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Evaluation Of Pain Levels And Pain Management In Patients After Elective Total Knee Replacement Surgery, Elif Karahan, Mediha Didem Koçoğlu Ağca, Sevim Çelik

Journal of Perioperative Nursing

Objective: The aim of this study was to evaluate early pain management outcomes in patients undergoing total knee arthroplasty.

Materials and methods: This descriptive cross-sectional study was conducted between 1 March and 30 September 2022. The sample consisted of 112 patients who underwent total knee replacement surgery. Data was collected during face-to-face interviews in the first 24 to 48 hours after surgery, using a patient information form and the revised American Pain Society patient outcome questionnaire (APS-POQ-R). One-way analysis of variance (ANOVA), independent-samples t test, Kruskal-Wallis test and Mann-Whitney test were used in statistical analyses. Ethical approval, institutional approval and …

Coming Alongside Women Experiencing Homelessness, Alexis Dang, Brianna Cowan, Tashayla Braxton, Ellen Jacobs, Elizabeth Cortes, Erin Smith

Nursing Leadership in Community Engagement Projects

Coming Alongside Women Experiencing Homelessness

Executive Summary

Six nursing students attending Seattle Pacific University (SPU), partnered with a women’s day center to provide and support healthcare needs for a leadership project. During the first few weeks of being at the shelter, we visited the agency site to get a better understanding of the population and have a greater idea of what the focus problems should be. Our assessments consisted of a windshield survey, in-person observations, and conversations with the shelter director, staff, and women to identify barriers within their healthcare services. We further gathered assessment information from our instructor, who …

Triaging Your Health Concerns, James Bato Borja, Jasleen Mendoza, Addie Mccuistion, Jordan Artz, Julia Greeley, Ashley Diloreto

Nursing Leadership in Community Engagement Projects

Improving Health Literacy on Appropriate Use of Medical Services

As part of a nursing leadership project, a team of nursing students at Seattle Pacific University (SPU) collaborated with a Washington State affordable independent living facility for seniors; they focused on providing information on the appropriate use of emergency care, urgent care, and primary care services for various health concerns. This project began with a team member recognizing a pattern within the older adult population entering the Emergency Department (ED). This observation showed that a noticeable portion of the older adult population could benefit from clarification about when to seek out …

Enhancing Newer Nicu Nurse Confidence With Resuscitation Through High-Fidelity, In-Situ Crisis Resource Management, Karen Rose

Doctor of Nursing Practice Final Manuscripts

Neonatal resuscitation is a low-volume, high-risk occurrence. Given the infrequency of resuscitation, newer neonatal intensive care unit (NICU) nurses may have little to no exposure to neonatal resuscitation events. This can lead to a lack of confidence in resuscitation skills, contributing to burnout, poor patient outcomes, and the potential for nursing turnover. This evidence-based practice project, guided by the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, focused on enhancing the perceived confidence in neonatal resuscitation skills among newer NICU nurses. To achieve this, multidisciplinary, high-fidelity, in-situ neonatal resuscitation crisis resource management (CRM) simulated events were implemented. …

Care Of The Critically Ill Nontrauma Patient: Improving Emergency Department Readiness And Patient Care Through The Implementation Of A Dedicated Resuscitation Bay, Martha H. Buck Rn, Bsn, Tcrn

Doctor of Nursing Practice Final Manuscripts

Current best practice among emergency departments worldwide includes the maintenance of a dedicated resuscitation space. This practice allows for team members and equipment to be ready at a moment’s notice to provide care to a patient in need of lifesaving interventions. This evidence-based performance improvement project seeks to implement this standard of care in a busy, urban emergency department in Southern California.

Prior to this study, patients at this facility were placed in the next available care space, without the maintenance of a dedicated resuscitation area for critically ill patients. Survey data evaluating staff levels of perceived readiness to care …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

Keep Our Children Smiling: Fluoride Varnish Education In The Pediatric Primary Care Setting, Isabella Mortola

Doctor of Nursing Practice Final Manuscripts

Background: Dental caries is the most common chronic childhood disease. In early childhood, it is associated with many negative factors such as pain, loss of teeth, and impaired growth. Fluoride varnish (FV) is a protective resin coating treatment that is reimbursable by most insurances and is recommended by the American Academy of Pediatrics (AAP), United States Preventative Services Task Force (USPSTF), and the American Dental Association (ADA) due to its high efficacy in preventing dental caries. FV is a low-cost treatment that can be easily applied in 1-2 minutes during a well-child visit in the primary care setting, where children …

Implementing An Abnormal Involuntary Movement Scale At An Outpatient Mental Health Clinic, Amanda Ghamsari

Doctor of Nursing Practice Final Manuscripts

Background: Movement disorders caused from psychotropic medications affect an estimated 500,000 people in the United States. These disorders bring an added cost for treatment to the patient, cause emotional distress, and may hinder daily life. Overall health and additional medication costs were increased for these patients by $25,879 per patient per year compared to patients without a movement disorder.

Purpose of Project: To address the issue, the team of mental health providers at an outpatient clinic assess their mental health patients at start of care and at follow up visits utilizing the Abnormal Involuntary Movement Scale. With the goal of …

Impact Of Mindfulness Education And Resources On Stress In Parents Of Children With Autism Spectrum Disorder, Jacqueline James

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to reduce stress levels of parents of children with autism spectrum disorder (ASD) by teaching them mindfulness practices and education on free and accessible methods to integrate mindfulness into their daily lives, as well as the benefits of mindfulness in reducing stress and improving psychological well-being.

Parents of children with ASD experience high levels of stress and numerous research studies support the use of mindfulness techniques to reduce stress levels in adults. The participants in this project included mothers who have at least one child with ASD who attend the Thompson Autism and Neurodevelopmental …

Reducing Inpatient Falls Utilizing Multimodal Standardized Patient Education: An Evidence-Based Practice Project, Sheryl Almandrez

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: This project aims to utilize multimodal standardized patient education as an evidence-based practice intervention to reduce inpatient falls.

Background: In 2022, Kaiser Foundation Hospital (KFH) San Diego had 116 falls. Inpatient falls with injury account for the second-highest Joint Commission (TJC) sentinel event and California Department of Public Health (CDPH) adverse events. These injuries include lacerations, subdural hematoma, subdural hemorrhage, hip fractures, and wrist fractures. The Centers for Medicare and Medicaid Services (CMS) have also stopped reimbursing hospitals for the care provided after patients have sustained a fall with injury.

The project was implemented at KFH-San Diego …

Dm Education On Lifestyle Modification To Improve Dm Knowledge Retention And Self-Care Confidence, Jinyoung Sanchez

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: The purpose of this evidence-based practice project was to provide diabetes education to improve diabetes knowledge and self-care confidence for patients with type 2 diabetes admitted to a tertiary hospital in San Diego. First, this study was to assess their DM knowledge and self-confidence before the education was provided. Second, based on the initial assessment and the education on lifestyle modification, 3 months of follow up was assessed to see if the education had been effective. Third, the study was to determine if the education also improved the self-confidence in managing diabetes on their own.

Background: Uncontrolled diabetes …

Human Trafficking And Resources Provision In The Ed, Kathryn Patrick

Doctor of Nursing Practice Projects

Human trafficking is both a human rights violation and a national health crisis. Despite nearly 165,000 identified cases in the United States since 2007, studies hypothesize that many more victims remain undetected despite up to 88% of trafficked persons interacting with the healthcare system during the time they are being trafficked. The lack of identification of these victims has often been attributed to healthcare providers' lack of knowledge regarding human trafficking indicators and lack of confidence in how to address trafficking situations when they are encountered. Emergency department care providers of a 500-bed central Illinois hospital received education and resource …

Addressing Farm Safety: Farm Safety Dinner Theaters In The Shenandoah Valley, Tammy Kiser, Michelle Seekford, Jeremy Daubert

Virginia Journal of Public Health

Statistics demonstrate that farm safety and wellness issues affect all ages in the agricultural community. However, an increased proportion of youth and older farm workers comprise the highest rates of farm-related morbidity and mortality. Engaging farmers in increasing safe practices in the agricultural community is an important, ongoing challenge.

Methodology

Farm Safety Dinner Theaters, an initiative created through community-based participatory research (CBPR) at the University of Kentucky, provide a relaxed environment where farmers and their families can identify safety and wellness issues, watch as the actors process these issues, and enjoy a meal. Seeing the situations played out in theater …

Enhancing Community Engagement: Perspectives From Researchers, Community Members, And Service Providers, Anne-Marie O'Brien, Elyssa Wood

Virginia Journal of Public Health

Purpose: Compare and contrast perspectives from Research Team Members (RT), Community Members (CM) and Service Providers/Others (SP/O) about barriers and facilitators to community engagement and participation in health research.

Methods: A cross-sectional, descriptive survey study with a convenience sample of adults who lived and/or worked in the Commonwealth of Virginia was conducted between May and July 2022. Descriptive statistics and chi-square analyses were conducted to identify similarities and differences across the three stakeholder groups.

Results: A total of 303 participants were involved in this study. In general RTs, CMs and SP/Os were similar in their responses to perceived barriers and …

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

Operations 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.

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 …

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. …

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 …

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 …

Using Gerontechnology For Care Transition Conversations In Senior Living, Roschelle L. Fritz, Catherine Van Son, Chris Veloicaza, Stephanie Soriano, Gabrielle Barling

ICHRIE Research Reports

Every day across the United States, thousands of senior living organizations assist with housing transition decisions for older adults experiencing health-related changes. These decisions impact resources for older adults and senior housing corporations, yet these decisions are based primarily on subjective observational data regarding older adults’ changes in function or cognition. Smart homes offering continuous, unobtrusive health monitoring with artificial intelligence capabilities are emerging as solutions offering health maintenance support and objective functional and health information. Such systems are well-positioned to support hospitality staff conversing with residents about transitioning from independent to assisted living. Our interdisciplinary nursing research and hospitality …

Analyzing The Cognitive Complexity Of The Questions On The Advanced Placement Computer Science Principles Exam, Lauren Zirpoli

Seton Hall University Dissertations and Theses (ETDs)

This convergent parallel mixed methods study with qualitative and quantitative content analysis was conducted to analyze and describe the cognitive complexity of the publicly released Advanced Placement Computer Science Principles Exam questions compared to the language of higher-order thinking found in research literature. Hess’ Cognitive Rigor Matrix was used to determine the frequency and percentage of questions categorized as higher-order thinking within each cell of the matrix. The qualitative method consisted of content analysis of the language of each question analyzed, followed by deductive coding, and culminated with categorizing the depth and type of thinking required on Hess’ Cognitive Rigor …

Evaluation Of Breastfeeding Interventions To Improve Duration In Women At Risk For Breastfeeding Attrition, Anthonia Anukam

The Corinthian

Children that are optimally breastfed have the healthiest start in life. The World Health Organization and the CDC recommend that mothers optimally breastfeed. Benefits of breastfeeding to children include the receipt of antibodies, reduction of ear, respiratory, and gastrointestinal infections, decreased sudden infant death syndrome, allergies, diabetes, and childhood leukemia. Several research studies have reported a strong positive correlation between breastfeeding and reduced infant morbidity and mortality. Evidence illustrates that the health benefits from breastfeeding are dose-dependent, thus the longer the breastfeeding duration the greater the acquisition of the enumerated benefits. However, premature cessation of breastfeeding less than the WHO …

Initiating Access To Palliative Care Earlier In Pediatric Oncology Patients, Anita Sharma

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Pediatric oncology patients should be referred to palliative care early but despite research indicating the clear benefits, there is still a delay in referring patients. One of the reasons include lack of understanding amongst providers on what palliative care is. Palliative care provides symptom management, emotional support and helps the patient and family with difficult decision making.

Objectives: This project aimed to increase the number of early referrals to palliative care. The Pediatric Palliative Care Screening Tool (PaPas) was utilized to help identify the triggers which should prompt the referral.

Methods: A chart review of patients diagnosed with …

Atrial Fibrillation, Julianna G. Perritt, Jennifer Goldsberry

The Corinthian

Atrial fibrillation, also known as A-Fib or AF, is a cardiovascular abnormality that is characterized by an abnormal heart rhythm or muscle contractions in the atria. These abnormalities are a result of disorganized electrical impulses. AF has various causes including, but not limited to, hypertension (HTN), heart surgery, thyroid disorders, heart defects, and acute alcohol ingestion. Persons with AF are often asymptomatic; however, some patients report heart palpitations, chest tightness, shortness of breath, and lightheadedness. A review of literature was conducted in order to determine the availability of risk factors, patient education, and treatment of AF.

Supporting South Korea’S Aging Population: How Ai And Iot Acceptance Connects The Young And Old, Bobby Im

Master's Projects and Capstones

In 2024, South Korea surpassed every other nation by becoming the country with the lowest fertility rate (below 0.7%). Population decline will hinder future ability to care for their aging population and although the government and private corporations are investing millions of dollars on developing Artificial Intelligence-Internet of Things (AI-IoT) devices to support the aging, the acceptance levels and the amount of family support required is undervalued. By examining AI-IoT’s current use and role in South Korea’s public health system this paper shows how intergenerational support helps optimize existing procedures and equipment, increases the level of acceptance and use, and …

Unlocking The Potential Of Peripartum Handoff: Standardizing Nurse Knowledge Exchange (Nke), Kiana Killian

Master's Projects and Capstones

Problem The absence of a structured and standardized handoff during patient transfers may result in the unintentional omission of patient information, medical errors and adverse events. No standardized bedside handoff process, referred to as Nurse Knowledge Exchange (NKE), was observed in Hospital A’s peripartum mesosystem during patient transfers from the Labor and Delivery (L&D) unit to the Postpartum unit. Context Hospital A is a medium-sized urban hospital located in Northern California. The peripartum mesosystem includes 21 postpartum rooms and nine laboring rooms. Intervention Through the recruitment of stakeholder engagement, review of literature supporting evidence-based practices, and a mesosystem assessment, a …

Enhancing Pain Documentation In Medical Surgical Units: Integrating Supportive Tools With Pain Nursing Education, Mariana Arias

Master's Projects and Capstones

Problem: Pain management in in-patient care, particularly involving opioids, is critical due to the associated risks. Proper pain assessment is essential to ensure safe medication administration and mitigate adverse effects.

Context: This quality improvement (QI) project aimed to improve opioid assessment and documentation rate above 90% compliance in two medical-surgical units, focusing on bedside nurses who play a crucial role in patient safety and effective pain management.

Interventions: A baseline survey provided nurses' understanding on compliance criteria and assessment timing. Interventions included visual reminders, informational posters, and instructions on how to access individual compliance reports.

Measures: A post intervention survey …

Increasing The Optimal Usage Of The Gad-7 And Phq-9 Screening Tools To Better Detect Co-Occurring Disorders In An Alcohol Use Disorder Clinic, Lauren Swansick

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Co-occurring disorders include substance use disorders and mental health conditions. These disorders affect 21.5 million individuals. Mental health screening tools, such as the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), are effective in screening individuals for depressive and anxiety mental health conditions within addiction settings.

Problem: Of those with an anxiety disorder, 20-40% will be diagnosed with an alcohol use disorder (AUD). Depressive disorders are the most common mental health conditions that can occur alongside an AUD. A literature review revealed that the PHQ-9 and GAD-7 are used in addiction treatment settings; however, not as …

Education For Primary Care Providers On Advance Care Planning, Lindsey Ward

Doctor of Nursing Practice (DNP) Projects

Background: Advance care planning (ACP) is a discussion of a patient’s end-of-life healthcare wishes. Its purpose is to indicate these wishes clearly should the patient be unable to make their decisions known to providers and family members due to a sudden health decline or medical emergency. Healthcare providers, specifically nurse practitioners, physician assistants, and physicians in the primary care setting, are well-positioned to facilitate these conversations with their older adult patients. However, research states that limited provider knowledge of and confidence in implementing ACP are significant barriers to its application in practice.

Problem: At a primary care clinic in Midtown …