Nursing Commons^™

Clinical Guidelines For The Perioperative Management Of Patients With Aortic Stenosis Undergoing Noncardiac Surgery, Owen Diehl

Doctor of Nursing Practice Scholarly Projects

Aortic stenosis (AS) is a common valvular disorder that causes left ventricular (LV) outflow obstruction. The prevalence of AS may increase with the aging population and the widespread availability of diagnostic capabilities like echocardiography. With the increasing patient population diagnosed with AS, the chance of encountering these patients during noncardiac surgery (NCS) increases. Performance of anesthesia is challenging in patients with AS due to the pathophysiological consequences of AS and the hemodynamic changes associated with anesthesia. The patient with AS presenting for NCS is at an increased risk of perioperative major adverse cardiac events (MACEs). This project aimed to determine …

The Effects Of Music Therapy On Pediatric Patients With Congenital Heart Defects In The Pre And Postoperative Setting, Janelle Marie Choy

Nursing | Student Research Posters

Congenital heart defects is a prominent medical occurrence especially in pediatrics. These defects often require surgeries and extensive treatment plans. These treatment plans often include invasive surgeries and extensive treatment plans which can require long recovery times along with potential surgical complications. This study aims to evaluate the effectiveness of music therapy on pediatric patients with congenital heart defects in the pre and postoperative setting and how music therapy can be implemented in treatment plans to yield effective recovery results for these patients. This research is significant as elevated vital signs and preoperative anxiety are associated with an increased need …

Blunt Cerebrovascular Injury (Bcvi): Universal Cta Neck Screening At Level 2 Trauma Center, Tamine Gogel

Doctor of Nursing Practice Projects

Blunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years …

Reducing Inpatient Falls Utilizing Multimodal Standardized Patient Education: An Evidence-Based Practice Project, Sheryl Almandrez

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: This project aims to utilize multimodal standardized patient education as an evidence-based practice intervention to reduce inpatient falls.

Background: In 2022, Kaiser Foundation Hospital (KFH) San Diego had 116 falls. Inpatient falls with injury account for the second-highest Joint Commission (TJC) sentinel event and California Department of Public Health (CDPH) adverse events. These injuries include lacerations, subdural hematoma, subdural hemorrhage, hip fractures, and wrist fractures. The Centers for Medicare and Medicaid Services (CMS) have also stopped reimbursing hospitals for the care provided after patients have sustained a fall with injury.

The project was implemented at KFH-San Diego …

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Implementing An Abnormal Involuntary Movement Scale At An Outpatient Mental Health Clinic, Amanda Ghamsari

Doctor of Nursing Practice Final Manuscripts

Background: Movement disorders caused from psychotropic medications affect an estimated 500,000 people in the United States. These disorders bring an added cost for treatment to the patient, cause emotional distress, and may hinder daily life. Overall health and additional medication costs were increased for these patients by $25,879 per patient per year compared to patients without a movement disorder.

Purpose of Project: To address the issue, the team of mental health providers at an outpatient clinic assess their mental health patients at start of care and at follow up visits utilizing the Abnormal Involuntary Movement Scale. With the goal of …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Analyzing The Cognitive Complexity Of The Questions On The Advanced Placement Computer Science Principles Exam, Lauren Zirpoli

Seton Hall University Dissertations and Theses (ETDs)

This convergent parallel mixed methods study with qualitative and quantitative content analysis was conducted to analyze and describe the cognitive complexity of the publicly released Advanced Placement Computer Science Principles Exam questions compared to the language of higher-order thinking found in research literature. Hess’ Cognitive Rigor Matrix was used to determine the frequency and percentage of questions categorized as higher-order thinking within each cell of the matrix. The qualitative method consisted of content analysis of the language of each question analyzed, followed by deductive coding, and culminated with categorizing the depth and type of thinking required on Hess’ Cognitive Rigor …

Initiating Access To Palliative Care Earlier In Pediatric Oncology Patients, Anita Sharma

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Pediatric oncology patients should be referred to palliative care early but despite research indicating the clear benefits, there is still a delay in referring patients. One of the reasons include lack of understanding amongst providers on what palliative care is. Palliative care provides symptom management, emotional support and helps the patient and family with difficult decision making.

Objectives: This project aimed to increase the number of early referrals to palliative care. The Pediatric Palliative Care Screening Tool (PaPas) was utilized to help identify the triggers which should prompt the referral.

Methods: A chart review of patients diagnosed with …

Utilizing Decision Tree Implementation And Provider Education To Improve Colorectal Cancer Screening Orders: A Quality Improvement Project, Alicia Kollar

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths (Jain, et al., 2022). Healthy People 2030 objectives include reducing the CRC death rate and increasing the proportion of adults who get screened (Healthy People 2030, n.d.). According to 2021 data, only 58.7% of adults are screened with a Healthy People target of 68.3%. Healthy People states that there are effective screening tools to detect colorectal cancer early, and people are more likely to survive it (Healthy People 2030, n.d.). Purpose: This quality improvement (QI) project aims to implement an …

Improving Mental Health Support For Nursing Students Through Mental Health First Aid (Mhfa) Training Of Clinical Faculty, Amy Sands

Graduate Theses, Dissertations, and Capstones

This project aimed to implement a process improvement program at the Louisville campus of Galen College of Nursing to improve the mental health support for nursing students through the training of Clinical Instructors (CIs) in using adult Mental Health First Aid (MHFA) and the ALGEE actions described within that program.

Strokes Of Excellence And Opportunity: A Program Evaluation Analyzing Emergency Department Stroke Care In A Newly Formed Five-Hospital Health System, Joshua Adams

Doctor of Nursing Practice (DNP) Manuscripts

Stroke is a significant public health problem in the United States and globally. For patients experiencing an acute ischemic stroke, also known as “infarct” or “brain attack,” the effectiveness of treatment is extremely time dependent. This DNP Project presents a program evaluation of stroke care delivered in five emergency departments (EDs) in community hospitals in a health system newly formed through the merger of two smaller organizations. This evaluation focused on assessing the five programs’ effectiveness in delivering timely and effective care to stroke patients with the standardized performance measure door-to-needle (DTN). The evaluation also included a review of factors …

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Integrating Health-Related Quality Of Life And Evidence-Based Polycystic Ovarian Syndrome Management: A Quality Improvement Initiative, Kami Beveridge Wast

Doctor of Nursing Practice (DNP) Manuscripts

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting approximately 10% of women of reproductive age, characterized by symptoms such as irregular menstrual cycles, infertility, and metabolic issues (Fatemeh et al., 2021). Despite its prevalence, the management of PCOS remains challenging due to its manifestations and impact on quality of life. Current treatment paradigms often fail to adequately address the comprehensive needs of this patient population, highlighting a substantial gap in care.

Utilizing the Plan-Do-Study-Act (PDSA) methodology, this quality improvement (QI) project aimed to enhance the management of PCOS and improve the quality of life for patients in a …

Nursing Students’ Perceptions Of The Impact Of Teamwork And Collaboration On Patient Care, Riana Square

Honors College Theses

Teamwork and communication are two topics that a vast majority of nursing students are introduced to in their first semester of nursing school. Many nursing students have a desire to improve their communication skills and have a better understanding of the inner workings of interdisciplinary collaboration. A study across multiple cohorts of Georgia Southern Nursing students was conducted to explore their perceptions of the correlation between teamwork and patient care outcomes. This study also explores nursing students’ readiness to communicate with other healthcare professionals and the effectiveness of the means to practice these communication skills while in nursing school. It …

Implementing An Insomnia Assessment And Management Algorithm In A Rural Pirmary Care Clinic, Rebekah Gaffin

Doctor of Nursing Practice Projects

Insomnia is the most common sleep complaint and significantly impacts quality of life and productivity. The accumulated total of direct and indirect healthcare costs related to insomnia is estimated to be as high as $100 billion/year and is associated with an increased risk of cardiovascular and cerebrovascular disease. Primary care providers play a critical role in identifying and implementing early interventions to address insomnia. However, this can be time-consuming, and providers may be unaware of the latest treatment guidelines and available resources. This project provided a research-based algorithm to identify and initiate treatment for patients 18+ with chronic insomnia in …

Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, Kendra Knaga

Doctor of Nursing Practice Projects

Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint …

Screening For Suicide In Veterans With Cancer, Dina E. Mcneil

Doctor of Nursing Practice Projects

Veterans are at a higher suicide risk than the general population. Veterans with cancer are at a 47% higher risk for suicide. The Veterans Health Administration has an annual suicide screening requirement, but no requirement for more frequent assessment in this high-risk population. Clinical staff may also be hesitant due to fear and anxiety, serving as a barrier to screening. The objective of this project was to educate oncology clinical staff about risk factors for suicide in veterans with cancer, the use of the Columbia-Suicide Severity Rating Scale (C-SSRS), referral processes, and local resources, and intended to increase the number …

Incorporating A High Fidelity Transgender Simulation Into Undergraduate Nursing Curriculum, Kacee Child, Jenniepearl Spencer

Doctor of Nursing Practice Projects: College of Nursing

Purpose

The purpose of this study was to evaluate the knowledge and attitudes of nursing students participating in a high-fidelity transgender patient simulation. The aims were to increase student knowledge and confidence to improve communication and provide more inclusive and equitable care.

Healthcare providers are not adequately prepared to manage the unique health needs of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Nurses are ideally positioned to address gaps in LGBTQ healthcare by providing culturally competent care. Yet, LGBTQ health education is lacking in most undergraduate nursing school curriculums.

Methods

62 undergraduate nursing students participated in a post-surgical …

Heart Failure Zone Tool: A Quality Improvement Project, Emily Scahill, Cindy Driggers, Angelica Marquez

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Heart failure is the leading cause of hospital admissions among adults over 65 years old and lack of patient knowledge regarding the self-management of heart failure is a key factor in rising readmission rates. This project enhances inpatient heart failure education using a laminated heart failure zone tool handout to guide heart failure education. The intent was to increase patients’ confidence regarding heart failure self-management and positively impact patients’ knowledge regarding the management of heart failure.

Materials and Methods

The process included identifying hospitalized patients who had been flagged as a heart failure core measure or had been identified …