Digital Commons Network^™

Adapting To Change: Adn Faculty Perspectives About The Future Of Adn Education: A Qualitative Case Study, Linda D. John

Doctoral Dissertations and Projects

The purpose of this qualitative, single case study was to offer more insight into how the adoption of the BSN as the entry-level for nursing practice affects the future ADN education and what the change means for ADN faculty at multiple programs throughout regions of the United States. Eleven ADN faculty were sampled to acquire their perspective about this phenomenon. Semi-structured, open-ended interviews enabled data collection. Rogers’ diffusion of innovation theory (DIT) facilitated an understanding about how ADN faculty are responding and adapting to the anticipated educational change. The central research question asked, “What is the perspective of ADN faculty …

Enhancing Pain Documentation In Medical Surgical Units: Integrating Supportive Tools With Pain Nursing Education, Mariana Arias

Master's Projects and Capstones

Problem: Pain management in in-patient care, particularly involving opioids, is critical due to the associated risks. Proper pain assessment is essential to ensure safe medication administration and mitigate adverse effects.

Context: This quality improvement (QI) project aimed to improve opioid assessment and documentation rate above 90% compliance in two medical-surgical units, focusing on bedside nurses who play a crucial role in patient safety and effective pain management.

Interventions: A baseline survey provided nurses' understanding on compliance criteria and assessment timing. Interventions included visual reminders, informational posters, and instructions on how to access individual compliance reports.

Measures: A post intervention survey …

Increasing Awareness And Communication To Decrease Catheter Days In The Surgical Intensive Care Unit, Kamila Fortney

Master's Projects and Capstones

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Determining The Impact Of Mindfulness Activities To Increase Joy In Work And Decrease Burnout: An Integrative Review, Kimberly Gleason Bogart

Doctoral Dissertations and Projects

This integrative review aims to evaluate whether mindfulness effectively increases joy in work and decreases nursing burnout. A lack of joy leads to feelings of burnout and negatively affects nurses and their desire to leave the profession. Nursing is often accompanied by intense emotional and physical demands that can lead to job dissatisfaction, anxiety, and stress. Burnout diminishes the quality of care and negatively impacts nurses’ well-being. This integrative review aims to explore mindfulness interventions to increase joy within nursing and potentially alleviate burnout. Drawing upon existing literature, this paper examines various mindfulness interventions and factors contributing to burnout among …

Reducing Delirium In Post-Surgical Patients Through Pre-Operative Risk Assessment Screening: A Policy Option, Skye Porter Berg Msn, Fnp

Doctor of Nursing Practice Final Manuscripts

One of the major complications and reasons for prolonged stay amongst patients who undergo surgery is related to the occurrence of hospital associated delirium. Unfamiliar environment, previous comorbidities, age and anesthesia can alter and affect cognitive status in the general population. While there is substantial evidence previously listing high risk patients through demographics as well as prior medical history, this study collectively gathers information based upon prior evidence-based practice data to determine the benefit of prescreening patients through use of a predictive indicator tool. Based on the literature review and inclusion data gathered from fifty patients undergoing surgery, it was …

The Lived Experiences Of High-Performing Black Male Students With Advanced Placement Courses, Griselda Almonte-Delgado

Seton Hall University Dissertations and Theses (ETDs)

Black male students are underrepresented in Advanced Placement (AP) courses. Studies on the perspective and experiences of high performing Black male students with Advanced Placement (AP) is limited. Available research indicates that high performing Black students are enrolled at half the rate of White students both nationally and locally in Advanced Placement (AP) courses (Dept. Of Civil Rights, 2021). Research uncovers multifaceted factors influencing enrollment, ranging from personal motivation to systemic barriers. To qualitatively address this dissonance, this research used Attribution Theory as its framework to examine the lived experiences and perceptions of eight high performing Black male students from …

The Impact Of Electronic Health Record Unintended Consequences On Quality Of Care Within A High Complexity Healthcare Organization, Joetta Powell

ATU Theses and Dissertations 2021 - Present

“Unintended consequences are unexpected, and unwanted outcomes that can limit the value of EHR implementation and adversely affect quality of care and patient safety” (Lee & Kang, 2021, p. 898). Few organizations have redesigned the EHR to improve usability to mitigate potential patient safety concerns. This study aims to identify unintended consequences in patient care workflows and determine educational needs related to EHR usability. A mixed method approach was used to investigate unintended consequences in deidentified patient safety reports submitted Jan 1, 2020, through December 31, 2023. The data was analyzed to identify error types and educational deficits. The Acute …

Promoting The Incorporation Of Regional Anesthesia To Improve Pain Management For Lower Extremity Surgeries, Kendra Knaga

Doctor of Nursing Practice Projects

Opioid addiction in the United States is a healthcare crisis and continues to increase yearly. Multimodal pain management is a priority intervention that needs to be implemented to manage pain with less intra and postoperative opioid use. Peripheral nerve blocks are one alternative that can be used to decrease opioid use and assist in controlling pain for foot and ankle surgeries. This project aims to educate, develop, and create a protocol for popliteal nerve blocks at Hillsboro Area Hospital in Hillsboro, Illinois. As a result, the long-term goal is to reduce opioid administration and improve pain control. An educational PowerPoint …

On Solid Ground: A Quality Improvement For Fall Prevention, Jessica Vergara

Cohort XII

Background/Problem Statement: Falls among older adults are a significant concern, affecting up to 30% of individuals aged 65 and older annually. Multiple risk factors contribute to falls, including age, comorbidities, medications, and environmental hazards. Despite the common belief that falls are inevitable with aging, this project emphasizes the preventability of falls through multidisciplinary management and proactive engagement in fall prevention programs.

Aims/Methods: The initiative focuses on implementing the Matter of Balance (MoB) program within an institutional setting. MoB has shown favorable effects on fall-related concerns. The study employs a comprehensive outreach strategy targeting older adults at risk of falling, those …

Internationally Educated Nurse Onboarding Program Evaluation Toolkit, Kolton Jacobson

Nursing Capstones

A large rural healthcare system has onboarded over 200 internationally educated nurses (IENs) and needed to develop an evaluation method to determine longitudinal program outcomes. This project’s purpose was to develop an evaluation toolkit to be utilized by this health system to evaluate and support overall program outcomes. The Casey-Fink Graduate Nurse Experience Survey was identified through a literature review to be utilized within the toolkit to evaluate program outcomes. Utilizing a descriptive evaluation research design with post-survey, expert opinions were collected from 20 IEN clinical educators at this health system about their expected use and effectiveness of the toolkit …

Impact Of Housing On Mentally Ill Unhoused Veterans’ Readmissions To Veterans Affairs (Va) Inpatient Psychiatric Services, Maryse-Noelle Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Unhouseness, also known as homelessness, coupled with mental illness, causes health problems for some veterans; financial difficulties, unemployment, and lack of affordable housing are factors contributing to veteran unhouseness (Tsai & Rosenheck, 2015). Approximately nine percent of the entire unhoused population in the United States are veterans (United States Interagency Council on Homelessness, 2020). Unhoused veterans experience negative health outcomes impacted by environmental and socioeconomic harshness, which are also factors of subsequent psychiatric hospital readmissions (Mascayano et al., 2022). The average cost per United States Veterans Affairs (VA) hospitalization was $30,282 in FY 2019 and $40,763 in FY 2020 (Wagner, …

Video Monitoring For Fall Prevention, Atongane Taku

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient safety is a vital aspect of healthcare. Falls and fall-related injuries continue to occur in hospitals worldwide and fall prevention is one of the top priorities in providing quality care. Fall assessment tools, bed alarms, patient rounding, patient education, physical restraints, environmental modification, bedside sitters, and remote video monitoring are some of the methods implemented to reduce falls. This project was a quasi-experimental study informed by Kotter and Cohen Model of Change. The initial purpose of this process improvement project was to educate staff on the significance of video monitoring in fall prevention and determine whether the education regarding …

Adaptive Leadership: Nurse Executives Building Organizational Adaptive Capacity During Times Of Crisis, Challenge, And Change, Kristian Poitier

Dissertations

Purpose: The purpose of this exploratory phenomenological study was to identify and describe the strategies used by nurse executives in acute care hospitals to build an adaptive capacity based on the five key characteristics of adaptive leadership identified by Heifetz et al. (2009).

Methodology: This qualitative phenomenological study identified and described the perceived impact of adaptive leadership on building an organization’s adaptive capacity as perceived by nurse executives in acute care hospitals, for-profit and not-for-profit, with the title of chief nursing officer (CNO) or chief nurse executive (CNE) in Southeast, West, and North Florida. The researcher was part of a …

An Exploration Of The Lived Experience Of Novice Adjunct Nursing Faculty As They Transition From Clinical Expert To Novice Educator, Angelique Tolentino-Martin

Doctoral Dissertations and Projects

This transcendental phenomenological study aimed to describe and understand the lived experiences of novice adjunct nursing faculty teaching in the United States in undergraduate nursing programs as they transition from clinical practice to academia. The theories that guided this study are Meleis’ transition theory and Schoening’s nurse educator transition model which provide a framework for the transition experiences for novice adjunct nursing faculty. The central research question is: What are the lived experiences of novice undergraduate adjunct nursing faculty transitioning from clinical expert to novice nurse faculty? Purposive sampling and snowball sampling were used to recruit participants who were novice …

Clinician Education Program: Promoting The Use Of Care Bundles In Reducing The Hospital Length Of Stay And Readmission Rates Of Adult Copd Patients, Nordita R. Bascon

MSN Capstone Projects

Management of COPD patients can cost hospitals approximately $308,502 per month. This is based on a single COPD readmission encounter costing $7,500 and estimated daily expenses of $2,883 (Davis, 2023; Hegwer, 2018). This executive summary outlines a clinician education program held at a community hospital in West Texas to promote patient quality care by encouraging healthcare professionals to use evidence-based chronic obstructive pulmonary disease (COPD) care bundles. Eighteen physicians and nurse practitioners attended the program. Then, a survey was conducted to assess the impact of the proposed program. Most attendees said they would incorporate care bundles in COPD care.

Internal …

Investigating The Impact Of Outpatient Mental Health Follow-Up Care On Continued Adolescent Suicidality: An Evidence-Based Change Project Proposal, Kimberly Feifel

MSN Capstone Projects

The escalating rates of adolescent suicide globally, coupled with the surge in pediatric hospitalization rates, underscore the urgent need for effective intervention strategies. Despite hospitalization, many patients persist in experiencing suicidal ideation and behaviors, often leading to readmissions. A significant portion of these individuals do not receive adequate outpatient mental health follow-up care post-discharge. As a leading pediatric healthcare institution committed to delivering exemplary care, particularly to those struggling with mental health challenges, the organization’s commitment demands proactive measures.

The attached proposal aims to establish an organizational policy to reduce 30-day readmission rates among adolescents with persistent suicidal thoughts and …

Optimizing Digital Proficiency To Improve Perceived Self-Efficacy In Telehealth Nurses, Serena Young

Doctor of Nursing Practice Projects

The use of telehealth to provide care management services has increased as healthcare continues to evolve. Seven million Americans were predicted to use telehealth in 2020, which increased to over 35 million through the pandemic. These services have been shown to decrease healthcare disparities and promote positive health outcomes. Education and training for nurses providing telehealth services have not kept up with the increased demand. Nurses providing care management telehealth services in a large tertiary health system have low perceived self-efficacy for technology. Leaders in the organization believe this is causing a lack of digital proficiency in their workforce. This …

Diabetic Coaching Program To Improve African American Patients Glycemic Control, Shonda Moore

Student Scholarly Projects

Practice Problem: The purpose of the practice problem was to find out if, among African Americans with type II diabetes who are over 18, adopting a diabetic coaching program that emphasizes diet management can result in better glycemic control over 10 weeks than for those who do not receive coaching.

PICOT: In African Americans with type II diabetes over 18 years of age (P), does a diabetic coaching program on diet management (I), compared to no coaching program (C), improve glycemic control (O) over 10 weeks (T)?

Evidence: The evidence used to guide this project came from databases, including PubMed, …

Implementing Hourly Rounding In Reducing The Rate Of Falls Among Older Adults In Long-Term Care Facilities, Alfred Amaechi

DNP Projects

Background

Falls are events with a resultant effect of an individual accidentally or unintentionally coming to rest on the floor, ground, or other lower level; also, injuries sustained from falls may be fatal or non-fatal depending on the severity of the fall (World Health Organization [WHO], 2021). Falls are the second leading cause of unintentional injury deaths globally; each year, an estimated 684 000 individuals die from falls globally, of which over 80% are in low- and middle-income countries; adults older than 60 years of age suffer the greatest number of fatal falls, and 37.3 million falls that are severe …

Implementation Of A Standardized Handoff Reference Tool From The Intensive Care Unit To The Operating Room, Sophia Agbomah, Stacie Summers

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: This quality improvement (QI) intervention evaluated the effectiveness of a standardized handoff reference tool for patients transferring from the Surgical Intensive Care Unit (SICU) to the operating room (OR) in a large metropolitan level I trauma center. There was minimal data to assess the quality of this sequence of patient transfer as no systematic ICU-OR handoff content practices were currently employed at the hospital. This project aimed to help fill the practice-knowledge gap that could impact some of the most vulnerable patients during ICU-OR transfer. Methods: Pre- and post-implementation staff surveys, live observations, and chart …

Uncontrolled Asthma In Pediatrics, Lydia M. Chapa-Wilson

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Asthma tends to be underdiagnosed and undertreated. Several studies concluded that asthma was poorly managed among pediatric care providers. To address the patient/problem, intervention, comparison, outcome, and setting (PICOTS) question: Among the pediatric providers at a primary care clinic in an urban Texas city, what was the effect of administering asthma control tests (ACT/C-ACT) on modifying the care plan of pediatric patients diagnosed with uncontrolled asthma? The purpose of this evidence-based practice (EBP) project was to evaluate the association between the test scores and the provider’s decision whether to change the patient’s care plan, and ultimately to bring the clinic …

Combating The Opioid Crisis: Opioid And Naloxone Training In A Rural School District, Phadra K. Murray

Doctor of Nursing Practice Projects

Background: The opioid epidemic is plaguing North Carolina and has crept its way into the academic setting of many elementary, middle, and high schools in the state, causing school nurses to scramble and search for ways to keep students safe. This DNP project was designed to educate school nurses in a rural county in eastern North Carolina about opioid education and naloxone administration. This project intended to increase the knowledge and confidence level of school nurses in case of an opioid overdose emergency within the school. As more and more children and adolescents experiment with opioids, there is an urgent …

Guideline For Sbhc Provider Education To Start The Hpv Vaccine At Nine Years Old, Jasmine K. Serrano

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

It is estimated that 80% of people worldwide, regardless of gender, will contract human papillomavirus (HPV) at some point in their lives. The HPV vaccine series prevents high-risk strains that are known to cause cancer and genital warts (Osaghae et al., 2022). School-based health clinics (SBHC) can increase access to and completion of the HPV vaccine series, which remains low throughout the United States (Javaid et al., 2017; Rane et al., 2021; Shah et al., 2020). This guideline was created to increase SBH provider education to start the HPV vaccine at nine years old. The project lead conducted a systematic …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Lncreasing Clinical Judgment And Critical Thinking Skills Using The Ncsbn Clinical Judgment Measurement Model In Licensed Nursing, Kathryn Roberts

Doctor of Nursing Practice Projects

Licensed nurses are having problems with critical thinking and using clinical judgment when caring for patients (Rogers & Franklin, 2023). There has been increased emphasis on critical thinking and clinical judgment in nursing school curriculum but not in hospital/orientation curriculum (Dickison et al., 2019). This quality improvement project aims to address the gaps in critical thinking and clinical judgment skills among licensed nurses by focusing on integrating the NCSBN-CJM, and cues into the prebriefing of the Respiratory Distress/Oversedation Scenario within the project hospital orientation program. The project utilized a quasi-experimental study design to investigate the cause-and-effect relationship by integrating the …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care Using A Collaborative Care Model, Christina Stephens

DNP Scholarly Projects

Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in …

Using The 4ms Framework To Prevent Falls, Gina L. Edgeworth

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Hospital falls are rising in inpatient facilities, requiring analysis and a plan of action to address the ongoing falls. A strategy taken among facilities is implementing a 4Ms Framework that allows the nurse to address what matters to the patient and assess their mentation, medications, and mobility upon admission. With an increase in falls on a med-surg unit, it was found that there was no straightforward process for addressing the needs and concerns of patients and no assessment of medications, mobility, or mentation for those aged 65 years and older. This knowledge gap prevents nurses from providing a structured framework …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Impact Of A Discharge Bundle On Boarding Hours In Acute Care Hospitals, Monica L. Herrera

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The national epidemic of boarding hours in the emergency departments prompted the implementation of a discharge bundle in an acute care hospital. This bundle included an ADT nurse, discharge orders written prior to 11AM, and EVS shifting employee hours. Initial findings indicated a reduction in boarding time by 126 minutes.

Clinical Practice Guideline For The Management Of Depression In Primary Care, Estrella Catherine Villarreal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: The prevalence of depression poses a significant challenge in primary care, emphasizing the urgent need to address this issue during patient visits. Primary care providers are at the forefront of managing depression, yet they encounter difficulties in screening, diagnosing, assessing, and treating this complex condition. Clinical guidelines serve as valuable tools for primary care providers and practices, offering support in identifying and addressing depression effectively. An evidence-based approach to treating depression in primary care, with a focus on collaborative interventions with behavioral health to enhance depression management for American Indian/Alaskan Native (AI/AN) communities.

Methods: The descriptive analysis was conducted …