Digital Commons Network^™

Implementation Of A New Graduate Registered Nurse Mentorship Program: A Quality Improvement Project, Cindy N. Ruisi

Nursing Doctoral

Transitioning from student to a registered nurse is a critical period for new graduates, often marked by challenges affecting confidence and job satisfaction. Mentorship programs have been identified as an effective intervention to support new nurses during this transition. The Academy of Medical-Surgical Nurses (AMSN) offers a structured mentoring program that can be leveraged to enhance the confidence level and job satisfaction of new graduate registered nurses.

This quality improvement project aims to implement a new graduate registered nurse mentorship program at a > 400-bed community hospital. This program will incorporate components of the established Academy of Medical-Surgical Nurses mentoring program, …

Supporting Well-Being For The Home Visiting Workforce: Organizational Supports For Experiences Of Bias & Discrimination, Beth L. Green, Nicole M. Lauzus, Yumi Lee, Ron Joseph, Erin Gaines, Center For Improvement Of Child And Family Services

School of Social Work Faculty Publications and Presentations

This learning brief is the third in a series to share findings from a 2023 statewide survey of over 700 members of Oregon’s home visiting workforce. This study has provided a wealth of information about Oregon’s home visiting workforce and what could be done to improve and support worker well-being and retention, with a focus on the needs and experiences of home visitors of color and those who speak languages other than English.

Little research has examined the extent to which home visitors experience racism or discrimination on the job, how this may impact their professional and personal well-being, and …

Implementation Of Delirium Screening In The Emergency Department: A Qualitative Study With Early Adopters, Anita N Chary, Annika R Bhananker, Elise Brickhouse, Beatrice Torres, Ilianna Santangelo, Kyler M Godwin, Aanand D Naik, Christopher R Carpenter, Shan W Liu, Maura Kennedy

Faculty, Staff and Students Publications

Introduction: Delirium affects 15% of older adults presenting to emergency departments (EDs) but is detected in only one-third of cases. Evidence-based guidelines for ED delirium screening exist, but are underutilized. Frontline staff perceptions about delirium and time and resource constraints are known barriers to ED delirium screening uptake. Early adopters of ED delirium screening can offer valuable lessons about successful implementation.

Methods: We conducted semi-structured interviews with clinician-administrators leading ED delirium screening initiatives from 20 EDs in the United States and Canada. Interviews focused on experiences of planning and implementing ED delirium screening. Interviews lasted 15 to 50 minutes and …

Best Practice Toolkit For Increasing Colorectal Cancer Screenings In At-Risk Adults, Zoe Windfelder

Student Scholarly Projects

Adult individuals at risk for colorectal cancer (CRC) do not have a direct, accessible best-practice toolkit to follow for screening measures. Research showed that at least three guidelines (i.e., American Cancer Society [ACS], American College of Gastroenterology [ACG], and U.S. Preventive Services Task Forces [USPSTF]) are used interchangeably daily by interprofessional staff for individuals with average to high-risk variables. The project was guided by the following PICOT question: For interprofessional staff supporting the at-risk adult population for colorectal cancer (P), how does the development of a best practice for coordination of care toolkit (I) compared to no structured program strategy …

Developing An Educational Program To Educate Nurses About Sickle Cell Disease And Vaso-Occlusive Episodic Pain, Margaret Sih Buo-Frundi

Walden Dissertations and Doctoral Studies

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Evaluation Of The Effectiveness Of The Implementation Of A New Workflow Process On The Incidence Of High Blood Culture Contamination (Bcc) Rates In The Emergency Department, Angelita Rodgers

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice Project was to evaluate the effectiveness of a quality improvement (QI) initiative to reduce blood culture contamination (BCC) rates in the emergency department (ED) of a large healthcare organization in the southeastern United States. Evidence-base sources indicated that high blood culture contamination (BCC) rates compromised diagnostic accuracy, leading to unnecessary treatments, increased hospital stays, and elevated healthcare costs. The project was guided by the evidence-based practice question: “How does the implementation of a new workflow process influence the incidence of high blood culture contamination (BCC) rates in the emergency department?” To address …

The Effect Of A Structural Wellness Intervention On Id Fellows And Faculty, Michael T. Czapka, Christopher Lehmann, John Flores, Erica Mackenzie, Elizabeth Bell, Aniruddha Hazra

Journal of Wellness

Introduction: Physician burnout is prevalent amongst Infectious Diseases (ID) physicians and trainees in the United States. There is limited data assessing the impact of structural interventions in reducing burnout among medical professionals.

Methods: The multifaceted intervention included increased faculty presence over the weekend and faculty support during the week. ID fellows were surveyed before and after the intervention and faculty were surveyed after the intervention using the Maslach Burnout Inventory for Medical Personnel and additional questions regarding wellness and time for education. Pre- and post-intervention responses were compared. Free response answers were analyzed to determine major themes. Metrics of clinical …

Effect Of Telehealth Interventions On Hypertension Management In A Veterans Affairs Community-Based Outpatient Clinic (Cboc), Cherilyn Schumacher

Student Scholarly Projects

Practice Problem: Per U.S. Department of Veterans Affairs (2020), hypertension (HTN) is prevalent in active and retired military personnel with 13% of those in active duty and in “more than one in three Veterans…making it the most common chronic condition for Veterans” (p. 1). Per the Electronic Quality Measure (eQM) portal, a PACT clinic in a CBOC is scoring well below the national and facility benchmarks, showing a need for an intervention that will improve HTN management.

PICOT: For current veteran patients ages 18-85 assigned to a PACT (P), what is the effect of nurse-led telehealth blood pressure …

Enhancing Emergency Department Efficiency: Utilization Of Streamlined Triage System To Reduce Waiting Times, Sunah Kim

Student Scholarly Projects

Emergency departments (EDs) often experience prolonged waiting times, leading to patient dissatisfaction and potential negative health outcomes. This project addresses the need for improved triage processes to enhance patient flow and reduce delays in care.

PICOT

In adult patients presenting to the emergency department (P), how does the implementation of a streamlined triage process (I) compared to standard emergency department protocols (C) lead to a reduction in waiting times (O) within a twelve-week period (T)?

Evidence

A review of current literature indicated that streamlined triage systems can significantly decrease patient wait times and improve overall ED efficiency by incorporating colors …

Attachment Styles As Moderators Of Loneliness In Remote Work, Brody Tj Loughlin

Doctoral Dissertations

This dissertation investigates the role of attachment styles in moderating the relationship between remote work and loneliness. Drawing on attachment theory, which posits that early life experiences shape attachment styles and influence social interactions, the study examines whether attachment styles (anxious, avoidant, and secure) moderate the association between remote work and feelings of loneliness. The research targets 394 remote workers, using a quantitative, cross-sectional survey design with proportional stratified sampling to reflect the distribution of hybrid and fully remote work arrangements in the U.S. workforce. The Extent of RemoteWork measure, the Three-Item Loneliness Scale, and the Adult Attachment Scale assess …

A Term Of Change, Gary Oyster Dds

Virginia Dental Journal

The document is an update from Dr. Gary Oyster, ADA Trustee for the 16th District, on recent actions taken by the ADA Board and Staff, including legislative issues, financial updates, and organizational changes.

The Impact Of Coordination Training On Motor Skills In Adolescent Handball Players Aged 14–15 Years: A Randomized Controlled Trial, Michał Spieszny, Wojciech Wąsacz, Zbigniew Kamys, Tadeusz Ambroży, Krzysztof Kasicki, Paweł Kapuściński, Łukasz Rydzik

Baltic Journal of Health and Physical Activity

Introduction: Motor skills are fundamental to athletic performance, particularly in sports like handball, where coordination, speed, and power are critical. This study aimed to evaluate the effects of an innovative coordination training program on the profile of motor skills of adolescent handball players compared to traditional training methods. Materials and Methods: A randomized controlled trial was conducted with 27 young handball players. Participants were divided into an experimental group (n = 15) receiving additional co-ordination training and a control group (n = 12) following standard training. The participants’ motor fitness was assessed using selected population tests from the …

Borderline Personality Disorder: A Narrative Review On Effective Psychotherapies, Marina Neri, Antonino Reitano, Lavinia Rinnone, Antonio Bruno, Fabrizio Turiaco, Felicia Matilde Ferreri, Carmela Mento, Maria Rosaria Anna Muscatello, Fiammetta Iannuzzo

Journal of Mind and Medical Sciences

Borderline personality disorder (BPD) is a severe mental disorder characterized by pervasive patterns of relational instability, chronic feelings of emptiness, sense of abandonment, self-injurious and anticonservative attempts. Pharmacological treatment has been found useful only for the management of severe symptoms and management of comorbidities, while psychotherapy is the main treatment for BPD. Although the disorder has long been considered resistant to any treatment, in recent years research has not only shown that BPD can be treated but also provided several manualized and empirically validated psychotherapeutic treatments. This paper set out to examine the most effective current psychotherapies for the treatment …

Avoiding Common Pitfalls In Medical Writing: An Editor’S Advice, Deanna Erin Conners

Milne Open Textbooks

Avoiding Common Pitfalls in Medical Writing is a useful companion text to comprehensive style guides for the biomedical sciences. This book walks authors through best practices for writing scientific papers and grant proposals in a concise and accessible format. Authors and teachers worldwide will benefit from these shared insights of an experienced scientific editor.

Read this book online at: https://milnepublishing.geneseo.edu/medical-writing/

Examining Assessment Tools To Predict Burnout Among Healthcare Practitioners And Students, Robin Hilliard Albertson, Lindsay Gietzen

Pacific Journal of Health

The U.S. health system is stretched thin by pressures to expand service delivery and improve outcomes while reducing costs. This pressure is intensified by global health crises and other factors, resulting in further reductions in the healthcare workforce due to burnout. The strain leaves healthcare practitioners at risk of experiencing negative consequences of burnout, even death [1]. This study explored the correlations between three validated assessment tools to determine if early signs of burnout in healthcare practitioners and students can be identified succinctly, thus expanding the current body of evidence on the strengths of environments supporting career retention and healthcare …

Making Reflection Assignments Meaningful And Enjoyable For Health Professions Students And Faculty, Karen A. Gibbs, Megan L. Trad, Shannon R. Herrin

Internet Journal of Allied Health Sciences and Practice

Purpose: Recognizing the professional and personal benefits of self-reflection, health professions programs routinely incorporate reflection activities into their curricula. However, designing, administering, and grading engaging, meaningful reflection activities that can be utilized for in-person or online teaching can be challenging for faculty and less than enjoyable for students. This study explored student perceptions of a shared activity using photovoice to stimulate individual and group reflection and discussion of learning during clinical experiences. Methods: Second year, doctor of physical therapy students were asked to reflect on their clinical experiences. During the semester-long assignment, each student completed a photovoice slide …

The Impact Of A Visual Remote Patient Monitoring Device (Leaf) On Hospital-Acquired Pressure Injuries (Hapi), Tyler Andrew Gunther

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The Critical Care Department at a large academic hospital in the Southeast has experienced a significant increase in healthcare-acquired pressure injuries (HAPIs), contributing to elevated mortality rates. Factors such as insufficient adherence to turning protocols and resource limitations impact patient safety, thus increasing the potential for adverse outcomes and increased costs. Purpose: The purpose of this DNP scholarly project was to evaluate the impact of a turn monitoring device, specifically the LEAF system by Smith and Nephew, on HAPI incidence in the critical care setting. The project aimed to address the identified barriers to compliance, enhance patient safety, …

Implementation Of Eat Sleep Console For Neonatal Abstinence Syndrome: A Quality Improvement Project, Harley Addison Kennington

Doctor of Nursing Practice Scholarly Projects

Problem Statement: A level III NICU and mother-baby unit within an inpatient hospital in the Southeast United States transitioned from the Finnegan Neonatal Abstinence Scale (FNASS) to the Eat, Sleep, Console (ESC) for treating Neonatal Abstinence Syndrome (NAS). Prior to ESC implementation, there was limited nursing education of ESC practice guidelines or consideration for proper implementation protocol. Purpose: The purpose of this evidence-based quality improvement project was to reintroduce nursing staff to the ESC NAS Care Tool and ESC charting guidelines within the NICU and mother-baby units. Methods: This project followed the PDSA process – Plan, Do, Study, Act, underscored …

Depression In Individuals With Chronic Liver Disease: Improving Screening In The Outpatient Setting, Kayla Corine Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Individuals with chronic conditions such as chronic liver disease experience higher rates of depression, often underdiagnosed and placing high risk demographics in jeopardy of adverse outcomes, including worsening prognosis, decreased quality of life, and increased symptomatology.

Purpose: Evidence advocates for routine depression screening within high-risk patient populations. This paper outlines the implementation of a quality improvement initiative aimed at enhancing depression screening at a selected outpatient liver clinic within an extensive hospital system by implementing the PHQ-9 questionnaire during patient clinic visits, where no standardized screening protocol was previously in place.

Methods: The Plan-Do-Study-Act cycle guided the implementation …

An Evidence-Based Bundle To Decrease Pressure Injuries (Pis) In Homecare, Esther Owookade

Student Scholarly Projects

Practice Problem: Pressure injuries are a significant problem in healthcare settings. The older adult patients in this home health agency have experienced an increased in incidences of pressure injuries which necessitates intervention.

PICOT: The PICOT question that guided this project was" In older adults 65years and above with pressure injuries in the home healthcare setting(P), does a pressure injury care bundle(I), compared to the current practices of standard care of repositioning alone( C),reduce the incidence of pressure injuries( O ) in 10 weeks (T)?"

Evidence: The evidence used to guide this evidence-based change project was from relevant health …

Prospectus For Expected Discharge Date Accuracy (Edd) – Prepare To Go, Mary Jane D. Esmilla Msn, Bsn, Rn

Master's Projects and Capstones

Problem: Accurate Expected Discharge Date (EDD) estimates are not just numbers on a chart. They are crucial for optimizing operations, reducing readmission risk, creating safe, timely discharge plans, identifying obstacles, providing transitional care, and enhancing patient satisfaction (Piniella et al., 2023). A hospital-based organization conducted a quality improvement project to improve EDD predictions and discharges, significantly improving patient satisfaction and outcomes. The project had shown that a 12% increase in accuracy, achieving 60% from the baseline of 48%, can be achieved through strong collaboration, transparent communication, and commitment to real-time documentation.

Context: A team analysis improved EDD accuracy, patient satisfaction, …

Reducing Same-Day Case Cancellation By Implementing 72 Hours Preop Phone Calls, Debbie Sharon Centeno

Master's Projects and Capstones

Problem: The increased frequency of same-day surgical cancellations affects patient care quality, causes loss of expenses for patients and facilities, and causes non-compliance with block utilization against regional standards.

Context: A collaborative effort was undertaken to reduce same-day case cancellations in the Ambulatory Surgery Unit (ASU). Patients received preoperative instructions 24 hours before surgery through email or phone call. Data collection revealed that the common causes of same-day cancellations were avoidable reasons (not NPO, patient ill, request for another schedule, no ride), indicating the need for improvement in delivering preoperative phone calls.

Interventions: This included educating preoperative nurses, creating a …

Clinical Trial Research Nurse New Employee Onboarding 30- 60 -90 Day Checklist, Arin Alesia Urban

Master's Projects and Capstones

Problem: The clinical trials research management team was plagued with high nurse turnover and poor clinical documentation due to a lack of seasoned clinical research nurses.

Context: A regional clinical trials team serving 22 hospitals within a Northern California not-for-profit health system.

Interventions: Mixed methods were used to inform the development of new employee onboarding for novice clinical trial nurses utilizing a structured 30-60-90-day checklist, improved communication channels, and continuous mentor support.

Measures: Monthly quality queries and quarterly staff turnover rates were tracked. Employee feedback was collected to assess the interventions' impact.

Results: The number of quality queries was reduced …

Improving Stroke Education Scores At A Primary Stroke Center, Jesse J. Young

Master's Projects and Capstones

Abstract

Problem: The COVID-19 pandemic precipitated a significant departure from the nursing profession, leaving healthcare organizations grappling with critical staffing shortages and compromising patient care standards. In 2023, an advanced Primary Stroke Center in a Northern California hospital’s STK-8 scores fluctuated between 80-100%, with an average annual score of 92.8%, putting the facility's primary stroke certification and long-term patient outcomes at risk.

Context: A 24-bed acute stroke and telemetry unit in a Northern California hospital and designated primary stroke center.

Interventions: The following measures were implemented to improve the quality of stroke care and enhance STK-8 compliance, including …

Educating Nursing Faculty In Mindfulness Practices To Reduce Students’ Anxiety Pre-Simulation, Virginia Gonzalez

Doctor of Nursing Practice Projects

This DNP project examines how mindfulness training for associate degree nursing faculty can enhance educator self-efficacy in implementing teaching methods that reduce anxiety among nursing students before simulation exercises. The primary issue identified is the lack of faculty training in pre-simulation facilitation practices, which is crucial for ensuring students are adequately prepared. Using a pre-test/post-test design, this initiative evaluated changes in educator mindfulness self-efficacy among 14 faculty members. Results indicated a significant improvement in self-efficacy scores. The pre-test mean score was 3.36, which rose to a post-test mean score of 4.60. These project results demonstrate that mindfulness training effectively enhanced …

Debriefing Orientation For Novice Simulation Faculty, Cindy M. Carter

Doctor of Nursing Practice Projects

Faculty new to the simulation environment lack the knowledge, skills, and confidence to deliver proper debriefing methods. The Doctor of Nursing Practice (DNP) project’s problem is the need for a standardized, evidence-based debriefing process in the undergraduate RN program at the College of Nursing in Oklahoma. The study aims to follow the International Nursing Association for Clinical Simulation and Learning (INACSL) best practices to implement a debriefing simulation for novice faculty to improve faculty self-efficacy with the debriefing process (Decker et al., 2021). The DNP student evaluated faculty using pre-and post-tests containing questions from the Debriefing Assessment for Simulation in …

Improving Hypertension Management In The Family Care Practice Through The Education Of Clinical Staff On Jnc-8 Guidelines, Shiny Michael

Doctor of Nursing Practice Projects

Hypertension is a major public health challenge, contributing significantly to global morbidity and mortality. Despite the availability of JNC-8 guidelines, adherence in clinical practice is often lacking. This project aimed to improve hypertension management in a primary care setting by educating clinical staff on the JNC-8 guidelines to enhance adherence to evidence-based practices. The primary purpose of this project was to address the lack of knowledge and suboptimal hypertension control through targeted educational interventions for clinical staff. The methodological approach involved a pre- and post-intervention design, with educational sessions conducted for medical assistants. Data on blood pressure control and staff …

Increasing High-Alert Medication Administration Competence In Undergraduate Nursing Students Using An Unfolding Obstetrical Simulation, Jenna A. Warf

Doctor of Nursing Practice Projects

This DNP project aimed to increase medication competence in undergraduate nursing students through an unfolding high-fidelity simulation. Before the implementation of this project, students at the project site had experienced minimal exposure to obstetrical nursing care and medication administration. This quality improvement project occurred at a community college in Texas, with undergraduate nursing students (n=18). The participants completed an Evolve pretest, unfolding high-fidelity simulation, Simulation Effectiveness Tool-Modified (SET-M) survey, and an Evolve posttest. The unfolding simulation consisted of a three-part simulation with a preeclamptic obstetrical patient that started at a physician’s office, progressed to triage, and ended as an inpatient …

Increasing Operating Room Efficiency Through Decreased Turnover Times, R. Keith Wolfskill

Student Scholarly Projects

The Operating Room (OR) is the financial engine of the modern hospital or surgical center. Over 40% of the hospital's cost is invested in the OR, but the facility recoups a monetary return of around 60-70%. Turnover time is a crucial factor in reducing costs. Uncontrolled, it can inflate operating costs, but when managed effectively, it can boost surgeon, patient, and staff satisfaction, enhance patient safety, and significantly reduce operational costs. The literature underscores the importance of reducing the time between operating room turnovers to improve OR efficiency. A key strategy that research consistently shows to be effective is the …

Quality Improvement Project: Evaluating The Impact Of An Intrapreneurial Skill Enhancement Program On Enhancing Innovation Perspectives And Overcoming Obstacles Among Nurse Practitioners At A Midwestern Academic Medical Center, Michael Thorn

Doctor of Nursing Practice Projects

Nurse practitioners (NPs) face barriers to being innovative in healthcare because of a need for more resources, education, and cultural inclusion compared to physicians and researchers (Joseph et al., 2019). NPs are often disregarded from involvement in the innovation ecosystem and seen as solely end-users of new products and services (Davis & Glasgow, 2020). This Doctor of Nursing Practice project aimed to assess the impact of a 5-week innovation and intrapreneurship course on NPs' perceptions of their ability to innovate at a Midwest academic hospital. The aim was to address the known innovation education gap that NPs rarely receive. Using …