Medicine and Health Sciences Commons^™

Unit Knowledge And Practice Of Emergency Nursing Interventions At A Tertiary Public Cardiac Health Center In Uganda, Harriet Namukwaya, Cliff Asher Aliga, Grace Nakate, Judith Mutyabule

School of Nursing & Midwifery, East Africa

Background: Research suggests that many of the millions of deaths and long-term disabilities resulting from acute cardiovascular events and other emergency conditions are preventable if effective emergency care services were readily available. Effective emergency care requires trained and competent staff, including registered nurses. Most educational pathways do not adequately prepare nurses to deliver sensitive health care services for those with acute illness and injury. This includes Uganda, where few capacity-building initiatives have targeted emergency nursing care delivery, leading to knowledge and practice gaps.

Purpose: This study aimed to assess emergency nursing knowledge and clinical practice at a tertiary …

Informing Healthcare Operations With Integrated Pathology, Clinical, And Epidemiology Data: Lessons From A Single Institution In Kenya During Covid-19 Waves, Allan Njau, Jemimah Kimeu, Jaimini Gohil, David Nganga

Pathology, East Africa

Pathology, clinical care teams, and public health experts often operate in silos. We hypothesized that large data sets from laboratories when integrated with other healthcare data can provide evidence that can be used to optimize planning for healthcare needs, often driven by health-seeking or delivery behavior. From the hospital information system, we extracted raw data from tests performed from 2019 to 2021, prescription drug usage, and admission patterns from pharmacy and nursing departments during the COVID-19 pandemic in Kenya (March 2020 to December 2021). Proportions and rates were calculated. Regression models were created, and a t-test for differences between …

Heart Failure, Molly Davis

Nursing Student Class Projects (Formerly MSN)

Heart Failure is defined as the pathophysiologic condition in which the heart is unable to generate an adequate cardiac output such that perfusion of tissues or increased diastolic filling pressure of the left ventricle, or both occurs (Huether & McCance, 2019).

Influence Of Cultural Competency Program On Bias In A Community Volunteer Program, Melodie L. Anderson

Student Scholarly Projects

Practice Problem: Individuals may express hesitancy in volunteering in community health programs that directly interface with persons experiencing poverty due to poverty biases. Failure to understand the issues and needs of those experiencing poverty may factor into disparities and inequities along the social determinants of health, leading to poorer population health, well-being, and quality of life.

PICOT: The PICOT question that guided this project was in volunteers (mentors) of community health programs (P) how does a cultural competency program (I) compare to the standardized training program(C) influence bias (0) over 8 weeks (T)?

Evidence: An evidence review indicated …

Teamwork That Affects Outcomes: A Method To Enhance Team Ownership, Brian Carlson, Richelle Graham, Brad Stinson, Jordan Larocca

Patient Experience Journal

Healthcare is the ultimate team sport, and this case study explores how to build teamwork across teams. The ability for nursing, environmental services and food and nutrition services to work collaboratively to benefit patients is paramount to a patients experience and outcomes. The case study describes how the work was done to build teams and then improved outcomes in both patient and employee experiences. The learnings are applicable to any team setting not just those described in this case study.

Experience Framework

This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework ( …

Addressing Stress In Graduate Nurse Practitioner Nursing Students, Shandria K. Sawyer

Electronic Theses and Dissertations

This project was developed to address the issue of high stress levels among graduate nursing students, which is a common phenomenon that increases the risks of mental health disorders, professional burnout, and poor-quality patient care among students and professional nurses after earning their degrees. This project sought to utilize a simple educational intervention delivered online to impart coping skills to graduate nursing students to assist them in reducing their stress levels. The intervention was a brief, single-session, self-guided educational module featuring informational and participative elements related to stress causes, the impacts of stress, and stress reduction techniques. In total, 11 …

Strategic Plan For Genomic Competencies Into Undergraduate Nursing Curriculum, Myerann Royce M. Mangalino

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: As genomics research continues to grow in medicine and in popular culture, an educational gap in nursing is inevitable. Nurses must have a strong understanding of genetics and genomics to effectively integrate them into current practice.Objectives: The objective is to identify gaps in the current undergraduate curriculum and build threads that may be incorporated into the current curriculum to fill the identified gaps. Methods: The foundation of this project was the Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines, and Outcome Indicators, 2nd Edition (Consensus Panel on Genetic/Genomic Nursing Competencies, 2008). A strategic plan was created to increase …

Evaluation Of An Australian Neurological Nurse-Led Model Of Postdischarge Care, Judith Dianne Pugh, Kathleen Mccoy, Merrilee Needham, Leanne Jiang, Margaret Giles, Elizabeth Mckinnon, Kym Heine

Research outputs 2014 to 2021

Neurological disorders are a leading cause of disease burden worldwide, placing a heavy demand on health systems. This study evaluated the impacts and cost savings of a community-based nursing service providing supported discharge for neurological patients deemed high-risk for unplanned emergency department presentations and/or hospital readmissions. It focused on adult patients with stroke, epilepsy, migraine/headache or functional neurological disorders discharged from a Western Australian tertiary hospital. An observational design was used comprising prospective enrolment of patients receiving nurse-led supported discharge and follow-up (Neurocare), 21 August 2018 to 6 December 2019 (N = 81), and hospital administrative data, 1 February …

Myasthenia Gravis, Rebecca Wheeler

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG), a neuromuscular and autoimmune disorder, is not completely understood by clinicians and scientists. The primary cause is thought to be anti-Acetylcholine receptor antibodies that attack the neuromuscular junction, causing destruction of post-synaptic junctional folds and blockade of the receptor. This causes frequent weakness and fatigability of voluntary muscles, making activities of daily living difficult for those living with MG. Although it is not an incredibly prevalent disease, the incidence is increasing in the United States due to better testing and diagnosis. Treatments are available, including cholinesterase inhibitors that raise the concentration of Acetylcholine at the neuromuscular junction …

Bispectral Index (Bis) Monitor: Applying The Evidence For Appropriate Application And Use, Mandy Christensen-Geraci, Becky Templin

Nursing DNP Projects

Abstract

Background: Accurate monitoring of sedation and proper utilization of the BIS Monitor in intensive care unit (ICU) patients can result in decreased use of sedative medications, which can lead to decreased time to extubation, thereby reducing costs and even perhaps the length of hospital stay. The purpose of this project was to provide education to medical intensive care unit (MICU) nurses to increase their knowledge and confidence using the BIS monitor.

Methods: A middle range theory, specifically the Synergy Model for Patient Care was used as a conceptual framework for designing the intervention and The Johns Hopkins Evidence-Based (JHNEBP) …

Women’S Priorities And Actions Mothering In The Context Of Intimate Partner Violence, Sharon Broughton

Electronic Thesis and Dissertation Repository

Being a mother is an important part of many women’s identities with consequences for women and children and shaping women’s priorities and actions when living in the context of intimate partner violence (IPV). However, understanding the nature of women’s priorities, the actions women take to address these priorities, and the factors shaping those actions remains limited. Drawing on an intersectional feminist lens, this dissertation explored the nature of women’s priorities, what shapes them and how women mothering in the context of IPV go about living out what is important to them. To situate these issues broadly within the discipline of …

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …

Implementing A Standardized Nursing Communication Tool To Improve Inpatient Nursing Communication, Ashley D. Nator

Dissertations

Implementing a Standardized Nursing Communication Tool to Improve Inpatient Nursing Communication

Ashley D. Nator

B.S. Nursing, University of Missouri-St. Louis, 2018

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice with an emphasis in Family Nurse Practitioner

August 2022

Advisory Committee

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C

Chairperson

Sarah Jackson, DNP, APRN, FNP-C

Amy Terbrock, MSN, PCCN, SCRN, RN

Copyright, Ashley D. Nator, 2021

Original: 08/2021 Revised: 09/2021, 10/2021, 04/2022

Abstract

Problem: Patient handovers occur among nurses more than 4,000 times …

Nursing Anxiety Self-Evaluation And Resiliency Methods, Dianne Deck

Dissertations

Abstract

Introduction: Nurses are stressed due to the demands of their job. This study aims to determine whether MICU nurses at a large Midwestern hospital would have reduced stress and anxiety after a 30-day meditation and exercise intervention.

Design and Methods: A quasi-experimental pre-post pilot study design was adopted. The convenience sample consisted of eight Medicine Intensive Care Unit (MICU) nurses in a large Midwestern urban tertiary medical center. Data collected included demographics, pre- post-Beck Anxiety Inventory Scale (BAIS), pre- and post-Single Item Stress Scale (SISS), and weekly diaries on exercise and meditation.

Results: The pre- post-SISS showed statistical significance …

Quality Improvement Competency Development For Correctional Nursing Leaders, Angela Chandler

Dissertations

Nurse leaders are often promoted with little to no leadership development. Lack of development is a leading cause of turnover. Leadership development is crucial to retaining qualified leaders and the National Academy of Medicine identified that quality improvement (QI) competency development for nursing leaders is critical to improved healthcare. To invest in leader development and improve QI competence, a structured, weekly, coaching intervention was used for four consecutive weeks to reinforce QI concepts and assist in development of a QI project plan for nursing leaders. The Beliefs, Attitudes, Skills, and Confidence in Quality Improvement (BASiC- QI) instrument was used before …

Improving Medication Education On An Infectious Disease Unit For Hospitalized Patients At Discharge: A Quality Improvement Project, Kristin L. Pilong

DNP Scholarly Projects

Medication education by nurses during patients’ hospital stay is an important component of patient care. Nurses’ knowledge of specific medications and the resources that support teaching patients about medications may play a key role in increasing their satisfaction with the hospitalization experience. This quality improvement doctoral project created and validated evidenced-based cognitive aids for nurses to support this process. The project is part of a quality improvement initiative at a hospital in South Jersey to create and validate cognitive aids for 5 high frequency medications prescribed for patients prior to discharge from the hospital The cognitive aids focused on three …

Training Sexual Assault Nurse Examiners (Sane) And Patient Advocates To Improve Utilization Of The Alabama Crime Victims Compensation Commission (Acvcc) Program For Sexual Assault Victims, Erica Starling

Doctor of Nursing Practice Projects

Background: Sexual assault is a nationwide problem that often goes unreported. According to the Rape, Abuse and Incest National Network (RAINN), every 68 seconds an American is sexually assaulted. One out of every six women has been a victim of sexual assault in their lifetime. Sexual violence has long-term effects on victims including post-traumatic stress disorder, suicidal ideations and/or attempted suicide, substance use disorder, work and/or family life struggles, unplanned pregnancy, and/or sexually transmitted infections (STI).

Purpose: The purpose of this project is to improve the utilization of the Alabama Crime Victims Compensation Commission Program (ACVCC) for victims …

Perioperative Risks Of The Patient With Heart Failure, Gabrielle Metoyer

Nursing Student Class Projects (Formerly MSN)

Perioperative Risks of the Patient with Heart Failure

Gabrielle Metoyer

Department of Nursing, Otterbein University

NURS 6810 – Advanced Pathophysiology

Dr. Deanna Batross and Dr. Shivani Bhatnagar

August 5, 2022

Abstract

According to the CDC (2020), heart failure occurs when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is an epidemic disease affecting 1-2% of the population worldwide (Schwinger, 2020). It is one of the leading causes of morbidity and mortality worldwide with an estimated 6.5 million adults with heart failure in the United States (Lo et al., 2021). Medical advances …

Hypertension-A Global Epidemic, Marie Tanyi

Nursing Student Class Projects (Formerly MSN)

Hypertension is a major cause of premature death and a leading cause of cardiovascular diseases globally. Heart diseases, renal failure, stroke, premature deaths, and disability mostly if not all contribute to the cardiovascular burden and thus pose a public health issue worldwide. The trends in hypertension are similar globally with a high prevalence noted in low and medium-income countries. Studies have identified smoking, unhealthy diet, physical inactivity, alcohol consumption, overweight or obesity, and sedentary lifestyle as modifiable risk factors in these populations. However, hypertension remains a substantial public health concern despite providers’ engagement in multi-component hypertension treatment and patient involvement …

Predictors Of Engagement In Nursing Professional Practice: Transforming Organizational Culture In The Post-Covid Healthcare Environment, Jennifer Garnand

Dissertations

Cultivating the shared belief that individuals matter within an organization enhances the empowerment of staff and supports enthusiastic engagement in organizational efforts aimed toward a common mission, vision, and goals (McShane & Von Glinow, 2019). The nursing profession has been plagued by an unprecedented decrease in engagement and diminished job satisfaction, particularly following the prolonged tenure of the COVID-19 pandemic, leading to subsequent attrition amidst a staffing crisis. This quantitative predictive correlational study seeks to determine whether proactive and persevering characteristics, professional identity, and passion of nurses are predictors of engagement in a post-COVID healthcare environment. The research was based …

Climate Change: Broaching The Concern In Nursing Education | Changements Climatiques : Aborder La Question Au Cours De La Formation Infirmière, Florence Myrick, Jacinthe I. Pepin

Quality Advancement in Nursing Education - Avancées en formation infirmière

No abstract provided.

Examining Perceived Stress And Diet Quality Among Low-Income Families Engaged With A Nutrition-Based Food Assistance Program, Kelsey R. Wolfe, Kathryn L. Dambrino, David Phillippi, Laura Gray

DNP Scholarly Projects

Abstract

Introduction: Evidence suggests poor-quality diets and high levels of stress have negative impacts on health, especially in low-income families in the southern United States. Nutrition-based food assistance programs were developed to meet nutritional needs of food insecure clients. The purpose of this scholarly project was to explore the relationship between perceived stress and diet quality among low-income families engaged with a nutrition-based food assistance program.

Methods: A retrospective and observational design was used to analyze previously collected survey responses from clients participating in a nutrition-based food assistance program in Nashville, TN (N = 425). Descriptive statistics and Spearman’s …

Remifentanil Patient Controlled Analgesia Use In Laboring Women: A Feasibility And Acceptability Study, Joshua Carr

Dissertations

Background/Purpose: Interest in remifentanil patient controlled analgesia (RPCA) as a treatment for labor pain has increased due to its unique pharmacodynamics and effectiveness on pain control among parturients. Despite its promise, RPCA remains infrequently used in the US. The purpose of this study was to 1) examine the implementation and acceptability of a new RPCA protocol in the labor and delivery ward of a mid-sized hospital, and 2) identify the attitudes and beliefs of healthcare workers in a real-world clinical setting.

Theoretical/Conceptual Framework: The holistic nature of Comfort Theory can account for the proposed mechanisms contributing to the …

Econsent Forms On Ancillary Applications With Electronic Medical Record Integration – Reducing Consent Error, Lilian Chan

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The purpose of this project is to utilize electronic consents (eConsents) with ancillary applications as an evidence-based intervention to reduce consent errors.

Background: Studies show that paper-based handwritten forms have an error rate of up to 50%. Consent errors, especially in the preparation of surgery, are not merely documentation errors but patient safety pitfalls that allow for incorrect surgeries or financial loss due to aborted or delayed interventional cases. Internal organizational evidence indicates the implementation of an evidence-based opportunity as there was no use of electronic tools for consents utilized in the inpatient setting.

Methods: Inpatient departments …

A Two-Step Approach To Increase Breastfeeding Adherence In Mothers With Preterm Infants, Jessica J. Glinski

Evidence-Based Practice Project Reports

Breastfeeding provides multiple benefits for mothers and infants. An overwhelming amount of evidence indicates that breastmilk optimizes infant growth and develops the immune system (Yu et al., 2018). Apart from the health benefits for infants, the immediate effects of breastfeeding for mothers include a decreased risk for hemorrhage, stress, and postpartum depression (Flemming, 2021). A mother’s psychological state impacts lactation success, mainly by affecting milk ejection (Dabas et al., 2019). Despite evidence suggesting that relaxation techniques are beneficial for all human beings, it is one of the least commonly used approaches for postpartum mothers (Joseph et al., 2019). The PICOT …

The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson

Evidence-Based Practice Project Reports

Anxiety disorders are very prevalent in the United States. The most common type, Generalized Anxiety Disorder (GAD), affects 6.8 million adults every year. GAD can cause significant deficits in a person’s ability to function, decrease their quality of life and increases a person’s risk of attempting suicide. The purpose of this evidence-based practice (EBP) project was to improve the outcomes of adults diagnosed with GAD in an internal medicine setting by implementing a protocol composed of a combination of interventions. A thorough literature search was conducted to find the best available evidence to support the project. A total of 11 …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

How Implementing A Digital Competency Management System Reduced Nurse Training Cost And Improved Npd Practitioner Satisfaction In A Pediatric Hospital, Dionne Margallo

Doctoral Projects

Healthcare organizations must have high-quality nursing staff to deliver optimal patient care. Educators and managers evaluate nurses by their performance through nursing competencies, or “knowledge, skills, [and] abilities” (KSA) (American Nurses Association, 2015, p. 86). Traditional competency evaluations and manual tracking posed a problem within one pediatric hospital. Leaders did not have a transparent way to see the knowledge and skills of their nursing staff. This resulted in increased organizational costs due to retraining and increased workload and job dissatisfaction among educators. The purpose of this quality improvement (QI) project was to evaluate how implementing a digital competency management system …

A Multimodal Approach To Decreasing Hesitancy And Increasing Uptake Of The Covid-19 Vaccine In The Family Care Setting, Meghan Zwierzynski

Evidence-Based Practice Project Reports

Since December 2019, the coronavirus disease 2019 (COVID-19) has swept across the world, infecting and killing millions of people, making it one of the worst pandemics in history (WHO, 2021). However, the rates of confirmed cases and deaths have slowed since the discovery of the COVID-19 vaccine. The purpose of this evidence-based practice (EBP) project was to decrease vaccine hesitancy and increase uptake of the COVID-19 vaccine in the family care setting. The Iowa Model-Revised (Iowa Model Collaborative, 2017) is a practical, effective multi-step change process that acted as a guide for the EBP project. A review of literature showed …

Effect Of Implementing Admission History Optimization On Perceived Nurse Documentation Burden, Chelsea Smith Hardin, Mary Johnson

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

Abstract

Electronic health records (EHR) and computer-based documentation is a powerful tool which has been adopted extensively in the last twenty years. The effect of EHR integration on staff has not been well studied, especially among nurses.

Purpose

The purpose is to investigate how optimization of nursing documentation effects the burden of documentation on nurses.

Methods

This project evaluated the admission history documentation at a community hospital that used essential data sets (EDS) to optimize the documentation process for nursing. To evaluate the documentation burden, the Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey will be used before implementation …