Digital Commons Network^™

Employee Engagement In The Pacu, Michelle Spadaro

Master's Projects and Capstones

A clear vision is a powerful tool that can help advance employee engagement within nursing units. There is a great need for a compelling vision for the operation of a safe, efficient, equitable, effective, and patient centered healthcare delivery system. It is crucial to identify what actions are needed to achieve this vision and what realistic strategies are necessary for success. The purpose of this vision statement is to achieve excellence in nursing by establishing a common identity and direction that responds to an ever-changing healthcare environment. The project was conducted on a 25 bed peri-operative and post anesthesia care …

Patient Satisfaction Related To Noise In The Coronary Care Unit, Anjanette S. Dominguez

Master's Projects and Capstones

Background The CCU staff recognized a department trend for low patient-satisfaction score related to environmental noise levels. Based on the Press Ganey score, the patient-satisfaction score plummeted in relation to noise level beginning in March 2014.

Purpose To improve patient satisfaction regarding noise level in the CCU to 100% by November 21, 2014.

Methods Senior & Fleming’s Hard System Model of Change guided this literature search of CINAHL and Fusion for articles published from 2009 to 2014. Specific terms used were noise, critical care, and sleep promotion. From September to November 2014, earplugs were offered to all alert/oriented patients entering …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

Design And Implementation Of A Sustainable, University-Based, Emergency Medical Response Service, Octavia A. Mandel Struve

Doctor of Nursing Practice (DNP) Projects

Collegiate-based emergency medical services (EMS), designed primarily to provide pre-hospital basic life support and emergency services, are venues by which nurses and other healthcare professionals, with an understanding of community health and social network issues, can maximize health promotion objectives for university and college campus communities. These EMS systems also provide vital support to city and county emergency services and promote positive community relationships with neighboring areas. They can provide excellent opportunities for students to develop critical skills for success in the healthcare and business world. The sustainability and vibrancy of collegiate-based EMS systems are primarily related to impact, benefit …

Influence Of A Palliative Care Protocol On Nurses' Perceived Barriers To Palliative Care And Moral Distress, Christina Cavinder

Evidence-Based Practice Project Reports

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported …

Nurses' Perceptions Of Structural Empowerment: A Practice Review Process Pilot, Andrea M. Lee-Riggins

Doctoral Projects

Nurses are professionally and morally obliged to monitor and evaluate nursing practice via active participation in review mechanisms that are designed to promote patient safety and care delivery, thereby improving patient care quality (American Nurses Association [ANA], 1988, 2001, 2004; O'Rourke, 2006). The purpose of this Doctor of Nursing Practice (DNP) project was to develop, pilot, and evaluate a nurse practice review process with frontline nurses within Fresno Heart & Surgical Hospital (FHSH), a small specialty hospital, affiliated with Community Medical Centers (CMC) in Fresno, California. A nurse practice algorithm was subsequently developed and structural empowerment was assessed with the …

The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

The Effects Of Education On Cardiovascular Disease Knowledge, Lauren A. Ostrowski-Winkler

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for adults in the United States. The three main risk factors for the development of CVD include hypertension, high cholesterol, and tobacco use; these factors are largely prevented or reduced through lifestyle modifications. Researchers indicate that knowledge of CVD mortality has been linked with individual action to reduce one’s CVD risk. Researchers have also indicated that segments of our underserved society, particularly those with the highest CVD mortality rates, are also the least knowledgeable about CVD and their own personal risk. These risk factors were a concern within the …

Psycap And The Impact On The Development Of Intercultural Sensitivity Of Healthcare Educators: A Mixed Methods Study, Helen A. S. Fagan

Department of Agricultural Leadership, Education, and Communication: Dissertations, Theses, and Student Research

This purpose of this explanatory sequential mixed methods study was to examine the intercultural sensitivity development process of faculty and staff at a health sciences college in the Midwest. In the quantitative phase, this study investigated changes in intercultural sensitivity over a three year period, along with the relationship between developmental level of intercultural sensitivity (as measured by Intercultural Development Inventory [IDI] [Hammer, Bennett, & Wiseman, 2003]) of participants and Psychological Capital (PsyCap, a multidimensional construct consisting of hope, efficacy, resiliency, and optimism [Luthans, Youssef, & Avolio, 2007]). In the qualitative phase (Case Study) data collection and analysis further explored …

Utilization Review Software: The Impact On Productivity And Structural Empowerment In Case Management Nurses In An Acute Care Setting, Kimberly Frazier

Nursing Theses and Capstone Projects

The Center for Medicare and Medicaid (CMS) seeks to achieve cost control by implementing aggressive cost containment mechanisms for an exploding Medicare population. One such mechanism is utilization review, which is employed to limit reimbursement of medical care that is determined to not be medically necessary. The CMS Conditions of Participation mandate that all hospitals determine whether a patient qualifies for an Inpatient or Observation stay. Utilization Review Specialist (UR) nurses were given the Conditions of Work Effectiveness Questionnaire II (CWEQ-II), Organizational Relationship Scale II (ORS-II), and the Job Activity Scale II (JAS II), six months after McKesson InterQual software …

Impact Of Nurse Managers' Leadership Styles On Staff Nurses' Intent To Turnover, Joseph Warren L. Perez

Nursing Theses and Capstone Projects

Nurse Managers have the unenviable responsibility of ensuring that nursing staff are engaged and perform their duties to the best of their abilities. Maintaining an environment conducive to maximizing nurses' potentials resulting in retention may be a by-product of an effective leadership style. The purpose of this study was to determine whether nurse managers' leadership styles have an impact on nurses' intent to turnover. Nurse Managers with more than one year of management experience were asked to complete the Multifactor Leadership Questionnaire (MLQ-5X). The 45-item questionnaire rates the participant's leadership style based on the answers provided. Results were then compared …

Improvement Of Standardized Documentation Of Patients With Copd In An Acute Care Setting, Kimberly Biery

Doctor of Nursing Practice Program Projects

The purpose of this project was to improve patient clinical outcomes of average length of stay, mortality rate, and readmission within 30 days by increasing health care provider order set usage and documentation as it relates to patients with a primary diagnosis of Chronic Obstructive Pulmonary Disease (COPD). Epic ™ computer based clinical documentation by healthcare providers at The Christ Hospital (TCH) was inconsistent. The PICOT question developed was: in the COPD population of an acute care hospital, how does standardized electronic COPD process measure documentation and order set usage compared to no COPD process measure documentation and order set …

The Impact Of Implementation Of An Evidence-Based Practice Model In A Long Term Acute Care Hospital, Michele L. Marshall

Doctor of Nursing Practice Program Projects

Inadequate and delayed implementation of current evidence into practice has contributed to medical errors, safety issues and patient deaths. The Institute of Medicine (IOM) has challenged the healthcare profession to achieve 90% of integration of current evidence into practice by 2020. The purpose of this doctoral project was to implement an evidence-based practice (EBP) model in a long-term acute care hospital as they began their journey in pursuit of Magnet recognition. Implementation of an EBP model, the Advancing Research and Clinical practice through close Collaboration (ARCC) model, involved conducting an initial organizational assessment of staff to understand the staff’s beliefs, …

Nurses Perceptions Of Shared Governance Two Years Post Implementation Of A Councilor Shared Governance Model, Kathleen L. Wilson

Doctor of Nursing Practice Program Projects

Participation in shared governance councils can provide nurses with an opportunity for input into organizational policies that influence quality health care outcomes. Nurse leaders are diligently seeking a practice model that has a foundation of engagement of staff in decision making, quality outcomes, competency, evidence-based practice, shared power and job satisfaction. With the Patient Protection and Affordable Care Act (PPACA) of 2010, health care systems can expect an influx of some 30 million more patients (Pfeifer, 2013). In addition, mandated purchase of health care insurance will replace the fee for service model with one that ties payment to outcomes and …

Factors That Relate To Registered Nurses' Readiness For Interprofessional Learning In The Context Of Continuing Professional Development, Collette Williams

Dissertations

Today’s health-care professionals practice in a highly technological, multidisciplinary environment. In order to provide safe, effective, and high-quality patient care, collaboration is required among all professionals. Traditionally each profession has operated independently in regard to continued professional development. The purpose of this study was to assess practicing registered nurses’ readiness toward interprofessional learning in order to align learning with current practice.

Method. An ex post facto study design was used to gather data to examine if there is a relationship between variables of demographics and readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) assesses the readiness for …

Post-Laminectomy Back Pain: Understanding The Progress From Acute To Chronic Pain State, James Derek Calhoun

DNP Projects

In the United States, 74.6% of patients who have lumbar laminectomy surgery have residual low back pain (Hussain & Erdek, 2014) and overall costs of low back pain may reach up to $200 billion per year (Carey & Frebuger 2013). To further address this problem, a study was conducted to determine if treatment in a chronic pain clinic could result in a reduction in the development of a chronic pain state for adult patients who have had lumbar laminectomy surgeries. A convenience sample of 50 patients was selected from the Interventional Pain Associates clinic at the University of Kentucky. Records …

A Single Competency-Based Education And Training And Competency-Based Career Framework For The Australian Health Workforce: Discussing The Potential Value Add, Sharon Brownie, Janelle Thomas

School of Nursing & Midwifery, East Africa

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation …

Employing Provider Mentoring/Coaching To Improve Preventive Quality Ordering, Julie Knox-Woodward

Walden Dissertations and Doctoral Studies

Preventive quality ordering is a provider intervention aimed at disease prevention through the ordering of industry-recommended health maintenance tests. This pilot study evaluated the effectiveness of provider mentoring/coaching to improve preventive quality ordering using the 2014 Agency for Healthcare Research and Quality best practice preventive clinical services guidelines. Literature indicates provider inconsistency in preventive and quality ordering as the primary cause of disparate health outcomes. Guided by theories of modeling and role-modeling, as well as the theory of cognitive continuum, this pilot study offered provider mentoring/coaching to encourage timely preventative quality ordering. Routinely monitored historic provider practice patterns in a …

Emergency Nurses' Knowledge Of Pediatric Complaints, Kari J. Blackburn

DNP Projects

Each year there are more than 25 million pediatric emergency department (ED) visits, with 37-60% of the complaints being non-urgent (Brosseau, Hoffman, Nattinger, Flores, Zhang and Gorelick, 2007). Injury is the number one reason children present to the ED and is strongly associated with a complaint of pain (AHRQ, 2013). While pain is a high volume reason for visiting the ED, there are other presentation causes that may pose a high risk to pediatric patients. Nausea and vomiting is not typically viewed as a high risk complaint, yet there are some high risk etiologies resulting in nausea and vomiting that …

Integration Of Technology Into A Nursing Curriculum Using A Mixed Method Approach, Susan Ramnarine-Singh

Walden Dissertations and Doctoral Studies

In 2011, the Institute of Medicine and 2010 Affordable Care Act addressed the need to use technology in nursing programs. The purpose of this study was to understand faculty perceptions of technology use and integration into the nursing curriculum at a college located in Texas. Lewin’s change theory acted as the theoretical framework to explore organizational dynamics involved in effective strategies. The guiding research questions explored faculty perceptions of technology use, types of technology used, and correlation to teaching experience using a convergent mixed-method approach. Thirty faculty members completed the Teacher’s Intention to Use Technology survey and 15 faculty members …

Selection Of An Instrument To Evaluate The Organizational Environment Of Nurses Working In Intensive Care: An Integrative Review, Brett Abbenbroek, Christine M. Duffield, Doug Elliot

Research outputs 2014 to 2021

To determine an appropriate survey instrument to evaluate the impact of organizational structures on the work environment of intensive care nurses.

Improving Value Based Purchasing Through The Implementation Of The Clinical Nurse Leader Role: The Chief Nursing Officer’S Case For Change, Leanne M. Hunstock

Doctor of Nursing Practice (DNP) Projects

The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical …

Factors Mediating Disruptive Behaviors In A Veterans Affairs Medical Center, Marylois Lacey

Dissertations

. Disruptive behaviors are often related to care giving situations in which the patient wants something that is not possible, refuses to participate in what is required, demands instant gratification, or demands immediate emotional support. In response to the patients’ demands and actions, health care providers use limit setting, activity demand, and denial of request. This study sought to answer the following questions: (a) Are code greens associated with symptoms of a medical and/or psychiatric diagnosis, denial of request, limit setting, and activity demand? (b) Are activity demand, denial of request, and limit setting more likely to be associated with …

Are Health Care Providers Following Evidence-Based Practice Guidelines For The Screening, Diagnosis And Treatment Of Childhood Obesity?, Cara Harris, Thu Tran

MSN Research Projects

The purpose of this study was to determine if preteens and adults are screened and given the diphtheria toxoid and acelluar pertussis vaccine.

Tetanus, Diphtheria, And Pertussis Screening And Pertussis Prevention Throughout The Age Span, Cara Harris, Thu Tran

MSN Research Projects

The purpose of this study was to determine if preteens and adults are screened and given the diphtheria toxoid and acelluar pertussis vaccine.

The Development Of A Comprehensive Adhd Program For Elementary School Educators, Angie Lee Echoles

Doctoral Projects

On average, teachers will teach at least one student with Attention Deficit Hyperactivity Disorder (ADHD) in any given school year without receiving any instructions at all on ADHD. ADHD affects 3% to 7% of school-age students and one in every twenty children (Centers for Disease Control and Prevention (CDC), 2010). It is classified as one of the most common mental health disorders affecting school-age students. The American Psychiatric Association (APA, 2013) defines ADHD as a hereditary, non-curable, common childhood disorder. A triad of symptoms is associated with this disorder: inattention, hyperactivity, and impulsivity, which all have a major impact on …

Introducing A New Cadre Into Uganda’S Health Care System: Lessons Learnt From The Implementation Process, Gerald M. Amandu, Leana R. Uys, Joseph Mwizerwa, Alex Erejo, Irene A. Cheruto, Margaret Chota

School of Nursing & Midwifery, East Africa

Uganda introduced Registered Comprehensive Nursing (RCN) and Enrolled Comprehensive Nursing (ECN) training programs in 1994 and 2003 respectively, to create certificate and diploma level cadre of nurses with competencies in general nursing, midwifery, public health, psychiatry, paediatrics and management. This paper is based on an evaluation study undertaken to assess how the programs were implemented including stakeholders’ perceptions about the graduates. Despite being relevant, the implementation process of both programs failed to meet acceptable standards. We conclude that introducing a new cadre of nurses without proper preparation hinders realization of their full potential including their contribution to the healthcare system.

The Influence Of Organizational Culture On Affinity For Knowledge Management Practices Of Registered Nurses, Gregory Allen

Faculty Publications - George Fox Digital

This study addressed the problems of hospitals’ duplicated effort and ad hoc knowledge management (KM) practices. The purpose of this quantitative study was to examine the focus and type of organizational culture in order to describe and predict the relationship between organizational culture and the affinity for KM of nurses working in health care organizations in Portland, Oregon. Guided by the competing values framework and social capital theory, this research study was undertaken to illuminate the possible relationship between the affinity for and probable use of KM and organizational culture in Oregon hospitals. Data were collected from 93 registered nurses …

An Educational Approach: Increasing College Freshmen's Knowledge Regarding Sexually Transmitted Infections, Jennie Mcclain

Evidence-Based Practice Project Reports

According to the Centers for Disease Control (2009), young adults account for only 25% o fsexually active persons in the United States, but account for 50% of the newly diagnosed cases of sexually transmitted infections (STIs). Some young adults may not have received appropriate or credible information on sexual health by which to make knowledgeable decisions that may influence the rest of their lives. High schools are not required to offer comprehensive sex education. Therefore, some students may have received abstinence-only sex education. Risk reduction and disease prevention are important in college health. This evidenced-based practice project included the creation, …