Digital Commons Network^™

A Patient Centered Quality Improvement Education Program Designed To Improve The Health Of Patients Living With Uncontrolled Hypertension In A Primary Care Setting, Alia Jamison-Dinowitz

Doctor of Nursing Practice Projects

Cardiovascular disease is the leading cause of death in the United States and it negatively contributes to poor health outcomes (Martinez-Garcia et al., 2018). Within the Antelope Valley in Lancaster California, 30.3 % of city residents have a hypertension diagnosis (Los Angeles County of Public Health, 2017). Much like the city at large, hypertension is a critical issue at AV Pediatrics and Family Medicine (AV Peds). This issue is driven by a variety of factors including a lack of understanding about hypertension and medication compliance, and a lack of understanding about healthy lifestyle choices. Providers at AV Peds have seen …

Evidence-Based Strategy To Improve Delirium Detection In Elderly Postsurgical Patients, Aimee Baker

Doctor of Nursing Practice Scholarly Projects

Postoperative delirium (POD) is a serious adverse outcome that frequently affects older adults. Patients experiencing POD are at greater risk for postoperative mortality, increased length of hospital stay, functional decline, and increased cost of care. Current global population trends indicate that the population of adults over the age of 60 years old will double over the next thirty years. Recent guidelines call for hospitals to implement routine delirium assessment to improve early intervention. Nursing delirium assessment tools are a critical resource for early delirium identification. Nursing delirium assessment tools are often highly sensitive and specific for delirium when used in …

Improving Emergency Department Nurses Communication Self-Efficacy With Underrepresented Populations Through Cultural Humility Training, Nikki L. Graham

Doctor of Nursing Practice Projects

Problem Description: The chasm of health inequality for underrepresented populations in the United States is growing, despite advances in healthcare and increased life expectancy. Disparities span the age and healthcare continuum for underrepresented populations, with increased mortality and morbidity rates in nearly every category. Non-white residents in Cook County face the same challenges. Historical lack of trust creates a reluctance to seek healthcare among Black populations, but when they do, they are disproportionately dissatisfied with their care, receive less aggressive treatment, and report higher levels of uncontrolled pain. Nurses, as the largest body of healthcare professionals, are uniquely positioned …

Reducing Reportable Hospital Acquired Pressure Injuries In The Medical Intensive Care Unit, Vallerie Push Msn, Rn, Cnl, Ccrn, Ryan Crabb Rn, Pamela D'Ambrosio Bsn, Rn, Sheryl Phino Msn, Rn, Ccrn,, Marianne Scofield Msn, Rn, Anne M. Aquila

Posters

The purpose of this quality improvement (QI) project was to reduce the rate of reportable HAPIs/1000 patient days in the MICU by 25% from a baseline rate of 2.92/1000 patient days to a target rate of 2.19 by September 30, 2023

Pods: A Team-Based Approached To Reduce The Left Without Being Seen Rate In An Urban, High-Volume Emergency Department, Charis Keane Md, Daryn Brauner Msn, Amy Bobbit Rn, Nikki Campbell Bsn, April Alfano Ms

Posters

The purpose of this QI project is to evaluate the impact of the Patient-Oriented Discharge System (PODS) model, a registered nurse-provider team-based approach, on reducing the rate of LWBS in a high-volume, urban ED

Improving Pain Air Cycles With Implementation Of Evidence-Based Reassessment Strategies, Carissa Corraro Dnp (C), Bsn, Rn.

Posters

The purpose of this quality improvement project was to implement evidence-based strategies (i.e., compliance audits, educational in-services, badge reels, and Posters with QR codes) to increase compliance of oncology nurses’ documentation of pain assessments and reassessments.

Health Equity Innovation To End Clinicians’ Unconscious Bias When Caring For Emergency Department Patients, Kenneth Forte, Adam Chess, April Alfano, Keri Bill, Cheryl Green, Mary Christoffersen, Joubin Bavarian

Posters

Bridgeport Hospital has successfully improved patient care by implementing Individualized Clinical Bias Scores (ICBS) for triage nurses in our emergency department (ED). Through the use of data analysis, we identified that patients of color were being assigned less urgent acuities when presenting with the same complaints as white patients. By addressing this implicit bias and implementing a new system of ICBS for our ED Triage Nurses, we have seen a significant improvement in the equitable treatment of all patients regardless of race or ethnicity.

A Pilot Project To Improve The Well-Being Of Inpatient Nurse Managers At An Academic Medical Center Through A Mindfulness-Based Intervention, Nancy Wiederhold

Doctor of Nursing Practice Projects

Purpose: To decrease inpatient nurse managers' burnout, stress, and compassion fatigue through attendance at a mindful, self-compassion intensive program.

Background/Significance: Nurse leaders and managers are indispensable pillars of the healthcare team, carrying the responsibility of shaping organizational success and ensuring quality patient care. Unfortunately, the current landscape of nursing leadership is clouded by sentiments of powerlessness, hopelessness, and guilt.

Description: Recognizing the practical challenges faced by nurse managers, a targeted intervention was implemented – a four-week, in-person mindfulness-based, self-compassion program. This initiative aimed to equip them with the tools to mitigate stress, burnout, and compassion fatigue. Led by a trained …

Implementing Distress Screening And Hospital Management Of Oncology Patients With Distress, Rhezarie Mae Agtarap

Doctor of Nursing Practice Projects

Of the nearly 2 million new cancer cases projected to occur in the United States in 2022, up to 65% of patients may be hospitalized in the first year of their diagnosis. Hospitalized oncology patients have been documented to experience psychological distress during their hospitalization related to physical and emotional challenges related to their disease. In ***, a tertiary hospital located in ***, Oregon, hospitalized cancer patients with hematologic malignancies and aggressive or advanced solid cancers have verbalized distress, including depression, anxiety, feelings of isolation, and fatigue during prolonged hospital stays. According to the National Comprehensive Cancer Network (NCCN), distress …

The Effect Of Continuous Glucose Monitoring On Glucose Control And Re-Hospitalizations In Type Ii Diabetes Mellitus Patients, Susan Ferguson

The Eleanor Mann School of Nursing DNP Capstone Projects

Purpose: This Program Development and Evaluation project was designed to improve the management of patients with type II diabetes mellitus through the implementation of a combined in-patient discharge protocol and outpatient continuous glucose monitoring protocol follow-up plan in a diabetes clinic following discharge from a rural-based acute facility hospitalization.

Method: This quasi-experimental project was based on Rosswurm and Larrabee's Model for Change framework. Outcome measures analyzed type II diabetes mellitus patients to assess the effects of a continuous glucose monitoring discharge protocol on pre- and post-glycemic levels, rehospitalizations, and patient (n=2) and provider knowledge (n=4) obtainment.

Results: In a comparison …

Implementation And Evaluation Of A Structured Mentorship Program, Cary Bedinghaus, Caroline Hillman

Doctor of Nursing Practice Scholarly Projects

The project addresses mentorship in a graduate nursing anesthesia program. The goal is to improve the existing mentorship program and to implement a durable and consistent system that gathers and responds to feedback from the students. Two literature reviews form the underpinnings of the structure and evaluation components of the project. Three structural components were identified in the review as highly effective in multiple studies of diverse mentorship programs. The first component is establishing an effective dyad matching scheme. The second component is establishing clear goals. The third component is maintaining the relationship and achieving goals through frequent and consistent …

All Clear For Virtual Simulation In Transition To Practice, Stephanie Barrett Msn, Rn, Onc

Posters

A knowledge gap in emergency management was identified through transition to practice program (TTPP) data and discussions with new nurses and nurse leaders. In response an Emergency Management Virtual Simulation (EMVS) was implemented. This evidence based educational method is engaging and is shown to increase confidence and learning outcomes. Virtual simulation gives new graduate nurses an opportunity to collaborate, critically think in stressful situations, and “experience the real-life chaos” in a safe learning environment.

Improving The Culture Of Patient And Family-Centered Partnerships: A Quality Improvement Project, Nicole S. Ardres

Doctor of Nursing Practice Projects

Problem Description: In 2020, the coronavirus (COVID-19) impacted the world, changing the landscape of the nursing profession. The pandemic changed societal norms to reduce transmission and death rates by instituting social distancing requirements, stay-at-home policies, and mask mandates. Hospitals enacted crisis standards of care, changed orientation and training practices, and restricted family visitation policies. In addition, nursing programs temporarily halted in-person clinical training experiences and transitioned to online learning. These were challenging times to enter the nursing profession. The pandemic worsened the nursing shortage, contributing to burnout, turnover, and increased use of agency or travel nurses, resulting in a loss …

Piloting A Simulated Electronic Health Record In Cambodia For Nursing Students In A Nursing Informatics Course, Eam Mao, Tricia Hester, Sreypeov Tun, Monirath Soun, Cheryl D. Parker

Nursing Faculty Publications and Presentations

Introduction

Electronic health records (EHR) integration is vital in modern healthcare, yet there is limited research on EHR training in nursing education in Cambodia and the ASEAN region. This study explores the implementation of simulated EHR training for Cambodian nursing students and its potential benefits for the curriculum.

Method

A four-week pilot was conducted with 62 Cambodian nursing students at the University of Puthisastra. Students participated in simulated EHR activities and completed a post-course survey to identify challenges such as medical terminology, computer literacy, and English proficiency.

Results

93.5% of students recommended continuing EHR training despite challenges, including difficulties with …

Mychart Patient Portal Utilization, Sherri Uteck

MSN Student Capstones

No abstract provided.

Implementing In-Room Recycling On A Family Medical Center, Ariann Schultz, Sarah Johnson

Articles, Abstracts, and Reports

No abstract provided.

Healthcare Professional Awareness Of Climate Health And An Evidence-Based Environmental Stewardship Framework, Patricia Joubert, Rosemary Timmerman, Angie Shemwell, Barbara Nguyen, Teresa Rangel

Articles, Abstracts, and Reports

No abstract provided.

Health Professional Concern For Environment And Behaviors To Protect Climate Health, Mary Jo Kelly, Sarah Johnson, Teresa Rangel, Gale Springer

Articles, Abstracts, and Reports

No abstract provided.

Primary Care Organizational Readiness And Implementation Climate For Task Sharing Of Tele-Mental Health Interventions, Frances Chu, Brenna Renn, Erin Abu-Rish Blakeney, Sean Munson, Oleg Zaslavsky

Articles, Abstracts, and Reports

Primary Care Organizational Readiness and Implementation Climate for Task Sharing of Tele-Mental Health Interventions

Chu, F.; Renn, B.; Blakeney, E.; Munson, S.; Zaskavsky, O. Providence Swedish/University of Washington, Seattle, WA

Purpose: To examine perceptions of organizational readiness and implementation climate for task sharing of telemental health (TMH) interventions from primary care healthcare professionals by levels of behavioral health integration (BHI) and roles. Background/Significance: BHI clinics have positive impact on patient outcomes. Task sharing, a strategy used to address shortages of behavioral/mental health (BMH) specialists, with TMH interventions adds complexity. Method: The mixed methods study surveyed 151 healthcare professionals with Organizational …

Moral Distress And Moral Injury In Military Healthcare Clinicians: A Scoping Review, Melissa A. Wilson, Amy Shay, J. Irene Harris, Nicole Faller, Timothy J. Usset, Angela Simmons

Nursing Faculty Publications

Introduction: Healthcare clinicians are often at risk of psychological distress due to the nature of their occupation. Military healthcare providers are at risk for additional psychological suffering related to unique moral and ethical situations encountered in military service. This scoping review identifies key characteristics of moral distress and moral injury and how these concepts relate to the military healthcare clinician who is both a care provider and service member.

Methods: A scoping review of moral distress and moral injury literature as relates to the military healthcare clinician was conducted on the basis of the Joanna Briggs Institute scoping review framework. …

2024 Spring Newsletter, Morehead State University. Nursing Department.

Nursing Department Publications Archive

2024 Spring Newsletter of the Department of Nursing at Morehead State University.

A Quality Improvement Project To Promote Awareness And Knowledge Of Nutrition As An Adjunctive Treatment Option For Chronic Insomnia, Sara J. Weelborg

Doctor of Nursing Practice Projects

Background

Insomnia is difficult to treat resulting in adverse outcomes. Traditional treatments are not always safe or accessible. Evidence, not readily available to providers, supports the adjunctive use of nutrition to ease symptoms.

Problem

Literature recommends the Mediterranean Diet for insomnia. A nutrition education module for psychiatric nurse practitioners (n=4) was created by a multidisciplinary committee to increase knowledge and comfort. Pre-post Likert-scale tool, multiple choice test, and interview questions were used to measure educational benefits.

Outcomes

All participants demonstrated knowledge acquisition (range 11% to 100%), increased intention to use information (range 9% to 43%), and positive feedback about nutrition …

Improving Emergency Department Belongings Inventory Electronic Medical Record Documentation, Shanekia Garrett, Stefanie Lai, Jairo Pagan, Wendy Lu, Katie Whitehead

Articles, Abstracts, and Reports

No abstract provided.

Developing A Health Equity-Minded Curriculum: The Impacts Of Cancer Care, Leanna Ross, Camille Ashley, Julianne Luttrell, Krismae Jimenez

Articles, Abstracts, and Reports

No abstract provided.

Maternal Prebiotic Supplementation During Pregnancy And Lactation Modifies The Microbiome And Short Chain Fatty Acid Profile Of Both Mother And Infant, Jacquelyn M. Jones, Stacey N. Reinke, Mahsa Mousavi-Derazmahalleh, Johan Garssen, Maria C. Jenmalm, Ravisha Srinivasjois, Desiree Silva, Jeffrey Keelan, Susan L. Prescott, Debra J. Palmer, Claus T. Christophersen

Research outputs 2022 to 2026

Background & aims: Improving maternal gut health in pregnancy and lactation is a potential strategy to improve immune and metabolic health in offspring and curtail the rising rates of inflammatory diseases linked to alterations in gut microbiota. Here, we investigate the effects of a maternal prebiotic supplement (galacto-oligosaccharides and fructo-oligosaccharides), ingested daily from < 21 weeks' gestation to six months’ post-partum, in a double-blinded, randomised placebo-controlled trial. Methods: Stool samples were collected at multiple timepoints from 74 mother–infant pairs as part of a larger, double-blinded, randomised controlled allergy intervention trial. The participants were randomised to one of two groups; with one group receiving 14.2 g per day of prebiotic powder (galacto-oligosaccharides GOS and fructo-oligosaccharides FOS in ratio 9:1), and the other receiving a placebo powder consisting of 8.7 g per day of maltodextrin. The faecal microbiota of both mother and infants were assessed based on the analysis of bacterial 16S rRNA gene (V4 region) sequences, and short chain fatty acid (SCFA) concentrations in stool. Results: Significant differences in the maternal microbiota profiles between baseline and either 28-weeks’ or 36-weeks’ gestation were found in the prebiotic supplemented women. Infant microbial beta-diversity also significantly differed between prebiotic and placebo groups at 12-months of age. Supplementation was associated with increased abundance of commensal Bifidobacteria in the maternal microbiota, and a reduction in the abundance of Negativicutes in both maternal and infant microbiota. There were also changes in SCFA concentrations with maternal prebiotics supplementation, including significant differences in acetic acid concentration between intervention and control groups from 20 to 28-weeks’ gestation. Conclusion: Maternal prebiotic supplementation of 14.2 g per day GOS/FOS was found to favourably modify both the maternal and the developing infant gut microbiome. These results build on our understanding of the importance of maternal diet during pregnancy, and indicate that it is possible to intervene and modify the development of the infant microbiome by dietary modulation of the maternal gut microbiome.

Nursing Care Regarding Social Determinants Of Health For Breastfeeding In Mothers And Infants, Natalie Jefson

Senior Honors Theses

Breastfeeding is incredibly important to the health and well-being of the mother-infant dyad. Because of this, there are both world-wide and national recommendations and guidelines for breastfeeding in the United States. Although many women choose to initiate breastfeeding, the percentage of women who continue breastfeeding for the recommended duration does not meet the Healthy People goal for the United States. Many factors influence this early breastfeeding cessation, including physical and socioeconomic barriers. Certain populations face increased barriers to reaching these goals related to social determinants of health which can and should be addressed by nurses through preventive measures and education.

Clinical Experiences Of Rn To Bscn Nursing Students In Kenyan Universities, Gladys Mbuthia, Gisela Rensburg Rensburg, Sheila Shaibu

School of Nursing & Midwifery, East Africa

Introduction and objective: Clinical learning environments play a great role in nursing training as they allow nursing students to develop their clinical skills by combining cognitive, psychomotor and affective skills. Consequently, clinical learning environments enable nursing students to bridge the theory-practice gap. Fewer studies have examined the clinical experiences of RN to BScN students in Kenya. This paper is part of analytical memo of a larger PhD study that sought to explore and describe the support needs of RN to BScN students in Kenyan universities. The paper focuses on clinical experiences of RN to BScN students.

Methods: Using a qualitative …

Improving Provider Ordered Annual Breast Cancer Screening In Primary Care, Alexis Manzella

DNP Projects

Significance and Background: Breast cancer is the most common cancer in women throughout the United States. Specifically, the state of Connecticut has one of the highest rates of breast cancer in the country. Multiple evidence-based organizations have developed specific guidelines for screening in clinical practice. These guidelines specify when a woman should be screened and how frequently. A project was put in place at a FQHC in Connecticut to increase the number of breast cancer screenings ordered, based on clinical guidelines. Evidence supported the use of provider education to increase the number of mammograms ordered (Marks,2022).

Purpose: Increase the number …

School-Based Virtual Care, Jill Held

MSN Student Capstones

No abstract provided.

Active Shooter Preparedness In The Urgent Care Setting, Lauren C. Shealy

MSN Student Capstones

No abstract provided.