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Infuse!_Volume 4_Number 1_2020, College Of Nursing

Infuse! College of Nursing Magazine

No abstract provided.

Improving Palliative And Hospice Knowledge Among Nurses In A Long-Term Care Facility., Kelly Rae Smith

Doctor of Nursing Practice Papers

Background: Early referral and implementation of palliative best-practices in patients with chronic diseases and at the end-of-life (EOL) significantly decreases patient symptom burden, increases quality-of-life, contributes to patient and family satisfaction with care, and reduces healthcare costs. Nurses in long-term care (LTC) are poised to help identify patients appropriate for referral, to provide quality palliative and EOL care, but lack adequate knowledge. Objectives: To determine if a short one-on-one or two-on-one palliative and hospice educational offering can improve (a) knowledge of best-practice palliative and hospice care symptom management techniques (b) the ability of nurses to identify patients appropriate for hospice …

Improving Delirium Management And Compliance On A Trauma/Surgical Universal Unit., Ardis Roederer

Doctor of Nursing Practice Papers

Background: Delirium is an acute, reversible syndrome that may cause cognitive impairment, disorientation, perceptual disturbances, attention discrepancies, and fluctuating psychomotor activities. Health professionals may not recognize, treat, or prevent delirium. More than seven million hospitalized adults, with an estimated cost of $164 billion annually, suffer from delirium each year. Consequently, delirium commonly affects 15 to 37% of the older adult population, yet less than 5% of delirium cases are documented in the electronic medical records of older adult patients. Early detection, intervention, and compliance with best practices are critical for the reduction of hospitalized delirium incidence. Aim: This project aimed …

A Concept Analysis: Adherence In Type 2 Diabetes, Balkys L. Bivins, Lorelei M. Bivins, Brenda Owusu

Faculty Articles

Aim: The aim of this analysis is to develop a better understanding of the concept of adherence among individuals with Type 2 Diabetes.

Background: The incidence and prevalence of diabetes in the United States continues to increase at epidemic proportions yearly.

Design: The analysis was conducted using Rodgers' evolutionary method including database searches from Cumulative Index to Nursing Health Literature (CINAHL), COCHRANE, EBSCO, Education Resources Information Center (ERIC), MEDLINE, PsycINFO, Institute of Electrical and Electronics Engineers (IEEE), and SocINDEX. Keywords included adherence, compliance, diabetes care, type 2 diabetes and theories.

Results: Rodgers' evolutionary method guided this inquiry of concept of …

A Needs Assessment & Implementation Strategy Of The Emergency Nurse Practitioner Post-Graduate Certificate., Nancy Wilding

Doctor of Nursing Practice Papers

Nurse Practitioners have been utilized to meet the growing needs of emergency departments during the shortage of Emergency Medicine-trained physicians. Stakeholders have recognized the benefits that Nurse Practitioners (NP) bring to Emergency Departments (ED) in providing quality, evidence-based, cost-effective quality care. However, there is a confusion of the emergency nurse practitioner (ENP) role and scope of practice by facilities, physicians, state boards of nursing, credentialing bodies, and patients that limit the ENP from practicing at their full scope of practice. To establish the role and expand the NPs' knowledge and skills to meet the needs of the ED setting, a …

Assessment Of Cognitive-Behavioral Symptoms And Functional Status Among Stroke Survivors, Chandel M, Shashi, Yashomati, Hemalata

Manipal Journal of Nursing and Health Sciences

Background: Stroke is one of the complex causes of death and disability. Stroke survivors often experience cognitivebehavioral and functional changes. Aim: The present study aims to assess the cognitive-behavioral symptoms and functional status among stroke survivors. Methods: A descriptive study was done in Neurology and Neurosurgery Out Patient Department of a tertiary care hospital in India. Consecutive 55 adult stroke survivors who were conscious and accompanied by the caregivers were included in the study. Standardized tools such as mini-mental status examination (MMSE), Neuropsychiatric Inventory Questionnaire (NIP-Q), and Barthel index were used to assess the cognitive, behavioral symptom, and functional status …

Wellness And Coping Of Residents In A Skilled Nursing Facility, Christine M. Larson

Doctoral Dissertations and Projects

Depression is common among older adults in long-term care (LTC) facilities. As many as 50%-80% of residents will experience depressive symptoms or have a diagnosis of depression. Depression increases the risk of poor health-related outcomes in older adults. A review of the literature suggests that early intervention using movement-based techniques decreases the risk for depression and improves depressive symptoms. This scholarly project aimed to reduce the risk of depression of residents in an LTC located in a suburban area in Midwestern United States. The LTC facility and a Doctor of Nursing Practice (DNP) student implemented the Chair One Fitness program …

Developing A Total Knee Care Pathway To Reduce Hospital Length Of Stay While Maintaining Quality Of Care, Katie Pace

Nursing Masters Papers

From 2002 to 2013, there was an increase in the number of total joint replacement procedures performed as well as a rise in healthcare costs associated with such procedures. The Affordable Care Act of 2012 leveraged a shift in Medicare reimbursement from a fee-for-model (a payment model where services are paid separately) to a bundled payment method linked to quality of care. Joint replacement surgeries, specifically total knee arthroplasties (TKA), are one of the largest procedural expenditures for Medicare. To reduce costs, care associated with a TKA procedure was bundled to include all aspects of the procedure including post-operative supportive …

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

Nurse Practitioner Occupational Burnout: A Focus On The Variables And Themes, Tanya G. Schlemmer

Nursing Faculty Publications and Presentations

Purpose: The prevalence of occupational burnout is high amongst service professionals and the nursing profession is no different. The rate of occupational burnout amongst nursing professionals and medical professionals is high. The themes or impact of occupational burnout amongst Nurse Practitioners is not well described in the literature. Herein this article describes the investigation into the issue of nurse practitioners and occupational burnout.

Data Sources: Scientific literature review, CINHAHL Complete and other online literature databases and resources. A State of the Science systematic review was conducted to further examine this issue to identify the prevalence of the problem amongst nurse …

Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd

Doctor of Nursing Practice Final Manuscripts

Background and Evidence Problem: As the population ages, there is an increase in the incidents of falls. Falls are the predominant cause of both nonfatal and fatal injuries among adults aged 65 years and older (Bergen et al., 2016). Extensive research has been conducted in fall prevention in hospitals, skilled nursing, and rehabilitation units. End-of-life care in a hospice setting presents a greater challenge in risk identification and prevention of falls. A local hospice had 457 falls between July 2018 to mid-March 2019 with a lack of consistent, detailed, fall education and documentation.

Evidence-Based Practice Intervention: Utilizing the American Geriatrics …

The Effects Of Anticholinergics On Mental Health, Michael D. Wagner

Nursing Capstones

No abstract provided.

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …

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 …

Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell

Nursing Masters Papers

Falls is a major public health problem globally, with an estimated 646,000 fatal falls per year. This makes falls the second leading cause of unintentional injury death. Falls are very costly with non-fatal fall injuries costing about $50 billion per year and fatal falls with an estimated $754 million. Many risk factors contribute to a person’s risk of falling. Risk factors include age, gender, muscle strength, underlying medical or disabling conditions, and unsafe environments. Patients who have been hospitalized are also among those at risk. Most hospitalized patients are assessed frequently to determine their risk of falling so that care …

Barriers To Patient-Centered Care For Dementia Clients In The Long-Term Living Setting, Shaina Gaba

Nursing | Senior Theses

When caring for people with severe dementia, the concept of the person being central is increasingly advocated in clinical practice. Person-centered care acknowledges autonomy in all facets of care. Recent studies examine behavioral changes in individuals with dementia and how health care teams address these alterations. Health care providers are vital for effective holistic management. Therefore, this review focuses on the current knowledge regarding care goals, practices, and perceptions of the client battling with cognitive decline. A literature review ascertains that clients with dementia respond to interventions and have decreased negative health outcomes, when providers ensure values and needs are …

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 …

Barriers To The Implementation Of Telehealth In Rural Communities And Potential Solutions, Mariana Barreiro, Ashley Coles, Caris Conradt, Emma Hales, Elizabeth Zellmer

Anna Vaughn School of Nursing Undergraduate Work

Telehealth is an ever-growing health care system, providing health services from a distance. Telehealth provides medical care through teletechnologies and two-way video and audio communication to connect doctors to patients. A detailed review was created to show the barriers and interventions of implementing a telehealth program in a rural area. The overall purpose of the systematic review was to find and explore relevant research and answer the question, “What are commonly encountered barriers to implementing telehealth in rural areas and what interventions can nurses implement to overcome these barriers?” The approach used to obtain quality data and research was convenience …

Caregivers Of Medically Fragile Children With Technology Needs, Vuong Prieto

Dissertations and Theses (Open Access)

Background: Medically fragile children (MFC) with technology needs have complex and challenging health care needs in the home setting. Providing care can have both negative and positive psychological and social impacts on the caregivers’ health related quality of life (HRQOL).

Aims: a) To examine the relationship between caregiver burden, caregiving satisfaction, and HRQOL in caregivers of MFC with technology needs. b) To identify caregiver and child related variables of caregiver burden and caregiving satisfaction.

Methods: A cross sectional study was conducted over four months at a children’s hospital and outpatient clinics. Caregivers completed three one-time surveys (Zarit Burden Interview, Caregiving …

Take A Shot: The Effect Of A Multicomponent Strategy To Increase Meningitis B Vaccination Rates, Valerie Cline

Evidence-Based Practice Project Reports

Neisseria meningitidis is the major cause of invasive meningococcal disease (IMD) (Peterson et al, 2018). Approximately 10-15 percent of IMD cases result in debility including neurological impairment, amputation, and death (Peterson et al, 2018). Outbreaks of IMD are sporadic and unpredictable. The incidence of IMD varies geographically, but serogroup B has become more prevalent in recent years. Meningitis-B (Men-B) has been the cause of several university outbreaks on different US college campuses since 2013.The purpose of this project was to implement an intervention at a midwestern university student health center to help students understand the risk of the disease and …

Effectiveness Of A Multi-Component Intervention Program For Treating Childhood Obesity, Suzy Free

Evidence-Based Practice Project Reports

Childhood obesity is one of the most chronic childhood illness worldwide (Centers for Disease Control and Prevention [CDC], 2019; World Health Organization [WHO], 2019). The prevalence of childhood obesity has been described as one of the most common chronic childhood conditions (CDC). The purpose of this evidence-based practice (EBP) project was to reduce the BMI scores of obese children using a multi-component intervention program that incorporates healthy eating, physical activity, and family involvement. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model was used to facilitate the implementation of this EBP project. The synthesis of the appraised literature established that utilizing …

Improving Type 2 Diabetes Mellitus In The Older Adult Population Utilizing Shared Medical Appointments In Primary Care Setting, Mailo Brantner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall management of Type 2 diabetes mellitus (T2DM) and its comorbidities is complex and costly. The American Diabetes Association (ADA, 2019c) recommends the use of team-based care and self-management tools to optimize the management of T2DM. Unfortunately, there is a national shortage of endocrinologists and certified diabetes educators (Stewart, 2008) along with a primary care provider shortage (Simmons & Kapustin, 2011). Thus, it is essential to implement a care model to increase efficiency while also promoting patient knowledge and self-management of T2DM to improve health outcomes. An example of an innovative care model is the shared medical appointment (SMA), …

Nurse Practitioners’ Perceptions Of Telehealth Behaviors, Michelle Austin

Doctoral Projects

Problem: NP’s must be proficient in the behaviors that are required for a successful patient encounter to provide the full benefit of nurse practitioner (NP) telehealth. Consequently, it is imperative for NPs to understand telehealth etiquette behaviors which include the technical and non-technical skills that are necessary for an effective NP-patient patient telehealth encounter (Haney, Kott & Fowler, 2015). Telehealth has been incorporated into healthcare delivery and its use is expanding. In the United States, it is predicted to be used by seven million patients in 2020 (US Department of Health and Human Services, 2018). Appropriate access to health care …

Improving The Process Of Making Preoperative Home-Medication Recommendations, Andrew Standefer

Doctor of Nursing Practice Projects

Improving the Process of Making Preoperative Home-Medication Recommendations

Many patients presenting for surgery have a list of prescribed medications they take daily to treat various comorbidities. Even though prescription drugs may offer patients therapeutic benefits during the perioperative period, they may also cause adverse effects when used in conjunction with anesthesia during surgery (Marley, Calabrese, & Thompson, 2014). Therefore, identification of medications for the preoperative patient to take or withhold is necessary.

Research indicates that clinicians often make inappropriate decisions regarding preoperative medication management in settings where no guideline exists (Renew, Bolton, Alvarado, & De Ruyter, 2015; Symons & McMurry, …

The Collaborative Health Objectives In Combatting The Effects Of Diabetic Peripheral Neuropathy (Choice): A Second Chance To Change Diabetic Destiny, Alishia A. Claibourn

Doctoral Projects

The Collaborative Health Objective in Combatting the Effects of Diabetic Peripheral Neuropathy (CHOICE); A Second Chance to Change Diabetic Destiny, is a research pilot study that will test the validity of The Diabetic Foot Book. Diabetic peripheral neuropathy (DPN) affects 60-70% of the diabetic population. The CHOICE project will use The Diabetic Foot Book, a patient education booklet, created explicitly for the DPN population. The goal of the pilot study is to evaluate the effectiveness of The Diabetic Foot Book to increase health literacy and affect behavior change in the DPN population.

Amending California Law To Incentivize Preceptors, Marina Nguyen

Culminating Project Papers (DNP)

Clinical preceptorship training is a unique component in medical doctors, physician assistant, and nurse practitioner's academic curriculum. Preceptors are licensed clinicians, mentor student(s) during their regular hours of employment without additional compensation. California is currently experiencing a primary care shortage crisis, and with the push to train more health care professionals to meet these shortages, there has been an increase in schools, but not enough preceptors to train new students. This shortage in preceptors is widespread throughout the United States, with many programs having difficulty securing a preceptor site to educate students (Association of American Medical Colleges, 2018).

The culminating …

Hourly Rounding: The Effects On Fall Rates In Adult Population In Acute Care Setting, Sheyla J. Pellicier Mercucci

MSN Capstone Projects

Falls are one of fourteen categories of hospital-acquired conditions (HACs) listed by the Centers for Medicare and Medicaid Services (2020). Falls are costly and stressful for everyone involved; patients, families, nursing staff and physicians. According to the United States Department of Health and Human Services (2019), about seven hundred thousand to one million hospital admitted patients fall every year. The estimated cost of a fall is about fourteen thousand fifty-six dollars if an injury occurs and can extend patient’s hospital length of stay (LOS) to up to 6.3 more days (Joint Commission Center for Transforming Healthcare, 2019).

When a patient …

Supporting Older Adults Through Aging In Place And Capable Programs, Laura Compton

OTD Capstone Projects

This experiential component or doctoral capstone project involved a partnership with Habitat for Humanity of Greater Memphis. Through this agency, projects were completed based on identified needs of the Aging in Place and CAPABLE programs. The Aging in Place (AIP) program provides critical home repairs to low-income adults aged 60 years and older. The CAPABLE program provides the same critical home repairs along with a select number of visits from a registered nurse and an occupational therapist to help the older adults age in place safely.

Mental Health Inpatient Hospitalization: What Nursing Can Learn From "Sensory Rooms.", Haley Wilson

Honors Theses

The purpose of this undergraduate thesis is to explore the use of sensory rooms in the psychiatric inpatient care setting. Mental illness is a serious issue, affecting millions each year. In 2018 the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that one in five, or 19.6% of U.S. adults experienced some form of mental illness. Inpatient hospitalization is limited to those individuals posing a risk for serious harm to themselves or others. A census conducted by SAMHSA on April 30th, 2018, indicated 129,115 patients in the U.S. were receiving mental health care treatment in the inpatient setting. An …