Other Nursing Commons^™

Implementation Of A Wellness Program To Address Health Disparities In A Vulnerable Population, Patricia Clark Pappas

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was to implement a Wellness program to address the health disparities in a vulnerable population. The population targeted was a local population that was served at a mental health facility for socioeconomically disadvantaged. The program focused on improving knowledge of cardiovascular health, empowerment and communication skills. Significance: The significance of the project is the improvement in ones wellness by provision of education, empowerment and communication skills. The attaining of these skills can translate into other areas of wellness and improved health outcomes. Populations at risk due to socioeconomic and racial differences can …

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …

Depression Screening And Early Intervention On The Post-Stroke Patient, Marco Oliver Dugan Lopez

Doctor of Nursing Practice (DNP) Projects

Statistics in the United States (US) have shown an increase in the prevalence of Cardiovascular Disease (CVD) or risk for developing CVD. Approximately 78 million American adults, 20 years and older, have hypertension, 31.9 million have elevated serum cholesterol levels, and 68.2 million use tobacco products. Within California, San Francisco (SF) was ranked 8th among counties with adult residents that have CVD. It is estimated that approximately 1.02% of these individuals will have a stroke each year and 16.25% will die from stroke. Of those that survive, it is estimated that at least half will develop neurologic deficits, and at …

Development And Implementation Of A Violence Risk Assessment Tool, Mira Aidasani-Diwata

Doctor of Nursing Practice (DNP) Projects

The purpose of this quality improvement project was to provide a means to effectively assess patients as they are admitted to the hospitals and to effectively communicate a patient’s violent tendencies within the healthcare setting. Workplace violence is a serious problem that affects all healthcare professionals. Although serious assaults and homicides attract more media attention, the majority of workplace violence consists of non-fatal assaults. Nurses, aides, and patient care technicians suffer the most non-fatal assaults resulting in injury. Due to the growing incidence of assault and injury among healthcare workers, some states are calling for additional study on workplace violence. …

Implementing Emergency Bedside Backpacks In The Nicu To Improve Patient Outcomes, Melissa M. Garcia

Master's Projects and Capstones

Abstract

Planning for a disaster, by implementing a unit specific disaster plan, has become an essential recommendation for Neonatal Intensive Care Units. Emergent situations have resulted from past natural disasters proving the need for additional planning when it comes to units with fragile populations. Research has shown instituting a specialized disaster plan, increases patient safety resulting in improved patient outcomes. This prospectus aims to implement emergency bedside backpacks as the first step in the development of a NICU specific disaster plan. These backpacks are meant to be an addition to the current hospital emergency plan, with the goal being to …

Fall Reduction With Nursing Interventions, Sin Ting Chan

Master's Projects and Capstones

The aim of the project is to reduce the patient’s fall rate in the medical surgical unit at an acute care hospital through improving the fall precaution process. The unit consists of 37 bed with a population of stroke, medical, and surgical patients. The focus of the nursing staff education using handouts, brochures, and poster will be based on the results from pre and post intervention audits. The goal of this fall reduction project is to have the nursing staff learn, review, and apply fall prevention interventions for fall risk patients in order to help reduce fall rate by 50 …

Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn

Master's Projects and Capstones

The objective of my project is to develop staff education regarding a nutrition initiative developed to address the 44% obesity rate among clients in our care. My target population is direct care staff working in the Intellectually/Developmentally Disabled (IDD) community, and high functioning clients who live independently in the community. The staff knowledge was tested pre- and post-education to demonstrate knowledge retained. Staff are required to get a score of 80 or better to pass. Test results are interpreted to see which content areas need further teaching or clarification. Initial results indicate that four areas of education need to be …

Improved Satisfaction On Postpartum Unit By Implementing A Discharge Nurse Role, Nicole Ware Rn, Msn

Master's Projects and Capstones

A three-month time period was used to develop a postpartum education program change by designing a discharge nurse role on the postpartum unit at University of North Carolina Women’s Hospital. The goal of the education change is to increase patient satisfaction scores of discharged post-natal mothers on the postpartum unit by having HCAPS and Press Ganey to improve up to10% over the next 6 months.

An observational assessment revealed a fragmented and antiquated discharge process. This process was paper based and difficult to complete in light of the short stay and high volume patient population. Informal nurse feedback as well …

N653 Fall Prevention Final Project, Sam Clark

Master's Projects and Capstones

N653 Fall Prevention Final Project

by Samuel K. Clark, RN

This project was done with patient safety in mind through the use of the most current EBP available.

Barriers Encountered By Nurses And Nursing Assistants That Prevent Purposeful Rounding, Mar Joseph B. Odias

Master's Projects and Capstones

Purpose: The aim of the study was to identify barriers encountered by registered nurses (RNs) and nursing assistants (NAs) that prevent purposeful (hourly) rounding.

Background: The literature has shown that purposeful rounding improves patient outcomes and safety. However, few studies show the barriers encountered by nursing staff that hinder the purposeful rounding process.

Methods: A pre-post test design was implemented on a 25-bed oncology, urology medical surgical unit with a staff of 38 RNs, 9 NAs, and 4 Unit Secretaries (US). A pre-implementation needs assessment survey was completed by 55% (21/38) of RNs, 33% (3/9) of NAs, and 100% (4/4) …

Increasing Self Care Compliance With Follow-Up Appointments, Elsa T. Owens

Master's Projects and Capstones

The congestive heart failure patient faces many challenges after discharge from the hospital. Learning how to manage diet, medications, and other lifestyle changes needed for symptom management can lead to multiple readmissions and rapid progression of condition. Many patients feel overwhelmed at time of discharge from the hospital, and many miss key components in discharge instructions and education. The main objective of the organizations Heart Failure program is to educate patients who have been admitted into the hospital with systolic or diastolic heart failure. Within our team we set out to educate our patients and their families on reducing incidents …

Enhancing Education Of Medication Side Effects To Improve Patient Outcomes, Kyle R. Woolley

Master's Projects and Capstones

Patient satisfaction scores regarding how effectively staff educates patients about possible side effects of new medications are not consistently above the national average at a large metropolitan hospital in California (MHC). The results of these patient satisfaction scores shed light on the need for evidence-based strategies to improve a patient’s perception of the medication education provided to them. The basis of the incentive to improve care is ultimately increased safety and better patient outcomes. From the Root Cause Analysis, it became apparent that a few common barriers need to be addressed, but the one most frequently reported by everyone that …

Videoconferencing For Improved Access To Care, Alana L. Hernandez

Master's Projects and Capstones

The aim of this project is to increase the amount of education visits completed by pharmacy nurses in an outpatient infusion clinic for patients receiving 5-fluoracil chemotherapy. Two approaches have been applied: securing additional nursing staff; and implementing a telehealth delivery system that utilizes asynchronous video and videoconferencing. The intervention will employ an internet-based application to secure a videoconferencing session between patients and nurses that are 25 miles apart; and offer a patient education video that will be used and an adjunct to videoconferencing. Microsystem data obtained by auditing schedules and patient charts showed pharmacy nurses completed 0% of pharmacy-patient …

Student Nurse Behaviors And Barriers To Successful Completion Of The Traditonal Bachelor's In Science Of Nursing (Bsn) Program., Carri Shaw

Honors Theses

Change is often said to be the only constant in life. This holds true to the rapidly growing field of nursing. In order to meet the demands of new challenges that emerge in nursing, the way future nurses are educated also has changed. Not all nursing students find that the profession is for them. Therefore, some attrition from school is expected. This descriptive study will explore factors that the literature suggests are related to attrition at a mid-sized public university in the Midwest. A survey given to two different level nursing cohorts will give insight to pre-licensure nursing students’ experiences …

Improving Management Of Inpatient Blood Glucose, Rachael K. Misitano

Master's Projects and Capstones

Epidemiologic studies indicate blood glucose management in the hospitalized patient population is not adequate; with approximately 30% of patients reporting values >180mg/dl. Patients with increased blood glucose levels pose a higher mortality risk as well as increased risks for dehydration, hypotension, renal injury, decreased wound healing, immunosuppression, and an overall increase in hospital length of stay (AACE, 2015). This project aims to improve inpatient management of blood glucose levels by facilitating MD-RN communication through a reduction in the current reportable blood glucose level. This project took place on a 17 bed adult medical-surgical unit at a large academic hospital in …

Comparison Of Outcomes In Heart Bypass Patients Undergoing Insertion Of An Internal Jugular Vein Central Line By Ultrasound Compared To Traditional Landmark Technique, Sayha Ol Ma

Doctoral Projects

Patients that undergo heart bypass surgery require central line placement from a healthcare provider. To place this device one must use either ultrasound guided or landmark technique. Using ultrasound guided compared to landmark technique may reduce complications. The goal of this project was to determine if ultrasound use of central line placement is a safer practice compared to using the traditional technique.

A retrospective chart review was performed to compare internal jugular central line placement by ultrasound with the traditional landmark placement to evaluate results related to patient outcomes. Data from fifty health records were analyzed using chi-square. The complications …

The Regional Study Of Sleep-Related Behaviors Of Nurse Anesthetists: Personal And Professional Implications: A Replication Study, Jarrod Fontenelle

Doctoral Projects

Universally, anesthesia providers are expected to be knowledgeable, astutely responding to clinical challenges while maintaining a prolonged vigilance for administration of safe anesthesia and critical care. A fatigued anesthetist is the consequence of cumulative acuity manifesting as decreased motor and cognitive powers. This results in patient harm, impaired judgement, late and inadequate responses to clinical changes, poor communications, and medical errors. With increased expectations and medical-legal claims, anesthesiologists work to provide efficient and timely services, but are rendered sleep deprived themselves. It is the right time to address the issue of the health of anesthesia providers and the profession. The …

La Formation Continue D’Infirmières De Soins À Domicile : Retombées Perçues Au Regard De L’Amélioration De La Qualité Des Soins Aux Aînés., Jérôme Ouellet, Joséphine Mukamurera

Quality Advancement in Nursing Education - Avancées en formation infirmière

Résumé

L’intensification du maintien des aînés à domicile qui présentent des problèmes de santé complexes exige des infirmières qu’elles mettent à jour leurs connaissances au moyen de la formation continue (FC). Or, peu d’études soutiennent que les activités de formation continue (AFC) que suivent les infirmières contribuent à long terme à améliorer la qualité des soins.

Cet article est issu d’une étude qui s’intéressait au rapport à la formation FC d’infirmières en soins à domicile (SAD) d’une région au centre du Canada, qui assurent le suivi d’aînés. Huit infirmières ont participé à des entrevues semi-dirigées. Les données collectées ont fait …

Nursing Students Critical Thinking And Research Utilization, Salima Moez Meherali, Joanne Profetto-Mcgrath, Pauline Paul

Quality Advancement in Nursing Education - Avancées en formation infirmière

Background: In the nursing profession critical thinking (CT) has increasingly been the focus of investigation for the past several years. CT dispositions and skills are valuable in nursing practice. Nurses need complex thinking skills to effectively manage the fast-paced and constantly changing health care environments in which they work. CT is also vital in developing evidence-based nursing practice. Nurses who are disposed to think critically are more likely to critically interpret the available evidence, and able to make high quality judgments and draw valid inferences. Currently, no published studies could be located that specifically examined the relationship between Critical …

A Parallel-Group Randomized Controlled Trial Of The Boa®-Constricting Iv Band, Richard N. Bradley

Richard N Bradley

Background. Few studies have demonstrated the ideal technique for placement of peripheral venous access.

Objectives. The purpose of this study was to conduct a randomized, controlled trial to determine if there was a difference in success rates for establishing peripheral intravenous lines (IVs) when using the BOA® Constricting Band (BOA) compared to a standard elastic tourniquet.

Methods. Eligible participants were paramedics working in the out-of-hospital setting and nurses working in a trauma center. The intervention group intended to use the BOA® for all IV attempts, while the control group intended to use standard elastic tourniquets. The primary outcome was success …

A Critical Hermeneutic Analysis Of Presence In Nursing Practice, Alicia L. Bright

Collected Faculty and Staff Scholarship

Nursing presence, although it involves action at times, is a humanitarian quality of relating to a patient that is known to have powerful and positive implications for both nurse and patient. However, this phenomenon has not been well understood. Three theories, drawn from the work of Paul Ricoeur and Hans-Georg Gadamer, served as the boundaries for both data collection and analysis. The theories were narrative identity, play and solicitude. This study follows a critical hermeneutic approach to field research and data analysis. Literature regarding nursing presence is reviewed and discussed, and in-depth conversations with eleven participants are recorded. Examining the …

Reducing High-Risk Alcohol Behaviors, Janette Neuman

Janette S. Jones

Clinical question: Does a theoretically supported, evidence-based alcohol risk reduction intervention implemented in a college health setting by an advanced practice nurse demonstrate improved alcohol related health outcomes for a Midwestern university campus? Answers to this question are discussed as obtained through implementation of a translational research project in 2011 on the campus of Indiana University-Purdue University Fort Wayne.

How Substance Abuse Impacts Pain Management In Acute Care, Dawn Dunn, Janette Neuman

Janette S. Jones

Article includes a review of evidence-based interventions useful for assessing and managing pain in patients with histories of substance abuse.

Understanding Veteran’S Health Beliefs: An Essential Part Of A Patient-Centered Approach To Treatment Adherence, Susan E. Phillips Dnp, Mph, Pmhcns, Mary Dolansky Rn, Phd

DNP Forum

Background: Patient centered care is a mechanism to encourage healthcare consumers to work together with health care professionals to achieve quality outcomes In the VA, non-adherence to treatment recommendations is problematic. Non-adherence results in poor use of VA resources as veterans come in for care but do not follow through with recommended treatment plans. Besides asking veterans about their health goals and preferences, understanding the veteran’s orientation regarding health beliefs and motivators for adherence to recommended treatment plans is essential for nurses who aim to help the veteran achieve healthy lifestyle behaviors.

Objective: The purpose of this study was to …

Introducing Telehealth To Pre-Licensure Nursing Students, Dwayne F. More

DNP Forum

Background

Telehealth has emerged as an important tool for healthcare providers. Telehealth concepts are not currently taught in many nursing courses.

Purpose

Introduce telehealth concepts to pre-licensure nursing students via a learning module and to test its effectiveness using pre and post-tests.

Method

A two-tailed t test used to analyze the difference between the pre and post-test scores supported the research question: “Is the use of a new telehealth learning module effective in teaching pre-licensure nursing students about telehealth?”

Multiple regression analysis demonstrated that demographic variables had no influence on the outcome of either test.

Discussion

The results of the …

Handoff Communication In The Emergency Department, Kristen Matichko

DNP Forum

The communication of patient information through use of handoff ensures continuity of care and patient safety. A study of hand-off reports between pre-hospital personnel and staff in the emergency department revealed a lack of complete or formal information dialogue. Nurses play a vital role in the process of communication and information exchange through the use of handoff despite minimal guidelines for that exchange in current nursing practice. The pre-hospital hand-off informational exchange impacts patient safety as well as the planning and implementation of nursing care based upon that information.

The sample used was from a convenience sampling of patients arriving …

The Relationship Between New Nurses Who Volunteer And The Caring Behavior New Nurses Exhibit In The Practice Setting, One Year Post Graduation, Nicolette Fiore-Lopez

Theses & Dissertations

Volunteering is engaged in by millions world-wide and nurses comprise a significant portion of those who provide their professional talents, unpaid, to the underserved in local, national and international efforts. Nurses who have engaged in volunteer activities anecdotally describe personally transforming experiences gained through their efforts and for many nurses volunteering becomes part of their professional mandate. Although many social disciplines have studied volunteering, to date there has been a paucity of research on nurses who volunteer. The purpose of this study was to describe the characteristics of novice nurses who volunteer and determine the influence of volunteering and associated …

Problem Solving Skill And Obesity In Children, Caitlin R. Spano

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract:

Introduction: Childhood obesity is a problem that leads to many serious health effects including early maturation, decreased quality of life and increased risk for cardiovascular disease. In 2012, over one third of children were considered obese (Childhood Obesity Facts 2015). Efforts have been made to reduce this number but they have not been fully successful (Nutrition Standards for School Meals 2015, Prevalence of Childhood obesity in the United States 2011-2012 2015). What other factors are causing kids to choose foods that lead to weight gain.

Literature Review: In research regarding psychological motivations of overeating, there has been a correlation …

Reinventing The Medical Request Process In A Correctional Healthcare Setting, Leah Murphy

Master's Projects and Capstones

This project was developed as part of a Clinical Nurse Leader course of study with the goal of gathering and evaluating microsystem data, and the creation and implementation of a process improvement project. The project was conducted in a correctional setting which houses male and female detainees with a wide variety of medical needs. The project addressed long wait times for detainees who have submitted a request for services from the medical department. The goal of this project was to reduce wait times for medical requests, and provide service for a greater number of patients. This project is needed because …