Digital Commons Network^™

The Curriculum Beyond The Curriculum: Developing The Whole Nursing Professional, Tiffani M. Wise, Lauren Sullivan, Venisa R. Morgan

Leadership Connection

The success of graduate nurses is dependent on development of the whole nursing professional, encompassing the abilities to engage, critically think, self-reflect, and manage stress. An effective partnership between faculty and the Office of Student Affairs allows for a holistic approach to learner-centered education giving students the skills for success.

Telling Our Story: From Change Resistance To Readiness, Nancyruth Leibold, Mary Bemker

Leadership Connection

Stories, transformational leadership, and change in the workplace intersect in this presentation! Change in the workplace is a challenging process. The use of stories or narratives by transformational nurse leaders is a positive strategy to promote the change process. A surgical nursing change project narrative is included.

Using Systems Thinking Leadership And Qsen Competencies To Design A Nursing Career Development Framework, Noreen T. Bernard, Cynthia A. Oster

Leadership Connection

The purpose of this presentation is to share the journey one Accountable Care Organization (ACO) took to meet the changing needs of the community by addressing current and future workforce shortages through building a sustainable nursing career development framework supported by Quality Safety Education for Nurses (QSEN) competencies.

Transforming Nurse Leaders Through A Mentored Leadership Experience, Karen M. Beranek, Kay Clevenger, Jennifer L. Embree, Jennifer L. Declercq

Leadership Connection

Session presented on Saturday, September 17, 2016.

The 2010 Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, calls for health organizations, including nursing organizations and nursing schools, to “provide nurses greater opportunities to gain leadership skills and put them into practice.” In an effort to prepare the next generation of nurse leaders, the International Leadership Institute (ILI) at Sigma Theta Tau International offers leadership development for academic and clinical nurse leaders, who wish to increase their leadership expertise. Often times, faculty members are promoted into leadership positions without adequate preparation. To facilitate this transition, the ILI …

Reboot And Refresh: How To Start Over, Jenny Paugh Hoffman, Jessica R. Wendorf

Leadership Connection

Session presented on Sunday, September 18, 2016:

Do you find that your chapter does something because 'that's the way we've always done it'? Settling into a rigid routine can make for a stale chapter experience. This session will show your leaders how to start fresh! This session is not eligible for continuing nursing education credits.

Medication Error Reduction Using Pda Technology By Nursing Students At The Point Of Care, Laly J. Joseph

Leadership Connection

Session presented on Monday, September 19, 2016:

Purpose: The purpose of this evidence-based pilot study was to determine if nursing students could calculate medications in a case study with greater speed and accuracy using a personal digital assistant (PDA) compared to students using textbooks and a calculator thereby reducing medication errors. Medication errors are a major cause of harm to patients in health care settings and reducing medication errors is a main concern in today's healthcare setting. Nurses are the main professionals involved in administering medications and administration is the part of the medication process with the least safeguards in …

Interprofessional Collaboration: A Leadership Imperative To Value-Based Care, Susan Thurman

Leadership Connection

Top priorities in all healthcare organizations are improving patient safety and the patient experience. Nationally, The IOM published concerns with fragmented processes causing harm. The Joint Commission highlighted ineffective communication as a factor in medical errors. It is crucial for leaders to promote
evidence based practices to improve patient outcomes.

Influencing Change In Developing Countries Through Mentoring Leaders: A Nursing-Led Quality Improvement Project In Peru, Patrick Albert Palmieri, Joan Elaine Edwards, Juan M. Leyva-Moral

Leadership Connection

Nurses are best positioned to lead large organizationa-

Aprn Transformational Leadership: Implementation Of Advanced Practice Nursing Leadership Structure Within An Academic Medical Center, Pam Jones, April Kapu

Leadership Connection

Session presented on Tuesday, September 20, 2016:

To meet the health care drivers of cost-effective, high quality and safe patient care, there has been a rapid growth in the number of APRNS across multiple clinical settings. More and more APRNs are rising to executive leadership levels, leading APRNs in both professional and operational practice. Bridging from clinical expert to expert organizational leader can be challenging without role development, mentorship and structural empowerment. In 2008, nursing executive leadership of an academic healthcare system recognized the need for specific leadership for APRNs deployed across multiple settings. Over a 6 year period, APRN …

Nursing Workload And Its Relationship To Patient Care Error In The Paediatric Critical Care Setting, Ruth M. Trinier

Leadership Connection

Session presented on Sunday, September 18, 2016:

Patient care error, a leading cause of death and disability in the critical care setting, contributes to suffering of the patient and family; can precipitate an emotional crisis for health care staff; and creates an increased financial burden to the health care system. Nurses, who provide the majority of direct patient care in the hospital setting, have reported a perception that increased workload contributes to many of these errors. Nursing practice, which requires complex knowledge work and vigilant patient assessment to promote best outcomes, may be compromised by time and manpower constraints. To …

Clinician Education Intervention: Adolescent Depression Management, Gina Botello

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Major depressive disorder is a mental illness that impacts adolescents' mental health. Effective treatments for major depressive disorder are available. Barriers such as clinicians' perceptions that adolescents should be referred to a child and adolescent psychiatrist when seeking mental health services marginalize the value of screening. This evidence-based quality improvement project aimed to implement a clinician-education intervention in an outpatient behavioral health clinic in a border town in Southwest Arizona using established guidelines from the American Academy of Pediatrics and the Canadian Network for Mood and Anxiety Treatments. This quality improvement project aimed to strengthen clinician use of the patient …

Promoting Safe Infant Sleep: The Creation And Appraisal Of A Practice Guideline For Nurses, Sharon C. Hitchcock

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Background: Every day in America, healthy infants are dying from sudden infant death syndrome (SIDS) and other sleep-related deaths. Once a terrifying mystery, these deaths, also called sudden unexpected infant death (SUID), are now considered preventable (American Academy of Pediatrics [AAP], 2016). SUID rates in the United States have remained stagnant and unacceptably high since the late 1990’s despite known modifiable risk factors (Centers for Disease Control and Prevention [CDC], 2017). These rates are higher than most other developed nations (MacDorman, Matthews, Mohangoo, & Zeitlin, 2014). Although prevention strategies are evidence-based and generally known and understood by nurses, studies have …

Implementing Evidence To Improve Chronic Insomnia Treatment For Older Adults In Primary Care: A Quality Improvement Project, Mariama Bayoh

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Background: Chronic insomnia (CI) affects over 50% of American adults 65 years and older. The most currently used treatment approach for this problem is inconsistent with the most up-to-date evidence-based clinical guidelines and research. Despite the apparent benefits of cognitive-behavioral therapy for insomnia (CBTI) as an effective tool for the treatment of CI in adults, pharmacologic treatment remains the standard care for CI in the primary care setting. This health care improvement project aimed to improve the application of evidence for CI treatment by increasing the clinic providers' awareness of CBTI as first-line treatment for CI.

Methods: The Plan Do …

Evidence Based Change: A Protocol To Reduce Ambulance Diversion Using The National Emergency Department Overcrowding Scale Tool, Kathryn S. Rogers

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Background: Ambulance diversion (AD) occurs when emergency departments (EDs) experience over-demand of available resources and can no longer accept ambulance patients. Current evidence however, shows that AD delays critical care, negatively impacting quality and cost. The purpose of this project was to reduce AD by creating an evidence-based protocol in the ED setting. Methods: Underpinned by Kurt Lewin's Change Theory and following a Plan Do Check Act model, a healthcare quality improvement team implemented an AD protocol in a busy urban ED. Baseline data was taken from historical hours of AD use and ambulance arrivals over the previous three years. …

Compassion Fatigue: A Leadership Driven Quality Improvement Project, Peggy Bradley

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Compassion fatigue, defined as the physical and mental exhaustion experienced by those who care for sick or traumatized people over an extended time-period (Merriam-Webster, 2019; Berg, et. al., 2016), has emerged as a leading concern for healthcare professionals and organizations locally, nationally, and globally. It negatively impacts personal and professional relationships, physical and mental health, personal and professional performance, as well as standards of patient care. Approximately 16% to 85% of the healthcare workforce suffers from compassion fatigue, putting them at increased risk for poor personal and professional judgment, reduced job satisfaction, increased turnover, and costs the economy billions of …

Evidence-Based Practice Change: Implementation Of A Collaborative Practice Model For Diabetes, Emma L. Edwards

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Background: The prevalence of type II diabetes mellitus (T2DM) in the United States is high, especially in underserved populations. Many patients with T2DM do not receive the optimal interprofessional collaborative care that has been shown to improve outcomes. A model of care that incorporates these evidence-based recommendations is integral to improving the quality of diabetes care. A growing body of literature identifies the use of a provider-clinical pharmacist collaborative practice (P-CPCP) model of care as an effective, innovative, and evidence-based practice that will improve patient outcomes.

Purpose: In response to an identified need to improve T2DM patient care in an …

Procalcitonin As A Prognostic Indicator Of Risk For Sepsis In The Neonate, Tara L. Cecil, Intermountain Healthcare, Janine Marie Saulpaugh, Paul Repass Iii Umberger

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Introduction. Procalcitonin (PCT) is a biomarker that rises at the onset of bacterial infection while remaining relatively low in other inflammatory processes. Diagnosing serious bacterial infection (SBI) in neonates presenting with fever without a source (FWS) is challenging and utilizing PCT can improve this process. This paper presents a synthesis of the evidence supporting PCT as a prognostic indicator in neonates.

Methodology. A comprehensive literature review was conducted to develop practice recommendations. A guideline, the Intermountain Healthcare Care Process Model (2013), was modified to include PCT, which was then validated by a panel of clinical experts.

Results. Evidence supports the …

The Effects Of Racial Battle Fatigue In Students Of Color: Increasing Awareness And Improving Coping Skills, Meyokia Smith

Group: Nebraska Methodist College

Students of color who attend predominately white institutions have reported experiencing racism, discrimination, or racial microaggression which has led to physiological, psychological, or behavioral stress responses coined as racial battle fatigue (RBF), a newer term describing these effects. This project sought to understand students of color's experiences of RBF through a focus support group while formulating coping mechanisms to assist students of color who may face RBF to build resiliency. The focus support group discussion concentrated on three main themes: Racial Battle Fatigue Awareness, Racial Battle Fatigue Experience, and Coping and Racial Battle Fatigue. Results from this study sought to …

A Multistudy Validation Of An Instrument For Nurse Job Satisfaction, John W. Nelson, Georgia J. Persky, Mary Ann Hozak, Alice Albu, Pamela S. Hinds, Kay Savik

General Submissions: Instruments, Tools, and Measurements

This study aims to validate an instrument of nurse job satisfaction, the Healthcare Environment Survey (HES), across settings and time through an organizational change.

Barriers And Facilitators For Successful Integration Of Nurse Practitioners Into Interdisciplinary Care Teams, Laura Stankovic

General Submissions: Clinical Settings Materials

The purpose of this review is to explore the barriers and interventions for successful NP integration to healthcare teams. Research aims are to study the evidence related to autonomy, empowerment, and physician oversight on NP practice; role ambiguity and incivility in healthcare teams; and interventions at the educational and professional levels to promote successful integration.

Workplace Health, Safety And Well-Being Of The Nurse, Registered Nurses' Association Of Ontario

General Submissions: Clinical Settings Materials

This guideline addresses the many factors that contribute to nurses' health, safety and well-being and makes specific recommendations that may influence the overall health and well-being of the individual nurse. This guideline also goes beyond global recommendations - such as developing broad-based strategies for nursing recruitment and retention - and includes recommendations specific to organizations, nursing education programs, researchers and, at the systems level, accrediting organizations.

Developing And Sustaining Nursing Leadership, Registered Nurses' Association Of Ontario

General Submissions: Clinical Settings Materials

This guideline is intended to assist nurses and others performing both formal and informal nursing leadership roles from the point-of-care to the board room, across a variety of practice domains and settings. It identifies evidence-based leadership behaviour that nurses can implement individually and collectively to benefit patients, health-care team members, organizations, systems and health-care policy, research and education.

Excellence And Evidence In Staffing, Kathy Douglas

Sigma Resource Papers

Staffing in hospitals and healthcare systems is complex, increasingly regulated, and closely associated with patient safety... Consequently, healthcare administrators are under pressure from insurers, patient advocates, unions, and state and national governments to define, secure and assure effective, safe, cost-effective staffing...

An issue that aΩects an organization so pervasively, cries out for definition. So this quest began by asking “What is excellent staffing?” And then, “How do we know when we’ve achieved it?” Investigation into these questions generated a lot of interest, but few answers. Thus the decision to convene an invitational conference that would bring a broad spectrum of …

Nurse Faculty Perceptions Of Role Stress And Faculty-To-Faculty Incivility, Anne K. Kleinhesselink

Dissertations

The purpose of this study was to determine the relationship between nurse faculty perceptions of role stress and faculty-to-faculty incivility using the stressor-emotion model of counterproductive work behaviors. A convenience sample of 79 nurse faculty from 39 undergraduate nursing programs in Iowa responded to an online survey. The survey consisted of two instruments: Workplace Incivility Civility Scale and Role Strain Scale. Findings revealed 76 participants perceived incivility as a problem and identified stress (n = 64) and demanding workloads (n = 54) as contributing factors. Pearson correlation results revealed a positive relationship between experienced incivility and nurse faculty …

Reducing Emergency Room To Inpatient Disposition Time, Kyle Disney, Beyli Disney

DNP and Student Works

Prolonged boarding times in the emergency department negatively impact patient outcomes, leading to increased mortality, infection rates, and decreased patient satisfaction. Effective and timely communication during handoffs between healthcare professionals is crucial to minimize these delays and improve overall patient care, with the use of standardized handoff tools significantly reducing adverse events and length of hospital stay. This Doctor of Nursing Practice (DNP) project investigated the impact of implementing a handoff tool on decreasing emergency room to medical surgical unit disposition time. Kurt Lewin's three-step model of change, popular among healthcare organizations, was used as the theoretical framework for this …

A Comparison Between Unit-Based Education And Centralized Education Among Staff Nurses, Marilyn J. Campbell

Dissertations

Educating staff nurses is pivotal in the evolving healthcare environment. Two staff development models used in the healthcare setting are unit-based and centralized. Unit-based education is a staff development model that places educators on individual units. These educators direct the educational development of staff nurses on their assigned units. Centralized education meets generalized learning needs and provides nursing departments with scheduled education sessions or impromptu meetings regarding changes to policies and procedures. In addition, centralized educators are assigned to address the learning needs of the nurses on several units with universal orientation (Cummings & McCaskey, 1992), coordinate and implement intravenous …

Early Identification Of Postpartum Depression Symptoms During The Antenatal Period Using The Edinburgh Postnatal Depression Scale, Cherie Didier

DNP and Student Works

This quantitative quality improvement project aimed to assess the effectiveness of implementing the Edinburgh Postnatal Depression Scale (EPDS) during the prenatal period in an obstetrical clinic in Memphis, TN. The primary research question was to investigate whether prenatal screening for postpartum depression (PPD) using the EPDS is effective in identifying at-risk individuals and improving maternal mental health outcomes.

Implementation Of Tai Chi Fall Prevention Program In A Community-Based Setting, Shabnampreet Kaur

Dissertations

The increasing rate of falls among older adults is a health concern that may lead to injuries and reduced quality of life. At the project site there was no systematic process to impact fall rates, so an evidence-based solution was sought. The purpose of this quality improvement project was to determine if the translation of Li et al.'s research regarding the Tai Chi fall prevention program would impact the rate of falls among adults 65 years and older. The project was piloted over 12 weeks in a community-based setting in urban New York. Imogene King's goal attainment theory and Kurt …

Neonatal Intensive Care Nurses' Perceptions Of Nurse Leader Behaviors And Their Impact On The Workplace Environment, Meggan R. Mcculley

Dissertations

Nursing leadership is a crucial component in today's healthcare organizations as nurses make up the largest profession in healthcare overall. Nurse leaders have the ability to affect the environment of the nurses' workplace in both positive and negative ways, thus impacting their Quality of Nurse Work Life (QNWL). QNWL is an indicator of nurse satisfaction within their workplace, and the ability of the nurse to make meaningful contributions to their home units and the organization. The purpose of this qualitative, interpretative phenomenological analysis (IPA) study was to describe what it meant to experience nursing leadership from the perspective of Level …

Expediting Stroke Transfers: Improving Door-In Door-Out Times In A Community Hospital Emergency Department, Susan E. Maynard

Dissertations

Patients with acute ischemic stroke are at high risk for death and disability without rapid treatment. Thrombectomy is a time-sensitive procedure that can restore blood flow to the brain.