Medicine and Health Sciences Commons^™

The Effect Of Formal Mentorship Programs On Nurse Faculty Retention: An Integrative Review, Lisa Livingston

Doctoral Dissertations and Projects

The nursing shortage has been a hot topic for decades, and literature supports a need to address this issue. Although faculty are critical to educating the nurses of the future, the shortage has impacted nurse faculty numbers as well. Nursing shortages are predicted to increase over the next decade. Evidenced-based interventions are critical to help sustain the nursing workforce. This integrative review highlights the importance of formal mentorship programs for new nurse faculty as a retention strategy for use by administrators of schools of nursing.

A Leadership Training Program Improves Nurse Manager Retention, Lisa A. Longley

Doctoral Dissertations and Projects

The need to retain nursing managers is at an all-time high. The turnover rate for a local xxxxxxxxxx (removed to protect privacy) healthcare system is 14% post pandemic compared to 8% pre-pandemic. The nursing management team reported a need for nursing specific management orientation because the current training included all organizational supervisors and covered general concepts, failing to meet the complex needs of frontline nursing managers. Literature confirms that organizations that provide nursing management training develop role competency have higher satisfaction and lower turnover rates. An organizational-specific needs assessment designed within the American Organization of Nursing Leadership competency framework was …

Implementation Of A Standardized Handoff Reference Tool From The Intensive Care Unit To The Operating Room, Sophia Agbomah, Stacie Summers

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: This quality improvement (QI) intervention evaluated the effectiveness of a standardized handoff reference tool for patients transferring from the Surgical Intensive Care Unit (SICU) to the operating room (OR) in a large metropolitan level I trauma center. There was minimal data to assess the quality of this sequence of patient transfer as no systematic ICU-OR handoff content practices were currently employed at the hospital. This project aimed to help fill the practice-knowledge gap that could impact some of the most vulnerable patients during ICU-OR transfer. Methods: Pre- and post-implementation staff surveys, live observations, and chart …

Propofol Disposal In The Operating Room: Addressing The Practice Knowledge Gap, Samantha Trulove, Audreau Conley

Doctor of Nursing Practice (DNP) Student Projects

Background: There is an increasing incidence of propofol diversion and abuse amongst healthcare workers. Barnes Jewish Hospital (BJH) has implemented the Stericycle controlled substance disposal system (CsRx) in the operating rooms (ORs) to address this issue; however, propofol continued to be left unsecured.

Purpose: The QI initiative aimed to raise anesthesia clinician awareness of propofol’s abuse potential and of the Stericycle CsRx container, ultimately to reduce unsecured propofol.

Methods: An educational intervention was utilized to address the identified problem. Data on unsecured propofol was collected via an auditing process of pharmaceutical waste bin contents at the BJH North campus endoscopy …

Reducing Unsecured Medications In Anesthetizing Area, Christine Bergesch, Kate Manuel

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Anesthetic medications should be secured consistently to prevent adverse outcomes such as medication errors, drug diversion, and financial loss. Standardized practice for medication stewardship is not established by Washington University Department of Anesthesiology (WUDA). Anesthesia providers’ imprudent medication stewardship practices are a continuous challenge due to the controlled and time-sensitive drugs they provide. Purpose: The purpose of this quality improvement (QI) project was to decrease the number of medications left behind unsecured in anesthetizing areas, describe the most frequently encountered barriers and category of medications left behind unsecured, and improve knowledge and utilization of the …

Improving Anesthesia Clinicians’ Knowledge And Confidence When Selecting Prophylactic Antimicrobials For Patients On Concomitant Antimicrobial Therapy, Garry Gregson, Emily Shands

Doctor of Nursing Practice (DNP) Student Projects

Anesthesia clinicians at Barnes Jewish Hospital (BJH) in Saint Louis, Missouri experienced uncertainty and discomfort when they selected preoperative antibiotics for patients who were already receiving concomitant therapeutic antimicrobials (CTA) unrelated to surgical prophylaxis. Various evidence-based interventions were proposed to address this issue. The first intervention was the addition of pathogens of concern to the surgical antimicrobial prophylaxis (SAP) protocol at BJH. The second intervention was the creation of a reference table that supplemented the revised protocol and allowed clinicians to efficiently determine the pathogens of concern for each surgery. This also included the CTAs efficacy for preventing surgical site …

Assessing Workflow In The Postanesthesia Care Unit, Laura Mcgrath, Emma Vierod

Doctor of Nursing Practice (DNP) Student Projects

The postanesthesia care unit (PACU) environment must function smoothly as a critical recovery area for monitoring of immediate postoperative patients. Timely responsiveness to complications is imperative to ensure patient safety. Following postanesthesia observation, a patient is discharged from the PACU to home or is admitted to the hospital. If this transition is delayed by excessive discharge times or poorly managed patient adverse events, it can cause major bottlenecks and issues with throughput for the perioperative setting. This project aims to study the present workflow in the PACU, identify gaps in the workflow and provide recommendations to perioperative leadership. Current PACU …

Child Health Nurses’ Perceptions Of The Family Community-Based Assistance Resourcing And Education Program In Contemporary Practice: A Qualitative Study, Nicole Latham, Jeanine Young, Josephine Wilson, Michelle Gray, Kendall George

Research outputs 2022 to 2026

Background. The Family Community-based Assistance Resourcing and Education Program (FCP) is a nurse home visiting program that was introduced in Queensland two decades ago to redress health inequalities for infants from families experiencing specific social stressors. Locally adapted versions of this home visiting program are still in use, but have not been evaluated. This study examined child health nurse perceptions of the adapted FCP in one regional Queensland health service. Methods. A qualitative descriptive exploratory study using two focus groups (conducted May 2019) with Child Health Nurses who delivered the FCP was conducted. Transcripts of digital recordings were analysed using …

Diabetic Management With Glp1-Ra Ozempic And Diabetic Education, Katrina Sivo-Souza

Doctoral Dissertations and Projects

A condition with observed poor management by most who possess a diagnosis, diabetes mellitus remains the seventh leading cause of death within the country. This diagnosis can and often does lead to severe complications, creating implications for not only the patient but also families, caregivers, and the community. Most diabetic patients possess a diagnosis of type 2 diabetes mellitus. The healthcare industry continues to implement improvement with diabetic management and complications resulting from diabetes. Research suggests that the standard of care for patients with diabetes begins with lifestyle modification to improve glycemic control. New medications, such as Ozempic (semaglutide), have …

Comparing The Causal Effects Of Observational Versus Active Roles In High-Fidelity Simulation: A Quantitative Study, Bethany D. Rose

Doctoral Dissertations and Projects

Among many of the innovative changes in nursing education, high-fidelity simulation is expanding roles and providing students with new perspectives. The purpose of this quantitative, causal-comparative, posttest only, nonexperimental, between-groups research design study was to determine whether students in active supervisor (observer) roles had an effect on associate degree nursing (ADN) students’ self-perceived knowledge, skills, and attitudes in comparison to students in active participant roles. A convenience sample of second-semester nursing students and third-semester nursing students enrolled in an ADN program in the 2023 academic year was utilized for this study. Participants completed a demographic survey and the Self-Evaluation Scale …

Support Systems: The Effect They Have On Domestic Violence Victims, Kimberly Diann Burton

Doctoral Dissertations and Projects

In the last five years, domestic violence has escalated in the number of episodes reported and in the severity of violence. Researchers attribute this increased frequency and severity to the COVID-19 pandemic. During the lockdown time of the pandemic, victims and their abusers could not escape from arguments, which resulted in tensions rising. This study brings attention to the fact that domestic violence is still a pervasive problem. It gives information to help the abused stay out of violent relationships and/or escape. There was conflicting research on whether support systems help victims of these violent relationships escape or stay in …

Improving Time To Defibrillation​, Jonathan Eyestone, Dana Gilbreth, Amanda Maloney, Tina Pham

Articles, Abstracts, and Reports

"ABSTRACT TITLE: Improving Time to Defibrillation

Background: Providence St. Vincent Medical Center (PSVMC) Medical Surgical units are not meeting the American Heart Association requirement of less than 3 minutes to defibrillation. Time to defibrillation in codes with shockable rhythms averages 4.2 minutes. In Mock Codes, only one met the time less than 3 minutes; four Mock Codes had times over 5 minutes. Resuscitation Quality Improvement CPR (RQI) training is required quarterly. Defibrillator practice with overall Code Blue competency is annual.

Purpose: Combine the hands-on practice of the defibrillator with the hands-on training for RQI.

Methods: The Medical Surgical unit 6 …

Anti-Obesity Medications Prescribing Measures Utilized By Primary Care Practitioners: Scoping Review, Sahra Abdullahi, Edward Venzon Cruz, Laurie Freeman, Eric Tanlaka

Nursing Publications

Background

Obesity is a chronic, complex and multifactorial disease with the prevalence increasing in North American adults. Novel AOMs are demonstrating weight loss results comparable to bariatric surgery when used effectively. As the gatekeepers to AOMs, primary care providers can play a key role in obesity management through exploring safe prescribing measures employed in primary care.

Objectives

This review will systematically map the existing literature on prescribing measures for AOMs to determine the extent, range, and nature of literature available on the measures utilized by PCPs when prescribing AOMs in North America.

Methods

One independent reviewer conducted a review using …

Failure To Progress Or Just Normal? A Constructivist Grounded Theory Of Physiological Plateaus During Childbirth, Marina Weckend, Kylie Mccullough, Christine Duffield, Sara Bayes, Clare Davison

Research outputs 2022 to 2026

Background and problem: During childbirth, one of the most common diagnoses of pathology is ‘failure to progress’, frequently resulting in labour augmentation and intervention cascades. However, failure to progress is poorly defined and evidence suggests that some instances of slowing, stalling and pausing labour patterns may represent physiological plateaus. Aim: To explore how midwives conceptualise physiological plateaus and the significance such plateaus may have for women's labour trajectory and birth outcome. Methods: Twenty midwives across Australia participated in semi-structured interviews between September 2020 and February 2022. Constructivist grounded theory methodology was applied to analyse data, including multi-phasic coding and application …

Pre-Eclampsia Training Needs Of Midwives In A Ghanaian Tertiary Hospital: A Cross-Sectional Study, Isabella Garti, Michelle Gray, Angela Bromley, Jing-Yu (Benjamin) Tan

Research outputs 2022 to 2026

Aim: This study aimed to assess the specific clinical and non-clinical training needs of midwives and determine their preferred approach to enhancing performance. Background: Pre-eclampsia remains one of the leading causes of maternal deaths in low and middle-income countries. Pre-eclampsia-related deaths may be due to reduced midwifery knowledge and inadequate management. Therefore, a training needs assessment is vital in identifying gaps in practice, especially, in poorly resourced settings for maximal use of training resources. Design: A hospital-based cross-sectional study. Setting: The largest tertiary hospital in Ghana. Methods: An online version of the validated WHO Hennessy-Hicks Training Needs Analysis questionnaire was …

Challenging The Nuances Of Pain Assessment With Co-Designed Audio-Visual Simulations In Nursing Education: A Descriptive Study, Michelle A. Kelly, Susan Slatyer, Naomi Tutticci, Joanne Ramsbotham, Sandra Johnston, Irene Ngune, Karen A. Theobald

Research outputs 2022 to 2026

Background: Appropriate management of pain remains a challenging issue. Surfacing nurses’ inherent assumptions about pain may lead to better pain management. This study developed and evaluated new audio-visual (AV) simulations for nursing students showcasing patient characteristics that may influence pain assessment. Methods: Descriptive pre/post intervention study informed by the STROBE framework. Participants were drawn from two Australian universities. Three AV simulations were codesigned by clinicians, educators, and health consumers. Data included: demographics, previous experiences of pain assessment; compassion scale, feasibility, and relevance of AV simulations. Quantile regression and content analyses were applied. Results: Full data sets of 491 participants (314 …

Core Competencies For Registered Nurse Preceptors: A Mapping Review Of Quantitative Studies, Colleen L. Ryan, Robyn Cant, Lynda Hughes, Darrelle Ahchay, Karen Strickland

Research outputs 2022 to 2026

Aims: To review the contemporary international literature on nurse preceptor competencies and map the components and their descriptors. Review Methods: A mapping review. Data Sources: Articles reporting evidence-based and validated Registered Nurse (RN) preceptor competencies published between 2013 and 2022 were identified. Open access databases such as PubMed and Google Scholar and the library healthcare databases Scopus and CINAHL were searched. The authors collaborated at each review stage that included screening, article selection, tabulation, mapping and preparation of findings. Results: Seven quantitative studies were included. Three were based on existing nurse preceptor competency data sets and four were purposely developed …

Audit Tools For Culturally Safe And Responsive Healthcare Practices With Aboriginal And Torres Strait Islander People: A Scoping Review, Jessica Muller, Susan Devine, Lynore Geia, Alice Cairns, Kylie Stothers, Paul Gibson, Donna Murray

Research outputs 2022 to 2026

Aboriginal and Torres Strait Islander people in Australia face disparities in accessing culturally safe and appropriate health services. While current cultural safety and responsiveness frameworks set standards for improving healthcare practices, ensuring accountability and sustainability of changes, necessitates robust mechanisms for auditing and monitoring progress. This study examined existing cultural safety audit tools, and facilitators and barriers to implementation, in the context of providing culturally safe and responsive healthcare services with Aboriginal and Torres Strait Islander people. This will assist organisations, interested in developing tools, to assess culturally responsive practice. A scoping review was undertaken using Medline, Scopus, CINAHL, Informit …

Thermoregulation In Colorectal Patients: Heating Co2 Insufflation Gas, Alejandro Conde, Alieu Jawara, Laura Savage, James Alberding Dnp, Michael Godbold

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

BACKGROUND: 600,000 colorectal surgeries are performed annually in the United States, with 26-90% experiencing some form of unintended hypothermia. Consequences of hypothermia include surgical site infections (SSIs), delayed wound healing, cardiac dysrhythmias, and increased hospital length of stay. Utilization of the laparoscopic approach to intra-abdominal colorectal surgery uses un-warmed CO₂ gas. Multiple studies demonstrate the addition of heated CO₂, for insufflation, reduces intraoperative hypothermia.

LOCAL PROBLEM: This project was implemented at a facility in Tennessee. On average, 250 laparoscopic colorectal cases are performed at this facility annually. Participants were adult colorectal surgical patients, 18 years …

Prevalence Of Sickle Cell Trait And Needs Assessment For Uptake Of Sickle Cell Screening Among Secondary School Students In Kampala City, Uganda, Shamim Namukasa, Sarah Nakaziba, Grace Among, Lydia A Sasira, Posiano Mayambala, Joseph Atukwatse, Mary Namuguzi, Ahmed Sarki, Rose Maina

School of Nursing & Midwifery, East Africa

Background Sickle cell disease (SCD) is one of the most frequent and traumatizing genetic disease in Uganda, with the prevalence of the sickle cell trait (SCT) estimated at 13.3% leading to serious psycho-social and economic impact on the patients and their families.

Aim This study aimed to determine the burden of SCT and factors influencing the uptake of screening services among secondary school students in Uganda.

Methods We used an analytical cross-sectional design with a multi-stage sampling approach. A total of 399 students from four secondary schools in Kampala City were enrolled in this study. Data were gathered using semi-structured …

Factors Associated With Hiv Testing Among Pregnant Women In Rwanda: A Nationwide Cross-Sectional Survey, Lilian Nuwabaine, Joseph Kawuki, Angella Namulema, John Baptist Asiimwe, Quraish Sserwanja, Ghislaine Gatasi, Elorm Donkor

School of Nursing & Midwifery, East Africa

Human immunodeficiency virus (HIV) testing during pregnancy is crucial for the prevention of mother-to-child transmission of HIV, through aiding prompt treatment, care, and support. However, few studies have explored HIV testing among pregnant women in Rwanda. This study, therefore, aimed to determine the prevalence and associated factors of HIV testing among pregnant women in Rwanda. We used secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS), comprising 870 pregnant women. Multistage stratified sampling was used by the RDHS team to select participants. We conducted bivariable and multivariable logistic regression to explore factors associated with HIV testing using SPSS …

Exploring The Relationship Between Staffing And Long-Term Care Worker Mental Health, Matthew R. Trombley

Doctoral Dissertations and Projects

This research delves into the relationship between staffing levels during a crisis in the healthcare workforce and the mental well-being of long-term care workers, with a specific focus on variables such as burnout, compassion fatigue, and compassion satisfaction. With increasing workforce shortages, the attention to providing quality care during this tumultuous period has become increasingly urgent. There has been scarce empirical research that has explicitly sought to comprehend the connection between staffing levels and the mental health of long-term care professionals. This study was designed as a non-experimental, quantitative correlational investigation, aiming to understand the intricate dynamics between patient-to-staff ratios …

Burnout Triggers In The Novice Registered Nurse, Sharon K. Nguyen

Doctoral Dissertations and Projects

Nurse burnout has been strongly associated with decreased patient satisfaction and reduced retention rates in the novice registered nurse. This phenomenon is exacerbating the already rising global nursing shortage. A strong correlation is established between novice registered nurses who endure repeated or multiple triggers, such as unsafe staffing ratios, inadequate preceptorship, and ineffective leadership to those who succumb to burnout. Burnout is a significant problem in the United States, impacting how healthcare is perceived by the public. In 2019 there were more than six million nurses, making up the largest segment of the healthcare population and directly affecting the safety …

Medication Errors In Hospitals, Isata Jalloh

Doctoral Dissertations and Projects

In hospitals, the issue of medication errors poses a serious problem, often leading to substantial health complications and, in some cases, even deaths among hospitalized as well as discharged patients. This health challenge not only imposes a substantial financial burden on patients, insurance providers, and Federal/State governments but also contributes to elevated healthcare expenses, hindering the effective allocation of resources to address other healthcare issues. Understanding the triggers of medication errors in hospitals is critical in solving this problem. The purpose of this integrative review is to determine the causes/triggers of medication errors in hospitals. This review will highlight the …

Lived Experiences: Growing Up With A Seriously Mentally Ill Parent, Deborah Lindell, Elliane Irani

Faculty Scholarship

Introduction: Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. Design: This study used an interpretive phenomenological design. Methods: Participants were invited to voluntarily …

Whs Guidelines For The Treatment Of Pressure Ulcers: 2023 Update, Lisa J. Gould, Jenny Alderden, Rummana Aslam, Adrian Barbul, Kath M. Bogie, Mohamed El Masry, Letitia Y. Graves, E. Foy White-Chu, Amany Ahmed, Kerriann Boanca, Jessica Brash, Katie R. Brooks, Wendy Cockron, Susan M. Kennerly, Aaron K. Livingston, Jeni Page, Catherine Stephens, Velena West, Tracey L. Yap

Nursing Faculty Publications and Presentations

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million. However, this estimate is derived from acute care facilities and does not include people who are living at home or in nursing facilities. Despite the implementation of hospital and facility-based preventive measures, the incidence of pressure ulcers has not decreased in decades. In addition to the burden of pain, infection and death, it is estimated …

Active Nursing Research Studies As Of 1-2024 (Study Summaries),, Vicki Babb, Kelly Ray, Breann Taylor, Debbi Bowman, Kaylyn Kistler, Erin Lacross, Naomi Adamski, Brooke Randol Msn, Rn, Agcns-Bc, Cmsrn, Cws, Stacy Greene, Preston Jennings, Jennifer Sorg, Olivia Figura, Rebecca Howard, Kelly Ray, Amber Childers, Kristy Jackson, Christine Fawcett, Lisa Morgan Bsn, Rn, Cnrn, Andrea D. Conley Msn, Rn, Agcns-Bc, Mscrn, Kellie Girardot Msn, Rn, Jennifer Thieman, Stephani Schultz Bsn, Rn, Cmsrn, Holly Platt, Abby Gaff, Chelsea Tetzlaff, Donna Hitzeman, Latoshia Gilbert, Meghan Winebrenner, Jan Powers Phd, Rn, Ccrn, Andrea Conley, Kristen Emenhiser, Rebecca Havens, Philip Roberts, Jennifer Esslinger Bsn, Rn, Cfrn, Ctrn, Lindy Bilimek Msn, Agcns-Bc

Nursing Active Studies

Nursing Clinical Action Team Chair and Co-Chair Education: Back to Basics in Leading the Unit-Based Team.

PI: Vicki Babb, Kelly Ray, BreAnn Taylor, Debbi Bowman

Project ROSC-O

PI: Kaylyn Kistler

Assessment of Nurse Perceptions Related to Shared Governance Culture.

PI: Erin LaCross, Naomi Adamski, Brooke Randol, Stacy Greene, Preston Jennings, Jennifer Sorg, Olivia Figura, Rebecca Howard Kelly Ray, Amber Childers, Kristy Jackson, Christine Fawcet

Nursing Evidence-Based Practice Survey Assessing Nursing Knowledge.

PI: Lisa Morgan

Custom Machine Learning Model for Hospital-Acquired Pressure Injuries (HAPI)

PI: Andrea Conley, Brooke Randol

Exploration of Intrinsic and Extrinsic Factors of Skin Injury in Intensive Care …

The Clinical Inquiry Process Diagram Question Development Checklist, Roy E. Brown

VCU Libraries Faculty and Staff Publications

This updated handout, previously published in 2023, serves as a reference for those who are either in an EBP course or are practicing healthcare providers involved in questioning practices to improve patient care. The handout guides the user from identifying and developing a question to determining whether the clinical question, based on evidence, will be an evidence-based practice project/initiative, a performance improvement project, or a research project. It aligns with the fifth version of the Clinical Inquiry Process Diagram and now includes several different formats that can be used when trying to create a focused clinical question.

• Update of The …

Intentional Learning Theory: Validating Its Measurement, Sarah Mollman, Timothy J. Muckle, Margaret Martinez

College of Nursing Faculty Publications

The purpose of this article is to describe and analyze the psychometric properties of the Learning Orientation Questionnaire (LOQ), which have not been previously published. Psychometric validation involves the accumulation of proper empirical evidence to confirm measurement of the intended construct, and to justify the intended uses of the scales. LOQ is based upon the intentional learning theory, which is a comprehensive, holistic learning theory. Through the expertise of the LOQ’s developer, educational researcher, and psychometrician, this article presents evidence of LOQ’s reliability and validity according to published best practices for scale development and validation. LOQ is a reliable and …

Hyperbaric Oxygen Therapy For Cancer Patients With Radiation-Induced Tissue Injuries, Abigail R. Roy, Julia Shannon, Sampaguita French, Daniel Weaver

Non-Thesis Student Work

Cancer, secondary to cardiovascular disease, is the leading cause of death worldwide (Centers for Disease Control and Prevention, n.d.). Radiation is a standard cancer therapy, however it can cause fibrosis of blood vessels, the breakdown of soft tissue, and subsequently lead to necrosis. When caring for cancer patients, it is imperative to consider the lasting effects interventions pose on their long-term health. Hyperbaric oxygen therapy (HBOT) is a healing treatment consisting of administering 100% oxygen to the body in a pressurized chamber; in turn, HBOT facilitates capillary regrowth, blood flow restoration, and increased efficiency of wound healing time. The efficacy …