Digital Commons Network^™

Qualitative Vs. Quantitative Train Of Four, Caleb Culbreath

Doctor of Nursing Practice Projects

The growing body of evidence linking residual neuromuscular blockade (NMB) to postoperative complications has underscored the need to integrate quantitative neuromuscular monitoring techniques into anesthesia practice. This study, conducted at a tertiary care center in southern Illinois, investigates the gap between current clinical practices and the latest evidence advocating for objective monitoring. The study utilized a non-experimental pretest-posttest design to evaluate an educational intervention's effectiveness in increasing anesthesia providers' knowledge of quantitative neuromuscular monitoring techniques and enhancing their awareness of the incidence and clinical implications of postoperative residual neuromuscular blockade. Analysis of the pretest and post-test responses revealed significant improvements …

Educating Srnas On Barriers And Facilitators Of Clinical Learning, Mesud Dedic, Richard Heuermann

Doctor of Nursing Practice Projects

A national survey of 143 Student Registered Nurse Anesthetists (SRNAs) conducted by Clancy and Bruinius (2022) revealed that factors impeding effective SRNA clinical education include unstable preceptorship, hostile environments, limited autonomy, and heavy didactic burdens. Clancy and Bruinius (2022) also found that facilitators of SRNA clinical education include rapport with preceptors, effective feedback, strong clinical site orientation, and beginning of day discussions. This project aimed to enhance second-year SRNAs' clinical success by mitigating these evidence-based barriers and employing these evidence-based facilitators by developing a presentation for SRNAs and assessing its effectiveness through a pre-implementation survey and post-implementation survey. The literature …

Development Of High-Fidelity Simulations For Srnas: Airway Fire And Venous Air Embolism, Ashlyn Russo, Brooke Skaggs

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) must swiftly recognize and treat high-risk, low-incidence complications in a high-stress environment. Most SRNAs do not experience high mortality or rare emergencies throughout their training. This project involves developing and implementing two high-fidelity simulations for airway fire and venous air embolism (VAE) to help SRNAs improve their skills in a safe learning environment. Objectives for this project include examining current evidenced-based literature to determine the efficacy of high-fidelity simulation on the SRNA’s knowledge and performance post-simulation, determining the incidence, pathophysiology, and treatments for airway fires and VAE, creating two high-fidelity simulation scenarios, and integrating the …

Educating Anesthesia Providers On The Physiological Effects And Anesthesia Implications Of Cannabis, Carmel Loud

Doctor of Nursing Practice Projects

In the U.S., currently 37 states have legalized cannabis for medicinal use prescribed by qualified medical professionals (National Conference of State Legislatures [NCSL], 2022). In 2012, the legalization of recreational cannabis began; as of 2022, 19 states have legalized the recreational use of marijuana (NCSL, 2022). This project aimed to optimize care for patients using cannabis by increasing anesthesia provider knowledge about cannabis. The project's aim was accomplished through a thorough review of the current medical literature and implementation of education to anesthesia providers about the physiological effects and anesthesia implications of cannabis. Thirteen CRNAs took a pre- and post-quiz …

Best Practice In Airway Management Of The Neonatal Population, Brittaney Montcalm

Doctor of Nursing Practice Projects

The historical idea that uncuffed endotracheal tubes (ETT) are the best method for pediatric airway management is being challenged in today’s current anesthetic practice. Whether to use a cuffed or uncuffed ETT in the neonatal population remains controversial. This project involved a comprehensive literature review of best-practice recommendations for neonatal airway management, focusing on the use of uncuffed versus cuffed ETTs. Literature review findings were presented as an educational PowerPoint presentation, and a quick reference guide for pediatric airway management was developed. A post-implementation questionnaire was administered to determine the effectiveness of the presentation and its perceived application in clinical …

Application Of Ultrasound For Difficult Vascular Access In Obstetric Patients, Carly Mccleland

Doctor of Nursing Practice Projects

This project aimed to create a three-tiered educational program to introduce the benefits of ultrasound application for peripheral IV placement in obstetrical patients. The main goals of this project were to increase successful first-attempt IV placement in obstetric patients who may be difficult to obtain IV access on. The first tier of education consisted of presenting findings from the literature review as an educational PowerPoint to all project stakeholders. The second tier of education included stakeholders practicing using the ultrasound for PIV placement on mannequin arms. The third tier, which is still on going, included implementation of the first two …

Discharge Lounge Utilization, Jessica Goneh, Areo Comonal

Doctor of Nursing Practice Projects

Efficient hospital throughput is crucial for maintaining quality patient care and managing healthcare resources effectively. This project examines the relationship between hospital throughput, measured by discharge lounge utilization, and the National Emergency Department Overcrowding Scale (NEDOCS) score. A mixed-methods approach was employed, combining quantitative analysis of discharge lounge utilization data with qualitative assessment of staff perceptions and operational challenges. The project was conducted over nine months in a large urban hospital. Results indicate a significant correlation between discharge lounge utilization rates and NEDOCS scores, suggesting that higher levels of discharge lounge utilization are associated with NEDOCS score improvement. Furthermore, qualitative …

Procedural Sedation Training: Competency Verification Through Simulation, Christine Hawknuff

Doctor of Nursing Practice Projects

A 450-bed tertiary hospital in Central Illinois lacked a standardized process for competency verification for procedural sedation care by registered nurses (RNs). Despite recommendations by many organizations, there are no consistent or standardized guidelines for verifying competency in nursing care of the procedural sedation. This project implemented a Procedural Sedation Training Course which comprised an in-person prelearning lecture, a group simulation learning experience, and an individual verification of competency through simulation.

Fifty-six RNs completed the Procedural Sedation Training Course and demonstrated competency through simulation, and 24 of these RNs completed a procedural sedation within the eight-month pilot period. Qualitative and …

Increasing Ob/Gyn Clinic Nursing Staff Knowledge And Comfort Level In Providing Breastfeeding Education, Nancy Moore

Doctor of Nursing Practice Projects

There are well known benefits of breastfeeding for both mother and child, yet the educational support from providers during prenatal visits is not consistent or well-documented. An educational presentation discussing guidelines of breastfeeding education, common breastfeeding problems and barriers to breastfeeding was developed and presented to a “Baby Friendly” hospital-based OB/GYN clinic staff at an urban St. Louis hospital. The goal was to increase staff knowledge and comfort providing education and resources surrounding breastfeeding to be used to increase discussion of breastfeeding during prenatal and postpartum visits. Evaluation of pre and posttest data showed an increase in knowledge regarding managing …

Dnp Final Report: Resilience Training For Entry-Level Bachelor Of Science In Nursing Students: An Evidence-Based Practice Project, Ashley N. Goar

DNP Final Reports

Nursing students have moderate to high levels of stress due to responsibilities, high expectations, course grades, and clinical requirements. The practice problem identified for this evidence-based practice project was that undergraduate nursing students had elevated levels of stress but did not know how to manage it. Multiple interventions have been used to address the problem, including positive thinking, mindfulness, resilience training, and distraction-focused therapies. The PICOT question “Will resilience training (I) for entry-level BSN students (P) affect stress (O) in less than three months (T)?” was developed to guide the systematic search for evidence. Based on the evidence, one hour …

Dnp Final Report: Increasing Rapid Response Activations, Carlton J. Rojas Jr

DNP Final Reports

In 2008, facilities were encouraged to develop an emergency response system. A system in which nurses could activate a team of specialists directed to the bedside of a patient with a deteriorating condition. Despite this initiative, nurses and hospital staff have failed to recognize deterioration and correctly activate a rapid response. The clinical problem: Nurses are failing to recognize patient deterioration and activate a rapid response. The practice question was, what will increase rapid response activations? This DNP Project focused on increasing the identification of patient deterioration and activation of the rapid response team. A systematic review of the literature, …

Modifiers Of The Effects Of Different Dimensions Of Social Support On Cardiac Rehabilitation Adherence., Melissa Amraotkar

Electronic Theses and Dissertations

Introduction: Cardiovascular disease (CVD) is a leading cause of mortality worldwide. Cardiac Rehabilitation (CR) is a Class I, level A indication for treatment and prevention further complications of CVD. The attendance rate for CR in the U.S. is very low, especially among female patients. Dimensions of social support, sex of the support provider, and the quality of primary intimate relationship are associated with health-promoting behavior and may influence CR adherence in patients. Purpose: The purpose of this study was to examine the relationship between dimensions of social support and CR adherence, and whether these relationships were moderated by factors such …

Acute Mechanical Circulatory Support In The Cardiovascular Icu: Investigating The Effects Of An Interactive Cardiovascular Dynamics Simulation Program On Nursing Clinical Judgment., Casey Saulman

Electronic Theses and Dissertations

Introduction: Education on acute mechanical circulatory support (AMCS), a therapy used in the cardiovascular intensive care unit (CICU) to manage cardiogenic shock (CGS) is limited for CICU nurses. There is a need to explore clinical judgment in CICU nurses and provide innovative learning experiences that foster judgment when managing AMCS. Methods: This mixed methods feasibility study investigated the effects of an interactive cardiovascular dynamics simulation program on CICU nurses’ knowledge, clinical reasoning, and clinical judgment. Semi-structured interviews explored the participants’ perceptions of the learning experience. Results: Twenty-one nurses completed the cardiovascular dynamics simulation program. The majority were white (85.7%), female …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Telehealth Acceptance And Medical Mistrust Among The Elderly Of Rural Appalachia: A Correlational Study Using The Medical Mistrust Index And Technology Acceptance Model, Victoria Hood-Wells

Electronic Theses and Dissertations

Adults aged 65 years and above have grown substantially over with past decade. However, the chance of developing multiple comorbidities only increases with age. Because elderly residents of rural Appalachia often encounter barriers to healthcare, rural nurses, providers, and policy makers must overcome physical and structural barriers, but also gain a more in-depth understanding of the personal and cultural attitudes impacting the use of new and innovative forms of healthcare delivery. With a slow and variable uptake of telehealth adoption in rural Appalachia, and in the presence of well-documented medical mistrust, this study was designed to better understand the degree …

Drivers Of Being Unhoused And The Prevalence Of Health Conditions Among Unhoused Individuals In Asheville, Nc, Andrea K. Yontz, Amber Beane, Tessa Frank, Amy Upham, Dustin V. Patil, Dan Pizzo, Steve Buie, Jacqueline R. Halladay

HCA Healthcare Journal of Medicine

Background

During the COVID-19 pandemic, there was an increase in the number of unhoused individuals in Asheville, North Carolina resulting in more tent encampments.

Understanding the physical, mental, and socially determined health characteristics associated with being unhoused can help guide stakeholders with policy development, healthcare program planning, and funding decisions to support unhoused individuals.

Methods

In this study, we used an observational cross-section methodology. Using a convenience sample approach, we interviewed 101 participants who were receiving services from 2 emergency hotel shelters, a day center, and a resource center. Data were analyzed using descriptive statistics, and open-ended responses were collected …

The Efficacy Of High-Fidelity Simulation On Knowledge And Performance In Undergraduate Nursing Students: An Umbrella Review Of Systematic Reviews And Meta-Analysis, Celeste Marie Alfes

Faculty Scholarship

Objectives: This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students. Design: Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results. Data sources: Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies. Review methods: The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). …

Disaster Response Self-Efficacy Of Students In The Nursing Department: A Cross-Sectional Study, Dilek Yılmaz, Gonca Buran

Makara Journal of Health Research

Background: Nurses take on important roles in disasters. In this regard, the disaster response self-efficacy of nursing students must be evaluated. The study aimed to determine the self-efficacy of nursing students in disaster response.

Methods: In this descriptive cross-sectional study, the study sample consisted of 207 nursing students who were in their third or fourth year attending the nursing department of a state university in the Marmara region of Türkiye between October and December 2023. Data were collected using a student description form and the disaster response self-efficacy scale.

Results: The mean age of the study participants …

Investigating Nursing Students’ Levels Of Knowledge About Alzheimer’S Disease, Dilek Doruk Kondakci, Aliye Mandiracioğlu

Makara Journal of Health Research

Background: Given that Alzheimer’s disease (AD) has become a major public health problem, this study aimed to investigate the AD knowledge level of nursing students who are health professional candidates.

Methods: The population of this cross-sectional study consisted of 346 nursing students taking up a 4-year program. They were asked to fill out a sociodemographic information form and answer questions from the Alzheimer’s Disease Knowledge Scale (ADKS).

Results: Among the participants, 67.6% were female and 98.8% were single. The mean age of the students was 20.55 ± 2.05 years. Their general knowledge about AD was low, with …

Using An American Sign Language Video Intervention To Improve Advance Care Planning Engagement Among Deaf Adults, Colleen Ann Manning Dnp, Aprn, Fnp-C

Doctor of Nursing Practice Final Project Abstract

PURPOSE This quality improvement (QI) project was intended to increase ACP engagement by 25% from baseline by implementing an ASL video intervention. The project was conducted at a Deaf community organization in Houston, Texas.

BACKGROUND Literacy and language barriers negatively impact access to healthcare and health information among the Deaf population. ASL video interventions aimed at improving health equity are supported in the literature.

METHODOLOGY The Plan-Do-Study-Act (PDSA) quality improvement methodology was used to create a video for the Deaf community about ACP using ASL and captioning. The PREPARE™ ACP Engagement Survey measured changes in ACP behavior due to a …

Effectiveness Of A Positive Psychotherapy Tool In Reducing Burnout And Increasing Morale Of Night Shift Mental Health Workers On An Acute Pediatric Psychiatric Floor, Esther Gatonye

Doctor of Nursing Practice Final Project Abstract

Purpose: This scholarly project's purpose was to enhance the well-being of mental healthcare workers on the night shift in an acute pediatric mental health unit by implementing the Three Good Things (3GT) positive psychotherapy tool. The project intended to address the issue of high burnout rates among healthcare workers and improve employee well-being and patient care.

Background: The project was implemented in a 16-bed Mental Health Unit within a pediatric hospital located in the Austin Metroplex.

Methodology: The project employed a non-randomized pre-, mid, and post-design and utilized surveys to evaluate burnout, well-being, and coping skills. Burnout was measured using …

Using The Confusion Assessment Method For The Intensive Care Unit (Cam-Icu) To Decrease Length Of Stay: A Scoping Review, Brooke D. Ward Bsn, Rn, Dnp Agacnp Student, Martina Little Bsn, Rn, Dnp Agacnp Student, Tracy Mcclinton Dnp, Agacnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is a prevalent challenge among ICU patients, impacting approximately 30% of admissions (Brennan et al., 2023). If left untreated, delirium can increase use of restraints, hospital length of stay, intensive care unit length of stay, and ultimately, morbidity and mortality. This scoping review assesses the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) to gauge its efficacy in reducing the length of stay in the ICU for adult patients with delirium.

Methods

A literature review from 2018 and 2023, using PubMed, CINAHL, and Medline were utilized for the search along with key words such as: length of …

Using Nurse-Assisted Telemedicine To Reduce Healthcare System Utilization By Rural Congestive Heart Failure Patients, Melissa Diehl Weidner

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is among the most common reasons for emergency room utilization and hospitalizations in those over age 65. With the rapidly aging population in the United States, the number of CHF patients is projected to continue to rise, disproportionately affecting rural communities. This research study evaluated an innovative nurse-led telemedicine program developed by one rural healthcare system to address the care and economic influence of rural CHF care. The purpose of this causal comparative analysis was to determine the impact a nurse-assisted telemedicine program had on the number of emergency room visits and hospital admissions for CHF …

Effectiveness Of An Educational Intervention On Post-Traumatic Stress Disorder Screenings For Healthcare Providers In Ambulatory Settings, Avis Simon

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

PTSD affects 3.6% of the United States adult population about 9 million people each year. Studies have found that 52% of the mental health population seen by healthcare providers who met the diagnostic criteria for PTSD are often undiagnosed. This quality improvement clinical project conducted at two military ambulatory clinics in the southeastern United States, aimed to evaluate the effectiveness of an educational intervention in improving post-traumatic stress disorder (PTSD) screenings and outpatient referrals among healthcare providers in ambulatory settings. Specific goals were to improve ambulatory providers' awareness and utilization of PTSD screening instruments in patients experiencing PTSD. The secondary …

Implementation Of A Standardized Process To Increase Referrals To The Tobacco Quitline In An Underserved General Oncology Cancer Survivorship Clinic, Kristyn-Mae Rosales

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this scholarly project was to implement a standardized process to increase referral rates to the tobacco quitline among cancer survivors in an outpatient center. The intent was to promote the usage of tobacco cessation resources for this vulnerable population.

BACKGROUND “Cigarette smoking remains the leading cause of preventable disease, disability, and death in the United States” (CDC, 2023). This project was implemented in an ambulatory clinic among the Harris County population, Houston, Texas. The aim of this project was to increase the number of quitline referrals by 20% in six months.

METHODOLOGY Interventions were implemented to …

An Undergraduate Baccalaureate Simulation On Weight Bias And Caring For A Patient With Obesity, Kathy Andrews

DNP Projects

Background: There is considerable evidence showing the correlation between weight related bias among healthcare professionals, and poor health outcomes for patients with obesity. Educating healthcare professionals on both safe and effective care practices and compassionate patient-centered care techniques can reduce the negative health impact of weight bias on this patient population. Purpose: This scholarly project adjusted the existing curriculum to address existing weight bias among a cohort of undergraduate baccalaureate nursing students and to inspire improvement in their care of patients with obesity. Methods: Using Kolb’s ELT a sequence of learning activities were adapted and implemented as a …

Enhancing Metabolic Syndrome Surveillance For Adults Taking Second Generation Antipsychotic Medication, Ilanit Marx

Doctoral Dissertations & Projects

Background: Individuals prescribed Second-Generation Antipsychotics (SGAs) face an increased risk of developing metabolic syndrome (MetS), characterized by a higher prevalence of metabolic abnormalities such as diabetes, dyslipidemia, hypertension, and obesity. This heightened susceptibility significantly raises the chances of developing cardiovascular disease and type 2 diabetes (Abdulhaq et al., 2021; Chen & Nasrallah, 2019).

Objectives: This quality improvement project aims to address the management of MetS in patients with severe psychiatric disorders prescribed SGAs. Applying the theory of planned behavior (TPB) framework, this project seeks to gain insights into the determinants shaping clinician behavior and provide a comprehensive understanding of the …

Telehealth: A Rising Intervention For Latina Mothers Experiencing Prenatal And Postpartum Depression, Britney Gutierrez

Nursing | Student Research Posters

Abstract: Background: Postpartum depression (PPD) is high among Latina women but often goes unrecognized and untreated. Recognition and management of PPD in this population is crucial as PPD contributes to negative health effects on the mother and infant. Purpose: This research aims to look into telehealth to improve screening methods and treatment for Latina mothers through a Spanish mobile health application that will provide screening and education on PPD. Method: This mixed-method quality improvement study will include 300 participants from an OB-GYN and Pediatrics community clinic, > 18 years old, of Hispanic/Latino ethnicity, Spanish speaking, currently pregnant, or had a child …

Nurse Suicide: Examining Depression And Anxiety In Critical Care Settings, Arianna Bernardine Barata

Nursing | Student Research Posters

Nurses play a critical role in healthcare, yet the demanding work environment often exposes them to stressors, leading to the development of depression and anxiety. According to the National Library of Medicine (NLM) (2021), 50.8% of nurses have stress, 74% have anxiety, 70.8% have depression, and 79.1% have at least one of them. Burnout, understaffing, COVID fatigue, alarm fatigue, patient ratios, and disrupted sleep patterns are some of the stressors nurses contend with in every shift. While some nurses may cope and overcome these challenges, many face more severe issues, such as suicide. Nurse suicide is an issue that has …

Preventive Strategies For Elder Abuse Within Hospice Care By Healthcare Professionals, Joshua Eason

Nursing | Student Research Posters

Background: Healthcare professionals providing hospice care need to have particular specialized abilities, empathy, and trust. Unfortunately, some of these medical professionals are unable to provide their patients the care they need, so they will instead abuse and ignore them. Elder abuse must be identified and addressed in hospice care settings if older patients are to have their rights and dignity upheld and a standardized, compassionate end-of-life care program is to be provided for each patient.

Purpose: The purpose of this study is to examine the effectiveness and preventative strategies for elder abuse, implemented by healthcare providers within the hospice care …