Digital Commons Network^™

Improving Family Centered Care In The Nicu, Poppy Kekana, Carin Maree, Christa Van Der Walt

Maternal-Child Health Nurse Leadership - Africa

The purpose of the project was aimed to improve bonding between parents and their preterm babies through early and continuing communication between mothers and babies, keeping parents informed about their child's conditions and involving mothers in the basic care of their babies.

This quality improvement project forms part of the deliverables of the first African cohort of Maternal Child Health Nursing Leadership Academy (MCHNLA). It focuses on improving family-centered care in a neonatal ICU of an academic referral institution admitting pre-term and sick infants. Due to various factors such as high tech environment, overcrowding, sick mothers and sick babies, there …

The Implementation Of A School Based Asthma And Allergy Program In A Rural School District, Florence Viveen Dood

DNP and Student Works

Asthma and allergies are the chief cause of chronic disease among children. The ability to properly manage asthma and allergies in the school setting requires a high level of coordination between the school district, the family, and the healthcare provider. Due to budget cuts, administrative issues, and legislation, schools often have reduced capability to employ school nurses. Consequently, students with health concerns are often managed by unlicensed assistive personnel who have minimal training. In response to this identified gap in care, the School Based Asthma and Allergy Program was developed. The first aim of the program was to train unlicensed …

Enhancing Critical Thinking Disposition And Clinical Judgment Skills In Senior Bsn Students Via Electronic Interactive Simulation, Deborah Lynn Weatherspoon

Dissertations

The problem investigated in this study was the lack of empirical evidence available regarding the effectiveness of electronic interactive simulation (EIS) for developing critical thinking disposition and clinical judgment skills in the senior baccalaureate nursing student.

The aim of this study was to identify an effective method of experiential learning simulation that may be independently accessed by the learner with a goal of enhancing critical thinking disposition and clinical judgment skills of senior baccalaureate student nurses (BSN).

The purpose of this experimental study was to compare the effects of EIS to traditional paper case studies on the critical thinking disposition …

Evaluation Of Shared Medical Appointments For Opioid Relapse Prevention In Patients Receiving Medication-Assisted Treatment In A Rural Health Clinic, Ashley M. Koch

Dissertations

The United States is facing an opioid epidemic. Access to medication-assisted treatment (MAT) is recognized as one crucial strategy in decreasing opioid abuse rates and improving population health through mitigation of infectious disease and overdose deaths. However, it has been reported that individuals suffering from opioid-use disorders have limited access to MAT. A synthesis of evidence supported project implementation of shared medical appointments (SMAs) for opioid relapse prevention as a means to support implementation of MAT, increase patient access to treatment, and promote social support in opioid abuse recovery. Accordingly, this project aimed to develop, implement, and evaluate a SMA …

Verification Methods Of Nasogastric And Orogastric Tubes: Improved Patient Outcomes Through Nurse Adherence To Practice Guidelines, Jennifer M. Kaple

Dissertations

Although there are various methods that are used to confirm the placement of nasogastric (NG) and orogastric (OG) tubes prior to the administration of any substance, there is none that is used universally and with certainty of safety. Unreliable and contradictory methods for confirming tube placement ultimately leads to misplaced tubes and causes considerable adverse events including pneumonia, lung collapse, and fatality. In adult patients within a northcentral Ohio community hospital, greater than 18 years of age, requiring the placement of an NG or OG feeding tube [P], how does implementation of a systems-wide approach to update adherence guidelines for …

Evaluation Of A Fellowship Program For Nurse Practitioner Graduates In An Academic Environment, Erica Schroeder

DNP and Student Works

The transition into the NP role is challenging and often lacks the support needed to overcome obstacles during the first year of practice which can lead to feelings of displeasure with one's self as well as discontent in the new professional role. Support of graduate fellowship programs may provide a reduction in the stress and decreased confidence experienced during NP role transition. Limited NP colleague support and organizational differences among practice settings makes it difficult to develop a one size fits all fellowship program for various employers to provide to the new NP. Research focused on graduate fellowship programs which …

Outcomes Of A School-Based Asthma Education Program: An Evidence-Based Practice Project, Jennifer A. Rohrbacher

Dissertations

The identified problem in school-aged children is a lack of education to recognize triggers, symptoms, and methods to self-manage asthma episodes. The PICOT statement of interest was: In children 8 to 12 years old, does implementation of the Open Airways for Schools, a school-based program for asthma management versus no previous program for asthma management affect knowledge, avoidance of triggers, school absenteeism, and peak flow readings following six group sessions of asthma education over a three week period. The purpose of the evidence-based practice project was to connect the identified problem and the needs of children to cope with asthma …

Safe Sleep/Reading Patient Education Handout, Tracy L. Gidden, Lory A. Lewis

General Submissions: Community and Population-based Materials

During the Fall of 2016, student leadership interns of Delta Xi chapter of Sigma Theta Tau International (STTI) implemented a project to address STTI goals of advancing world health, and celebrating nursing excellence through leadership and service. The project they chose was to support a nationwide initiative, Project Night Night, by collecting donations, assembling, and distributing tote bags to children in homeless shelters. Each tote contains a fuzzy blanket, a cuddly stuffed animal, and an age-appropriate book.

Adult Asthma Care: Promoting Control Of Asthma (2nd Ed.), Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this best practice guideline (BPG) is to provide nurses and other health-care providers with evidence-based recommendations of foundational asthma care for adults with a diagnosis of asthma.

This guideline aims to assist nurses and other health-care providers help persons with asthma achieve asthma control, thereby minimizing and, ideally, preventing morbidity and mortality and improving quality of life. The scope of this guideline includes effective assessment and management interventions for adults (defined as persons aged 18 and older) who have a diagnosis of asthma.

For more information including supplementary information and available translations, visit https://rnao.ca/bpg/guidelines/adult-asthma-care

Adopting Ehealth Solutions: Implementation Strategies, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this best practice guideline (BPG) is to provide evidence-based individual, organization, education, and system/policy recommendations to: 1) enhance the capacity of all individuals involved in the implementation of an eHealth solution within a health care organization; 2) establish suitable infrastructures to support eHealth education needs; and, 3) facilitate technology-enabled health system transformation.

The Individual/Organization Recommendations provided in this Guideline will have relevance for all individuals involved in the implementation of an eHealth solution within a health care organization, regardless of their role. Academic institutions may use the Education Recommendations to develop or enhance their eHealth curricula. Lastly, …

Preventing Falls And Reducing Injury From Falls (4th Ed.), Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This best practice guideline (BPG) focuses on the prevention of falls and fall injuries in all adults at risk for falls -; including those living in the community -; who are receiving care from nurses or other health-care providers. Evidence reviewed for this guideline included studies conducted in three main health-care settings:

• community (including primary care and home care)
• hospital
• long-term care

For more information including supplementary documents and available translations, visit https://rnao.ca/bpg/guidelines/prevention-falls-and-fall-injuries

Crisis Intervention For Adults Using A Trauma-Informed Approach: Initial Four Weeks Of Management (3rd Ed.), Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this best practice guideline is to focus on how nurses and the interprofessional team can provide effective trauma-informed crisis interventions (immediately and to up to four weeks post-crisis) in adults (18 years and older) in order to optimize evidence-based practices and clinical outcomes. The guideline is applicable in all practice settings and promotes consistent, evidence-based response and care. The guideline is relevant for:

• all domains of nursing practice (i.e., clinical practice, research, education, and policy and administration)
• social service
• other members of the interprofessional team across all practice settings at the unit, organization, and system levels

For …

Integrating Tobacco Interventions Into Daily Practice (3rd Ed.), Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this best practice guideline (BPG) is to provide best practices for tobacco interventions for nurses and other health-care providers across all care settings, with evidence-based recommendations related to assessment and interventions for adults who use tobacco.

The scope includes all forms of commercial tobacco and is not limited to smoking alone. The recommendations will help nurses and other health-care providers gain the knowledge required to screen all clients for tobacco use, implement an intervention plan with individuals who use tobacco, treat or refer clients, add tobacco use content to enhance health professional education programs, ensure tobacco intervention …

Initiating Birthing Partner Support In A Low Risk Maternity Unit, Nabachwa Oliver Norah, Elizabeth Ayebare, Gorrette Nalwadda

Maternal-Child Health Nurse Leadership - Africa

The Maternal-Child Health Nurse Leadership Academy Africa (MCHNLA Africa) develops the leadership skills of maternal and child health nurses and midwives who work in a variety of healthcare settings. The academy prepares these nurses for effective interprofessional team leadership as they strive to improve the quality of healthcare for childbearing women and children up to 5 years old. The program is presented in cooperation with our funding partner Johnson & Johnson.

Nurses and Midwives from Malawi, South Africa, Swaziland and Uganda participate in an 18-month leadership academy. During MCHNLA Africa the mentees create and effectively lead an interdisciplinary team with …

Strengthening The Signal Functions In Lejweleputsua Health District, Mookho Kumpi, Rebecca Motete, Elgonda Bekker

Maternal-Child Health Nurse Leadership - Africa

The purpose of this leadership project was to strengthen World Health Organization (WHO) signal functions in all seven-delivery sites in the district to improve responsiveness to routine and emergency care.

Apart from being a quality improvement project this project was also a leadership development initiative in the STTI Maternal Child Health Nurse Leadership Academy. Lejweleputswa is one of the five districts in South Africa that under-performed during 2011-2013 period with regard to perinatal outcomes. Baseline statics on current levels of WHO signal functions coverage was retrieved from District Health Information System using a designed tool. Facilities were classified as Basic …

Gaps In Pain Management In Assisted Living, Pamela G. Wisor

DNP and Student Works

Assisted living (AL) is a growing lifestyle choice option available to the ailing aged in the United States. Increases in chronic disease may predispose this population to acute and chronic pain due to increased longevity with medical advances. The elderly populations in these facilities are frail with multiple chronic illnesses and cognitive and/or functional impairment adding to the difficulty in effective pain management practices. The burden of providing pain management in AL is on the nursing assistant whose education and scope of practice may not include performing pain assessment that impact resident quality of life and outcomes. Continuing education in …

High-Fidelity Simulation Influences On Novice Baccalaureate Nursing Students, Barbara Connelley

Dissertations

Current research supports high-fidelity simulation use as a method for educating junior and senior nursing students. The purpose of this study was to examine the relationship that existed between the use of evidence-based high-fidelity simulation and the novice baccalaureate nursing students' development of their nursing knowledge, performance skills, critical thinking skills, and self-confidence. A four-year university that offered a Bachelor of Science degree in nursing was the site of the study. This quasi-experimental quantitative study used a simple interrupted time-series, nonequivalent dependent variables, within-group design. Novice baccalaureate nursing students enrolled in their first theory and clinical course comprised the convenience …

Undergraduate Sorority Students' Perceptions Of Current Body Size, Ideal Body Size, Eating Habits, And The Relation To Body Image Dissatisfaction, Julie Beiter

DNP and Student Works

Disordered eating patterns and body discontent are widespread in Western society, especially among young women. Many adopt the "thin ideal," a belief that women should have very slender bodies with small waists and minimal body fat. This body image is shaped by television, social media, and magazines. Research has shown that women who internalize the thin ideal are more likely to have concerns with body image dissatisfaction and disordered eating habits. The goal of the current descriptive correlational study was to examine relationships between perceived current body size, imagined ideal body size, actual body weight, eating patterns, and body satisfaction …

Preoperative Cognition Screening And Postoperative Delirium In Older Surgical Patients, Lucy Andrews

DNP and Student Works

People 65 years or older are having surgery later in life and are at risk of developing a major postoperative complication, delirium. The Montreal Cognitive Assessment, is a preoperative cognitive screening tool which was used to screen thirty-three older orthopedic surgical patients to reduce the incidence of this serious postoperative complication. Patients who scored below normal were identified as at risk and monitored to ascertain if identification and monitoring influenced their postoperative course. At the first postoperative visit, each patient was evaluated for falls, confusion, and the ability to follow the required postoperative home exercise program to identify an undetected …

Laboring Down: A Pretest-Posttest Educational Study, Kristen Eberlein

DNP and Student Works

The primary aim of this study was to determine the effectiveness of an educational video in increasing labor and delivery nurses' knowledge of laboring down. The secondary study aim was to determine if the educational intervention affected nurses' anxiety levels when caring for patients who are laboring down. Nurses took an anxiety measure test and a knowledge test before and after watching the educational video. The results of the difference in knowledge pre-intervention to post-intervention achieved statistical significance (t = 3.22, df =14, p = .006). The mean number of correct answers increased from 5.87 (SD = 1.96) …

Implementing Strategies To Improve Patient Perception Of Nursing Communication, Ghada Dunbar, Stacey Nagar

DNP and Student Works

According to the Joint Commission (TJC), effective communication and patient and family centered care impacts quality and safety (2014). The aim of this project was to improve patients' perception of nurse communication in an adult inpatient telemetry unit in California by creating a training module for nurses on caring behaviors and implementing a structured rounding tool (SRT) to evaluate patient perception of nursing caring behaviors. The SRT was implemented prior to nurse education and responses before the training were compared with those after. The nurses attending a training session on caring behaviors completed the Caring Assessment for Caregivers (CACG) survey …

Implementing An Electronic Medical Record: Creating A Request For Proposal, Renee L. Kelly

DNP and Student Works

The quality of inter-professional team documentation, when documenting on paper, has consistently failed to meet the recommended standards because of ineligible handwriting, which leads to wrong information recorded in patients' charts, and incomplete health histories. When developing a comprehensive electronic medical record system to serve an orthopedic office, this requires significant time, open and honest communication, dedication from each member of the team, and resources. In an orthopedic office setting, an inter-professional team was formed to develop and evaluate a request for proposal for an electronic health record system, compared to the current documentation process influences a decision for a …

National Institutes Of Health Stroke Scale Certification Improved Assessment And Care Of Veterans: A Quality Improvement Project, Joshua W. Baker

DNP and Student Works

This pilot project sought to fill the gap in practice that included a lack of early recognition, assessment skills and practice guidelines for the care of stroke patients, improving patient care and hand off communication. A team was formed at an 11-unit Veterans Health Administration facility. The team comprised various nursing disciplines whom were invited to discuss the current state of veteran care, and current evidence based practices of stroke recognition and care. Pre- and post- intervention tests were administered and data was collected to measure the assessment, recognition, and comfort level of registered nurses (RNs). Data revealed nine out …

Change In Culture: Addition Of A Clinical Pharmacist To The Emergency Department Antimicrobial Culture Review Process, Samantha Streiff, Denise Ramponi, Thomas W. Cline

DNP and Student Works

Objective: To evaluate the effectiveness of a unit based pharmacist in assisting with antimicrobial selection of female patients discharged from the emergency department with a diagnosis of an uncomplicated urinary tract infection.

Diabetes Management In The African American Community, Ella Porter-Wright

DNP and Student Works

The purpose of this project was to explore the effectiveness of utilizing an evidence based diabetes tool kit and a physical activity program in the management of A1C levels >8.0 of African American adult patients.

The Development Of An Immunization Training Program For Low-Income Families Within The Community, Amanda W. Cooper

DNP and Student Works

Objective: The purpose of this study was to assess knowledge levels regarding childhood immunizations among low-income parents in an effort to improve the immunization rate of 19 to 35 month old children. Design and Sample: Participants (n=36) were administered a pre- and post-test questionnaire asking for correct identification of vaccine needs of children 19 to 35 months of age. Measurements: Descriptive statistics and McNemar's test were uses to answer the PICOT question and define the sample. Intervention: A QI project using the Plan-Do-Study-Act (PDSA) cycle was implemented in a public health department care setting in Georgia to provide childhood immunization …

A Quality Improvement Plan For Safe Medication Administration For Unlicensed Personnel Working In A Type "A" Assisted Living Facility, Bridgett E. Sterling

DNP and Student Works

There is an increase in Assisted Living Facilities (ALF's) throughout the United States that has been coupled with residents that have increasingly complex conditions leading to unanticipated problems related to poor medication management (Woods, Guifang, Hawsook, & Phillips, 2010). The Texas Department of Aging and Disability Services (DADS) provides the best practice guidelines for licensed Type "A" ALF in Texas and for this clinical project.

Teaching Critical Thinking With Problem-Based Learning, Christopher Cureton

DNP and Student Works

Critical thinking (CT) capabilities are crucial for the contemporary nurse and vital for the delivery of safe patient care. As health care and technology continue to evolve, so must the teaching methods used by educators to develop the CT abilities of nursing students. Teaching methods must be interactive, student-focused, and address the various learning needs of diverse student populations. The review of the literature found that the active teaching strategies of problem-based learning (PBL) and case studies are effective in promoting CT development in nursing students. The evidence-based teaching project proposes the use of PBL case studies as the primary …

Assessing Nurses' Knowledge About Autism Spectrum Disorders, Cynthia Queisser

DNP and Student Works

Background: Autism spectrum disorders (ASD) consist of a group of neurodevelopmental disorders with lifelong effects. Autism is rising at an alarming rate for unclear reasons. Increasing ASD rates create major concern for nurses in a variety of clinical surroundings and they need to be adequately prepared to interact with and provide care for these special individuals.

Method: The methodology included the use of a nonexperimental, quantitative research design using two different knowledge assessment tools, the Survey of Knowledge of Autism Spectrum Disorders among Professionals along with the Knowledge about Childhood Autism Among Health Workers (KCAHW), the implementation of an evidence-based …

Alarm Management: A Quality Improvement Project To Decreased Non-Actionable Cardiac Telemetry Alarms, Tammy Paarlberg

DNP and Student Works

A high number of non-actionable cardiac alarms compromise patient safety. Up to 99% of telemetry alarms are false or non-actionable, leaving nurses to guess which 1% of alarms are real. This alarm fatigue phenomenon leaves patients vulnerable and nurses guessing. The incorporation of evidence-based guidelines into a policy and guidelines, followed by education, is insufficient to reduce the number of alarms and alarm fatigue. Key stakeholders must make concretive efforts to effect change.