Digital Commons Network^™

Express Yourself! Implementing An Evidence-Based Intervention To Improve Efficacy Of Transformational Leadership For Nurse Managers, Jenna Blind

Dissertations

Transformational leadership is the antecedent of a healthy work environment, satisfied employees, and high quality patient outcomes. Implementing evidence-based interventions to improve upon principles of transformational leadership aligns with the recommendations set forth by the Institute of Medicine's (IOM) Future of Nursing Report (2011). The precursor to developing a leadership workforce that is able to manage change, help others work towards a shared vision, and engage healthcare providers to strive for excellence in care delivery. The purpose of this scholarly project was to improve efficacy of transformational leadership skills of nurse managers using an evidence-based expressive writing intervention and to …

Evaluating Critical Thinking In New Graduate Nurses Through Reflective Journaling, Robbin Guynn

Sigma Foundation for Nursing Research Grant Reports

The purpose of this project is to look at the development of critical thinking in newly graduated nurses to see if reflective journaling can help accelerate the process.

Using Ultrasound-Guided Peripheral Intravenous Access In Difficult Intravenous Access Patients, Diana Hampton

Dissertations

Inserting a peripheral intravenous catheter (PIVC) can be challenging on the first attempt. At the project site there was no systematic process to impact failed first-attempt success for PIVC access, so an evidence-based solution was sought. The purpose of this quality improvement project was to determine if the implementation of the Emergency Nurses Association's (ENA) Clinical Practice Guideline: Difficult Intravenous Access would impact the number of patients identified as difficult intravenous access (DIVA) and first-attempt success for peripheral intravenous access. The project was piloted over 12 weeks in a community living center in a Veterans Administration facility in the southern …

Improving Nurse's Documentation In The Emergency Department, Jacqueline N. Wright-Cole

Dissertations

The appropriate documentation and effective hand-off communications are essential components for attaining and maintaining the continuity of quality care for patients in the emergency department. Despite global efforts and standards geared towards improving the accuracy and function of documentation, the issue of incomplete documentation and hand-off communication persist in the local emergency department. Incomplete documentation and handoff communications have been regarded as key factors of delayed patient care as well as discontinuation of care in the clinical setting. A detailed study conducted for evaluating the effectiveness and benefits of the Institute Healthcare Improvement SBAR guideline as a checklist on nurses' …

Implementing Clinical Practice Guideline To Impact Postpartum Hemorrhage Among Immediate Postpartum Mothers, Teresa C. Okolo

Dissertations

Postpartum hemorrhage (PPH) can lead to untoward conditions in mothers following childbirth. At the project site there was no accurate method for measuring blood loss, resulting in the early identification of PPH, so an evidence-based solution was sought. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if the implementation of the California Maternal Quality Care Collaborative (CMQCC) Quantitative Blood Loss (QBL) Clinical Practice Guideline (CPG) would impact blood loss within two hours post-delivery among mothers with a vaginal or cesarean delivery in an urban hospital in New York over four weeks. Kristen Swanson's theory of caring …

Gamification And The Effects On Confidence In The Student Nurse, Gerald R. Connors

DNP and Student Works

Nursing educators are challenged with conveying vast amounts of complex nursing arts and science content to learners every day. The relationship between learner and nursing educator should be one of collaboration to ensure the smooth instruction of broad and deep nursing concepts. Knowledge acquisition, confidence, learner engagement and enjoyment are critical to the learning process, but often students are challenged with these behaviors (Garrison et al., 2021). Research in the last five years has suggested that the use of gaming in the nongaming setting, like clinical healthcare, can strengthen knowledge, increase content retention, and subsequently increase confidence (Marquez-Hernandez et al., …

Health Literacy: The Knowledge And Experiences Of Senior Level Baccalaureate Nursing Students, Catherine M. Cormier

Dissertations

The purpose of this study was to assess the health literacy knowledge and experiences of senior level baccalaureate nursing students enrolled at state universities in Louisiana. Three hundred and sixty-one students from eight baccalaureate nursing programs agreed to participate in the study.

Rewards, Challenges, Coping, And Recommendations For Improvement In Two Nursing Schools During The Covid-19 Pandemic, Kala Ann Mayer, Lorretta Krautscheid

Creating Healthy Work Environments (CHWE)

By attending this session, you will be able to describe nursing faculty and student challenging and rewarding experiences during nursing school in an ongoing pandemic environment, coping strategies, and professional quality of life enhancement recommendations at two institutions of higher learning.

Detailed abstract attached.

Impact Of Delirium Observation Screening Scale On Identifying Delirium In Hospice Patients, Elsie E. Glasu-Atunuwa

Dissertations

Delirium in the elderly can impact health outcomes, making it essential for healthcare workers to identify and manage delirium early. At the project site, there was no evidence based approach to the early identification of delirium. The purpose of this quantitative quasi-experimental quality improvement project was to determine if the translation of Neefjes et al.'s research using the Delirium Observation Screening Scale (DOSS) would impact the identification of delirium with provider notification among adult patients in a hospice facility in South Texas over four weeks. Virginia Henderson's need theory and Kurt Lewin's change theory provided the theoretical foundations for the …

The Magnet Journey: Understanding The Role Of Unit Culture In Evidence-Based Practice Adoption, Kim Schippits

Dissertations

The purpose of this exploratory study was to identify salient cognitive beliefs and cultural assumptions that affect the emergence and maintenance of evidence-based practice (EBP) in the hospital setting.

A Post Pandemic Intervention To Reduce Burnout In Nurses In An Acute Care Setting, Erica J. Larson

DNP and Student Works

The purpose of the project was to determine in nurses working in an acute care setting how a positive psychology intervention (Three Good Things), compared with no positive psychology intervention, affects perceived burnout within a four- week period of time.

Exploring Nurse Job Satisfaction, Lisa Bauer

DNP and Student Works

This project explored the relationship between nurse job satisfaction following the initiation of a shared governance communication framework in a Birth Center in a small Minnesota hospital. Shared governance is a communication framework where frontline nursing staff were involved with the hospital nurse leadership team in a unit-based decision-making process that impacted their daily work.

Engaging Interprofessional Collaboration In The Implementation Of Breastfeeding Patient Education In The Prenatal Setting, Lisa Cerqua, Dawn Davison, Caitlin Dwyer, Janice E. Hobba-Glose

Creating Healthy Work Environments (CHWE)

True collaboration is a crucial component of implementing change and promoting a healthy work environment in the healthcare setting. This project highlights the significance of collaboration in implementing a standardized prenatal breastfeeding education curriculum. The outcome demonstrated successful improvement in breastfeeding initiation rates and achievement of Baby Friendly Hospital Designation.

Cultivating Your Most Precious Resource Through Professional Development, Lynn W. Newberry

Creating Healthy Work Environments (CHWE)

A robust continuous professional development program (CPD) is critical to ensure excellent outcomes. It is essential for leaders to understand the factors that enhance the impact of CPD on its workforce. This presentation will provide three strategies for healthcare leaders to consider when cultivating their most precious resource.

Fostering Resilience Among Nurses For Healthy Work Environment: A Systematic Review, Divya Raghavan, Teena Jones, Sangeeta Edward

Creating Healthy Work Environments (CHWE)

Stressful work environments have serious implications. Nurses working in a challenging atmosphere have increased risk of psychological burnout syndrome, emotional exhaustion, and other health-related symptoms. Nurses who have better adaptations thrive the best in midst of adversities. It is imperative to foster nurse resilience to create a positive work environment.

Piloting The Practice Of Centering In Clinical: An Exploration Of Students' Perspectives, Zarah Borines, Cecelia Fernan

Creating Healthy Work Environments (CHWE)

Nursing students in the clinical setting practiced centering during three successive weeks. Centering, through pausing, contemplation and intentional breathing, is a way to live Watson's (2018) Caritas Process 1 of cultivating loving-kindness and equanimity and Caritas Process 2 of being authentically present.

The Experience Of Transitioning For The Transgender Person: An Appreciative Inquiry Approach To Advance Gender Affirming Care, Shelley Evans

Dissertations

The process of transitioning has a significant impact on improving quality of life among transgender and nonbinary people (Johansson et al., 2010). Transitioning is the act of moving towards a gender identity that feels more aligned with internal identity (Rankin & Beemyn, 2012). However, despite promising research that supports the benefits of medical, social and/or legal transitioning, the understanding of the experience has not been fully explored (Evans et al., 2021), and it is a barrier to advancing the delivery of gender affirming care among nurses, other health care providers, and health care organizations. There is a need to awaken …

Improving Recognition Of Depression Among The Adult Patients In Psychiatric Settings, Jane A. Ferraris

Dissertations

Depression rating scales may improve depressive symptom identification. At the project site, there was no consistent process for determining patients' depressive symptoms, so an evidence-based solution was sought. The purpose of this quality improvement project was to determine if the translation of Dunlop et al.'s research utilizing the Hamilton Depression Rating Scale-6 (HAMD-6) would impact the rate of identification of depressive symptoms and referrals to psychology for Cognitive Behavioral Therapy (CBT) among adult patients.

It's More Than Nursing: The Experience Of Psychological Safety Of Pre-Licensure Nursing Students Who Identify As Black, Indigenous, And People Of Color, Melissa M. Anozie

Dissertations

The healthcare environment mandates its staff are able to communicate freely and openly to provide high quality patient care leading to positive patient outcomes. As the largest healthcare profession and those who are at the bedside most often with patients, registered nurses play a vital role in ensuring these outcomes. As advocates for the most vulnerable, nurses must communicate often but before doing so, they must feel psychologically safe. Psychological safety is how one perceives the benefits, risks, and consequences of asking a question, sharing an opinion, reporting an error, or revealing one's true self to others. It is a …

Evidence-Based Practice Sustainability And Nursing Professional Governance, Melora D. Ferren

Dissertations

Patient care that is not based on evidence-based practice (EBP) could be considered malpractice, and it threatens patient safety, quality, and fiscal performance. EBP implementation is complex, and sustainment of these practices is such a persistent challenge that up to 70% of organizational change fails to be sustained. Sustainment of EBP decreases healthcare costs and improves patient outcomes. Professional attributes that influence sustainability are not well understood. Nursing professional governance (PG) is a framework of professional attributes that includes accountability, professional obligation, collateral relationships, and decision-making. This framework includes attributes that are necessary for professionals to effectively govern their profession …

Development And Evaluation Of A Policy Recommendation For Improving The Palliative Care Experience: A Quality Improvement Project, Cheryl Evans, Melissa George, Jade Jasken, Eleanor Jones

DNP and Student Works

Nature and Scope of the Project: Background: Palliative Care (PC) is the practice of alleviating and preventing symptoms of chronic or life-threatening illness across the lifespan (WHO, 2018). Unlike hospice care, PC can be considered along with curative treatment to focus on symptom management and goals of care to improve the patient's quality of life. An estimated 40 million people worldwide are in need of PC services, with only 14% currently receiving it (WHO, 2018). Objective: To develop a policy recommendation that increases knowledge of PC practices as well as encourages the use of a screening tool to increase necessary …

Program Effectiveness Of A New Nurse Mentorship, Jennifer Malig

Dissertations

Nurses are leaving the bedside at alarming rates impacting healthcare organizations. It is well documented the need will surpass demands increasing strain and stress for already struggling healthcare facilities and team members. After reviewing literature for reasons for increases and ideas to decrease nursing turnover, it was discovered new nurses leave the profession within their first year. According to the 2021 NSI National Health Care Retentions and RN Staffing Report, since the COVID-19 pandemic, rates of nurses leaving the bedside has increased to 19.5%.

A new nurse mentorship began July 2022. The goal of the program was to increase new …

Perceptions Of Role Transition Among Nurses Working In Both Clinical And Faculty Positions, Teresa A. Wenner

Dissertations

In response to the current nurse faculty shortage and the anticipated return of a nationwide shortage of Registered nurses (RNs), the use of part-time clinical nurse educators has been increasing. It was not known how nurses experience the work-role transition from clinical expert to part-time clinical faculty member when they subsequently work in both a clinical and an academic setting. Thus, the purpose of this qualitative phenomenological study was to explore this population. Research questions were: 1) How do part-time clinical nurse faculty members perceive the work-role transition from clinical expert to clinical instructor when they continue to maintain their …

Development Of A Medication Reconciliation Policy In Outpatient Mental Health Facility, Karen E. Webster

DNP and Student Works

Adverse drug events and medication discrepancies are patient safety challenges for patients and healthcare professionals. Medication errors result in approximately 7000 deaths annually, and adverse drug events harm 1.5 billion people and cost $3.5 billion annually (Dunham & Makoul, 2008). Medication reconciliation can significantly decrease medication errors. "It involves obtaining, verifying and documenting the patient's current medicines and comparing to their medication orders and the patient's condition to identify and resolve any discrepancies" (Duguid, 2012, p. 15). The deliberate time taken to complete medication reconciliation plays a significant role in patient care, along with increasing the quality of care provided. …

Frameworks For Patient Safety In The Nursing Curriculum, Theresa M. Chenot

Dissertations

Patient safety (i.e., the degree to which patients are free from accidental injury) has received a great deal of media coverage during the past few years. Professional and regulatory agencies have indicated that patient safety education should be provided to healthcare workers to improve health outcomes. The primary purpose of this exploratory study was to gain a better understanding of the current status of patient safety awareness among pre-licensure nursing students. To this end, six research questions guided the study:

1. Will interpretable item constructs be identified when responses to the Healthcare Professional Patient Safety Assessment Curriculum Survey (HPPSACS) are …

Improving Patient Care Through Effective Nurse Delegation To Assistive Personnel, Toni Hamilton

DNP and Student Works

A pre/post survey design was employed to assess the knowledge and willingness of medical surgical-telemetry nurses to delegate tasks to AP working within a new caregiver model after receiving an educational intervention. Patient falls and HAPI rates were collected pre/post intervention and compared for statistical differences.

Improving Provider Confidence And Knowledge Of Sexual Assault Treatment Through Education And Guideline Implementation, Tera Sabatino

DNP and Student Works

Sexual assault is a pervasive public health concern that disproportionately affects women and can have long-term effects in every aspect of a woman's life (Nathan & Ferrara, 2020). While acute treatment of sexual assault has been standardized, follow up care for victims has not. This project was created to improve OB-GYN provider confidence and competence when treating sexual assault victims in the clinic. Education as well as treatment guidelines and tips were used as an option to fill this care gap. Objectives of the project included improving knowledge of sexual assault and treatment through education as well as improving standardized …

Emergency Department Bedside Handoff Report For Increased Communication And Patient Experience: A Quality Improvement Health Program, Mickey Muller

DNP and Student Works

A BHR process was implemented in a suburban ED on the 7:00 AM, 3:00 PM, and 11:00 PM shift changes to improve communication and patient experience. Nurse perceptions of care quality were explored using a survey with a four-point Likert scale, and nurse compliance with the program was evaluated with a self-auditing tool.

The Effect Of Patient Activation On Transition Clinic Adherence, Megan S. Mcgraw

Theses

Heart failure (HF) affects more than five million Americans and is one of the most commonly occurring reasons for admission to the hospital among adults aged 65 and over. Evidence is growing that the higher amount of patient engagement or activation, the better the health and cost outcomes. The purpose of this study was to determine if there was a relationship between a higher patient activation score, as determined by the PAM-10, and completion in the heart failure transition clinic. The design for this study was a quantitative descriptive study. The patients were given the questionnaire prior to discharge from …

The Attraction Of Nursing Academia To Practicing Nurses: A Phenomenological Study, Edna R. Magpantay-Monroe

Dissertations

Nursing faculty shortage is a critical issue that required investigating because the demand for producing nurses is increasing. The purpose of this qualitative study was to understand the phenomenon of why nursing academia is attractive to practicing nurses. Using a phenomenological research design, the study focused on exploring the lived experiences of 20 practicing nurses in the teaching profession. Written reflections and semi-structured interviews were used to gather the data. The major findings of the study provided insights into the participants' passion for teaching and continuous learning. The themes that emerged as viable and sustainable recruitment and retention strategies are: …