Surgical Site Infection Reduction Through Nasal Decolonization Prior To Surgery, Melissa S. Schmidt

Master's Projects and Capstones

Surgical site infections (SSIs) are the most common and expensive healthcare-acquired infection. The objective of this nurse-driven process improvement project was to implement a cost-effective and practical decolonization protocol to improve outcomes for high-risk veteran populations undergoing surgery at a large veteran’s hospital in the Pacific Northwest. Prior to the implementation, a decolonization protocol was used for cardiac and orthopedic preoperative patients. The process involved screening for methicillin-resistant Staphylococcus aureus (MRSA) colonization via nasal swab preoperatively and treating positive patients with mupirocin ointment to nares BID and chlorhexidine showers for five days prior to surgery. Adherence to the protocol was …

Crna’S Knowledge And Attitudes Regarding Acupressure As An Adjunct To Postoperative Nausea And Vomiting Prevention, Kimberly A. Homa, Jacqueline Kuhn

College of Science and Health Theses and Dissertations

Background: Postoperative nausea and vomiting (PONV) continues to be a problem for patients despite multimodal pharmacologic treatments available. Although acupressure has demonstrated clinical usefulness, it is still not widely used in mainstream anesthesia practice. Objectives: The purpose of this descriptive survey design was to assess current knowledge and attitudes among CRNAs and SRNAs regarding acupressure for PONV treatment. A secondary objective was to develop an educational handout designed to increase the use of acupressure as an adjunct to postoperative nausea and vomiting prevention using the findings from this current study. Methods: A descriptive, cross sectional survey design was utilized to …

Cervical Cancer, Mary Jedlicka

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Pediatric Intensive Care Unit Skin-Care Team, Anna Therianos Konstantin

Master's Projects and Capstones

In the United States, pressure injuries (PIs) cost $9.1–$11.6 billion per year and claim more than 60,000 patient lives. The large Northern California hospital where this CNL project was conducted has had an 8.33% incidence of hospital-acquired PIs at or greater than stage two in the pediatric intensive care unit (PICU). Pressure injury prevention was not a high priority for the nursing staff; nurses were unaware of current PI prevention protocols or the PI prevalence in the PICU. The goals are to reduce PIs by 20% in 3 months, increase PI nursing education, and improve patient outcomes. Nursing skin-care rounds …

Safe Sleep In The Nicu Environment For Sids Prevention, Renee J. Aumua

Master's Projects and Capstones

Abstract

Sudden Infant Death Syndrome(SIDS) remains a leading cause of death for infants less than one year of age. Historically, Neonatal Intensive Care units have been exempt from following SIDS safe sleep guidelines recommended by the American Academy of Pediatrics(AAP) for SIDS prevention due to patient medical status and environment. However, in 2011 these guidelines were updated by the AAP to include NICU specific recommendations. This is a very important change due to this patient population being at a higher risk for SIDS than the term, well newborn. The Safe Sleep project was conducted in a 35 bed, tertiary care …

The Effect Of Bundled Interventions On Prevention Of Hospital Acquired Clostridium Difficile Infection, Kaitlin Kendys

Evidence-Based Practice Project Reports

Clostridium difficile infection (CDI) rates have steadily increased in hospitalized patients due to the change in epidemiology. Approximately 13 of every 1,000 inpatients are either infected or colonized with C. difficile (CDC, 2013). CDI rates continue to rise due to the hyper-virulent strain of C. difficile and length of therapy needed to treat CDI. The average cost for a single inpatient CDI is more than $35,000, and the estimated annual cost burden for the healthcare system exceeds $3 billion (Walsh, 2012). The purpose of this evidence-based project (EBP) was to reduce hospital-acquired CDI rates over a 3-month period-oftime from November …

Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano

Evidence-Based Practice Project Reports

Patient/visitor violence against healthcare (HC) employees is a type of workplace violence (WPV) and considered a dangerous hazard within HC occupations (Bureau of Labor Statistics, 2015). Lack of recognition of the true incidence and underreporting of WPV may contribute to a false sense of security within a HC facility (HCF). Therefore, fully addressing the problem may be met with administrative resistance, resulting in poor employee perceptions of support and commitment for a zero-violence environment. A retrospective analysis was conducted on the HCF’s online incident reports, security request calls, and data from a previously deployed WPV employee survey. The emergency department …

Development Of A Protocol For Implementing A Registered Nurse-Led Annual Wellness Visit In A Primary Care Setting, Jennifer R. Campbell

Doctoral Projects

This project was a quality improvement initiative utilizing a new format to deliver the Medicare Annual Wellness Visit (AWV) to Medicare recipients. The purpose of the project was the development of a protocol for implementing a registered nurse (RN)-led AWV in a primary care setting. The pilot project focused on changing the clinic’s current AWV structure from a provider-led format to a RN-led format. The pilot was geared towards improving care coordination, while enhancing preventive services and early intervention for chronic disease management. The 6-week pilot was used to help identify areas of weaknesses in the registered nurse-led AWV. During …

Implementation Of A Multifactorial Fall Prevention Protocol, Laura Wilkerson

Evidence-Based Practice Project Reports

According to the Joint Commission Center for Transforming Healthcare (2016), moderate to severe injuries from falls on average add 6.3 days to a hospital stay and cost approximately $14,056 per patient hospitalization. The purpose of this evidence-based practice (EBP) project was to implement a multifactorial approach to identify patients at risk for falls on admission to the orthopedic/neurosurgical unit and provide individualized interventions necessary to prevent falls. The Iowa Model of Evidence-Based Practice and Orlando’s Nursing Process Discipline facilitated the implementation of this project. A total of 45 staff members on the unit were educated on the multifactorial fall protocol …

Sexually Transmitted Infection Prevention In 18 To 24-Year-Old Heterosexual Men: Pilot Study, Susan P. Mckeefrey

Doctoral Projects

The CDC reported that there were over 20 million cases in the United States and half affected young adults, 15 to 25-year olds. Strategies STD prevention have been developed by the CDC but does not include avoiding alcohol or other similar agents in the context of a sexual encounter. The purpose of this study was to assess the effectiveness of STD prevention education intervention by improving Condom Use Self-Efficacy in heterosexually 18 to 24-year old men. It was hypothesized self-efficacy would improve with a face-to-face brief educational intervention. A quasi-experimental, pre-/post-test design with simple randomization of subjects into control and …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

The Peanut Allergic Patient: Diagnosis, Treatment, And Prevention, Daniel W. Hill, Jane Lassetter Phd, Rn, Craig Nuttall

Student Works

The prevalence of peanut allergies (PAs) continues to rise through recent decades, despite the best attempts to reverse that trend. PAs are unpredictable and can be life-threatening. Therefore, it is imperative that nurse practitioners (NPs) are fully aware of the most recent guidelines and evidence regarding diagnosis, treatment, and prevention of PAs. This article presents information on current research in diagnosis and treatment of PA, as well as the latest guidelines established to prevent PA development. NPs should understand this information, allowing them to provide the best care possible for their patients.

An Off-Season Brace-Free Neuromuscular Ankle Training Program Among Brace- Reliant And Nonbrace-Reliant Division Ii Female Athletes, Katelyn Koeninger, Jillian Markus, Linsey James, Kristen Thomas, Heidi Neitzke, Robert Topp, Joseph A. Brosky

School of Nursing and Health Science: Faculty Scholarship

Background: Neuromuscular training (NMT) has been shown to be effective in preventing recurrent ankle injuries. However, the NMT effect during the off-season in athletes who wear and those who do not wear an ankle brace during their sport season remains undetermined.

Purpose: The purpose of this study was to determine the effect of an off-season bracefree neuromuscular ankle training program on ankle functional ability among female athletes who wore and those who did not wear an ankle brace during the sport season.

Study Design: This study included a pre- and posttest 2-group cohort.

Methods: In this study, division II female …

Nurse Burnout And The Effects Of Coping And Stress Management, Meghan Baranda

Senior Research Projects

Aim: To investigate the relationship among nurses and decrease in nurse burnout followed by primary research to compare the relationship of certain coping mechanisms and burnout levels. Setting and Subjects: Southern Adventist University and BS, MSN, DNP students. Results: Showed that practicing stress management and coping mechanisms contributed to a decrease in burnout levels, especially coworker support, family support, positive attitude/optimism, exercise/physical activity, and spirituality/religion. Conclusions: Primary research supported the findings from the initial research study, which gives further evidence that coping and stress management is important and effective in minimizing burnout levels.

A Nursing-Driven Pathway To Lung Cancer Screening; A Push For Prevention, Teresa Elizabeth Giamboy

Walden Dissertations and Doctoral Studies

Lung cancer affects many individuals each year and accounts for many deaths around the globe. Lung cancer screening is a preventative health measure that has the ability to detect lung cancer earlier. The purpose of this project was to focus on the education of nursing staff within a community health system, with subsequent implementation of an electronic health record clinical decision support system, to create a direct referral pathway to lung cancer screening, delivered through patient education. The concept of prevention was the framework for this project design, which was further organized around the plan-do-study -act model, while taking into …

An Evaluation Of The Feasibility Of Implementing The National Institute Of Children’S Health Quality (Nichq) Physical Activity And Nutrition Survey In Pediatric Primary Care, Candice Greene

Doctor of Nursing Practice (DNP) Projects

Pediatric obesity is a growing problem in the United States of America causing both immediate and long-term health implications including: cardiovascular disease, diabetes, bone and joint problems, sleep apnea, and social and psychological problems (Centers for Disease Control and Prevention, 2015). The purpose of this quality improvement project is to implement and evaluate an evidence-based screening tool for identifying modifiable risk factors for childhood obesity in children in a pediatric primary care office. The National Institute for Children’s Health Quality (NICHQ) Physical Activity and Nutrition Survey (Appendix A) was administered to 25 pediatric patients ages 2-18 presenting to their primary …

Oral Sex And Hsv-1 Knowledge Among College Freshmen Females, Karen Hendry

Doctor of Nursing Practice (DNP) Projects

Herpes simplex 1 (HSV-1) disease transmission to the genitals has life long health consequences for young women. The aim of this DNP project was to assess knowledge among female college freshmen regarding HSV-1 transmission to the genitals during oral sex.

A voluntary and anonymous online survey was e-mailed to 648 female college freshmen using their college e-mail account. A 19% (N=121) survey response rate was achieved. Seventy-three percent of the college females reported receiving oral sex. Ninety-five percent of the college females knew the possible risk of HSV-1 transmission during oral sex. Ninety-six percent of the female students …

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …

Caring For Patients With Delirium In The Intensive Care Unit, Susan Archer

Walden Dissertations and Doctoral Studies

Patients in hospital intensive care units are at increased risk to develop delirium, a condition which is characterized by a disturbance of consciousness and a change in cognition. Critical care nurses must have the knowledge to assess, recognize, and manage delirium. The purpose of this project was to develop an evidence-based policy for the assessment of delirium and a comprehensive nursing education plan which included an analysis and synthesis of the literature, a curriculum plan, and a pretest/posttest. The Johns Hopkins Evidence-Based Practice Model framed the project, which used a multidisciplinary team approach. Two nursing leaders, each with a doctor …