Digital Commons Network^™

Nursing Shortage Crisis: Can Implementing Supplemental Instruction Impact Nursing Students' Success In Nursing Programs?, Lauren Smith

Doctor of Nursing Practice Projects

This quality improvement project (QI) aimed to provide nursing students in the traditional Bachelor of Science in Nursing (BSN) program with different forms of supplemental instruction (SI). The problem identified considered that nursing students' success rates have been dwindling for years, decreasing the number of nurses available. The purpose was to evaluate the effectiveness of SI in promoting student success throughout the semester. SI was first introduced at the University of Missouri-Kansas City in 1973 and is utilized primarily to improve student success in courses that are often considered "high-risk" for failure (Bowman et al., 2021). When SI is appropriately …

Quality Improvement Project Integrating Telemedicine To Reduce Patient No-Shows, Ferdinand Akoko

Doctor of Nursing Practice Projects

No-show among psychiatric outpatient clinic patients is a major problem due to disrupted clinical flow, reduced productivity, and financial losses. This quality improvement project implemented telehealth services to decrease the no-show rates in an outpatient psychiatric clinic in Texas. This project employed quantitative methods to compare the no-show rates pre- and post-intervention for 90 days. The quantitative data were analyzed by paired t-tests. A total of 1,790 appointments were sampled during the implementation period. The obtained results are statistically significant in decreasing the rates of no-shows for all adult appointments from 18% to 13% (p ≈ 0.0067). New appointment no-shows …

Improving Patient Awareness And Compliance With Telephone Follow-Up Calls Post Visit, Ajibola Kutti

Student Scholarly Projects

Practice Problem: In a high-volume clinic without current follow up practices post visit, a telephone follow-up (TFU) intervention was implemented within three days of patient outpatient appointments.

PICOT: The PICOT question that guided this project was: In adult patients in a high-volume clinic (P), does the implementation of telephone follow-up calls by nurses (I) compared to current practices (C) improve patient compliance and post-office follow-up visits (O) over 10-weeks (T)?

Evidence: The literature provided recommendations and evidence that supported the effectiveness of following up with patients within three days of leaving the healthcare clinic. TFU’s are a cost-effective intervention that …

Using Home Telehealth To Reduce Hospital Readmission Rates In Heart Failure Patients In The Emergency Room, Margaret Ashby

Student Scholarly Projects

Practice Problem: In one hospital, the readmission rates and emergency room visit for patients who are diagnosed with heart failure (HF) was increasing.

PICOT: Among veterans who are hospitalized for HF (P) does the enrollment into a care coordination program for these veterans (I) compared to current practices (C), reduce the hospital readmission rates and emergency department visits (O) within 10-weeks (T)?

Evidence: The literature supports the idea that home telehealth as a home monitoring program for patients who have chronic diseases such as heart failure (HF) and has had success in patients with hypertension amongst patients. Transition strategies from …

Quality Improvement Project: Incivility In Nursing Education: Utilizing An Educational Module And Professionalism Guide To Address Incivility In A Nursing Students, Jennifer Schadler

Doctor of Nursing Practice Projects

Incivility is a well-documented issue in the nursing profession that begins in nursing education and follows graduates into nursing practice. Nursing academia has a responsibility to address incivility to prevent inappropriate behaviors from becoming embedded into the culture. The problem addressed in this quality improvement project is incivility among nursing students at a private college. The purpose of this project was to apply evidence-based incivility interventions to address uncivil behaviors of nursing students. The hypothesis was that the implementation of a civility mentor module and professionalism guide would impact perceived incivility among nursing students. The project was conducted using the …

Using An Evidence-Based Practice Nurse Recognition Practice To Improve Job Satisfaction, Hali Bianchi

Student Scholarly Projects

Practice Problem: The project targeted low job satisfaction and high nurse turnover in a Central Florida bone marrow transplant unit, impacting patient care and costs.

PICOT: (P) For registered nurses (RNs) on the bone marrow transplant unit, (I) does implementing an evidence-based practice employee recognition program (C) compared to no employee recognition program, (O) lead to an increase in job satisfaction (T) over 10 weeks?

Evidence: The evidence supported the effectiveness of meaningful recognition programs, such as personalized verbal acknowledgment from leadership, in boosting job satisfaction among nurses.

Intervention: The intervention involved nurse managers using a weekly employee recognition …

Nurse Retention Amid Workplace Adversity: Examining Strategies And Outcomes, Horace Smith

Student Scholarly Projects

Practice Problem: This project aimed to evaluate the effectiveness of nurse retention strategies in enhancing job satisfaction, focusing primarily on Emergency Department (ED) Registered Nurses (RNs). A comprehensive approach was adopted within the ED of a veteran hospital in the Southeast, aimed at promoting staff retention.

PICOT: The PICOT question guiding this project is as follows: In a veteran hospital's Emergency Room (ER) located in the southeast (P), how does the implementation of nurse retention strategies (I) compared to current standards (C) increase their job satisfaction (O) over a period of ten weeks (T)?

Evidence: This project …

Transitions Of Care And The Prevention Of Readmissions, Beatriz Granado

Student Scholarly Projects

Unplanned hospital readmissions often result from poor discharge planning and challenges during the transition from hospital to home, including medication errors and weak communication with primary care providers. A well-organized and personalized discharge plan can significantly reduce hospital stays, lower readmission rates, minimize medication errors, and improve patient outcomes, all while decreasing healthcare costs. In post-discharge Medicare-eligible patients (P), how does transitional care coordination through organized, personalized, and patient-focused discharge planning (I), compared with standard or no transitional care coordination provided (C), affect readmissions (O) within the 30-day post-discharge phase monitored over a 10–12-week period (T)? A search was conducted …

The Price We Pay: An Integrative Review Exploring The Effects Of Wellness Culture On Nurse Burnout Rates, Rebekah Lillian Vance

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify cultural factors contributing to nurse burnout and to explore the strategies and effectiveness of wellness culture and cultural changes on nurse burnout rates. Nurse burnout has been attributed to a myriad of factors and has been identified in nursing since the 1970s. While other professions with similar burnout issues have investigated and implemented culture-wide changes to address burnout, nursing has remained stagnant in the field of burnout research, often applying single interventions that fall short of creating significant, lasting change. An integrative review of nursing, peer-reviewed literature was conducted in an …

Health Policy: Food Allergy Restaurant Education Law, Joanna Ko

Doctor of Nursing Practice Projects

Food allergies are a rising public health concern with no indication of deceleration. The purpose of this Doctor of Nursing Practice (DNP) project is to enact an Arkansas state law to protect the food allergy community in dining out at restaurants to increase quality of life and decrease adverse allergic reactions. The current Arkansas state legislation for restaurant food allergy employee training is absent and action needs to be taken to safeguard the food allergy community from life-threatening reactions. The methodology involved contacting the six states that have previously implemented similar food allergy legislation. It encompassed performing a thorough search …

Exploring Negotiated Autonomy In The Physician–Physician Assistant Collaborative Dyad, Stephen Robie

Doctor of Philosophy in Translational Health Sciences Dissertations

Physician Assistants (PAs) are integral members of multidisciplinary medical care teams who practice medicine legally under the supervision of physicians. During medical care, supervision is a dynamic process of collaboration wherein a PA who displays competence is granted increasing independence by the supervising physician. This process has been referred to as negotiated autonomy. Despite being noted in work-force literature, the mechanics of how negotiated autonomy operates in real-time have not been described. As organizations increasingly work to integrate PAs into practice, new-hire training programs called ‘on-boarding’ have been implemented to accelerate PA professional development with a goal of increased efficiency …

The Future Of Nursing Leadership: Incorporating E-Learned Artificial Intelligence (Ai) Pathways With A Precautionary Focus On Patient-Centered-Care, Jamie Anne Marcus Dr., Bonnette Villalba Webb

FDLA Journal

Artificial Intelligence (AI) is a data-driven mathematical process that incorporates machine-based-logic, usually in the form of algorithms. Education, training, and competencies are now conducted through virtual reality, robotics, simulation, and technology learning-based-platforms by healthcare organizations. This represents a significant change in the future of nursing practice. The adaptability of technology-based-learning platforms can impact the quality and efficiency of learning for some of the workforce population. Nurses' perception of technology and AI-driven nursing practice may vary based on generational orientation and can be a potential barrier to learning, practicing, and adaptability of this framework. The forging of well-trained resilient nurse leaders …

Increasing Nurses’ Knowledge Of Cultural Preferences Influencing Diabetes Self-Management Among Sierra Leoneans, Winstina Aminata Taylor

Walden Dissertations and Doctoral Studies

The practice problem identified at the project site was the lack of nurses’ knowledge of how cultural preferences influence diabetes self-management practices among African Americans with diabetes mellitus. An educational program focused on the cultural preferences of Sierra Leoneans that influence diabetes self-management practices was provided for 48 nurses who worked in the agency. The doctoral project included concepts from nursing education and cultural competence theories to inform the approach. The project followed the ADDIE model process steps to develop and implement the educational program. The sources of evidence included pre- and posteducation surveys administered to participating nurses to assess …

Increasing Nurses’ Knowledge Of Cultural Preferences Influencing Diabetes Self-Management Among Sierra Leoneans, Winstina Aminata Taylor

Walden Dissertations and Doctoral Studies

The practice problem identified at the project site was the lack of nurses’ knowledge of how cultural preferences influence diabetes self-management practices among African Americans with diabetes mellitus. An educational program focused on the cultural preferences of Sierra Leoneans that influence diabetes self-management practices was provided for 48 nurses who worked in the agency. The doctoral project included concepts from nursing education and cultural competence theories to inform the approach. The project followed the ADDIE model process steps to develop and implement the educational program. The sources of evidence included pre- and posteducation surveys administered to participating nurses to assess …

Leadership In Extreme Contexts: An Emerging Typology, Ashley Williams

Electronic Theses and Dissertations

This study investigates the relationship between leadership and extreme contexts through the lens of rural hospitals facing environmental jolts. Rural hospitals offer a unique setting for this research, given their inherent geographic isolation, lack of resources, and the critical role these facilities play in their communities. Through a qualitative analysis of interviews with Chief Executive Officers of rural hospitals, this research takes a grounded approach to build theory surrounding how leadership not only shapes but is shaped by extreme contexts and environmental jolts. The research results in four primary contributions. Namely, this study extends existing typologies on leadership in extreme …

Determining The Impact Of A Diabetes Logbook In Improving Self-Care Among African Americans With Type 2 Diabetes, Winifred Moore

Doctor of Nursing Practice Projects

Type 2 diabetes is a prevalent chronic disorder that is associated with defects in the metabolism of glucose. The management of type 2 diabetes depends on patients’ adherence to self-care activities. However, patients at the project site reported poor glycemic control, which increased their risk of diabetes complications. The purpose of this quality improvement project was to educate nursing staff on the use of diabetes logbooks to improve self-care among African Americans with type 2 diabetes and thereafter have the nursing staff educate diabetic patients. A quasi-experimental pre-post-intervention design involving 30 African American adults (mean age 43.70 years) with uncontrolled …

From Knowledge Gap To Empowerment: Patient-Operated Insulin Pump Management For Bedside Nurses, Bernadette J. Amao

Doctor of Nursing Practice Projects

Acute care nurses often struggle with the complexities of managing patient-operated insulin pumps (PIPs) due to limitations in training. With the rising prevalence of insulin pumps, equipping nurses with the necessary skills to navigate these devices effectively is essential. This quality improvement project addressed this critical gap by enhancing bedside nurses' self-efficacy in PIP management. Drawing upon Bandura's self-efficacy theory, this project hypothesized that targeted educational interventions could significantly improve nurses' confidence in managing PIPs. A four-week educational program was implemented to cover basic knowledge, troubleshooting, and patient interaction aspects of insulin pump management. The intervention tool was designed to …

Impact Of Gamification In An Online Rn To Bsn Program, Deosha Anderson

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance student engagement in an online RN to BSN program by incorporating gamification strategies into the curriculum. Traditional teaching methods often fail to maintain student interest, leading to low engagement and reduced program completion rates. This project sought to determine the impact of gamification on student engagement compared to no gamification. The intervention involved integrating gamified elements into the online RN to BSN program to create a more interactive learning environment. The project employed a quantitative, quasi-experimental design with a pre-intervention and post-intervention assessment. Data on student engagement metrics, including login frequency, time spent …

Enhancing Student Simulation Debriefing Using Video Recording, Lisa Hall

Doctor of Nursing Practice Projects

This quality improvement project aimed to show how video recording can increase vivid feedback by expanding the students' memory by reviewing the recording to recall and reflect on their roles during the simulations. This project sought to help the learner understand how well the simulation ran and what was done to improve its performance. The interventions involved video recording each simulation scenario. The recording was used during the debriefing session to help the students recall and reflect on their actions during the scenario. The project employed a quantitative, quasi-experimental design with a pre-intervention and post-intervention assessment. Data was collected using …

Articulator Q2 2024

Metro Denver Dental Society Articulator Magazine

The MDDS Articulator magazine has been serving as the voice for Denver's dental community for over 100 years.

Distributed to approximately 2,000 dental professionals quarterly, the Articulator features local news, industry trends, practice management guidance, data-driven research and more. The award-winning publication is available to member dentists in both print and digital forms.

This issue features a deep dive in Denver's rich dental history, explores why dentists love the Mile City High, what's next for MDDS, updates from local nonprofits, the dangers of perfectionism, the importance of leaving yourself open to new opportunities and more.

Looking Back...And Forward, Karen Foster Dds

Metro Denver Dental Society Articulator Magazine

The author reflects on the need for constant evolution and calls for member engagement, realistic goal-setting, and innovative solutions to ensure MDDS remains relevant and valuable to both seasoned and new dentists, emphasizing the need for adaptation and active participation in shaping the future of the organization.

The Association Of Nursing Homes' Organizational Context With Care Aide Empowerment: A Cross-Sectional Study, Alba Iaconi, Matthias Hoben, Whitney Berta Phd, Yinfei Duan, Peter G Norton, Yuting Song, Stephanie A Chamberlain, Anna Beeber, Ruth A Anderson, Holly J Lanham, Janelle Perez, Jing Wang, Katharina Choroschun, Shovana Shrestha, Greta Cummings, Carole A Estabrooks

Faculty, Staff and Student Publications

Background and objectives: Organizational context is thought to influence whether care aides feel empowered, but we lack empirical evidence in the nursing home sector. Our objective was to examine the association of features of nursing homes' unit organizational context with care aides' psychological empowerment.

Research design and methods: This cross-sectional study analyzed survey data from 3765 care aides in 91 Western Canadian nursing homes. Random-intercept mixed-effects regressions were used to examine the associations between nursing home unit organizational context and care aides' psychological empowerment, controlling for care aide, care unit, and nursing home covariates.

Results: Organizational (IVs) culture, social capital, …

1 A Phenomenological Study Of The Lived Experiences Of Hospital-Based Physical Therapy Department Leaders’ Most Successful Change Management Initiative, Joseph Patanella

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

A phenomenological study of the lived experiences of hospital-based physical therapy department leaders’ most successful change management initiative

Problem: Change management initiatives are consistently employed in healthcare to promote quality care. Of concern is that not all initiatives are successful. Individuals involved in successful change management can offer insight to those approaching initiatives.

Purpose: The purpose of this phenomenological study is to describe the lived experiences of hospital-based physical therapy department leaders’ most successful change management initiative.

Methods: The research design was a qualitative approach. A phenomenological research design was employed, using the voice of a group that has …

Primary Care In The University Setting After Covid-19: A Multiple Case Study Of Student Health Services In Oregon, D. Chad Johnson

Dissertations and Theses

In 2020, the COVID-19 pandemic disrupted operations across the settings of primary care and higher education institutions (HEI). HEIs faced sudden decreases in revenue because of reduced enrollments and external pressures to rapidly adapt delivery methods to accommodate the inability to provide in-person classes. Similarly, most primary care settings experienced major reductions to in-person visits and fee-for-service revenues. Student health services (SHS) exist within both primary care and higher education settings and are a unique and poorly understood aspect of primary care. This research set out to explore this under-studied primary care setting by answering the question: "How has COVID-19 …

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 …

Clinical Nurse Manager Fatigue And Its Personal And Professional Impacts, Carlene Galanopulo

Walden Dissertations and Doctoral Studies

Workplace fatigue has been empirically linked with errors, injuries, and chronic health issues that negatively impact the healthcare worker, patients, and staff with whom that person comes in contact, as well as the organization for which that person works. The experience of fatigue in clinical nurse managers (CNMs) has been understudied. The purpose of this study was to understand the individual experience of fatigue and its professional and personal impacts as more fully described by CNMs. The research question that guided this study involved the professional and personal impact of fatigue as described by CNMs. The occupational fatigue in nursing …

Adapting To Change: Adn Faculty Perspectives About The Future Of Adn Education: A Qualitative Case Study, Linda D. John

Doctoral Dissertations and Projects

The purpose of this qualitative, single case study was to offer more insight into how the adoption of the BSN as the entry-level for nursing practice affects the future ADN education and what the change means for ADN faculty at multiple programs throughout regions of the United States. Eleven ADN faculty were sampled to acquire their perspective about this phenomenon. Semi-structured, open-ended interviews enabled data collection. Rogers’ diffusion of innovation theory (DIT) facilitated an understanding about how ADN faculty are responding and adapting to the anticipated educational change. The central research question asked, “What is the perspective of ADN faculty …

One Stitch At A Time: Examining The Self-Care Of Art Therapists And The Potential Of Fiber Arts For Wellbeing, Elaine Chippero

Expressive Therapies Capstone Theses

The goal of this thesis was to understand why art therapists are particularly at risk for burnout, why it is essential for art therapists to engage artmaking for their own self-care, and why fiber crafts are particularly suited for self-care. The literature was collected and organized using reflective journaling and visual–tactile coding and then presented in the following review. The first two sections of the literature review include comprehensive definitions of burnout and self-care and how both concepts have been discussed in literature relating to the helping professions and specifically art therapists. The third section covers the historical context of …

Enhancing Pain Documentation In Medical Surgical Units: Integrating Supportive Tools With Pain Nursing Education, Mariana Arias

Master's Projects and Capstones

Problem: Pain management in in-patient care, particularly involving opioids, is critical due to the associated risks. Proper pain assessment is essential to ensure safe medication administration and mitigate adverse effects.

Context: This quality improvement (QI) project aimed to improve opioid assessment and documentation rate above 90% compliance in two medical-surgical units, focusing on bedside nurses who play a crucial role in patient safety and effective pain management.

Interventions: A baseline survey provided nurses' understanding on compliance criteria and assessment timing. Interventions included visual reminders, informational posters, and instructions on how to access individual compliance reports.

Measures: A post intervention survey …

Increasing Awareness And Communication To Decrease Catheter Days In The Surgical Intensive Care Unit, Kamila Fortney

Master's Projects and Capstones

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …