Digital Commons Network^™

Stress And Burnout In Nurse Leaders, Laura E. Johnson, Kiersten J. Nichols, Jayme A. Sakhitab

Nursing Masters Papers

Problem: Nurse leaders commonly experience stress and self-reported burnout. The associated negative consequences are compelling, yet few studies to date consider the nurse leader population. Stress is “a multidimensional phenomenon determined by a person’s perceptions and may be assessed as harm, loss, threat, or challenge” (Udod, Cummings, Care, & Jenkins, 2017a, p. 160). Burnout is a lack of professional fulfillment caused by emotional, physical, and psychological stress (Nurse Burnout, 2019). Drivers are associated and contributing factors which lead to stress and self-reported burnout.

Purpose: The purposes of this correlational study are to (a) identify drivers from the literature and …

Oh My Stomach: Constipation Management, Zoë Collette

Cohort VIII

Introduction: The purpose of this quality improvement project, as an adult gerontology/acute care nurse practitioner (AGACNP) working in a mental health hospital, was to provide the best intervention for those who are suffering from constipation. Previously, I was treating patients with Colace 100 mg Po BID, and now, various literature reviews proved that polyethylene glycol 3500 (PEG 3500) was a more effective treatment option. The goal of the PEG treatment was to help with the ease of a bowel movement within 24-48 hours. The project was conducted at Behavioral Hospital of Bellaire, a mental health hospital in Houston, Texas. A …

Becoming A Trauma Informed Care Organization, Katie Robery

School of Professional Studies

The Brockton Area Mutli Services Inc or BAMSI is a private, non-profit human services organization providing services to adults and children with developmental disabilities, mental illness, behavioral health, and public health needs. Founded in 1975, BAMSI is in the business of “bringing people and services together.” BAMSI transforms lives by building the capacity of individuals, families, organizations, and communities to learn, thrive, and achieve their goals. BAMSI services promote the recovery, resiliency, and self-determination of the people we serve. As a human services leader, we strive to be the provider of choice. (Duffy, 2019) With an emphasis on respect and …

Converting Threats Into Opportunities Predicting Medical Error Reporting Behavior., Whitney Thomas Rogers

Electronic Theses and Dissertations

Medical errors are a public health epidemic and a major threat to patient safety. Estimates suggest they may be responsible for 210,000 - 440,000 preventable deaths per year. This would make medical errors the third leading cause of death in the United States. The societal burden of medical errors is steep, with the economic impact near $1 trillion. The purpose of this study was to use a theory-driven approach to better understand the reporting behavior of healthcare professional. Increased error reporting leads to heightened awareness of the precursors or conditions generating errors, which can then be corrected. In its most …

Screening For Fibromyalgia In Patients With Chronic Widespread Pain, Justus Ongaga

Nursing Capstones

Background: Fibromyalgia has an estimated prevalence of 2% of the United States population, with a greater estimated prevalence among women (3.4%) than with men (0.5%). In addition to widespread pain, fibromyalgia symptoms include fatigue, headache, sleep disturbance, anxiety, depression, memory problems, and numbness/tingling sensations. If the condition remains untreated or is poorly managed, then fibromyalgia can present problems among individuals, families, and communities. The lack in fibromyalgia screening processes at a Midwest Pain Clinic presented opportunity for the project.

Objectives: The purpose of this clinical project was to increase fibromyalgia screening by using the Fibromyalgia Rapid Screening Tool (FiRST) in …

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

Point-Of-Care Reminders To Prompt Provider Adherence With Diabetes Care Guidelines For Adults, Eric E. Spohn

Evidence-Based Practice Project Reports

Diabetes is a complex, chronic illness, and a leading cause of morbidity and mortality (ODPHP, 2019). Gaps in diabetes care exist between clinical guidelines and interventions provided in the clinical setting (ADA, 2015; Chauhan et al., 2017; Renders et al., 2001; Worswick et al., 2013). Improved diabetes management strategies and interventions among healthcare providers are essential to close the quality gap. The purpose of this evidenced-based practice (EBP) project was to prompt providers to adhere to diabetes care guidelines using a paper point-of-care reminder over a 12-week period. Provider performance rates covering four specific guidelines were measured: HbA1c, microalbuminuria, diabetic …

Implementation Of A Training Program In The Use Of The Electronic Medical Record To Improve Performance On Quality Measures And Reduce Burnout Among Healthcare Providers, Mary Monica Nara

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rapid adoption and implementation of the electronic medical record (EMR) in health care has contributed to worsening burnout among healthcare providers (HCPs), particularly primary care physicians. Other HCPs such as nurse practitioners (NPs) and physician assistants (PAs) who provide primary care have been equally affected by the increased clerical burden related to the increasing documentation requirements from payers and are at risk for burnout. Rates of burnout in NPs are currently not well known. Burnout has been linked to decreased quality of care for patients. Inadequate training and lack of skills in the use of the EMR have contributed to …

Dnp Project: Improving No-Show Rates In Primary Care, Mai-Linh T. Nguyen, Sarah M. Kuzara

Doctor of Nursing Practice Projects

Abstract

This paper explores the factors that contribute to no-show rates in the primary care setting and effective interventions to improve no-show rates. The average no-show rate in the primary care setting is 23%, (Dantas, Fleck, Olivaria, & Humacher 2018). In 2018, the no-show rate at the WeCare Clinic was 50-60%. A literature review was conducted to gather information regarding why patients choose to no-show their appointments, the common causes of high no-show rates, and effective interventions found to decrease no-show rates. We investigated the primary causes of a high no-show rate at the WeCare Clinic by interviewing staff and …

Improving Caregiver Health Literacy Of Pediatric Febrile Illness: A Patient Care Initiative, Rebecca T. Shipley

DNP Final Reports

Background: Pediatric fever, though typically harmless and incredibly common, can cause substantial fear and anxiety for caregivers unfamiliar with how to manage or treat this condition at home. Studies evaluating pediatric emergency department (ED) rates have repeatedly found fever to be a leading reason for clinical evaluation. Local EDs record percentages as high as 40% of pediatric patients seek evaluation primarily for fever. Purpose: Provide educational resources for high-risk populations to reference at home regarding fever so that avoidable ED visits decreased and caregiver knowledge of fever improved. Methods: An educational program was implemented at a pediatric primary care clinic …

Assessing The Cost-Benefit Of Hiring A Deu-Prepared Rn Graduate: Does It Help Reduce Organizational Costs?, Tonya D. Bryant

UNLV Theses, Dissertations, Professional Papers, and Capstones

Costs associated with training new nurses from the time of hire to the time of independent practice can cost organizations nearly $100,000 per nurse (Acuna, Yoder, Madrigal-Gonzalez & Yoder-Wise, 2017; Silvestre, Ulrich, Johnson, Spector, & Blegan, 2017; Trepanier, Early, Ulrich & Cherry, 2012). New-hire costs for a dedicated education unit (DEU)-prepared newly qualified newly hired nurse (NQNHN) may be prohibitive for some hospitals when considering the cumulative amount of time and costs dedicated to training these specially prepared nurses who have previous clinical and organizational experience from their time as nursing students within the organization over the duration of their …

Holistic Lifestyle Counseling By Physical Therapists: Current Practice And Barriers To Improvement, Savannah Grogan

Honors College Theses

Context: Unhealthy lifestyle habits are a significant risk factor for chronic disease and death in the United States of America. The healthcare system is largely focused on symptom-management and disease treatment with seemingly little regard for prevention, but physical therapists are particularly well-placed to improve patients’ health through lifestyle counseling and modification. Objectives: To assess the current state of holistic health promotion among physical therapists and to identify barriers to improving these practices. Design: An electronic survey was completed by physical therapists in and around the state of Kentucky. Descriptive statistics were used to assess participant demographics and the state …

Using Shared Mental Models To Conceptualize Patients As Professionals, Decision-Makers, Collaborators, And Members Of Interprofessional Healthcare Teams, Umair Majid

Patient Experience Journal

Patient engagement has become the buzz-phrase of 21^st Century health care. Around the world, healthcare systems involve patients in a wide range of activities including drug development, research, and policy design. There are strong institutional pressures for patient engagement in healthcare activities that have been bolstered by ethical imperatives and social and organizational benefits from patient engagement. There is a trend to center efforts to cultivate engagement initiatives that are meaningful to patients and family. However, these efforts are characterized by multiple challenges, for example, tokenism and the lack of organizational support. These barriers may persist in healthcare professionals’ …

Acuity-Based Staffing: Improving Patient Outcomes And Staff Satisfaction, Natalie Long

MSN Capstone Projects

Traditionally, nurse staffing practices have been based on a nurse-patient ratio model and have not incorporated patient acuity. More recent literature has shown that acuity-based staffing can improve patient outcomes and staff satisfaction. The Emergency Department (ED) is an area that has fluctuating patient acuity and volume. To incorporate acuity in to staffing in the ED, the acuity mix over the past year can be used to calculate required nursing hours, therefore providing the number of required nurses for that facility. The calculated number of staff can then be distributed over a 24 hour period. By incorporating acuity in to …

Home Telemonitoring In Heart Failure, William Huff

MSN Capstone Projects

Heart failure (HF) exacerbation is a major source of hospitalization, mortality, and healthcare cost to home health agencies. Unmonitored accumulative fluid retention between skilled nurse visits, base knowledge deficits in HF pathophysiology and dietary restrictions, and lack of basic monitoring equipment such weighing scales are primary contributors to HF related hospitalizations in the home health setting. It has been discovered that early recognition of decompensating HF can reduce or eliminate HF related hospitalization, mortality, and healthcare costs associated with the management of exacerbation. When a patient is sent to the emergency room (ER) for fluid overload secondary to HF, massive …

Effect Of Lifestyle Modifications On Blood Pressure And Bmi In Overweight Or Obese Adults With Primary Hypertension, Mariska Vandenbergh

Evidence-Based Practice Project Reports

Hypertension (HTN) and obesity contribute to poor cardiovascular outcomes which can be managed with diet and exercise lifestyle changes. In addition, self-awareness (SA) of eating patterns can be a useful tool to promote adherence to lifestyle changes. The purpose of this project was to determine the effect of lifestyle education, the DASH diet, and tools to increase SA for adult clinic patients who were overweight with hypertension. The REAP and PIH tools were utilized to increase patients’ SA of their diagnosis and current dietary habits. A literature search over five databases was conducted and analyzed thoroughly. National guidelines strongly recommend …

The Influence Of End Of Life Education On Stress, Anxiety, And Attitude Of The Healthcare Profession Student, Chiquesha Davis

DNP Final Reports

Providing comfort and support to the dying patient is a significant part of the dying process. When soothing a patient, who is dying, the goal is to prevent or relieve suffering as much as possible. Respecting the patient's health and quality of life goals and decisions is essential. Healthcare profession students can experience multiple levels of anxiety, stress, and a negative attitude while taking care of the dying patient. The implementation of a successful intervention is at the cornerstone of helping reduce stress, anxiety, and attitude change in healthcare profession students. The application can also have a positive impact on …

Potential Impacts Of Covid-19 On Individuals With Intellectual And Developmental Disability: A Call For Accurate Cause Of Death Reporting, Dalton Stevens, Scott D. Landes

Population Health Research Brief Series

Why might the COVID19 case fatality rate be higher among people with intellectual and development disabilities?

A Crisis Is A Terrible Thing To Waste: Recovering A Sense Of Agency In Coronavirus Times, Steven F. Freeman

School of Continuing and Professional Studies Coronavirus Papers

No abstract provided.

Implementing Protocols In The Emergency Department To Improve Care For Sexual Assault Patient, Kelly Ciccone

Student Scholarly Projects

This quality improvement project answered the following question: Does implementation of sexual assault forensic examination protocols with educational training increase the number of staff who are knowledgeable and available to complete sexual assault forensic examinations and reduce wait times for individuals who present to the emergency department and have indicated that they were sexually assaulted, over no use of protocols, within a 15-week time frame? Evidence-based state protocols for performing sexual assault forensic examinations were implemented through educational training that incorporated national training criteria and hands on simulation skills practice. Evaluation of outcome measures confirmed an increase to over 80% …

The Provider’S Approach To Addressing Vaccine Hesitancy, Leslie Hohenbrink

Physician Assistant Capstones

Heralded as one of the greatest innovations in medical science was the discovery and implementation of vaccines to prevent illness. It is why our society is no longer plagued with diseases such as smallpox and polio on a large scale. In recent years though, society has faced a new emerging threat in the form of vaccine skepticism and avoidance. Different terms have been used to describe this distrust in vaccines. The current preferred term of vaccine hesitancy is associated with refusal or postponement of vaccination despite vaccine accessibility and availability. This term is preferred over previous labels such as anti-vaxers, …

Increasing Adult Influenza Vaccination Rates In The Primary Care Setting, Leah Prescott Msn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Provision of vaccinations is one of the most basic interventions aimed at health promotion and disease prevention in the primary care setting. Despite increased public awareness and improved access to vaccinations through minute-clinic settings, health fairs, and employer-offered vaccination clinics, adults in the United States continue to fall short of national goals. Literature demonstrates vaccination rates among adults vary widely and may be affected by a multitude of factors, however vaccination rates may be greatly improved with increased provider engagement.

Objectives: The purpose of this project was to develop, implement, and evaluate a program to improve immunization rates in …

A Collaborative Approach To Incentivizing Healthy Food Choices Among Uncontrolled Diabetic Patients At A Local Federally Qualified Health Center To Improve Health Outcomes, Briauna J. Taylor

Doctoral Projects

Background: The rate of uncontrolled diabetes among patients at a local Federally Qualified Health Center (FQHC) is higher than the nation standard, a phenomenon believed to be caused by the effects of social determinants of health (SDOH). SDOH, specifically food insecurity, play a significant role in health outcomes of diabetic patients. Increasing access to healthy foods, thereby reducing food insecurity, has the potential to improve glycemic control and reduce diet related chronic disease.

Objectives: The project aims to determine if partnership with a membership based incentivized grocery store has the potential to positively impact health outcomes among vulnerable patients with …

Time For Quiet Reducing Nighttime Interruptions In The Icu (Turn In-Icu): Evaluation And Implementation Of A Nonpharmacological Sleep Bundle To Improve Sleep Quality, Delirium, And Nighttime Sedation Requirements, Christina Junker, Msn, Rn, Ccrn

Doctor of Nursing Practice Projects

Background: Undisturbed, restful sleep is essential for physiological as well as psychological well-being. For critically ill patients, sleep deprivation caused by frequent nighttime interruptions is associated with poor sleep quality and negative patient outcomes.

Objectives: The purpose of this Quality Improvement (QI) project was to promote uninterrupted sleep between the hours of 10 PM and 5 AM. Outcomes for evaluation consisted of the following three components: (1) sleep quality, (2) incidence of delirium, and (3) nighttime sedation requirements. Except for sleep quality, these variables were compared before and after the intervention.

Methods: A descriptive, before and after design for data …

Nurse’S Perception Of Safety Culture And Patient Safety Following Implementation Of A Handoff Communication Process Between Pre-Operative And Operating Room Nurses, Tracy Willett, Msn, Mba, Rn, Nea-Bc, Cnor

Doctor of Nursing Practice Projects

Background: In a hospital environment the care of the patient is transferred multiple times during his or her stay. Current needs assessment indicates that nurses’ perception of safety culture with handoff communication and patient safety is an area of focus for the practice site.

Objectives: This study aimed to improve the Pre-operative and Operating Room nurses’ perception of safety culture measured with four valid and reliable survey questions. The second study’s aim was to improve patient safety with the handoff process, measured by the number of adverse events reported by the practice site.

Methods: Pre-implementation data was collected. Nurses worked …

Utilizing A Mentorship Approach To Address The Underrepresentation Of Ethnic Minorities In Senior Nursing Leadership, Kimberly Jean-Louis, Msn, Mpa, Rn, Nea-Bc

Doctor of Nursing Practice Projects

Many healthcare institutions have acknowledged the benefits of and the need for a workforce that reflects the diverse patient populations they serve. However, few healthcare organizations have made progress in increasing the diversity of their leadership teams. The American Hospital Association’s Institute for Diversity in Healthcare Management (2016) found that while minorities represent 32% of hospital patient populations across the nation, they only account for 11% of executive leadership. The objective of this DNP project was to implement a 4-month mentorship program that empowered minority nurse leaders who desire career advancement to executive leadership roles and provide them with realistic …

Effect Of Provider Education On Urinary Incontinence Knowledge And Assessment, Kendra L. Roloff

Nursing Capstones

Nearly 50% of women in the United States will experience urinary incontinence at some point during their lives. Urinary incontinence impacts multiple aspects of a woman’s life, yet remains underdiagnosed by primary care providers. The purpose of this project is to implement education and reminders for primary care providers, in order to improve urinary incontinence knowledge and assessment of women 18 years of age or older. The project was carried out in a primary care clinic with primary care providers serving as the participants.

A quasi-experimental one-group pretest-posttest design was utilized. Data from a five question pre- and posttest were …

Self-Talk: Mentoring And Empowering Faculty To Contribute To Organizational Change, Brian Culp

Faculty Articles

We can effectively mentor if in possession of qualities to empower mentees, which include: effective communication skills, knowledge of the professional realm, enthusiasm, passion and the ability to create an equitable and supportive organizational environment with the mentee. The authors of this article propose that self-talk (ST) or inner speech is a helpful means of inspiring mentors, colleagues, teachers, and friends in navigating communication challenges with themselves and others. A three-step approach to implementing ST for the purpose of mentoring involves: (1) awareness of the ST they are currently using; (2) follow-up with the mentee’s active reflection of and recording …

The Role Of Financial Insecurity And Expectations On Perspectives Of Mental Health Services Among Refugees, Jacqueline M. Siven

USF Tampa Graduate Theses and Dissertations

This dissertation examines how perspectives of mental health among refugees are situated within the realities of the refugee resettlement system, a population for which information on this issue is quite limited. Through in-depth interviews and participant observation with Congolese refugees and non-Congolese refugee-serving professionals in a major Florida city, this dissertation examines how perceptions of mental health and mental health services among refugees were affected by financial insecurity and disparities in expectations. Local Congolese refugees expected the American Dream; they believed that once they arrived they would find prosperity through hard work. Instead they experienced frustration and distress because the …

Provider Behavior Change Approaches To Improve Family Planning Services In The Ouagadougou Partnership Countries: A Landscaping Review, Kathryn Spielman, Elizabeth Tobey, Martha Silva, Leanne Dougherty

Reproductive Health

This landscaping review summarizes available evidence (as of 2020) on the effectiveness of provider behavior change interventions for improving family planning services in Ouagadougou Partnership countries and presents current or recent provider behavior change interventions not formally evaluated. The findings are summarized along with reflections about possible research and programming investments to address challenges and opportunities.