honors Projects, 2020-current

Abstract

Background: Unless you are a healthcare provider or licensed healthcare professional, understanding the United States healthcare system and its accompanying medical jargon can be confusing and overwhelming to try to navigate. Even more difficult is comprehending what resources are available to specific populations and how to gain the most benefit from these offered resources. Limited health literacy skills have been identified as the largest barrier in identifying an individual’s health outcomes. Health affects every stage of life. The purpose of this paper is to analyze what health literacy implementations look like as well as the age and developmental stage …

The Changing Face In The Workplace: The Arrival Of The Millennial Generation, Sarah Clonch

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The entrance of the Millennial generation into the nursing workforce signifies a bright future for the nursing profession and the nursing workforce. This study began with a current review of available research that identified the Millennial generation and their views toward job satisfaction and work engagement, as compared with Baby Boomer and Generation X nurses.

PubMed, CINAHL Complete, and Google Scholar databases were employed to find 15 peer-reviewed articles for evaluation. The research findings suggest that Millennial nurses have lower rates of job satisfaction and work engagement, compared to nurses of older generations. Overall, the extracted data results were significant …

Improving Human Papillomavirus Vaccination Rates Among Kentucky Adolescents, Cori Arena

DNP Projects

Background: The Human Papillomavirus (HPV) is a significant factor associated with the development of HPV-associated cancers in the United States. The administration of the HPV vaccination is a critical prevention strategy in reducing HPV-related cancers in the United States. The state of Kentucky has lower than average HPV vaccination rates compared to the national average. There is a significant amount of evidence exploring barriers and facilitators of the HPV vaccination administration. There are several multi-level barriers associated with low uptake of the HPV vaccination in adolescents. Multiple sources of evidence have indicated that parents who receive a provider recommendation are …

Standardizing Patient Handoffs In The Icu – Implementing The “I Put Patients First” Tool., Wislande Joseph

Master's Projects and Capstones

Abstract

Background. Ineffective patient handoff can result in poor nurse communication, increasing the likelihood of adverse events including medication and documentation errors.

Context/Problem. In one 20-bed ICU unit in a northern California community hospital, 48 patient handoffs were observed over 2 weeks. Only 29% occurred at the patient’s bedside; 39.5% used a standardized handoff tool; and 54% included the patient and/or family. These findings indicate significant quality gaps in the unit’s ICU patient handoff processes.

Intervention. The educational intervention consisted of one introductory and two follow-up teaching sessions related to best practices for handoff processes followed by implementation …

Peripheral Iv Bundle, Alicia Hanna

Graduate Theses, Dissertations, and Capstones

Abstract

It is estimated that over 90% of hospitalized patients require IV access during their hospitalization. Peripheral IVs (PIVs), while less risky than central lines, are not without risk to the patients. Intravenous (IV) infiltration in pediatric patients is a very common complication associated with IV access, accounting for about 67% of IV catheter removals; a less common complication, but much more serious complication of a PIV can be a blood stream infection (BSI) which can account for up to 35% of BSIs seen in patients. BSIs are associated with increased length of stay, increased morbidity and can result in …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Ntchs© Health Literacy Intervention Pilot Study, Genevieve Evenhouse

Doctoral Projects

This pilot study explored the effectiveness of a validated curriculum called, “Navigating the Health Care System” (NTHCSÓ) in improving the health literacy of high school-aged adolescents in response to the national call to promote knowledge and skills in all ages, and socio-economic and cultural groups to achieve healthier lives. Low health literacy has been shown to greatly affect the quality of lives, health outcomes, and health spending of individuals with and without health conditions across social demographics. High school-aged adolescents are the population of interest of this study due to their developmental milestones which allows for knowledge and skill building …

Timely Follow Up Care After Initiation Of Adhd Medication In Children: A Quality Improvement Project, Rebecca Haas

DNP Scholarly Projects

Background: Enhancing medication safety, strengthening compliance and mitigating side effects requires close monitoring. A child, defined by Centers for Medicare and Medicaid Services, as being between the ages of 6 years and 12 years of ages, with Attention Deficit Hyperactivity Disorder (ADHD) must have an initial medication visit within 30 days of a first-time trial of ADHD medication. Increasing staff awareness of organizational policy of expected timeframe for medication checks and annotating appointment slots as initial medication checks will decrease the number of days between the first-time trial of ADHD medication and a child’s medication assessment. Methods: The Model for …

Improving Pediatric Oral-Systemic Health Through Motivational Interviewing: An Interprofessional Training Intervention, Oksana Prodan

Doctor of Nursing Practice (DNP) Projects

Introduction: In response to the prevalence of early childhood carries (ECC) in the United States, recommendations were established for pediatric primary care providers to routinely incorporate oral-systemic health promotion services into clinical practice. An interprofessional education project was developed between Advanced Practice Registered Nurses (APRNs) and dentistry students in San Francisco to assist trainees in the effective delivery of oral systemic health promotion services. Improving health promotion communication skills was identified as an area of need for both sets of learners. Therefore, the IPE activity was designed to incorporate Motivational Interviewing (MI) into the training along with pediatric oral …

Failure-To-Rescue Simulations As A Risk Management Strategy For Registered Nurses, Trena K. Seago

Graduate Theses, Dissertations, and Capstones

In the hospital setting, prevention of failure-to-rescue (FTR) events is an important aspect of patient safety. The use of patient simulation as a strategy to educate nurses on the prevention of these events offers two modes of learning: 1) experiential learning through simulation and 2) reflection through debriefing. The act of practicing to recognize a deteriorating patient through experiential learning and reflection may help increase nurses’ self-efficacy in recognizing a similar situation in their future practice. This quasi-experimental, one-group, pretest-posttest pilot study investigated the use of patient simulation among registered nurses (RNs) in the hospital setting as an anticipatory educational …

Using A Kindle To Improve Parental Perceptions Of Pain In Their Children: A Dnp Scholarly Project, Andrew Gearhart

DNP Scholarly Projects

Patient satisfaction is an important goal for health care providers, as it is associated with treatment success, and patients are more likely to adhere to medical treatments when they are satisfied. Emergency departments are among the lowest ranked healthcare settings nationwide in terms of patient satisfaction. Pediatric patients often experience pain and/or anxiety while in the hospital setting and are at an increased risk of having unpleasant experiences while receiving care. The purpose of this DNP scholarly project is to determine whether the introduction of a Kindle Fire tablet was effective in decreasing parental perceptions of pain while their child …

A Pediatric Respiratory Care Curriculum For Emergency Department Nurses, Luzmaria Alcala-Van Houten

Doctoral Projects

As pediatric visits to community hospitals increase, the Institute of Medicine (IOM) and the Pediatric Emergency Care Network (PECARN) recommend that staff be provided improved education, protocols, and resources to improve patient outcomes (Emergency Medical Services for Children, n.d.). Acute respiratory disorders are the most commonly seen complaints in children aged 0–24 months, with an average of 2–4 visits a year. The purpose of this Doctor of Nursing Practice (DNP) project is to create a pediatric respiratory care curriculum for emergency department nurses in the Kaiser Permanente Central Valley Area (CVA) and to have it evaluated by a group of …

A Program To Prepare Frontline Nurse Leaders For Peer Review, Suzanne K. Murdock

DNP Scholarly Projects

Introduction: The purpose of nursing peer review is to assess the quality of nursing care against established standards, identify strengths and weaknesses in practice, and identify knowledge gaps. Studies of nurse peer review predominantly focuse on staff nurse attitudes and knowledge after an educational intervention and barriers to implementation. Frontline nurse leaders (FLNL) can influence adoption of new practices such as peer review.

Purpose: The purpose of this project was to engage frontline nurse leaders in a role specific peer review program, preparing them to support their staff in the implementation of peer review in the future and providing an …

Exploring What It Is Like To Be An Undocumented Alien In Seek Of Healthcare, Eliany C. Torrez Pon

Honors Undergraduate Theses

Currently, there are about 11.8 million undocumented aliens in the United States who are not eligible for public insurance or any type of private coverage obtained through the American Health Care Act of 2017. This creates barriers to healthcare for this large population and has negative implications for the healthcare system. Despite the availability of clinics and low-cost healthcare, this group tends to underuse resources or seek healthcare for emergencies only which leads to increased cost totaling approximately $1.1 billion a year. The goal of this qualitative study is to better understand what it is like to be an undocumented …

Using Social Narratives To Improve The Healthcare Experiences Of Children Diagnosed With Autism Spectrum Disorder, Margaret Spindel

Senior Honors Projects, 2010-2019

Children with Autism Spectrum Disorder (ASD) often experience significant emotional stress when they visit a healthcare provider. The focus of this research project was to explore the use of social narratives to help reduce stress associated with this environment. Social narratives are short stories designed to walk a child through a potential situation that they will encounter, that they may not be familiar with, or that they are not currently handling properly. As part of an initial literature review, evidence for the need for additional intervention in the healthcare setting for children with ASD was established. Continuing literature review then …