Guideline To Decrease Nursing Turnover In Intensive Care Units, Carol L. Mention

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Turnover rates of registered nurses working in intensive care units continue to increase significantly after the pandemic. Many nurses have left the profession due to the increased workload and stress during and after the COVID-19 pandemic. Having staffing challenges and turnover can affect the outcome of this patient population. Intensive care nurses experience workplace violence at an increasing volume. Also, robust nurse onboarding and training programs can help decrease turnover rates. The current national guideline does not address these concerns about nursing turnover. A guideline project was performed to identify needed recommendations based on evidence for stakeholders to …

Bundle For Left Ventricular Assist Device (Lvad) In The Ed, Tina Morris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose

Left Ventricular Assist Device (LVAD) is a high-risk, low-volume patient population with admission rates of up to 72%. The purpose of this study was to provide a care bundle to increase the knowledge of the emergency department (ED) staff and decrease the door to consult times to the advanced heart failure (AHF) team for LVAD patients presenting to the ED at a level I trauma center in Texas.

Methods

In collaboration with emergency clinical staff, the project team implemented a bundle that included a pathway for the LVAD patients upon presentation to the ED, targeted education for clinical staff …

Developing Toolkit For Adults With Autism Spectrum Disorder In An Oncology Outpatient Clinic, Brittany J. Johnson Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Autistic adults are at higher risk of being diagnosed with co-occurring health conditions, and yet they are a vulnerable group for disparities in access and outcomes. One of the key barriers to better outcomes is poor patient-provider communication. This study the use of AASPIRE’s AHAT communication toolkit as a channel between healthcare workers and autistic adults to facilitate their appointments within the outpatient oncology department, as well as assessing healthcare providers’ knowledge and self-efficacy in caring for the patients. Sixteen healthcare providers (12 registered nurses and four patient care assistants) completed pre and post intervention surveys and utilized the AHAT …

Improving Empathy With Simulation: A Quality Improvement Project, Jami Layne

Doctor of Nursing Practice Projects

This study examines the effectiveness of simulation-based training in enhancing empathy levels among undergraduate nursing students. A lack of empathy can negatively impact the healthcare outcomes of patients (Levett-Jones et al., 2019). Improving the empathy levels of nursing students can improve patient outcomes and impact student learning outcomes such as the student’s ability to think critically and improve communication and social skills (Chua et al., 2021; Ferri et al., 2017; Hakansson Eklund et al., 2019; Koukourikos et al., 2021). The purpose of the quality improvement project was to improve empathy levels in undergraduate associate degree nursing students and increase the …

Harnessing The Power Of Complementarity Between Smart Tracking Technology And Associated Health Information Technologies: Longitudinal Study, Youyou Tao, Ruilin Zhu, Dezhi Wu

Publications

Background: Smart tracking technology (STT) that was applied for clinical use has the potential to reduce 30-day all-cause readmission risk through streamlining clinical workflows with improved accuracy, mobility, and efficiency. However, previously published literature has inadequately addressed the joint effects of STT for clinical use and its complementary health ITs (HITs) in this context. Furthermore, while previous studies have discussed the symbiotic and pooled complementarity effects among different HITs, there is a lack of evidence-based research specifically examining the complementarity effects between STT for clinical use and other relevant HITs. Objective: Through a complementarity theory lens, this study aims to …

Improving Nutrition Screening Practice In The Hospitalized Heart Failure Patient Population, Amanda J. Bourgeois

DNP Projects

Background: Heart Failure is a disease known to affect nearly 6.5 million adults in the United States. Characterized by recurrent hospitalizations, heart failure significantly contributes to morbidity, mortality, and healthcare costs in the United States and worldwide. Because malnutrition is prevalent in the heart failure population, healthcare providers must perform nutritional assessments on admission to intervene in the case of malnutrition, prevent deterioration, and improve patient prognosis. Without intervention and early identification of malnutrition, heart failure hospitalizations will remain a significant problem.

Purpose: The purpose of this study is to evaluate the effect of an evidence-based educational program for cardiac …

An Educational Intervention On Provider Knowledge Of Hypertension Guidelines And Home Blood Pressure Monitoring, Alison Claire Oesterritter

DNP Projects

Background: While hypertension is the leading preventable risk factor for cardiovascular disease, disease control remains suboptimal. In the U.S., 47% of adults have hypertension, but only 25% are controlled. Despite having quality evidence-based guidelines, many recommendations are not implemented due to clinical inertia, or the tendency to not change therapy when targets aren’t met. Research has shown that this can be overcome with educational programs. Purpose: To provide training on hypertension guidelines and home blood pressure monitoring (HBPM) to overcome clinical inertia and improve patient outcomes related to hypertension. Methods: The project was a quasi-experimental, pre- and post- …

The Clinical Inquiry Process Diagram (V. 5), Roy E. Brown

VCU Libraries Faculty and Staff Publications

This updated edition of The Clinical Inquiry Process Diagram improves on the 2023 version. It provides a depiction of the steps involved in the clinical inquiry process, covering research, performance improvement, and evidence-based practice. The revisions in this version emphasize the importance of alerting users to the iterative nature of clinical inquiry and the ongoing need to assess the situation or patient based on evolving evidence. It's crucial to recognize that the clinical inquiry process does not follow a linear, sequential progression. Instead, individuals may find themselves concurrently addressing different aspects of the process or revisiting prior steps as they …

Standardizing Nasogastric Tube Securement: A Quality Improvement Initiative, Shannon Lee Thompkins

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: At a large academic medical center located in the northeastern United States, nasogastric tubes (NGT) were traditionally secured with tape. The institutional policy was nonspecific with no written procedure. The inconsistent use of nasal bridle securement devices (NBSD) and predominant use of tape has the potential to lead to a high rate of NGT dislodgement.

Background: NGT complication and dislodgement rates range from 2%-36% (Gimenes et al., 2019). Stabler et al. (2018) report 29%-63% NGT dislodgement rates in critically ill patients. Patients with intracranial hemorrhage dislodge NGTs in 25% of patients (Rahman et al., 2022)

Available Knowledge: Based on …

Relationships Among The Concepts Of Organizational Theory And Nurse Burnout Before And After Covid-19, Bridget M. Webb

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Nurse burnout is a global health priority that has been compounded by Coronavirus 2019 (COVID-19). Organizational theory states that nurse burnout is directly impacted by operant mechanisms (nurse characteristics, nurse specialization) and hospital-wide models. The purpose of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination), operant mechanisms (nurse characteristics, nurse specialization), and outcomes (nurse burnout) before and after COVID-19.

Research Question: The specific aim of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination) and operant mechanisms (nurse …

Relationships Between Nursing Students’ Attitudes Toward The Nursing Profession, Fear Of Covid-19, And Intolerance Of Uncertainty: A Cross-Sectional Study, Banu Terzi, Fatma Azizoğlu, Çağla Seven

Makara Journal of Health Research

Background: Nursing students were caught unprepared for the COVID-19 pandemic. Both the inability to control the epidemic and the interruption of education caused students to experience fear, anxiety, and uncertainty. This study investigates the relationships between nursing students’ attitudes toward the nursing profession and their fear of COVID-19 and intolerance of uncertainty.

Methods: This cross-sectional study included 727 nursing students who were members of the Student Nurses Association and who volunteered to participate in the research. Research data were collected using the Student Information Form, The Fear of COVID-19 Scale, the Intolerance of Uncertainty Scale (IUS-12), and the …

Mentoring Nurses After Specialty Training Or Orientation In Labor And Delivery, Benjamin Jlopleh Worji

Master's Projects and Capstones

Mentoring Nurses After Specialty Training or Orientation in Labor and Delivery

Abstract

Background: The setting for this project was a northern California hospital-based healthcare system referred to as “Hospital KV.” Hospital KV is a non-profit, integrated hospital that operates to improve the community’s health. Hospital KV’s maternal child health (MCH) department comprises a labor and delivery(L&D) unit, a mother and baby unit (MBU), also referred to as a postpartum unit, and an intermediate nursery (IMN).

Problem: The hospital KV MCH department faced the challenge of a nursing shortage. The nursing shortage was associated with substantial challenges to Hospital KV, its …

Conflict Resolution In Healthcare: The Vital Role Of Developing Conflict Management Skills Among Nurse Leaders, Kris Maddalena

Doctor of Nursing Practice Projects

Nurse leaders at the unit level play a vital and indispensable role in acute care settings. Their influence extends beyond administrative tasks, as they significantly impact crucial factors such as nurse retention rates, patient outcomes, and the overall work environment of the unit-level teams. Effective unit-level leadership has been consistently associated with improved outcomes, increased job satisfaction, and decreased turnover among nurses (Aiken et al., 2011). This DNP project is focused on enhancing conflict management skills among unit-level nurse leaders in an acute care setting. The project followed a quality improvement sequence, which included obtaining a needs assessment for unit-level …

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …

Block Charting For Hemodynamic Unstable Patients, Tasha Walker

Student Scholarly Projects

Practice Problem: The intensive care unit poses many challenges for nurses. Nurses are placed in a position to decide on dosing and administration, which could conflict with their scope of practice, and documentation needs to coincide with orders. The accuracy of nursing documentation plays a vital role in measuring the outcomes, and failure to document accurately could result in noncompliance with scope of practice or a medication error.

PICOT: For intensive care nurses (P), how does block charting of vasoactive medications (I) compared to current documentation practices (C) affect the accuracy of nurses' documentation (O) within 4 weeks?

Evidence: Nursing …

Utilizing A Validated Screening Tool And Treatment Protocol For Managing Agitation And Violence In A Psychiatric Emergency Services Unit, Zarah Ashcroft

Doctor of Nursing Practice

Background and Significance. Agitation is a significant concern in psychiatric units. If not detected early, agitated individuals are at high risk for becoming aggressive and violent, potentially causing harm to themselves, hospital staff, and property. The Psychiatric Emergency Services unit receives agitated and violent patients with psychiatric illnesses and substance use disorders. Purpose/Goal/Objectives. This quality improvement project aimed to implement a treatment protocol using the Broset Violence Checklist (BVC) to promote the early identification and management of potential for patient violence and aggression. Methods/Key Activities. Staff education for the nurses and providers on assessing patients at risk for aggression and …

Staff Education Project To Decrease Variations In Surgical Optimizations, Shelly Bressoud

Walden Dissertations and Doctoral Studies

No abstract provided.

Transformational Leadership Training For Leaders, Kristie M. Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …

Point Of Care Testing: Best Practice Toolkit For Improving Access To Point Of Care Testing In Mobile Medicine, Michaela Gist

Student Scholarly Projects

Practice Problem: Healthcare for persons experiencing homelessness (PEH) is a complex issue. Chronic and communicable diseases are disproportionately represented within this population. Healthcare spending is 2.5 times more costly in comparison to those who have not experienced homelessness. Although mobile health clinics aim to reduce the concerns with access to care, they do not eliminate barriers if the appropriate tests are not immediately available.

PICO: In the homeless population treated in mobile medicine (P), what is the effect of point of care testing (I) on turnaround time (O) compared with outside laboratory testing (C)?

Evidence: Critical analysis of the literature …

Nurse Leader Rounding To Provide Fall Prevention Strategies, Kerri Philipbar

Student Scholarly Projects

Practice Problem: Falls while patients are hospitalized are all too common. It was identified that the 300-bed facility in Southeast Georgia had a clinical practice gap with inpatient falls. Inpatient falls cause unnecessary pain and suffering to the patient and families. In addition to the negative effects to the patients, it creates a hardship to the organization. Increased length of stay and additional testing and treatments are charged to the hospital because of a fall.

PICOT: The PICOT question for this project is as follows: In adult patients in an acute care setting (P), does nurse leader rounding to …

Evidence-Based Intervention For Decreasing Chronic Kidney Progression In Patients With Type Ii Diabetes Mellitus, Lynn M. Johnson

Student Scholarly Projects

Practice Problem: The overall management of Type II Diabetes Mellitus (DM II) and the complications that accompany along with comorbidities are debilitating and financially exhausting. The American Diabetes Association dietary recommends a consistent low-carbohydrate diet to maintain optimal blood glucose levels to prevent complications and progression of other comorbidities. Uncontrolled diabetes mellitus leads to the development of chronic kidney disease (CKD) which can lead to the progression to End Stage Renal Disease.

PICOT: In patients in the outpatient setting aged 18 years and older(P), how does the ADA dietary guidelines for patients with type II DM(I) compared with patients self-reported …

Patient Navigational Tool Increase Resource Use In A Latino Population, Kimberly Burrus

Student Scholarly Projects

Practice Problem: The practice problem is a patient navigation tool in a mobile health clinic for the Latino population to help improve utilization of resources within Daviess County, Indiana, and improve overall health literacy and health of those populations?

PICOT: The PICOT question that guided this project was: In a mobile health clinic serving Latino populations (P), does a navigation tool (I) compared to current practices (C) improve utilization of services (O) within a 12-week timeframe (T)?

Evidence: The evidence that guided this project showed patients with limited English proficiency, immigrant families have a disparity of health literacy, and an …

The Effects Of An Influenza Vaccine Education Bundle On Environmental Management Services Workers, Michelle Keister

Student Scholarly Projects

Practice Problem: Environmental Management Service Workers have low vaccination rates. They work around a vulnerable patient population.

PICOT: For Environmental Management Services (EMS) workers (P), does the use of an Influenza Vaccine Education Bundle (I) compared to the current practice (C) impact EMS worker influenza vaccine compliance (O) within a 10-week period (T)?

Evidence: Using an educational vaccine bundle that increases access to the vaccine, provides education regarding the vaccine, and comes from a trusted source will increase flu vaccination rates among Environmental Management Services workers.

Intervention: Implement a vaccine education bundle.

Outcome: After implementation in 2023, vaccination rates …

Improving Cervical Cancer Screening Rates In The Primary Care Setting, Esmeralda Young

Student Scholarly Projects

Practice Problem: Cervical cancer screening with Pap is the recommended standard practice for women aged 21 to 65. The project aimed to increase low cervical cancer screening rates at a primary care clinic.

PICOT: The PICOT question that guided this project was: (P) In women 21 to 65 years old in the primary care setting (I), does proactive pre-scheduling of cervical cancer screenings (C) compared to current standard practice (O) affect cervical cancer screening rates (T) over eight weeks?

Evidence: The evidence strongly supported improving cervical cancer screening among the targeted population. Studies showed that Pap smear screening reduced the …

Camera Assisted Monitoring Device As A Tool To Reduce Falls In Inpatient Adults: An Integrative Review, Pamela Oriaifo

Doctoral Dissertations and Projects

Background: Adult inpatient falls remain a significant challenge in many hospitals, resulting in poor quality of life and severe financial burden. There have been tremendous efforts to curb the number of falls ranging from environmental modification, clinician education, review of medications, and use of assistive devices. One such assistive device is the use of camera monitoring systems. This systemic review scopes camera/video-assisted fall prevention programs in hospitals. It was hypothesized that camera/video-assisted fall prevention programs would reduce adult inpatient fall and costs significantly. The outcomes of camera or video-assisted fall prevention programs were considered in some hospital settings. Method: The …

Implementation Of A Pcp Referral In Urgent Care For Patients With Hypertension, Teri Alesha Scott

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adult patients with uncontrolled hypertension at Saluda Pointe Urgent Care (SPUC) do not have an established primary care provider (PCP) for follow-up.

Purpose: To improve access to care by establishing patients with uncontrolled hypertension (>140/90) with a PCP.

Method: Implement a PCP referral at SPUC for patients with uncontrolled hypertension. The Primary Care Connection Center (PCCC) contacted the referred patients within 72 hours to schedule an appointment. An Organizational Change Management (OCM) Solutions survey measured provider attitude and readiness for change before and after implementation.

Inclusion Criteria: Adult patients 18 and older, without an …

Assessing Organizational Readiness For Evidence-Based Practice (Ebp) Change For The Implementation Of A Postoperative Neuropathic Mastalgia (Pnm) Scale Among General Surgery Ambulatory Practices, Jessica Terry Gonzalez

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Assessing postoperative neuropathic mastalgia (PNM) among oncology breast surgical patients is not commonly performed using a surgery specific pain scale at large South Carolina healthcare organization and is historically misdiagnosed, mismanaged, despite representing a common and significant complication (Gong et al., 2020; Humble et al., 2015; Mejdahl et al., 2019). Studies show that early identification of patients with neuropathic-specific pain following breast cancer-related surgery facilitates better pain management and patient outcomes (Pereira et al., 2017; Sipilä et al., 2012). Assessing organizational readiness to adopt Evidence-Based Practice change is recommended to facilitate the identification of potential barriers to implementation …

Evaluation Of A Revised Clinical Ladder Program In Addressing Clinical Competence And Performance, Accountability, Professional Growth, Rewards And Benefits, Job Satisfaction And Engagement, And Autonomy And Decision Making, Vaughn Hansen Msn, Rn, Ne-Bc

Doctor of Nursing Practice Projects

Background: The surge of nurses leaving the profession has increased in recent years raising concerns that unless systemwide changes are implemented this trend will increase exponentially for years to come. Healthcare organizations struggle to retain an experienced, competent nursing workforce and seek ways to keep them from leaving. A clinical ladder program is one potential method being implemented in which healthcare organizations mitigate the exodus of nurses and create a healthier work environment.

Objectives: This doctoral project aimed to measure the perceptions of how well a revised clinical ladder program influenced the nursing workforce satisfaction in the following areas: clinical …

Discrimination Against Hispanic And African American Women And Interventions To Improve Patient Outcome: An Integrative Review, Sandi Daneri Cruz Rivera

Doctoral Dissertations and Projects

Racial discrimination in health care has been a heavy topic of discussion on social media. Discrimination against women of color such as those of African American and Hispanic descent has been found to have negative health effects. The aim of this project was to identify how racial discrimination influenced African-American and Hispanic women’s health and current interventions that have been implemented to help address these issues. The findings showed that women who experienced discrimination not only in health care but in everyday life did experience negative health outcomes including cardiovascular disparities, obesity, increasing inflammatory markers, and mental health disparities. Implementations …

Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster

Electronic Theses and Dissertations

Nurse turnover is prevalent among new graduate nurses. Many new graduate nurses feel unsupported by their peers, lack self-confidence, or feel overburdened due to the workload assigned to them. New graduate nurses with support systems are more likely to stay with an organization. Research suggests the creation of a supportive environment for new graduate nurses to help increase nurse retention in this demographic. A unit-based transition onboarding program was launched to create a supportive environment to help retain new graduate nurses on a medical-surgical unit. New graduate nurses with at least 1 to 3 years of experience completed a Likert-type …