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Descriptive, Comparative, And Correlational Study Related To End-Of-Life Care Prior To The Covid-19 Pandemic Outbreak (Time 1) And 12 Months Following Lockdown (Time2), Elizabeth Infante

Theses & Dissertations

Background

Palliative care has grown in its acceptance nationally and formed the base of a growing number of programs to provide care in a way that recognizes the importance of supporting people with chronic, debilitating, and life-limiting illnesses by focusing on “care” rather than “cure.” This special care warrants an understanding by all nurses and requires education across specialties and disciplines. Despite the increase of palliative care services in hospitals and other settings, long-term care and home care agencies continue to struggle with the education of staff and delivery of care to clients that incorporate the central tenets of what …

An Educational Program For Nurses To Incorporate Spiritual Care Into Clinical Practice, Alicia J. Thomas

Walden Dissertations and Doctoral Studies

Spiritual well-being is associated with several positive outcomes, including a greater tolerance of the emotional and physical demands of illness. Spiritual care is a basic element of holistic nursing, yet nurses generally lack spiritual care knowledge and abilities and are often unable to satisfy patients’ spiritual care needs. Therefore, nurses are in urgent need of relevant training to enhance their abilities to provide patients with spiritual care. Evidence-based education was lacking at the project site, a privately owned long-term care facility. Primary care attention was focused on the patients’ physical care; however, insufficient attention was being paid to spiritual care, …

Stakeholder Perspectives Of A Pilot Multicomponent Delirium Prevention Intervention For Adult Patients With Advanced Cancer In Palliative Care Units: A Behaviour Change Theory-Based Qualitative Study, Anna Green, Annmarie Hosie, Jane L. Phillips, Slavica Kochovska, Beverly Noble, Meg Brassil, Anne Cumming, Peter G. Lawlor, Shirley H. Bush, Jan M. Davis, Layla Edwards, Jane Hunt, Julie Wilcock, Carl Phillipson, Eugene Wesley Ely, Cynthia Parr, Melanie Lovell, Meera Agar

Nursing Papers and Journal Articles

Background: Theory-based and qualitative evaluations in pilot trials of complex clinical interventions help to understand quantitative results, as well as inform the feasibility and design of subsequent effectiveness and implementation trials.

Aim: To explore patient, family, clinician and volunteer (‘stakeholder’) perspectives of the feasibility and acceptability of a multicomponent non-pharmacological delirium prevention intervention for adult patients with advanced cancer in four Australian palliative care units that participated in a phase II trial, the ‘PRESERVE pilot study’.

Design: A trial-embedded qualitative study via semi-structured interviews and directed content analysis using Michie’s Behaviour Change Wheel and the Theoretical Domains Framework.

Setting/participants: Thirty-nine …

Implementation Of An Acute Care For The Elderly (Ace) Unit In A Community Hospital, Kimberly A. Colonnelli

Doctor of Nursing Practice (DNP) Projects

Background: “Baby boomers” (born between 1946 and 1964) represent 15% of the total population of the United States (Population Reference Bureau, 2019), but 50% of its total healthcare expenses (Mattison, 2021). Growth of this population will have a corresponding rise in demand on healthcare resources. Replication of a geriatric inpatient care model (Palmer et al., 1994) was introduced in a large geographically and ethnically diverse integrated care delivery system.

Problem: The demographic for this small community hospital located in Northern California has a larger percentage of patients over the age of 65 compared to other facilities within this …

Letter To The Editor From Baptist Health South Florida Chief Well-Being Officer, Ana Viamonte Ros

Nursing & Health Sciences Research Journal

No abstract provided.

Impact Of Nurse Residencies On A Graduate Nurse’S First Year, Melinda R. Fox

MSN Capstone Projects

The purpose of this presentation is to highlight the importance of the graduate nurses first year in their clinical role and highlight the positive impact of nurse residency programs. The target audience for this presentation includes, but is not limited to, the University of Texas at Tyler students and professors enrolled in NURS 5382: Capstone. The observers of this presentation will be able to describe the rationale behind the importance of Nurse Residency Programs, discuss the current literature recommendations, and understand the overview of the change process proposed.

A Good Life: Palliative Care In The World Of Dementia, Nicola Farmer

Journal of Interdisciplinary Graduate Research

Objective: The World Health Organization (2019) reports that dementia is the seventh leading cause of death with an estimated 50 million people worldwide with this disease. In the United States out of one and a half million Medicare patients on hospice in 2016, only 18% had dementia (The National Hospice and Palliative Care Organization, 2017). McAteer and Wellbery (2013) identified that while referrals to services seem to be on the rise, many are not made until the patient is close to death in the last weeks of an illness. The purpose of this project was to review the literature to …

Faith Into Action: Prayer Shawls And Ministry, Laura Van Loon

International Journal of Faith Community Nursing

No abstract provided.

Spiritual Care: The Overlooked Need In End-Of-Life Care, Michael Howard Vrmeer

Doctor of Nursing Practice Scholarly Projects

Background: A number of studies have validated the use of the FICA tool to evaluate a patient’s spirituality. FICA has been helpful in many palliative care settings to screen for spiritual problems that influence the patient's overall health. Aim: The project was a quality improvement initiative with the purpose of implementing the FICA tool as part of the admission assessment to increase chaplain referrals for inpatient palliative care services. Methods: The staff received an in-service on using the FICA questions on admission, and a prompt to complete the screen was placed at each work station in the project setting. Results: …

Improving Progressive Care Nurses’ Confidence And Performance During In-Hospital Cardiac Arrest (Ihca): A Continuous Quality Improvement Initiative, Katelyn Barley

Doctor of Nursing Practice (DNP) Manuscripts

The literature is clear regarding the benefits of high-quality cardiopulmonary resuscitation (CPR) in relation to patient outcomes. The American Heart Association (AHA) guidelines recommend immediate initiation of chest compressions and defibrillation as soon as possible to increase the chance of survival from cardiac arrest. The development of automatic external defibrillators (AEDs) have increased the survival rates of out-of-hospital cardiac arrest, however rates of survival from in-hospital cardiac arrest (IHCA) have not improved over the past several decades despite an increase in resuscitation research.

This project was to develop a system of quality improvement related to patient outcomes from IHCA. The …

The Black Church, Social Media, And Vaccine Hesitancy: A Program Evaluation Of A Virtual Town Hall Meeting Intended To Educate, Empower And Expedite Covid-19 Vaccine Uptake Intent Among Black Americans., Nina Johnson

Doctor of Nursing Practice Papers

Background: Vaccines are among the most important public health interventions of the 20th century saving millions of lives each year. Notwithstanding, the United States has seen a growing resistance to vaccinations since the late 1990s. Vaccine hesitancy (VH) is a delay or decline to accept vaccines, despite the available of safe and effective vaccines (WHO, 2019). Combatting VH in Black communities is especially challenging, complex, and multifaceted due to an elevated sense of medical mistrust from persistent racial discrimination, injustices and medical malfeasance. The current coronavirus-19 disease (COVID-19) pandemic has further magnified the intersection of this structural racism, the associated …

Respite For Acute Care Nurses With The Use Of A Resilience Room, Marisella Perales

Doctor of Nursing Practice

Background and Significance of the Problem. Nurses are exposed to higher levels of occupational stress in acute care units when compared to other departments within the hospital (Faraji et al., 2019). A qualitative assessment identified a need for resources to be provided for acute care nurses experiencing occupational stress. Purpose. To establish an area for respite and increase nurses’ knowledge about a Resilience Room and a support system to manage occupational stress. Objectives. To educate 75% of acute care nurse on respite care, have 50% of the nurses report utilization of Resilience Room, and increase the nurses use of a …

Leadership Strategies To Support Resilience, Katee Paine

Nursing Masters Papers

Healthcare institutions have garnered national attention due to high levels of healthcare worker burnout, stress, and turnover rates. As the largest population of healthcare workers, nurses are often confronted with stressors that can lead to burnout in their practice and work environment. The global COVID-19 pandemic has highlighted and magnified these stressors over the past year, such as emotional strain of caring for dying patients, long shifts, rotating schedules, increased workload demands, and high-stress work environments. Resilience, characterized by an ability to bounce back from adverse situations, has been found to play an important role in navigating and adapting to …

Spirituality And Opioid Addiction Recovery, Carol A. Ammon, Msn, Mba, Dnp, Stacey Boyer, Psyd, Stephen Dutton, Mdiv, Pd, Courtney Slater, Phd

Full-Text Theses & Dissertations

Purpose: Opioid Use Disorder (OUD) is chronic relapsing disease and requires intense rehabilitation. A link between spirituality and addiction recovery. The purpose of this study was to investigate whether addressing spiritual concerns among hospitalized patients with OUD warrants a specific intervention to assist patients with their unique spiritual needs.

Methods: This qualitative-only study recruited fourteen eligible participants and resulted in five qualitative interviews. The FICA Spiritual Assessment Tool© was used to conduct the interviews and all interviews were coded for theme development.

Results: The results of this study demonstrated that spirituality as a phenomenon in addiction recovery can be determined …

Nursing Attitudes To Hospice Care In The Intensive Care Unit, Claudia Lacivita

Master of Science in Nursing Theses and Projects

Nurses deliver care to patients 24 hours per day and are experts in the care of critically ill patients in the intensive care unit (ICU). The critical care nurse is trained to assess, treat, and monitor severely ill patients to facilitate their recovery, but may often feel ill-prepared and lacking the support usually available to the hospice or palliative care nurse. It also can be difficult to refocus when the desired outcome changes from stabilizing and getting a critically ill patient better to hospice or end-of-life care (EOLC). The purpose of this project was to improve the delivery of care …

Grieving Nurses' Need For Support, Tammy Patterson

Master of Science in Nursing Theses and Projects

Veteran nurses vacate their positions after more than 20 years of nursing experience due to the chronic emotional grief experienced after patient death. Nursing programs lack the curriculum support to sufficiently instruct student nurses how to appropriately deal with patient death. This lack of understanding leads the way for nurses to develop unhealthy coping mechanisms and withdrawing from the profession. A needs assessment was conducted and confirmed the desire and demand for support of nurses experiencing grief. A method was developed to support grieving nurses who are experiencing or will experience grief. A peer support group was established to assist …

Spiritual Dimensions Of Care: Need For Spiritual Care Interventions In Nursing Clinical Practice, Jillian Jack

Doctor of Nursing Practice Projects

Empirical research has identified emerging evidence concerning the value and importance of spirituality in the provision of nursing care. Spiritual well-being has important implications for a patient’s well-being and there is evidence that points to the association between spirituality, individual healthcare outcomes, and quality of life (QOL). Assisting patients in meeting their spiritual needs is also recognized internationally. Despite the fact that spiritual care is an essential part of nursing care, there remains a gap concerning spiritual care practices in the nursing clinical environment. The magnitude of the problem has to do with the lack of spiritual care education training. …

Pain And Spiritual Distress At End Of Life, Kathryn Lee Robinson

Dissertations

Purpose: The purpose of this study is to examine the relationship between unmanaged pain and spiritual distress in adults newly admitted to hospice.

Background/Rationale: Current evidence supports the presence of a positive relationship between increased physical pain and spiritual distress for those with advanced cancer and/or receiving palliative care services. Nonetheless, spiritual distress remains a relatively understudied area; anecdotally, assessment and management of physical symptoms often take precedence over interventions for spiritual distress in patients at end of life (EOL) on hospice. Research is needed to examine the relationships between physical pain, spiritual distress, and other relevant variables specific to …

Nurse-Physician Collaboration During Bedside Rounding: What Is The Impact On The Nurse?, Martha Decesere

Electronic Theses and Dissertations, 2020-2023

Poor communication is identified as the root cause for the majority of sentinel events in hospitals, including wrong site surgery, medication errors, and failure to rescue. Interdisciplinary rounding (IDR), a long-standing practice in the Intensive Care Unit (ICU), provides a forum for communication and collaboration and has been linked to improved patient outcomes. Most of the research regarding IDR has been performed in the ICU setting within academic medical centers. IDR outside of the ICU has demonstrated similar clinical outcomes but a gap exists in the literature regarding the impact of IDR participation on the nurse, particularly for nurses working …

Coaching Nurse Leaders In Conflict Management And Team Building To Improve Retention, Jeanette Black

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Retention of assistant nurse managers (ANMs) was identified as a concern from interviews with executive leadership and ANMs employed at a large hospital within a Northern California integrated health system. The nurse leader orientation training was reviewed, with gaps identified in conflict management and team building.

Context: The attrition rate of U.S. nurse managers in 2010 was 8.3%, higher than executive nurse leaders, with replacement costs equal to 75% - 125% of a nurse manager’s salary (Loveridge, 2017). Employee turnover and dissatisfaction due to conflict can have detrimental effects on retention, productivity, morale, and quality of patient care. …

Developing A Training Program For Omaha Metro Area Sexual Assault Nurse Examiners Caring For Individuals With Developmental Disabilities, Emily Blanchard

Capstone Experience: Master of Public Health

Individuals with developmental disabilities experience many barriers to healthcare and are at a substantially higher risk for sexual assault and trauma. There is a need for more inclusive and collaborative healthcare policies, practices, and education to guide healthcare providers during their encounters with individuals with developmental disabilities as patients, especially during forensic examinations following sexual assault and trauma. In the Omaha metro area, physical therapists at the Munroe-Meyer institute provide clinical services in a transdisciplinary program that refer victims of sexual violence to local health systems’ Sexual Health Nurse Examiners (SANEs).

There is an existing service gap for individuals with …

Suffering & Dividedness: A Journey Toward Wholeness In A Healing Profession, Tatum J. Geerdes

Faculty Tenure Papers

No abstract provided.

Spiritual Care In Nursing Practice In Veteran Healthcare, Elizabeth Burkhart, Anna Bretschneider, Sharon Gerc, Mary E. Desmond

Nursing: School of Nursing Faculty Publications and Other Works

Spiritual care is important in nursing practice, and spiritual well-being and spiritual care are associated with better health. Military veterans, a unique patient population, want spiritual care to cope with chronic conditions. It is unclear whether spiritual care is provided in veteran health care in the United States. This study used a qualitative descriptive method, guided by the Spiritual Care in Nursing Practice (SCNiP) theory, to describe spiritual care in nursing practice and facilitators/barriers in veteran health care. Individual interviews were conducted with 39 registered nurses (RNs) at a U.S. veteran health system. Findings were consistent with the SCNiP theory …

Managing The Effects Of Poor Sleep Quality In Nurses, Emily Huene, Sarah Rausch, Georgia Vasiu, Hannah Lopez, Rachael Valentz, Msn, Rn, Ccrn

Anna Vaughn School of Nursing Undergraduate Work

Staffing shortages, high turnover rates, and prolonged work shifts has caused decreased sleep quality in nurses due to fatigue. The fatigued nurse causes concern for safety, coordination and agility, patient avoidance, lack of compassion, impaired cognitive function, risk for chronic diseases, and patient care errors. This systematic research review was designed to identify evidence-based practice nursing interventions currently being used to manage the effects of reduced sleep quality. Methods for performing this systematic research review were to search multiple databases using keywords, scanning article titles and abstracts, and critiquing for relevance and quality. Findings from this systematic review found multiple …

Operationalizing A Theoretical Framework To Improve Patient Perception Of Care, Debra J. Morton

DNP Qualifying Manuscripts

The Centers for Medicaid and Medicare Services publicly report information that allows comparisons to be made across all hospitals to support consumer choice. A hospital’s reputation, coupled with the financial impact, depends on patient satisfaction, which must be taken seriously. Care experience scores are primarily nurse-driven, and nurse leaders have a large responsibility to produce results. The practice of commanding and directive leadership has never been effective long term. Nurses want leaders to make sense of a situation and explain the why. The need to inspire and create alternative ways to help nurses connect purpose to practice is imperative …

Reducing Compassion Fatigue In Hospice Nurses Through Education, Gregory Daniel Friesz

Walden Dissertations and Doctoral Studies

Compassion fatigue is a secondary stress reaction that results from providing care to those undergoing traumatic life events. Frequent exposure to dying patients with complex medical concerns has been identified as a contributing factor to compassion fatigue and resultant turnover among hospice nurses. The purpose of this project was to assess whether the provision of education to hospice nurses regarding compassion fatigue resulted in a demonstrable improvement in their levels of compassion fatigue. Watson's theory of human caring and Roy's adaptation model provided the theoretical foundation for this project. The practice-focused question for this project asked whether a reduction in …

Assessment Of Cancer-Related Fatigue In Breast Cancer Survivors, Meagan Walker

Walden Dissertations and Doctoral Studies

Cancer-related fatigue (CRF) is a persistent and debilitating problem for many breast cancer survivors. Although many CRF measurement tools are available, no consensus exists on the most appropriate tool to use for breast cancer survivors. The purpose of this project was to identify the best method of assessing CRF in breast cancer survivors. The practice-focused question inquired about the most appropriate way to assess fatigue in breast cancer survivors. The central concepts of the project were CRF and cancer survivorship. This project was informed by the theory of health as expanding consciousness and Mishel's theory of uncertainty in illness. The …

'Through The Eyes Of The Dying' - Identifying Who May Benefit From Bereavement Follow-Up: A Qualitative Study, Jane L. Phillips, Elizabeth A. Lobb, Francis Bellemore, Terrence Hays, David C. Currow

Medical Papers and Journal Articles

Introduction: Bereavement support is an integral element of palliative care. Emerging evidence stipulates that bereavement support should be reserved for those most at risk of poor outcomes. While this evidence makes identifying those at risk of experiencing a complex bereavement a necessary first step, it has been difficult to arrive at a consensus as to whom that should be.

Aim: To explore whether palliative care in-patients with advanced disease are concerned about the bereavement needs of others and, if so, is it their next-of-kin.

Design: A qualitative study using semi-structured interviews, and thematic analysis using a constant comparative method.

Setting/participants: …

Transitioning With Grace: Improving Quality Of Life For Comfort Care Patients In The Intensive Care Unit, Melissa Ashley

Doctor of Nursing Practice Projects

The primary aim of this project was to develop and execute a standard protocol of interventions for comfort care patients on a medical intensive care unit. Staff at a 15 bed MICU at a Midwest urban teaching hospital from June 1 until August 11, 2018 were trained to execute a standardized protocol of interventions for comfort care patients. Seventeen MICU patients who transitioned to comfort care were offered a standardized set of evidence-based interventions, after staff attended educational in-services on providing high quality end of life (EOL) care. Checklists were used to determine intervention compliance. Pre-project and post-project surveys were …

Leadership Rounding In The Intensive Care Unit To Improve Satisfaction, Stephanie Laborde

Master's Projects and Capstones

A mid-sized hospital in Alameda County would like to increase its Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) scores by improving the patient care experience. The specific aim for this project is that by August 2018, the implementation of daily leadership rounding in the ICU will result in an increase of patient satisfaction HCAHPS scores by 5%. The project team used the Plan-Do-Study-Act cycle to guide the implementation of leadership rounding. Leadership rounding was conducted daily over a 10-week period by the project team, which consisted of the floor manager and clinical nurse leader (CNL) student. The project …