Digital Commons Network^™

Reducing Falls On A Cardiac Telemetry Unit, Tracey C. Fields

MSN Student Capstones

No abstract provided.

Grief And Loss: Catholic Filipino Traditions, Edgar D. Montesa

International Journal of Faith Community Nursing

Catholic Filipino traditions regarding death, loss, and grief, consist of Christian, paganistic and animistic elements. The peculiar beliefs and practices reflect ethnic Filipinos' values and views of things. They help contemporary Filipinos cope with a loved one's death and with the challenges posed by a pandemic. They have certain implications for faith community nurses.

Executive Summary: Quality Improvement Initiative Personalized Interdisciplinary Fall Prevention Plan And Fall Rates At An Inpatient Rehabilitation Hospital, Kayla Jackson

Walden Dissertations and Doctoral Studies

Despite ongoing fall prevention strategies, falls continue to be a concern across healthcare organizations. There has been an identified increase in the fall rate at an inpatient rehabilitation facility (IRF) in the southeastern United States. An interprofessional and collaborative approach to fall prevention has been found to lead to a decrease in falls with injury and an increase in the culture of safety. This doctor of nursing practice (DNP) project involved an evaluation of a quality improvement (QI) initiative of a personalized interdisciplinary fall prevention plan at a rehabilitation hospital located in the southeastern region of the United States. The …

Executive Summary: Quality Improvement Initiative Implementing Fixed Water Dispensers In An Inpatient Psychiatric Hospital, Elycia Victoria Hernandez

Walden Dissertations and Doctoral Studies

The current hydration system using water pitchers was outdated and inefficient, leading to potential risks of contamination, inconsistent hydration, and increased staff workload in this inpatient psychiatric facility. Psychiatric patients may struggle to access adequate hydration due to cognitive or behavioral limitations. Addressing this gap is essential for improving patient care, enhancing operational efficiency, and ensuring consistent access to clean water. This DNP scholarly project was an evaluation of an interprofessional team-based quality initiative to replace traditional water pitchers with fixed water dispensers in an acute inpatient psychiatric facility. The primary practice-focused question was: Will an interprofessional team reach consensus …

Creation And Implementation Of A Nurse Practitioner Student Escape Room, Sara Arn, Msn, Crnp, Agpcnp-Bc

College of Nursing Posters

Introduction

Educational escape rooms have been gaining popularity in nursing institutions over the past few years. The current literature focuses on the creation, implementation, and benefit of escape rooms for undergraduate nursing students. This poster presentation describes the creation and implementation of an educational escape room targeted to the experiences and skills of advanced practice nursing students enrolled in nurse practitioner programs.

Nurse Graduates’ Experiences With Pain Science – A Qualitative Study, Rachel Bee, Cynthia Goodrich

Wisdom & Compassion: The LUSON Journal

Background: While the nursing profession has made great strides in pain management over the last 20 years, patients often report being under-assessed and undertreated for pain.

Purpose: The study purpose was to understand the lived experiences of practicing nurses who had completed a baccalaureate-level pain management course during their undergraduate training. The study aims included understanding how pain management skills were implemented in the clinical arena, determining barriers to implementing pain management skills, and identifying opportunities to improve the patient experience regarding pain management.

Design: The researchers implemented a qualitative methodology with a phenomenological design. Data collection consisted of semi-structured …

An Integrated Review: Faith Community Nurse Transitional Care Model Health Ministry, Youn Kyeong Cummings

DNP Qualifying Manuscripts

The hospital readmission rate is highest among underserved communities, and providing a continuum of care to these populations can yield a greater reduction in the readmission rate. Church and faith-based clinics often help underserved communities, and equipping them with the transitional care model (TCM) and an Advanced Practice Registered Nurse (APRN) with specialized training as a Faith Community Nurse (FCN) can implement whole-person care, improve the health of the community, and reduce hospital readmission.

California has a 14.5% readmission rate. There is uncertainty surrounding the presence of transitional care departments in California's community hospitals, with some of these facilities offering …

Comparing Costs And Predictors Of Low-Value Healthcare Service Use Among Primary Care Nurse Practitioners In The Southwest United States, Sara B. Nugent

Nursing ETDs

Low-value healthcare services (LVHSs) are unsupported by current evidence, associated with harmful patient outcomes, and equate to over $100 billion in wasteful spending annually. The aims of this descriptive, comparative study were to establish baseline prevalence and costs associated with LVHS use among primary care nurse practitioners (NPs), and to test the influence of different geographical regions and patient populations. A secondary data analysis of the Merative™ MarketScan® 2021 databases was conducted. LVHS prevalence was lower or fairly equal to that of other studies, and direct claim costs were very-low cost. Extremely high low-value lumbar radiographic imaging claim costs were …

How Do Older Adults Define A Good Death? A Scoping Review, Ellen L. Csikai, Quentin R. Maynard

Midwest Social Sciences Journal

A scoping literature review of the concepts of ‘good death’ and ‘dying well’ among older adults was conducted. The purpose was to identify aspects that older adults specifically considered important in defining a ‘good death’. The search revealed five articles published between 2005 and 2019 that met inclusionary criteria for the review. Primary among the views of the older adults in these studies of a ‘good death’ was the desire to avoid being a burden to families; done so by dying pain-free/peacefully (preferably in sleep) and preparing in advance by involving family in decisions and funeral/estate planning. Family support throughout …

Increasing Self-Efficacy Of Nurse Practitioner Preceptors In Primary Care By Using The One-Minute Preceptor Model, Amy J. Lancaster

Doctoral Dissertations and Projects

Nurse practitioners represent the fastest growing profession in the United States, with 385,000 practitioners currently licensed. Over 70% of these licensed practitioners are serving in primary care settings. As the growth of this workforce continues, so does the need for nurse practitioner preceptors. The preceptor plays an essential role in championing clinical competencies for nurse practitioner students. This project was implemented in a primary care setting with an aim to improve the self-efficacy of nurse practitioner preceptors by using the One-Minute Preceptor teaching method to improve the practicum experience for both the preceptor and the nurse practitioner student. The One-Minute …

A Qualitative Study On Transnational Caregiving For Older Parents In China, Silai Dong

Lingnan Theses (MPhil & PhD)

The increasing number of international migrations in China poses challenges for the care of older parents who are left behind, considering China’s emphasis on family support. This study aims to investigate transnational care arrangements for older parents whose children are overseas. It mainly addresses three research questions:1) What are the contents of filial piety in the context of international migration? 2) How do Chinese transnational family members negotiate and distribute elder care responsibilities? 3) To what extent can the transnational caregiving model explain elder care in Chinese transnational families?

The transnational caregiving model proposed by Baldassar, Baldock, and Wilding, in …

A Comprehensive Community Awareness Website To Increase Screening Colonoscopy Rates Among Adults In Flower Mound, Tx, Alexandra Biltz

Doctor of Nursing Practice Final Project Abstract

PURPOSE Colorectal cancer is the second leading cause of cancer-related deaths in both men and women. The purpose of this scholarly project was to implement a website and flyer to increase screening colonoscopy rates in adults ages 45 to 75.

BACKGROUND There are no formal models or guidelines for increasing screening colonoscopies in the United States. The literature search also revealed that many Americans do not have a good general knowledge of colorectal cancer and colonoscopies.

The project was implemented at an ambulatory gastrointestinal endoscopy center in Flower Mound, Texas.

METHODOLOGY The website was created using Wix and a flyer …

Companion Dogs And Depression, Anxiety, And Posttraumatic Stress Disorder In Adult Icu Survivors: A Scoping Review, Lindsey Nelson, Sue Lasiter, Amanda Emerson

People and Animals: The International Journal of Research and Practice

Intensive care unit (ICU) survivors are at risk for developing persistent psychological sequelae that have been linked to decreased quality of life and increased mortality after hospital discharge. Standardized evidence-based treatments are lacking, mainly focus on physical rather than psychological recovery, and often occur in formal settings. Benefits of human– companion dog relationships have not been explored in the ICU survivor population before. Thus, the purposes of our review were to summarize the literature focused on the influence of companion dogs on depression, anxiety, and posttraumatic stress disorder (PTSD); identify what is known about the potential role companion dogs play …

Combating Dehydration In The Dementia Patient, Crystal L. Widemon

MSN Capstone Projects

Dehydration is a prevalent global health issue impacting individuals across all demographics, with the elderly—especially those suffering from dementia—being particularly vulnerable. As the elderly population grows and dementia rates increase, addressing dehydration becomes crucial to reduce hospitalizations, mitigate healthcare costs, and enhance patient well-being. This executive summary outlines a proposed intervention aimed at improving fluid intake among elderly dementia patients residing in residential care facilities.

Research indicates that dehydration significantly impacts the health and financial costs associated with dementia care. Studies have shown that dehydration exacerbates cognitive decline and behavioral symptoms in dementia patients, leading to increased dependency and healthcare …

Rheumatoid Arthritis Disease Activity Is Associated With Frailty In Veterans, Courtney N. Loecker

Theses & Dissertations

Frailty, a physiologic vulnerability to everyday stressors, affects approximately 30% of the 1.3 million Americans with rheumatoid arthritis (RA) and is associated with increased risk for adverse health outcomes. Active RA manifests as inflammation, pain, and joint damage leading to functional impairments and morbidity which cumulatively influences frailty. However, the relationship between RA disease activity and frailty is incompletely understood.

This study evaluated the relationship of RA disease activity and frailty at baseline and over up to five years in Veterans. A cohort study was performed using data from the Veterans Affairs Rheumatoid Arthritis registry. RA disease activity was measured …

Decreasing Incivility Through Improved Communication And Teamwork, Marvin Ernest Tamayo

Master's Projects and Capstones

Problem: Workplace incivility (WI), lateral violence (LV), and bullying in healthcare settings are pervasive issues negatively impacting staff morale, turnover rates, and patient care outcomes. High turnover and low employee satisfaction scores from a September 2023 culture of safety survey signaled a toxic work environment characterized by ineffective communication and unprofessional behavior. Context: A 24-bed telemetry-stroke unit at a 172-bed acute care facility in the North Bay area of San Francisco.

Interventions: The Transtheoretical Model (TTM) of behavior change and the Crucial Conversation frameworks were used to improve staff communication and reduce incivility.

Measures: September 2023 and March …

Preventing Hospitalization-Associated Disability, Elizabeth M. White

Master's Projects and Capstones

Problem: Hospital-associated disability (HAD) affects one-third of hospitalized adults, diminishing post-discharge independence and contributing to high mortality rates. Identifying at-risk patients through early assessment of nutritional and functional status upon admission is critical to personalizing care and improving discharge outcomes.

Context: A 24-bed adult medical-surgical unit in a 173-bed suburban hospital in Northern California is part of a large not-for-profit healthcare organization. Interventions: Nursing staff received education on the Enhanced Recovery Medicine (ERM) pathway designed to prevent HAD. A visual display board, maintained and updated by unit champions, gave staff performance feedback. Nursing leadership reviewed admission assessments and addressed barriers …

Navigating Change: Cultivating Faculty Support For Curriculum Revision Through The 4ms Framework, Sarah Dearing

Doctor of Nursing Practice Projects

Public campaigns have increased awareness of Alzheimer’s disease and other dementias, however, education for healthcare providers concerning brain health and appropriate screenings to identify elderly patients at risk is not present. This curricular policy change project outlines the need for faculty buy-in to complete a curriculum change that addresses the lack of geriatric-evidence based education within an Associate of Applied Science in Nursing (AASN) program. Qualitative data identifies the amount of geriatric-evidence based education present in the current AASN curriculum map. Using Lewin’s change management theory (CMT) and the Cognitive-Affective-Social Theory of Learning Environments (CASTLE), an educational module teaching the …

Enhancing Family Nurse Practitioner Education Through End-Of-Life Simulation: A Quality Improvement Project, Deborah Jamison

Doctor of Nursing Practice Projects

Providing compassionate and effective end-of-life care is a crucial skill for Family Nurse Practitioners (FNP) students (Collins & Small, 2019). However, many students experience significant anxiety and lack confidence in such challenging situations. The problem identified for the Doctor of Nursing Practice (DNP) Quality Improvement (QI) project is the lack of training focused on end-of-life care in the FNP program at a College of Nursing (CON) within an academic clinical center. The project’s purpose was to improve confidence and anxiety levels among FNP students in providing end-of-life care. The project aimed to create an inventive and immersive end-of-life simulation with …

It Was Difficult To Understand The System: Developing A Coordinator Role To Support International Nursing Students- A Qualitative Study, Nick Gibson, Amanda Graf, Tania Beament, Neil Ferguson, Esther Adama, Deborah Kirk, Joyce Muge-Sugutt, Kylie Mccullough

Research outputs 2022 to 2026

International students are an important component of the host country and universities bringing economic, social, and community contributions. International students are the most vulnerable students with challenges related to academic expectations, language proficiency, and socio-cultural integration. This study explores the challenges of international students in a Western Australian School of Nursing and Midwifery. An exploratory questionnaire (n=10), three focus groups (n=15) and a quality improvement survey (n=80) informed this study. Four themes emerged: stress in the first weeks, incorrect and/or late enrolments, lack of guidance and support, and system navigation nightmares. Other issues included: accommodation, culture shock, financial concerns, information …

Transformative Learning: Changing Nurses’ Perceptions About People In Poverty, Jacqueline Debrew

Journal of Social, Behavioral, and Health Sciences

Background: Meaningful learning experiences with clients in poverty may help nursing students change their perceptions towards those experiencing poverty and, thus, provide unbiased, nonjudgmental care when they become nurses.

Purpose: The purpose of this research was to understand what learning activities and experiences nursing students found meaningful and led to a change in prior perceptions of people in poverty.

Methods: Guided by Mezirow’s Theory of Transformative Learning, accelerated BSN students enrolled in a mental health nursing course (n = 14) were assigned reflective journals throughout the semester on their assigned clinical experiences, which were analyzed for emergent themes.

Results: …

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 …

Educating Nurses On The Components Of A Healthy Work Environment, Kathryn L. Scott

Doctoral Dissertations and Projects

It is essential to look at the entire picture to ensure patient care is offered in the highest quality manner possible. One must look at patient satisfaction, quality outcomes, and job satisfaction experienced by the nursing staff providing care to accomplish this goal. Research has shown that nurse burnout has increased exponentially as of late. Some blame the COVID-19 pandemic; others look at the generation of nurses graduating from nursing school and starting in the field, comparing the baby boomer nurse to the Gen Z nurse. Many factors are involved, and with the recent addition of paying particular attention to …

Evaluation Of An Educational Training On Telehelath Utilization Rates And Hospital Readmissions In A Home Health Setting., Gabrielle A. Coomer

Doctor of Nursing Practice Papers

Background: Hospital readmissions are on the rise and continue to be a concern within healthcare due to their effects on the quality of care and healthcare costs. Telehealth strategies have been utilized across healthcare settings to improve hospital readmission rates.

Purpose: The purpose of this project was to evaluate the effectiveness of a telehealth training program in increasing telehealth utilization rates and reducing the acute care hospitalization rate within a single home health agency.

Intervention: A 30-minute PowerPoint presentation on the definition of telehealth, goals, and benefits of telehealth, patient eligibility, special considerations for clinicians, billing and coding guidelines, …

Lgbt Cultural Competence Education For Nurse Leaders In A Large Metropolitan Healthcare System: Quality Improvement, Trevor Mcguffin, Andrew Mitchell

Doctor of Nursing Practice Papers

Background: In the United States, seven percent of adults identify as LGBT. The LGBT population is disproportionately affected by health disparities and barriers to care when compared to the cis-heterosexual population. Due to healthcare providers’ limited LGBT health education and experience, inconsistencies in LGBT culturally competent care perpetuate health disparities and barriers to care for the LGBT population.

Purpose: The purpose of this quality improvement project was to educate nurse leaders on LGBT cultural competency and facilitate nurse leaders’ behavior change.

Methods: This quality improvement project consisted of three LGBT cultural competence modules and two guided behavior change pathways. Outcomes …

Improving Transitions In Care Through Early Discharge Planning: A Quality Improvement Initiative., Sarah Markgraf

Doctor of Nursing Practice Papers

Background: A substantial body of evidence has shown transitions in care are one of the weakest links in healthcare networks, especially for older adults with complex comorbidities. Residents receiving short-term rehabilitation (i.e., rehab) transitioning to home from a skilled nursing facility (SNF) are the most vulnerable in the first 30 days post-discharge for adverse resident events, including avoidable rehospitalization. Avoidable rehospitalizations cost Medicare billions of dollars annually and lead to poor resident outcomes. Early discharge planning in SNFs for short-term stay rehabilitation has decreased rates of avoidable rehospitalizations, improved quality of life in geriatric residents, and improved care partners' perceived …

Exploring Maternal Perspectives On Human Milk Banks In Pakistan And Identifying Barriers And Enablers For Establishment, Hina Baba Jan, Naghma Rizvi, Kiran Mubeen, Marina Baig

Journal of Asian Midwives (JAM)

Background: Low-and middle-income countries including Pakistan still have low breastfeeding rates and infant feeding remains a concern. Human milk banks (HMBs) play a crucial role in neonatal and infant health by providing safe, pasteurized donor human milk to infants who do not have access to their mother's own milk, particularly preterm and low-birth-weight infants. The perception regarding the concept and use of HMBs has yet to be explored in several contexts, especially in the low-and middle-income countries including Pakistan.
Aim: To explore the perceptions of mothers regarding human milk banks in Pakistan, focusing on the barriers and enablers to …

Assessing Readiness To Quit As An Intervention For Tobacco Cessation In Oncology Patients, Victoria Gabriela Maddox

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Smoking and tobacco use is the leading cause of preventable death in the United States. Twenty percent of all cancer diagnoses are directly linked to smoking, and tobacco-related diseases and cancers contribute to one in every five deaths annually in the United States. Less than one in ten smokers are successful at quitting. Smokers attempting to quit are more successful in cessation programs after evaluation of self-efficacy, such as the readiness to quit.

Purpose: This evidence-based practice project aimed to evaluate the impact of motivational interviewing with the 5A’s model on smoking cessation efforts in patients at an …

Appropriate Policies For Patients Utilizing Insulin Pumps With Continuous Glucose Monitoring During Hospital Admission, Mary Elizabeth Holiday

Doctor of Nursing Practice Scholarly Projects

Problem Statement: A growing number of patients with diabetes are using advanced diabetes management technology with an integrated insulin pump and continuous glucose monitor (CGM); however, multiple concerns surround their use during hospitalization, ranging from patient safety risks to nursing comfort in overseeing these devices.

Purpose: This project aimed to determine if an accurate, reformed inpatient policy supporting specific automated insulin pump use during admission maintained patient glucose control, improved patient satisfaction, and increased nursing comfort levels.

Methods: Pre- and post-policy nursing knowledge surveys, retrospective admission glucose metrics, and patient experience narratives were evaluated.

Inclusion Criteria: Patients and nurses were …

The Implementation Of Comfort Medication Kits In Hospice Patients’ Homes To Reduce Hospice Revocations, Brandi J. Parker

Doctor of Nursing Practice Projects

Background: When hospice patients experience a symptomatic crisis at the end of life, unmanaged symptoms can lead to unwanted hospitalizations and the revocation of their hospice benefits. Strategies to reduce the incidents of hospice revocation are needed to improve patient care and quality of life.

Purpose: The quality improvement project aimed to reduce hospice revocation rates by implementing comfort medication kits in eligible hospice patients’ homes.

Methods: The project’s intervention included identifying patients at high risk for revocation, patients with a cancer diagnosis, and patients with a prognosis of two weeks or less. Comfort medication kits were placed in the …