Digital Commons Network^™

Healthcare Providers Monitoring Of Serum Potassium Levels In The Treatment Of Heart Failure, Sara Burwell, Megan Chaney, Corey Shoemaker

MSN Research Projects

The purpose of this study was to determine if patients older than 65 years of age received the influenza vaccine.

Influenza Vaccination Of The Older Adult Patient And Documentation By The Healthcare Provider, Sara Burwell, Megan Chaney, Corey Shoemaker

MSN Research Projects

The purpose of this study was to determine if patients older than 65 years of age received the influenza vaccine.

Effects Of A School-Based Education Intervention On Bmi And Physical Activity, Lauren M. Panner

Evidence-Based Practice Project Reports

In 2011, the CDC reported that there are 12.5 million obese children and adolescents living in the United States (U.S.). The financial burden of childhood obesity in the U.S. is estimated to be 14 billion dollars. The objective of this evidence-based practice (EBP) project was to answer the question: In school-aged children, how does school-based, structured, family-oriented physical activity education affect body mass index (BMI) compared to usual education over an eight week time period? The Stetler Model of EBP and the health belief model were used to guide this project in a rural, Northwest Indiana elementary school. For eight …

Depression Screening Of Young Adult Freshmen Students, Marlee R. Steele

Evidence-Based Practice Project Reports

Depression is a mental health issue that requires prompt identification and treatment. According to the CDC, it is estimated that in the U.S .one in 10 adults suffer from depression (CDC, 2011) with 4.7% of young adults, 18-39 years, suffer from depression (CDC, 2006). Many young adults report that college life is often more stressful than anticipated and the demands placed not only academically, but also socially, adversely affect their psychological and physical health (Dyson & Renk, 2006). The purpose of this EBP project was to answer the PICOT question: How does a depression screening tool in combination with a …

Perceptions Of Hospital Patient Safety Culture In Department Of Veterans Affairs Station 593 Southern Nevada, Kimberly Falco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opportunities for error exist, adverse events occur, and challenges endure. However, patients will continue to experience preventable adverse events unless steps are taken. Efforts to improve patient safety are critical to today's healthcare environment. The Department of Veterans Affairs (VA) believes that the identification of adverse events allows for creation of system improvements to increase patient safety.

Implementing safety culture requires a proper assessment of existing barriers and potential challenges. Patient safety culture assessments start by evaluating the current patient care environment. This assists the organization in identifying barriers to patient safety and in working toward creating a culture of …

Development And Implementation Of A Quality Improvement Initiative: Systematic Follow-Up Of Patients Who Have Spinal Cord Stimulator Implants, Irina Rajala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recent medical advances and the rising prevalence of chronic pain in the US population contribute to the use of spinal cord stimulator (SCS) implant as a treatment modality for chronic pain management. As the numbers of patients receiving SCS implants steadily increases, the challenge of managing this device grows and the need for SCS implants follow-up programs rises. Follow-up programs need to focus on implant longevity and efficacy to improve the quality of care outcomes.

This Doctor of Nursing Practice (DNP) quality improvement initiative was developed to provide systematic follow-up for patient with SCS implant. The project includes the creation …

Comparison Of Study/Article Characteristics And Methodological Quality Of International Nurse Workplace Violence Research Published Before And After The Joint Commission Sentinel Event Alert On Disruptive Behaviors, Terressa Margarette Stowell Love

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The majority of new nurses experience workplace violence from other nurses. The purpose of this study was to compare study/research characteristics and methodological quality of international nurse workplace violence research published before and after the 2008 release of the U.S. The Joint Commission (TJC) sentinel event alert on disruptive behaviors.

Methods: Thirty-nine quantitative nurse workplace violence research articles published between 2001 and 2012 were assessed and divided into two groups: articles published (a) before the 2008 TJC sentinel event alert or the same year, i.e., 2001-2008 (BTJC) and (b) after the 2008 TJC sentinel event alert, i.e., 2009-2012 (ATJC). …

Implementing A Bystander Awareness Program On A University Campus, Robert Joseph Vadovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Between 17% and 62% of college students experience some form of violence during their time at school. About 25% of female college students experience a sexual assault before graduating. One university had seen an increase in violence, including assaults and bias events. Administrators and nurses implemented a bystander awareness program to help alleviate this growing problem. Members of the college's residence life staff and its Greek organizations (fraternities and sororities) participated in the Step Up program, a prosocial training program to get people to intervene safely when witnessing acts of violence. Participants (N=236) completed surveys prior to the program, immediately …

Sickle Cell Disease: A Quality Improvement Initiative For Emergency Department Providers, Pretrescia Marie Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sickle Cell Disease (SCD) is an incurable, chronic condition that results in a constellation of disorders, frequent emergency department (ED) visits, and repeated hospital admissions. Those affected often suffer from pain crisis, infection, acute chest syndrome, stroke, and multi-organ impairment and frequently do not receive adequate pain management during acute pain episodes because ED providers view them as drug seeking. The majority of patients with SCD are African-American and may be low income, uninsured, or on Medicaid. As a result, these demographics make ED under-treatment of pain in patients with SCD a health equity issue. This was a pre-experimental one …

The Effects Of A Violence Assessment Checklist On The Incidence Of Violence For Emergency Department Nurses, Sarah Knapp

Evidence-Based Practice Project Reports

Workplace violence (WV) is commonplace in American culture, and nurses working in emergency departments (ED) are not immune to its effects. Violence against emergency department nurses is prominent in current nursing literature, and a cause for major concern. Regrettably there is no consistent tool being used to assess for potential patient violence specific to the emergency department. Current assessment tools have been developed and are commonly used in the mental health arena. This evidence-based practice project concentrated on answering the clinical question of whether or not a violence risk assessment checklist reduced the incidence of violence and increased perception of …

Nurses’ Perceptions Of Sustainability Of Magnet® Efforts, Heather Vartanian, Kathleen Bobay, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Magnet® designation and redesignation efforts are time and resource intensive. The results of a survey of nurses’ perceptions about 4 components of sustainability indicate differences between Magnet and non-Magnet hospitals. Evaluating nurses’ perception of the sustainability of Magnet efforts will help nurse executives determine where to commit financial, time, and human resources.

Development Of A Lateral Workplace Incivility Nurse Liaison Position In The Psychiatric Healthcare Setting, Christopher L. Brown

Nursing Theses and Capstone Projects

Workplace incivility is becoming commonplace in all work environments including health care. Research highlights the dangerous, distressing, and costly side effects of lateral workplace incivility (LWPI) including nursing staff's overall health, organizational commitment, and intent to stay. Historically, organizations have been considered safe work environments but LWPI has increased over the last several decades. There has also been limited research related to LWPI as it affects psychiatric healthcare staff and no study recommending a needs assessment or developing a position to educate and assist victims. The purpose of this project was to assess psychiatric healthcare staff's understanding and exposure to …

Nurses' Perceptions Of Shared Medical Appointments, Kristin Monza

Nursing Theses and Capstone Projects

With the increased economic burdens placed on Americans in recent years, the topic of healthcare has been in the forefront. As healthcare reform embraces the country, healthcare organizations are forced to re-examine their business structure more accurately to reflect the changing culture and patient population. The Shared Medical Appointment (SMA) is a model in the chronic disease setting, and many of the benefits and proficiencies have been studied but no studies have assessed nurse experiences or perceptions of SMAs. The purpose of this study was to determine the Registered Nurses's experience with and perception of SMAs. A descriptive exploratory design …

A Pilot Intervention To Engage Nurses To Lead Transformation Of The Workplace, Molly Patton

Theses and Dissertations

The often toxic work environment in which nurses practice contributes to decreased well-being, job dissatisfaction, and poor retention rates, while negatively impacting quality and patient safety. Most leadership programs and resources target nurses in formal leadership positions and are exclusive of the bedside nurse. The purpose of this research utilization project was to determine immediate and short-term outcomes of an educational leadership workshop for nurses, including intent to change the work environment and subsequent action to change the work environment. The goal was to develop, deliver, and evaluate an evidence-based educational intervention to empower nurses at all levels of care …

Examining Generational Differences Across Organizational Factors That Relate To Turnover, Kimberly Asuncion

All Graduate Theses, Dissertations, and Other Capstone Projects

Turnover continues to pose a problem for all organizations across industries. This study examines the complex nature of turnover, by examining the relationship of turnover intentions with perceptions of distributive justice, procedural justice, growth opportunities, and recognition across age groups. Age groups will be used as a proxy for generational cohort membership. Results of the study confirm previous research that generational differences do exist; however, those differences are fairly small. Perceptions of distributive justice, procedural justice, growth opportunities, and recognition were found to be significant predictors of turnover intentions regardless of the age group.

Evaluating Discharge Readiness Of Patients At A Primary Stroke Center, Amanda Green

DNP Projects

The diagnosis of stroke is very prevalent in healthcare and it is estimated that someone in the United States suffers from a stroke every 40 seconds (Lloyd-Jones et al., 2009). In order to optimally prepare these patients for discharge and improve patient outcomes, it is important to understand the needs of the patient and caregiver and to meet these needs. In order to evaluate this, the focus of this project was to evaluate the discharge readiness of patients at a primary stroke center. “Discharge Needs of the Stroke Patient and Caregiver” focuses on a review of the literature in order …

The Role Of Internal Communication And The Effect On Employee Engagement, Cherie Gaither

Graduate Theses, Dissertations, and Capstones

The purpose of this project was to build and evaluate internal communication interventions that would enhance employee engagement. The desired outcome of the communication team’s efforts was to show a significant increase in employee engagement, as compared to peer institutions.

Implementation Of Shared Governance, Sheryl Glasscock

Graduate Theses, Dissertations, and Capstones

Implementation of shared governance in any facility presents challenges for leadership as well as the nursing staff. The implementation of shared governance for this organization yielded positive results operationally, and for the development of nursing overall.

Evaluation Of The Clinical Integration Model For Hospital Care Delivery, Cheryl Mckay

Nursing Theses and Dissertations

Purpose: Two studies were used to evaluate whether introduction of the Clinical Integration Model (CIM) would decrease cost, length of stay (LOS), and mortality in two populations: a psychiatric in-patient population and congestive heart failure (CHF) patients. Objectives: 1. Evaluate reliability and validity of a process tool, the CareGraph, essential in the CIM. 2. Determine if there is a difference for LOS and cost between patients receiving care in the CIM and those receiving care in a traditional primary care delivery model in a psychiatric population; compare the same parameters as well as survival in the CHF population. Methods: Reliability …

Improving Outcomes Of Acute Coronary Syndrome Patients Through Disease Specific Care Certification, Terri Ginn Lemon

Doctoral Projects

Cardiovascular disease remains the number one killer of Americans, accounting for over 800,000 deaths in 2008. Improving a hospital’s performance by obtaining and maintaining The Joint Commission Disease-Specific Care Certification is one method of impacting acute coronary syndrome patient outcomes. The purpose of this capstone project was to provide consultation services to ready the cardiology division of a large community hospital in south Mississippi for the process of obtaining Joint Commission Disease-Specific Care Certification in the area of acute coronary syndrome. The activities of the consultation included facilitating an examination of the current organization of ACS patient care; reviewing core …

The Use Of Provider Audit And Feedback On Improving Hypertension Control In The Type 2 Diabetic Population, Kara Painton

Evidence-Based Practice Project Reports

As the seventh leading cause of death, diabetes affects more than 25 million Americans and contributes to major cardiovascular diseases and complications (CDC, 2011). The cost of care for these Americans is astounding: $174 billion dollars was spent on diabetes care in 2007 (ADA, 2011). Furthermore, an estimated 75% of patients with type 2 diabetes have concomitant hypertension, and nearly one-half of these patients have uncontrolled hypertension (Thomas & Kodack, 2011; USDHHS, 2011). An initial chart audit at an outpatient, rural clinic in east central Illinois revealed that 90% of the type 2 diabetic population had concomitant hypertension, and only …

The Use Of Positive Deviance To Deliver Patient-Centered Care, Jodie Gary

Nursing Theses and Dissertations

What happens when critical care nurses find themselves in situations where patient care needs are not covered by practice guidelines or standard orders or when the needs conflict with those guidelines and orders? Sometimes usual practices such as call the supervisor, call the physician, or follow the protocol just do not meet the needs of the patient at the exact time and place. Experienced critical care nurses often discuss such situations in private; however, there is little information in the literature about the types of situations encountered and the decision- making processes used in these situations. Those discussions that were …

The Effect Of Heart Failure Education On Intermediate Care Unit Nursing Staff's Knowledge Of Heart Failure, Self-Care, And Best Practice Guidelines, Carol Budgin

Evidence-Based Practice Project Reports

Heart failure (HF) is a chronic disease affecting nearly six million people in the United States with an annual cost of nearly 33 billion dollars. If nurses are inadequately prepared to care for and/or educate patients with HF, evidence-based (EB) nursing care will be suboptimal and hospital readmission rates with the subsequent increased costs for care will continue to soar. To address their higher-than-national average HF readmission rates, an EB nursing project was implemented at a local, urban community hospital to assess intermediate care unit (IMCU) nursing staff’s knowledge of HF, selfcare, and best practice guidelines. The Rossworm & Larrabee …

Nurse Manager Transformational Leadership Practices And Patient Outcomes Among Magnet And Non-Magnet Hospitals, Bridgett Byrd Sellars Phd, Msn, Ma, Rn

Dissertations

In 2004 the Institute Of Medicine called for healthcare leaders to embrace and adopt transformational leadership practices to promote quality of care and favorable patient outcomes. Nurse managers are accountable for 24-hour operations of their departments and influence patient outcomes. The purpose of this research was to examine the relationships among nurse manager transformational leadership practices, patient outcomes and hospital types (Magnet, On The Journey, and Non-Magnet). A correlational study examined relationships between self-reported transformational leadership practices of nurse managers and patient outcomes by hospital types. The study was conducted using a purposive sample of Association of California Nurse Leader …

General Education Requirements In A Community College Baccalaureate Rn-To-Bsn Program, Jason Bentley Krupp

Educational Leadership & Workforce Development Theses & Dissertations

Increasing demand for nurses with bachelor degrees, the growing culture of accountability in higher education, and the community college baccalaureate phenomena provided the impetus for this study. This ex-post facto quantitative study examined the graduation rates and time to degree of 240 students who were enrolled in a bachelor of science in nursing (BSN) program at a community college in Florida between Fall of 2002 and Spring of 2004. The general education course enrollment patterns of the students were analyzed to determine if they impacted student graduation rates and time to degree. Graduation rates and time to degree of students …

Staff Nurse Perception Of Leadership Styles Among Nurse Managers, Robert A. Jaffe

Nursing Theses and Capstone Projects

This project examined if transformational nurse managers were perceived by their nursing staff as more effective leaders than transactional or passive/avoidant leaders using the Transformational Theory of Leadership through administration of the Multifactor Leadership Questionnaire (Form 5X) to nurse unit managers and staff nurses. 80 staff nurses and seven unit nurse managers participated in the study. Unit nurse managers completed the MLQ (Form 5X) about themselves and nursing staff completed the MLQ (Form 5X) about their unit nurse manager. Using descriptive statistics unit nurse manager results were compared with nursing staff results. The goal was for unit nurse managers to …

The Effect Of Education On Evidence-Based Practice And Nurses' Beliefs/Attitudes Toward And Intent To Use Evidence-Based Practice, Steve Mooney

Nursing Theses and Capstone Projects

Purpose: Does tradition or "we have always done it this way" provide for safe, confident care? The care nurses provide should be based on evidence. Many barriers to evidence-based practice (EBP) exist. Nurses' lack of knowledge about EBP and nurses' beliefs/attitudes toward and implementation of EBP need to be addressed. Hospital administration and nursing staff must be aware of current practice guidelines. Awareness of the need for EBP demands a process/action to change practice habits. The rewards of implementing EBP should motivate a transformation leading to adaptation of EBP care. The research question this project proposed to answer was: Will …

Barriers To Timely Administration Of Thrombolytics In Acute Ischemic Stroke Patients, Elizabeth Joseph

Electronic Theses and Dissertations

Stroke is a leading cause of long term disability in the United States. The therapeutic benefits of intravenous thrombolytics is time dependent in an acute ischemic stroke patient and is an important determinant of 90 day and one year functional outcomes. This study investigated areas in the stroke alert process of a community based primary stroke care center that resulted in the delay of administration of thrombolytics within 60 minutes of an acute ischemic stroke patient's arrival to the emergency room. A retrospective descriptive design was utilized and chart reviews were done on 40 patients that received thrombolytics in the …

Tobacco Treatment In College Health, Joanne Brown

DNP Projects

ABSTRACT: Tobacco Treatment in College Health

The college years are a critical time in the development of smoking behavior and tobacco use. Smoking is linked to 30% of cancer deaths, 80% of deaths from chronic obstructive pulmonary disease and early cardiovascular disease and death. Effective treatment interventions at this time provide an opportunity to drastically reduce premature morbidity and mortality.

This document follows the progression from the discussion of the problem to evaluation of an intervention. The first manuscript is a review of existing literature on Internet interventions with young adults, including methodology, theoretical frameworks and outcome measures for tobacco …

A Bridge To One World: An Indigenous Wisdom-Based Approach To Designing A Transcultural Patient Family Advisory Council, Julie Lundberg

Theses and Graduate Projects

As health care organizations face increasing challenges to accommodate diverse patient populations amid growing concerns of persistent health disparities, there is urgent need to better understand and listen to diverse, unique patient experiences. This paper describes the design and implementation of a transcultural Patient Family Advisory Council (PFAC) as a concrete step towards ensuring that the voices of culturally diverse patients and families are effectively engaged to improve the patient experience at a large, Midwestern healthcare organization. Storytelling, ritual and dialogue provide a wisdom-based approach to the design of a Bridge to One World practice model grounded in Leininger's Culture …