Medicine and Health Sciences Commons^™

Protocol: Factors Influencing The Implementation Of Non-Pharmacological Interventions For Behaviours And Psychological Symptoms Of Dementia In Residential Aged Care Homes: A Systematic Review And Qualitative Evidence Synthesis, Hunduma D. Ayeno, Gizat M. M. Kassie, Mustafa Atee, Tuan Nguyen

Research outputs 2022 to 2026

This is a protocol for a Cochrane Review. The objectives are as follows. This paper aims to describe a protocol for a systematic review that will synthesise the qualitative evidence regarding factors influencing the implementation of non-pharmacological interventions (NPIs) for behavioural and psychological symptoms of dementia (BPSD) management in residential aged care homes (RACHs). The planned systematic review aims to answer the research question: ‘What are the factors influencing the implementation of NPIs in the management of BPSD at RACHs?’. Additionally, the planned systematic review also aims to generate recommendations to guide stakeholders (e.g., clinicians and aged care staff) and …

Development Of A Midwifery Student Peer Debriefing Tool: An Interpretive Descriptive Study, Kate Buchanan, Carolyn Ross, Dianne Bloxsome, Jen Hocking, Sara Bayes

Research outputs 2022 to 2026

Background: Psychosocial traumatisation associated with giving birth, can occur in those present with the woman giving birth, a phenomenon known as vicarious trauma. It has been identified that there are currently no interventions available for midwifery students who have experienced vicarious trauma following difficult birth experiences. Objective: To explore whether the counselling intervention developed by Gamble et al. (2005), can be adapted for midwifery students to be appropriately and feasibly used as a counselling intervention with peers who have experienced midwifery practice-related vicarious trauma. Design: Interpretive descriptive methodology. Setting: This study was set at two Australian universities from which pre-registration …

Improving The Utilization Of Lunch Breaks For Nursing Staff, Norma Dawson, Kelsey Robinson, Bridget Miller, Deborah Monck, Beth Kessler

Operational Transformation

The Med-Surg Unit at LincolnHealth has a high number of nursing staff missing lunch breaks, despite encouragement and existing efforts to promote taking breaks. In addition, there are many instances where staff are not accounting for the breaks they have taken on their time sheets.

The Impact Of Reporting Patient Safety Events: An Integrative Review, Catherine M. Amitrano

Doctoral Dissertations and Projects

Since the 1999 Institute of Medicine landmark report, To Err is Human, leading organizations such as the Agency for Healthcare Research and Quality have been working with healthcare leaders to reduce patient harm. A problem in healthcare is errors continue to occur at alarming rates. The COVID-19 pandemic impacted patient safety efforts and organizations are trying to get to pre-pandemic patient safety progress. The purpose of this integrative review was to review and evaluate individual research studies on patient safety event reporting and summarize what is known about the topic in terms of how patient safety event reporting impacts patient …

Faith-Based Intervention To Prevent Adolescent Self-Injury: An Integrative Review, Adekemi O. Akinyemi

Doctoral Dissertations and Projects

This integrative review explores the efficacy of incorporating faith-based (Christian/spiritual) interventions within the framework of Dialectical Behavior Therapy (DBT) to prevent non-suicidal self-injury (NSSI) among adolescents aged 11-19. As the prevalence of NSSI among this demographic group continues to rise, understanding the potential benefits and challenges of integrating faith-based components into evidence-based therapeutic approaches is crucial. The review synthesizes existing literature, drawing on empirical studies, theoretical frameworks, and clinical evidence to assess the impact of faith-based integration in DBT. Through a comprehensive analysis of diverse sources (e.g. CINAHL, PubMed, PsycINFO, NIH) this review was able to shed light on the …

Improving The Socio-Emotional Competence Of Academic Nurse Educators: An Experimental Study, Helen Freeman

Doctoral Dissertations and Projects

An academic nurse educator with a high level of socio-emotional competence (SEC) can create an inviting learning environment that promotes the highest level of achievement from students. The purpose of this two-group pretest-posttest experimental study was to determine the extent of effectiveness of socio-emotional intelligence education and a reflection-guided professional development plan in improving the socio-emotional competence of academic nurse educators. The Bar-On emotional social intelligence (ESI) conceptual model and the Purkey invitational theory were frameworks used to guide the study. The Emotional Quotient Inventory (EQ-i 2.0) was used as the data collection instrument to measure the pretest and posttest …

Facilitator Ethnicity And Clinical Judgement Among Senior Minority Students Using Unfolding Case Studies, Rachael King

Doctoral Dissertations and Projects

Unfolding case studies are a technique used in advancing critical thinking in order for nursing students to enhance their clinical judgement. The format at which they are delivered can influence the degree of learning, understanding, applying, analyzing, and evaluating for students, especially senior minority nursing students. This quasi-experimental posttest survey between-groups study involved implementing unfolding case studies with a randomly selected minority or non-minority facilitator video recording for senior minority nursing students. After completing the case study, all participants were given a posttest survey, the Clinical Decision Making in Nursing Scale (Jenkins, 1983). The survey evaluates students’ self-perceived clinical judgement. …

Do More Than Train New Nurses...Retain Them! A Qualitative Research Study, Kerrin L. Hampton

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study is to understand the orientation experiences of new graduate nurses and identify retention practices that are relevant and beneficial to the population of interest. Study participants were new graduate nurses employed at a five-hospital healthcare system. Using social constructivism as the theoretical framework, the study sought to answer the research question of what are the lived experiences of new graduate nurses during orientation? Ten new graduate nurses participated in individual interviews to discuss their personal orientation experiences. The interviews informed the researcher regarding the meaning and value new graduates place on their orientation …

Approach To Pivie In Pediatrics: Standardization For Early Detection, Jamie Green, Jill Gregory, Elizabeth Murphy, Jessica Miller, Nicole Manchester, Frank Harris, Meaghan Wildes, Cecilia Inman, Jenn Paradis, Faye Weir

Operational Transformation

PIVIE (Peripheral Intravenous Infiltration & Extravasation) can have devastating effects, especially in the pediatric population. The condition may disrupt vasculature severe enough for permanent skin and tissue loss that can lead to impaired limb function due to severe scarring. Problem: No standardized process existed either to prevent or review these events at Barbara Bush Children’s Hospital at Maine Medical Center prior to the study. PIVIEs were measured through the event reporting platform and only severe PIVIEs were being documented in this report. All infiltrations (1-4 on the infiltration scale) should be measured for accurate benchmarking. Occurrences in the electronic medical …

Undergraduate Baccalaureate Nursing Student Knowledge And Attitudes Towards Neonatal And Pediatric Pain Management Practices, Jordan Lee Slowik

Doctoral Dissertations and Projects

Research has indicated that pain management practices amongst registered nurses is inadequate across all age groups; however, it is frequently noted that children receive less analgesia in comparable situations than adult clients leading to harmful and costly consequences. There is a distinct gap in nursing educational research understanding nursing student knowledge and attitudes towards neonatal and pediatric pain management practices. Using a convenience sample from a private, Christian-based university in the southeastern United States, this study used a quasi-experimental, one-group pretest/posttest design to understand the impact of elective nursing courses on undergraduate baccalaureate nursing student knowledge and attitudes towards neonatal …

Improving Access To Mainehealth Care At Home, Amanda Kunkel, Mhcah Intake Department, Mhcah Scheduling Department, Mhcah Clinical Leadership Team

Operational Transformation

It is known that there are capacity limitations at MaineHealth Care at Home caused by a decrease in staffing. This leads to limited availability of home health services to patients in the community and can also contribute to increased length of stay for patients in acute care hospitals. MaineHealth Care at Home needs a way to measure current capacity to accept referrals and improved systems for communicating with referral sources.

The Long And Winding Road: What Comes Next After Detox, Michelle Pryce, Karen Lasater

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Detoxification centers are specialized facilities treating patients with substance use disorder (SUD). The detoxification process is a medically managed treatment where substances are slowly weaned from the body. This process lasts approximately 5-7 days. Most patients meet the criteria for SUD upon admission, but do not seek specialized post-discharge treatment, which has been found to increase long-term sobriety.

LOCAL PROBLEM: The site was a 16-bed adult detoxification center located in South Carolina. The operations manager identified there was no standardized discharge educational planning process to support long-term sobriety. This project’s aim was to increase the percentage of …

Dnp Final Report: Effects Of Open-Access Scheduling On Patient No-Show Rates In An Outpatient Clinic, Maria Aileen A. Wilkinson Msn, Mba, Rn

DNP Final Reports

No-show rates in a South Texas outpatient clinic have been as high as 16% to 20% which increases wait times to be seen in the clinic and decreases patient access to outpatient care. This no-show rate data has continued despite multiple interventions that have been implemented in an academic health science center. Physical, socio-economic, geographic, and health/lifestyle factors affecting no show or missed appointments are crucial to determining the most appropriate interventions to alleviate this issue. No-show rates are important metrics to improve because it directly affects the organization's revenue, access to care, and appointment wait times. Research evidence regarding …

Utilization Of Depression Screening In Patients With Type 2 Diabetes Mellitus, John T. Norris Bsn, Rn, Dnp-Pmhnp Student, Robin Gordon Bsn, Rn, Dnp-Pmhnp Student, Margaret Harvey Phd, Aprn-Bc, Acnp, Chfn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes is a chronic metabolic disorder affecting millions of individuals worldwide. Research has shown that individuals with diabetes are at a higher risk of developing depression in comparison to those of the general population. Depression affects the individual's emotional well-being and has a significant impact on the management and outcomes of diabetes (Mather, 2022). This research study aims to investigate the feasibility and effectiveness of implementing the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is one the most effective assessment tools available to identify symptoms of depression (Celik, 2020).

Methods

In this retrospective chart review, at least 50 …

Addressing Social Determinants Of Health In Medication-Assisted Treatment Programs, Audrey Hunter

The Eleanor Mann School of Nursing Student Works

ntroduction: Medication-assisted treatment (MAT) is considered the most effective treatment for patients with opioid use disorder (OUD); however, MAT program retention rates are consistently low across the United States. Addressing social determinants of health (SDOH) through text message could impact MAT retention; therefore, a pilot project at a federally qualified healthcare center (FQHC) was implemented.

Methods: The Protocol for Responding to and Assessing Patients’ Assets, Risk, and Experiences (PRAPARE) SDOH screening tool was implemented for patients undergoing MAT for OUD. Community resource referrals were provided via text message based on the screening results. Retention in treatment was measured by prescriptions …

Improvement Of Patient Outcomes Through The Use Of Intensivist Nurse Practitioners, Leigha Fish

The Eleanor Mann School of Nursing Student Works

This mixed retrospective and prospective cohort study aimed to compare mortality outcomes and associated factors between two cohorts of patients diagnosed with respiratory failure: on-call physicians and Interventional Nurse Practitioners (INPs). The analysis involved 143 patients, 82 in the on-call physician cohort and 61 in the INP cohort. Contrary to initial expectations, the two cohorts had no significant difference in mortality rates (p = 0.143). However, significant differences were observed in critical variables affecting mortality, including Time from Admit to Procedure Performance (p = 0.029), ICU Length of Stay (p = 0.013), and Ventilator Days (p = 0.048), with INP-managed …

Screening For Social Determinants Of Health Screening In The Primary Care Setting: A Quality Improvement Project, Arifa Khan

DNP Projects

Significance and Background: Social determinants play a major role in the overall health of our nation. While screening for social determinants of health (SDOH) in the primary care setting is encouraged, there is no streamlined process in place. Studies have determined that improved SDOH screenings can result in better patient outcomes and a decrease in healthcare costs. A protocol to improve SDOH screenings was needed to guide patient outcomes at a Federally Qualified Health Center (FQHC) in Connecticut.

Purpose: Deliver education to providers and healthcare staff across the health system on significance of social determinants of health and PRAPARE screening …

The Association Between Nurse Staffing And Quality Of Care In Emergency Departments: A Systematic Review, Jonathan Drennan, Ashling Murphy, Vera J. C. Mccarthy, Jane Ball, Christine Duffield, Robert Crouch, Gearoid Kelly, Croia Loughnane, Aileen Murphy, Josephine Hegarty, Noeleen Brady, Anne Scott, Peter Griffiths

Research outputs 2022 to 2026

Background: The relationship between nurse staffing, skill-mix and quality of care has been well-established in medical and surgical settings, however, there is relatively limited evidence of this relationship in emergency departments. Those that have been published identified that lower nurse staffing levels in emergency departments are generally associated with worse outcomes with the conclusion that the evidence in emergency settings was, at best, weak. Methods: We searched thirteen electronic databases for potentially eligible papers published in English up to December 2023. Studies were included if they reported on patient outcomes associated with nurse staffing within emergency departments. Observational, cross-sectional, prospective, …

Implementation Of An Education Program To Decrease Inpatient Falls, Elizabeth M. Carpenter, Jewyl Gibson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Inpatient falls are affecting 1 million patients across the United States every year with 25% of fall resulting in injury. Approximately 25% of falls are preventable with accurate assessment and appropriate fall precaution interventions. According to the literature, obtaining an accurate fall risk assessment is the first step in inpatient fall prevention.

LOCAL PROBLEM: Patient falls increased on 2 cardiac stepdown units in a level III trauma center in Knoxville, Tennessee. From 2020- 2022, the combined units experienced a 48% increase in patient falls. Nursing leadership identified staff knowledge deficits and inaccurate scoring of fall assessments as primary contributors …

Using The Confusion Assessment Method For The Intensive Care Unit (Cam-Icu) To Decrease Length Of Stay: A Scoping Review, Brooke D. Ward Bsn, Rn, Dnp Agacnp Student, Martina Little Bsn, Rn, Dnp Agacnp Student, Tracy Mcclinton Dnp, Agacnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is a prevalent challenge among ICU patients, impacting approximately 30% of admissions (Brennan et al., 2023). If left untreated, delirium can increase use of restraints, hospital length of stay, intensive care unit length of stay, and ultimately, morbidity and mortality. This scoping review assesses the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) to gauge its efficacy in reducing the length of stay in the ICU for adult patients with delirium.

Methods

A literature review from 2018 and 2023, using PubMed, CINAHL, and Medline were utilized for the search along with key words such as: length of …

The Efficacy Of High-Fidelity Simulation On Knowledge And Performance In Undergraduate Nursing Students: An Umbrella Review Of Systematic Reviews And Meta-Analysis, Celeste Marie Alfes

Faculty Scholarship

Objectives: This umbrella review aimed to consolidate the evidence base on the impact of high-fidelity simulation on knowledge and performance among undergraduate nursing students. Design: Umbrella review with meta-analyses of pooled effect sizes, followed by an additional meta-analysis of primary studies from the included systematic reviews, excluding overlapping results. Data sources: Systematic searches were performed up to August 2023 in PubMed, Embase, and Cochrane Library. We included reviews that compared high-fidelity simulation against other learning strategies. Review methods: The risk of bias was assessed for each included systematic review (ROBIS tool) and primary study (RoB 2 or ROBINS-I as appropriate). …

Medication Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates, Kayla Sherea Williams Bsn, Rn, Hannah Lee Brenner Bsn, Rn, Madison Makenzie Yount Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Background The Centers for Disease Control and Prevention (CDC) found that each day more than 140 U.S. residents die from drug overdoses, specifically due to opioids. Due to this, alternatives were created to reduce overdoses and ensure safety. Medication assistance therapy (MAT) is an effective form of treatment for people with substance use disorders and is defined as the use of medication in conjunction with counseling or therapy for the treatment of substance use disorders. The efficacy of MAT is used adjunctively with psychotropic medications compared to using no MAT and using psychotropic medications alone with individuals who are experiencing …

Strategies To Reduce Ventilator-Associated Pneumonia Incidence In Mechanically Ventilated Pediatric Critical Care Patients: A Scoping Review, Morgan A. Moore Bsn, Rn, Kianna Cherry Bsn, Rn, Mallory Crenshaw Bsn, Rn, Rachel Kincy Bsn, Rn, Christen N. Parnell Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose/Background

Ventilator-associated pneumonia (VAP) is a severe problem in pediatric intensive care units (PICUs), resulting in increased morbidity, mortality, duration of stay, and healthcare expenses. Traditional preventative measures are well-established, but the influence of ventilator filters in preventing VAP is unknown. The current evidence on the efficacy of VAP bundles and ventilator filters is variable and challenging to address. This scoping review aims to determine how VAP bundle compliance and ventilator filter utilization impact the incidence of VAP in mechanically ventilated pediatric critical care patients.

Methods

A scoping review was carried out per the Population, Concept, and Context (PCC) framework. …

Cognitive Behavioral Therapy To Prevent Nurse Burnout In Sub-Saharan Africa, Anna C. Johnson

MSN Capstone Projects

Overall, burnout prevention has been shown to foster nurse resilience, ability to cope with stressors, teamwork, and improving the personal value of “doing good” and “being good”; the effects have been shown to last between 6 months and one year. The current evidence is strong enough to recommend a change to current nursing practice via annual Cognitive Behavioral Therapy (CBT) trainings to strengthen nurse resilience.

This researcher proposes to implement a CBT-based burnout prevention program in Ghana’s capital of Accra in sub-Saharan West Africa. There is ample evidence that African nurses face many of the same burnout issues that nurses …

Decreasing Re-Intubation Rates In Mechanically Ventilated Adult Patients: A Scoping Review, Anne J. Shearin Bsn, Rn, Wesley Gray Bsn, Rn, Philip Habegger Msn, Aprn, Fnp-C, Evan Gregory Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Donna Lynch-Smith Dnp, Aprn, Acnp-Bc, Ne-Bc, Cnl

Doctor of Nursing Practice Projects

Decreasing Re-Intubation Rates in Mechanically Ventilated Adult Patients: A Scoping Review

Purpose/Background

Critically ill patients often require mechanical ventilation to support respiratory function. Prolonging mechanical ventilation can increase adverse outcomes. Weaning patients from the ventilator as soon as clinically appropriate can decrease adverse outcomes. The decision to wean mechanical ventilation lacks a standardized approach. This scoping review will evaluate the literature about the effectiveness of a standardized weaning protocol in decreasing the number of reintubations within 72 hours of extubation.

Methods

We conducted a literature search on PubMed, CINAHL, Scopus, and Medline between November 2020 and November 2023 using key …

Evaluating The Effectiveness Of Sglt2i Or Glp1ra Vs. Sulfonylurea Initiation After Hospital Admission For Congestive Heart Failure And Type Ii Diabetes Mellitus: A Scoping Review, Alyssa Ptacek Bsn, Rn, Amber Majors Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Carrie Harvey Phd, Aprn-Bc, Acnp, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The need for effective pharmacological management in patients with congestive heart failure (CHF) and type II diabetes mellitus (T2DM) is an ever-growing task for healthcare providers, especially in the primary care setting. Patients with multiple comorbidities are less likely to adhere to required rigorous medication schedules and lifestyle modifications, resulting in accelerated disease progression and defeated efforts of healthcare providers. Traditionally, sulfonylureas have been the medication management of choice by healthcare providers due to their affordability compared to modern medication. Current guidelines recommend that individuals with poor glycemic control could benefit significantly from using older sulfonylureas with other antidiabetic …

Factors Associated With Anaemia Among Pregnant Women In Rwanda: An Analysis Of The Rwanda Demographic And Health Survey Of 2020, Lilian Nuwabaine, Joseph Kawuki, Livingstone Kamoga, Quraish Sserwanja, Ghislaine Gatasi, Linet M Mutisya, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background: Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda.

Methods: Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26).

Results: Of the 435 pregnant …

Impact Of Fall Education To Oncology Staff On Oncology Patient Fall Rates, Danni Sloane

Articles, Abstracts, and Reports

Significance & Background

Falls and fall-related injuries impact patients' health outcomes and are the most commonly reported adverse event in hospitals. Patient falls also affect reimbursement rates and can increase length of stay by about 6.3 days and increase undue patient harm. An increase of patients falls on the medical and surgical oncology acute care units have caused undue physical harm, increased moral distress, mental fatigue, and burnout in nurses; as well as placing financial burdens on the healthcare system. Implementing fall education and interventions aligns with national patient safety goals, is a top-priority project, is in alignment with the …

Educational Campaign: Using Exercise To Prevent Postpartum Depression, Ruth Platt

MSN Capstone Projects

Postpartum depression is one of the most common medical ailments surrounding childbirth. It affects up to 20% of postpartum women and has detrimental effects not only on the mother but her infant and family as well (Navas et al., 2021). Currently, the medical community takes a reactive approach to postpartum depression by screening and treating cases of postpartum depression as they occur. An evidence-based search of peer-reviewed articles found that exercise in the perinatal period had a positive effect on maternal mental health and decreased postpartum depression scores. This is especially true for women who have a history of depression …

Use Of Acupuncture As A Complementary Therapy For The Treatment Of Chronic Pain In The Veteran Population To Improve Outcomes: An Integrative Review, Tabitha T. Smithers

Doctoral Dissertations and Projects

Clinical care in patient management is progressive and should change as evidence-based practice research is available. Veterans’ experiences with pain related to their service-related injuries are unique. This pain can limit their ability to function in society successfully. Many of the patients continue to experience uncontrolled pain, as well as side effects from medications that have been prescribed. This integrative review focused on the use of acupuncture as a complementary therapy to improve pain and quality of life in the Veteran population. The review analyzes systematic reviews, randomized control trials, and additional levels of evidence from scholarly articles supporting the …