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Prevention Of Central Line-Associated Blood Stream Infection (Clabsi) In Adult Icu Patients, Salima Allahbachayo

Student Scholarly Projects

Practice Problem: Central line-associated bloodstream infections (CLABSI) account for most hospital-associated preventable infections in the United States and globally. Implementation of a multifaceted approach including evidence-based CLABSI bundle care has shown to prevent this infection in patients with a central line.

PICOT: The PICOT question that guided this project was that in adult intensive care unit (ICU) patients, how does the use of central line bundle care compared to central line care without bundle decrease central line-associated bloodstream infections within eight weeks?

Evidence: The evidence from a rigorous literature review showed that using a central line bundle …

Evaluation Of The Clarity, Usefulness And Willingness To Adopt A Joint Military Nursing Professional Practice Model By Military Nurse Leaders, Lozay Foots Iii

Graduate Theses, Dissertations, and Capstones

Abstract

The goal of this project was to evaluate the clarity, usefulness and willingness to adopt a Joint Military Nursing Professional Practice Model by military nurse leaders into the military health system. This paper specifically examined leader feedback and perceptions prior to implementation of the Joint Professional Practice Model (JPPM) into designated pilot sites within the Military Health System (MHS) Nursing environment. This project includes Chief Nursing Officer (CNO) discussions reflecting the clarity of definition of model components, usefulness of the model and its components, and willingness to adopt the JPPM. This information will be used to modify the new …

“This Isn’T Just Busy, This Is Scary”: Stress, Social Support, And Coping Experiences Of Frontline Nurses During The Covid-19 Pandemic, Erin S. Craw, Tess M. Buckley, Michelle Miller-Day

Communication Faculty Articles and Research

Despite having previous experience and extensive trauma training, the COVID-19 pandemic presented unprecedented challenges for nurses working in hospital settings. During the pandemic, nurses struggle to care for patients and protect themselves from infection, while navigating ongoing organizational changes. Guided by prior literature on social support and coping, this study explores nurses’ experiences of coping with stress while treating COVID-19 patients during the pandemic. In-depth semi-structured interviews were conducted with 14 active staff nurses working in hospitals and one licensed practical nurse (LPN) at a rehabilitation center who treated COVID-19 patients during the pandemic. An inductive thematic analysis was employed …

Nurse Practitioner Role Perception, Job Satisfaction, And Anticipated Turnover In The Middle Atlantic States, Jenna R. Sabatino

Seton Hall University Dissertations and Theses (ETDs)

Background: The need for nurse practitioners (NPs) in the US has become very evident in recent years. However, the established significance of NPs in the healthcare system does not ensure that NPs are satisfied with their role. To date, no studies have examined NP job satisfaction in the Middle Atlantic States (MAS), which includes New York, New Jersey, and Pennsylvania. Only one study, thus far, has looked at NP role perception from the NPs own perspective, and was completed in the Midwest region of the US. Similarly, no studies have examined NP anticipated turnover the Mid-Atlantic region of the US. …

Commentary On “Burnout And The Sexual Assault Nurse Examiner: Who Is Experiencing Burnout And Why?”, Jacqueline Callari Robinson, Jeneile Luebke, Sarah J. Hoffman, Kaylen M. Moore, Peninnah M. Kako, Lucy Mkandawire-Valhmu

College of Nursing Faculty Research and Publications

In the paper Burnout and the Sexual Assault Nurse Examiner: Who is Experiencing Burnout and Why? in this edition of the Journal of Emergency Nursing (JEN), Zelman et al examine the frequency of burnout and its accompanying features among sexual assault nurse examiners (SANEs) in North Carolina using the Maslach Burnout Inventory scale. The authors’ cross-sectional study provides the field of forensic nursing with essential knowledge and contextual understanding of burnout among SANEs working within forensic programs and those working in emergency departments of varying sizes, including some located in rural areas. The knowledge garnered from this study is also …

A Quality Improvement Evaluation On A Nurse Residency Program, Mary Christine Richards

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this DNP project was to explore new graduate nurse (NGN) residency program retention data in a large healthcare system to assess if participant retention met or exceeded identified retention benchmarks. The second project question explored NGNs’ reasons for leaving the organization after the first year of experience. The Plan Do Study Act model framed this quality improvement evaluation project. The total number of NGN residency participants for the system in 2020 was 586 and 680 in 2021.Year one retention in 2020 was 539 (92%). Year one retention in 2021 was 625 (92%). Year two retention data were …

Staff Education On Hepatitis C Screening Guidelines, Duy Le Trinh

Walden Dissertations and Doctoral Studies

Hepatitis C virus (HCV) is found worldwide, but the burden is much higher in correctional settings compared to general populations. In a detention centered located in Washington, the nurses at booking do not know who are at risk for Hepatitis C. This Doctor of Nursing (DNP) project attempted to answer the question of if educating nursing staff at the detention facility in Washington increase their knowledge of the importance of screening inmates for hepatitis C.The purpose of this project was to educate nursing staff about the risk factors for HCV so that proper screening can be done. Knowles’s adult learning …

Novice Nurses’ Perceptions And Expectations Of What Constitutes Nursing Practice, Mcfrances Catherine George

Walden Dissertations and Doctoral Studies

AbstractAfter completing preceptorship programs, novice nurses work independently to provide patient care at the bedside. Novice nurses may leave bedside nursing with a minimum of 1 year of experience, resulting in vacant bedside nurse positions. These vacant positions are a problem because this could lead to low patient satisfaction, higher patient mortality rates, and failure to rescue in emergent cases. The purpose of this study was to explore the perceptions and expectations of nursing practice related to performance, demands, and requirements from novice nurses. Afaf Meleis's 1960 transition theory guided the understanding of novice nurses' perceptions and expectations of nursing …

Policies That Support Emergency Department Staff In Providing Behavioral Health Care, Lizabeth Lepp Hennig

Walden Dissertations and Doctoral Studies

A significant portion of individuals with a behavioral health (BH) condition return to emergency departments (ED) seeking care, resulting in reduced quality of care, and contributing to disproportionate healthcare costs. Care can be improved and return visits to the ED reduced where behavioral health care and follow-up care planning are provided as part of their treatment. However, policies expected to create declines in ED use for behavioral conditions are typically in short duration or are difficult to use given other funding and policy constraints. With little known about how policy is supporting the engagement of ED staff who are critical …

Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky

Walden Dissertations and Doctoral Studies

Emotional intelligence (EI) is defined as the capacity to recognize and manage emotions and feelings to guide behaviors which is an ability that is crucial for nurse mangers to possess. Understanding the key factors for predicting emotional intelligence in nurse managers may influence hiring practices and the appointment of managers who will influence job satisfaction, employee engagement, retention, and turnover. The purpose of this quantitative predictive correlational study, guided by King’s theory of goal attainment and Mayer and Salovey’s four-branch ability model of EI, was to determine whether age, years of experience as a nurse, and years of experience as …

Retention Strategies For The Current Nursing Workforce, Jennifer Higgins

Walden Dissertations and Doctoral Studies

Retaining a robust nursing workforce is essential to care delivery. As the generation gap in the nursing field widens, retention strategies that align with the current nursing workforce must be considered. Rapid turnover is a looming concern as baby boomers retire and millennials become the leading generation in the nursing workforce. Nurse leaders must identify and deploy strategies that will provide a meaningful work environment to retain nurses in this majority group. The purpose of this project was to address the gap in practice of rising turnover, low nurse engagement, and reliance on premium labor to deliver care. The sources …

Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson

Walden Dissertations and Doctoral Studies

This project was an evaluation of a quality improvement (QI) initiative conducted in a large medical enterprise to address the problem of poor performance of their hospitals in accreditation surveys. The desired outcome was to evaluate whether an innovative plan of correction process was impactful in reducing the negative outcomes of regulatory and accreditation surveys. The practice-focused question guiding this project addressed the effect of the pre-accreditation evaluation and a plan of correction process in this QI initiative on reducing requirements for improvement (RFI) and condition-level deficiencies (CLD) cited in a recent The Joint Commission survey review. This project was …

The Efficacy Of Barcoded Medication Administration In The Emergency Department, Aleksandr Vasserman

Walden Dissertations and Doctoral Studies

The practice problem addressed in this Doctor of Nursing Practice project was safe medication administration in the emergency department (ED). Paper-based delivery of medication administration is prone to errors and multiple points of failure affecting patients’ safety. The gap in nursing practice was the lack of analysis regarding the efficacy of the barcoded medication administration (BCMA) process in the ED. The practice-focused question for this project addressed whether the implementation of BCMA in the ED effectively reduced medication administration errors as compared to the previously used paper-based, non-BCMA process. The aim of this doctoral project was to review the efficacy …

Effect Of Compassion Fatigue And Burn Out Education In The Nurse, Pamela Spendiff

Walden Dissertations and Doctoral Studies

Evolving changes in healthcare have caused increased levels of pressure on registered nurses (RNs) which increases compassion fatigue (CF), secondary traumatic stress (STS) and burnout (BO) and negatively affect compassion satisfaction (CS) which may affect a nurse’s abilities and skills to provide quality care for patients and cause the RN to leave the profession. The mindfulness technique is one method which may help reduce CF, STS and BO in RNs. The purpose of this quasi-experimental study, guided by the compassion satisfaction and compassion fatigue model (CS-CF), was to determine what effect a mindfulness-based intervention (MBI) has on CF, BO and …

Promoting A Culture Of Self-Care: Application Of A Caring Science Framework To Prevent Nursing Faculty Burnout, Angela M. Braswell

DNP Scholarly Projects

BACKGROUND: Threats to nurses’ well-being from chronic workplace stress often leads to burnout. Lack of self-care contributes to nursing faculty burnout due to the inability to maintain well-being. Emerging evidence points to theory guided self-caring practices as effective coping strategies to manage the negative effects of workplace environments on well-being.

METHODS: This quality improvement project aimed to provide nursing faculty and staff in the academic workplace with opportunities to cultivate and enhance self-care practices to promote overall health and well-being following principles of Caring Science and Jean Watson’s 10 Caritas Processes^®. A multifaceted set of interventions were provided: …

Implementation Of A Standardized Medication Reconciliation Protocol In A Psychiatric Stabilization Setting, Sara Robinson

DNP Scholarly Projects

BACKGROUND: Medication errors are a prevalent patient safety concern across healthcare settings. High-quality medication reconciliation is an intervention and expected standard of care that can help to prevent adverse drug events. This quality improvement project focused on implementing a standardized medication reconciliation protocol on a short-stay psychiatric unit.

INTERVENTION: An evidence-based toolkit supported by the Agency for Healthcare Research and Quality (AHRQ), Medications at Transitions and Clinical Handoffs (MATCH) was selected as the framework for developing and implementing this protocol.

Congruent with the evidence-based toolkit recommendations, baseline data collection and needs assessment provided context for tailoring the intervention to the …

Staff Education Program On Postpartum Depression Screening, Pamela Barstow

Walden Dissertations and Doctoral Studies

AbstractPostpartum depression (PPD) in the US is a serious health concern that negatively impacts an average of 11.5% of women, with 13.36% of women in Virginia in 2018 reporting PPD symptoms. Mothers experiencing PPD may have trouble bonding with their infants, which may negatively impact childhood growth and development. However, fewer than one-half of pediatricians screen mothers of infants for PPD. Literature supports staff education on PPD to promote the wellbeing of postpartum mothers and their infants. Using the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this Doctor of Nursing Practice project was to …

The Efficacy Of Barcoded Medication Administration In The Emergency Department, Aleksandr Vasserman

Walden Dissertations and Doctoral Studies

The practice problem addressed in this Doctor of Nursing Practice project was safe medication administration in the emergency department (ED). Paper-based delivery of medication administration is prone to errors and multiple points of failure affecting patients’ safety. The gap in nursing practice was the lack of analysis regarding the efficacy of the barcoded medication administration (BCMA) process in the ED. The practice-focused question for this project addressed whether the implementation of BCMA in the ED effectively reduced medication administration errors as compared to the previously used paper-based, non-BCMA process. The aim of this doctoral project was to review the efficacy …

Educating Nurse Leaders On The Application Of Watson’S Caring Science, Diane Lm Updyke

Walden Dissertations and Doctoral Studies

Nurse leaders’ creation of a culture of caring for their nursing staff has been shown to improve nurses’ job satisfaction and retention, and ultimately patient outcomes. At the project site, there was a perceived gap in nursing leadership practice in integrating a culture of caring into leadership and management practices. Although staff and leadership identified similar caring behaviors, staff members did not perceive nursing leadership as caring, which affected the former’s job satisfaction. The purpose of this education project was to provide site leaders with information on specific caring behaviors and how to model these behaviors with staff using Watson’s …

Military Emergency And Critical Care Nurses’ Lived Experiences Of Resilience, Carla Ann Wiese

Walden Dissertations and Doctoral Studies

Resilience has been studied across a myriad of populations. Many resilience studies have focused on military service members, including military healthcare personnel, specifically nurses. Although many quantitative resilience studies have been conducted, there have been few qualitative studies in this area. Qualitative studies have focused solely on spiritual resilience, although mixed methods studies have identified other resilience characteristics. The aim of this descriptive phenomenological study was to identify resilience characteristics through rich description within the situational and philosophical patterns of resilience and gain a better understanding of how emergency and critical care military nurses honed resilience in the face of …

Improving Medical-Surgical Nursing Knowledge Of Congestive Heart Failure, Sylvia Rene Cunningham

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing practice project was to address the nursing gap in knowledge about congestive heart failure (CHF) management. Lack of staff knowledge on this topic inhibits their ability to educate patients. Poor patient understanding can lead to frequent readmissions and poor patient outcomes. The project aim was to determine if educating medical-surgical nurses about CHF management increased their knowledge of topic. The ADDIE model was used to design staff education. Lewin’s change theory guided the project. Nine registered nurses attended a power point presentation. A pre-education questionnaire was distributed, and participants created unique identifiers. The …

Implementation Of Education And Use Of A Screening Tool To Assess Palliative Care Needs In The Critical Care Setting, Megan Stoeckinger

DNP Projects

Purpose: The purpose of this study was to measure palliative care knowledge, attitudes, perceived empowerment, and familiarity of the Supportive Palliative Care Indicators Tool (SPICT) among critical care nurses and advanced practice providers (APPs) before and after viewing a web-based educational video on an adult medicine intensive care unit (MICU).

Methods: This study was a one group pre- and post- implementation assessment using a web-based educational video and electronic surveys. The population included critical care nurses and advanced practice providers (APPs). This study spanned the timeframe between January 2022 and March 2022.

Results: Paired t-tests comparing pre-intervention …

Improving Smoking History Screening And Documentation To Increase Lung Cancer Screenings In Primary Care Clinics, Destinee R. Rein

DNP Projects

BACKGROUND: In the United States, lung cancer has the highest mortality rate of all other cancers among men and women. Kentucky is ranked 50th among all states, leading the nation in new lung cancer cases each year. Lung cancer screening using Low dose Computed Tomography (LDCT) can reduce lung cancer-related morbidity and mortality. Lack of smoking history documentation to identify eligible patients is a major contributing factor to low national screening rates. Obtaining complete smoking history remains the most important technique in identifying candidates for lung cancer screening.

PURPOSE: The purpose of this quality improvement project was to evaluate …

The Impact Of Icu Telemedicine On Patient Outcomes In The Surgical Critical Care Setting: An Observational Study, Megan Steely

DNP Projects

Abstract

Background: In April 2020, the University of Kentucky (UK) implemented a division entitled the Enhanced Care through Advanced Technology Intensive Care Unit (eCAT ICU) to provide tele-critical care (TCC) services in all critical care areas at UK Healthcare. The eCAT ICU at UK HealthCare was the first TCC delivery system of its kind in the state of Kentucky. Use of TCC has been associated with improved patient outcomes and decreased costs.

Purpose: The purpose of this study was to analyze targeted outcomes in the surgical critical care population pre- and post-implementation of TCC at UK HealthCare. Specifically, the aims …

Screening For Severe Mental Illness In A Correctional Setting Using The Brief Jail Mental Health Screening Tool, Stephanie Kohl

DNP Projects

Abstract

BACKGROUND: Prisoners who are detained in jails and detention centers have higher rates of Severe Mental Illness (SMI) compared to the general population. However, SMI is often unidentified in this population, largely due to lack of assessment using effective SMI screening tools and lack of knowledge among prison staff about the prevalence of SMI and the importance of identification in the correctional setting. Prisoners with SMI often act out violently against others and themselves. Current standard practice for SMI screening varies significantly across jails. Many jails use standard medical questionnaires which help obtain a brief medical history but often …

Leadership Styles And Rn Turnover Intentions In Long-Term Care Facilities, Kelli M. Casey

Walden Dissertations and Doctoral Studies

Employee turnover is a concern for leaders in the nursing home industry because employees with turnover intentions may negatively impact the continuity of operations and strategic plans, resulting in poor quality of care for residents. Grounded in House's path-goal theory, the purpose of this quantitative, correlational study was to examine the relationship among idealized attributes, idealized behaviors, inspirational motivation, intellectual stimulation, individualized consideration, contingent reward, management by exception-active management by exception-passive, and turnover intentions in RNs. The independent variables were the subcategories of transformational and transactional leadership. The dependent variable was turnover intentions. Participants included 110 nonmanagement RNs working in …

Blood Stream Infections Related To Hemodialysis Catheter Use, Patricia Goodman

Walden Dissertations and Doctoral Studies

Abstract Hemodialysis is a life-sustaining procedure for patients diagnosed with end-stage renal failure. Most of these patients initiate hemodialysis with a tunneled central venous catheter, with some depending on its use for long-term treatment due to poor vascularity. Catheter-related bloodstream infections in hemodialysis patients are a complication of hemodialysis catheter use with a high morbidity and mortality rate. A quality improvement (QI) project was conducted to answer the practice-focused question of whether the use of chlorhexidine swabs and caps for central venous catheter dressing changes decreased the rate of hemodialysis catheter-related bloodstream infections. Resolution to this problem would benefit the …

Clinical Guidelines For Identifying Early Warning Signs Of Deterioration In Rehabilitation Patients, Tchaiko Abiola Hicks

Walden Dissertations and Doctoral Studies

Failure to recognize early warning signs of clinical deterioration can cause critical complications and a sentinel event with legal implications. These complications are preventable if nurses have evidence-based guidelines to guide their critical thinking to identify early warning signs. The purpose of this project was to close this gap by developing a Clinical Practice guideline for identifying early warning signs of clinical deterioration for the rehabilitation center. The clinical practice question addressed what evidence supported the development of a clinical guideline for nurses to recognize early warning signs of a deteriorating patient improve the quality of care of patients at …

Evidence-Based Discharge Planning For Assisted Living Facility Residents, Annick Sheron Kelly

Walden Dissertations and Doctoral Studies

AbstractLack of staff knowledge is one of the leading challenges contributing to ineffective discharge planning from assisted living facilities. Recognizing that appropriate discharge planning is essential to the well-being of residents, the purpose of this doctoral project was to develop a staff education program based on current evidence-based discharge planning procedures for residents of an assisted living facility. Knowles’s adult learning theory; Lewin’s change theory; and the analysis, design, development, implementation, and evaluation model guided development of the staff education program. According to a review of the literature, evidence-based strategies for resident discharge planning included early discharge planning; tailored support, …

Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar

Walden Dissertations and Doctoral Studies

Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …