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Articles 1 - 30 of 388
Full-Text Articles in Medicine and Health Sciences
The Lived Experiences Of The Newly Graduated Generation "Z": Registered Nurse Entering The Intensive Care Unit, Matthew Robert Loveitt
The Lived Experiences Of The Newly Graduated Generation "Z": Registered Nurse Entering The Intensive Care Unit, Matthew Robert Loveitt
Doctoral Dissertations and Projects
The purpose of this transcendental phenomenological study was to illuminate, understand, and describe the meaning of the lived experiences of Gen Z new graduate registered nurses (NGRNs) transitioning directly into the ICU in their first position as registered nurses. Duchscher’s stages of transitional theory and the Strauss-Howe generational theory provided this study’s theoretical framework, focusing on the Gen Z NGRN transition into practice. This study answered the following central research question: What is the lived experience of Gen Z NGRNs transitioning into the ICU work environment employed in their first position as registered nurses? Data were collected for this study …
Improving Triage Accuracy In The Emergency Department, Joselyn Silverman
Improving Triage Accuracy In The Emergency Department, Joselyn Silverman
Master's Projects and Capstones
Problem: High rates of patients being mis-triaged was occurring at Hospital X leading to poor patient outcomes and incorrect staffing levels.
Context: This quality improvement project took place at Hospital X’s emergency department. A stakeholder analysis and a microsystem assessment along with a staff survey was created in order to determine areas of improvement and staff responsiveness.
Interventions: Eight educational seminars were conducted along with Hospital X leadership and students created supplemental materials for the staff to use on a daily basis.
Measures: Two data pulls were conducted over the course of the quality improvement project; one prior to the …
The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban
The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban
Master of Science in Nursing Family Nurse Practitioner
This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …
Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner
Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner
MSN Capstone Projects
Although a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.
The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, …
Utilizing Mock Code Simulation To Enhance Nurses’ Confidence A Benchmark Project, Denecia Mark
Utilizing Mock Code Simulation To Enhance Nurses’ Confidence A Benchmark Project, Denecia Mark
MSN Capstone Projects
Each year, about 292,000 adult patients in the United States have an in-hospital cardiac arrest (IHCA), with substantial variance in their rate of survival (Merchant et al., 2020). Graduate nurses must be knowledgeable and prepared to respond to codes. Mock Codes or simulation-based teaching will allow nurses to practice skills, expand their knowledge, and gain self-confidence in a secure and controlled setting with no risk to patients, reducing nurses' anxiety. CPR certification is currently updated every two years, and research has shown that learned skills begin to deteriorate after three months. As a result, if simulated codes are introduced skills …
Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner
Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner
MSN Capstone Projects
Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …
Workplace Violence In Emergency Departments, Education And De-Escalation Training: A Benchmark Study, Summer Block
Workplace Violence In Emergency Departments, Education And De-Escalation Training: A Benchmark Study, Summer Block
MSN Capstone Projects
Most people do not go to work and fear being assaulted or harassed daily. However, for emergency nurses in this county that is exactly what it has come to. Up to 96% of emergency department nurses state they have been verbally abused. This entails name calling, verbal threats, being shouted at and being sworn at. Anywhere from 25% to 60% of these nurses have had to face physical assaults while on the job. (Al-Aadi, 2020; Copeland & Henry, 2017; Grinberg, 2022; Li et al., 2019; McDermid et al., 2019). Physical assaults can include being spit on, slapped, punched, kicked, choked, …
Nursing Innovation: Improved Perioperative Care With A Redesigned Urological Drape, Olivia Sonneborn, Indra Jolayemi
Nursing Innovation: Improved Perioperative Care With A Redesigned Urological Drape, Olivia Sonneborn, Indra Jolayemi
Journal of Perioperative Nursing
Inventions and innovations have the potential to change lives.1 Perioperative nurses strive for improved patient care2 and are well positioned to develop creative and innovative solutions to clinical challenges faced when caring for patients in the perioperative environment. Fluid leakage during percutaneous nephrolithotomy (PCNL) surgery poses risks to both patients3 and staff. The PCNL drape was developed by a collaborative perioperative team to reduce these risks and improve the quality of care provided to patients.
Environmental And Occupational Health Risks: Educating Undergraduate (Adn-Bsn) Nursing Students For Safer Practice, Dorinda A. Mercado
Environmental And Occupational Health Risks: Educating Undergraduate (Adn-Bsn) Nursing Students For Safer Practice, Dorinda A. Mercado
Doctor of Nursing Practice (DNP) Projects
Background: Globally, adverse health effects, including deaths and disabilities, occur from living or working in unhealthy domains where exposure to environmental and occupational hazards exists. A multitude of these hazards are present in clinical settings in the healthcare environment where nurses care for patients and risk ongoing exposures to toxic substances.
Problem: Environmental and occupational health education is rarely included in the standard undergraduate nursing curriculum, contributing to a deficit among nurses in environmental health awareness and knowledge.
Methods: The study design was a pre/post evaluation of a single cohort (n=32) of undergraduate nursing students to assess environmental and occupational …
Mindfulness Meditation To Reduce Nurse Burnout: An Ebp Implementation Project, Lester Denson Jr
Mindfulness Meditation To Reduce Nurse Burnout: An Ebp Implementation Project, Lester Denson Jr
MSN Capstone Projects
Hospitals across the United States are suffering from poor staffing (American Nurses Foundation, 2021). A common thread throughout those facilities is that nurses are leaving their jobs due to self-reported burnout, contributing to the staffing shortage and low morale (Shah et al., 2021).
Mindfulness training plays a part in decreasing emotional exhaustion for staff nurses. A reduction of emotional exhaustion has been discovered after the implementation of mindfulness-based intervention programs, with continued improvement after completion of the program (Sarazine et al., 2021; Bianchini & Copeland, 2021). The benefit of this implementation would be a reduction of nurse burnout which ultimately …
Increasing Medical-Surgical Nurses' Palliative Care Self-Efficacy Using The Cares Tool: A Quality Improvement Project, Rebekkah L. Stanko
Increasing Medical-Surgical Nurses' Palliative Care Self-Efficacy Using The Cares Tool: A Quality Improvement Project, Rebekkah L. Stanko
Nursing (graduate) Student Scholarship
Background: Over 35% of all deaths in the United States occur in the acute care hospital setting, and 75% of end-of-life (EOL) patients require palliative care. Registered nurses (RNs) with strong palliative care self-efficacy (PCSE) promote positive death experiences for patients and families by minimizing patient suffering and maintaining clinical and ethical standards. Employers can enhance RNs’ PCSE through educational interventions and resources.
Problem: Inpatient acute care hospital RNs lack PCSE because acute care is traditionally curative, and RNs receive limited EOL care education.
Methods: A quality improvement project was conducted. Participants were a convenience sample of RNs …
Development Of A Resilience Program To Combat Burnout In Nursing Practice, Maggie Lynch
Development Of A Resilience Program To Combat Burnout In Nursing Practice, Maggie Lynch
DNP Scholarly Projects
Burnout has been identified as a national health crisis, with implications for the retention and health of critical healthcare workers. Acknowledging the innate stressors of providing healthcare it is the responsibility of leaders in the industry to mitigate burnout to sustain the workforce critical to healthcare in the United States. Understanding resilience and how to foster it in nurses will contribute to burnout prevention and consequently improve the quality of health care provided Americans. Resilience training has been identified as a valuable approach to retention of the workforce. This scholarly project developed a resilience training program for newly licensed registered …
The Dedicated Education Unit: Increasing Capacity And Confidence, Heather Marie Van Housen
The Dedicated Education Unit: Increasing Capacity And Confidence, Heather Marie Van Housen
Doctor of Nursing Practice (DNP) Projects
Background: In the American Association of Colleges of Nursing (AACN) 2020 annual survey, nursing schools turned away 66,274 entry-level applications to baccalaureate nursing programs in the United States due to a faculty shortage and clinical placement sites (AACN, 2021).
Local Problem: Hospitals need more qualified nurses to meet community needs. The need for clinical faculty and additional clinical placement sites disrupts the workforce pipeline through local nursing schools. A new approach to clinical education is needed to prepare more students for the growing complexities of independent nursing practice.
Methods: Dedicated Education Unit (DEU) implementation to expand pre-licensure nursing student clinical …
Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Amanda H. Tran
Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Amanda H. Tran
Master's Projects and Capstones
Problem: According to a pre-survey collected, approximately six percent of medical-surgical nurses report expert knowledge with the “Inpatient Handoff Sepsis Bundle Checklist,” a checklist that details interventions to be taken when a patient is diagnosed with sepsis. About thirty-five percent of these nurses also report expert confidence levels in caring for sepsis patients. Therefore, there is an opportunity to provide education so that nurses may confidently and competently care for sepsis patients.
Context: A medical-surgical unit at Hospital A affiliated with a large, non-profit, integrated healthcare system located in the San Francisco Bay Area.
Intervention: Create an educational handout to …
Increasing Sepsis Bundle Compliance Through Nurse Education, Parth S. Papaiya
Increasing Sepsis Bundle Compliance Through Nurse Education, Parth S. Papaiya
Master's Projects and Capstones
There exists opportunities for improvement in regards to sepsis management and compliance rates in efforts to reduce sepsis-related complications and incidents in the ED. SEP-1 fallouts and requirements linked to education gaps about sepsis bundle protocols, nurses’ attitudes about implementation of the protocols, and differences in nurse/physician order sets present as deterrents for timely sepsis management and improvements in the rates of compliance/adherence. Denouncing the usage of standardized protocols/use of order sets have been identified as a process gap and a much needed opportunity for improvement. It is presumed that the failure to implement, in addition to improper documentation of …
A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller
A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller
Evidence-Based Practice Project Reports
U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …
A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings
A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings
Evidence-Based Practice Project Reports
Generalized anxiety disorder (GAD) is a debilitating psychological condition that affects 3.1% of the American population and is one of the leading causes of disability (Anxiety and Depression Association of America, 2022; Baxter, 2014). The purpose of this evidence-based practice project was to implement a multimodal intervention to decrease GAD symptoms in adults in the primary care setting. The PICOT question that guided this project was: In adults, over the age of 18, who have been diagnosed with generalized anxiety disorder (GAD), does the combination of digital cognitive behavioral therapy (CBT) through a smartphone application, lifestyle modification education, and pharmacotherapy …
Telehealth And Its Impact On The Management Of Type 2 Diabetes Mellitus, Melissa N. Toulios
Telehealth And Its Impact On The Management Of Type 2 Diabetes Mellitus, Melissa N. Toulios
Evidence-Based Practice Project Reports
Diabetes mellitus type 2 (T2DM) is a growing epidemic that affects millions of people throughout the world. The recent COVID-19 pandemic has created many new challenges, including access to health care for treatment of chronic diseases, such as diabetes (Robson & Hosseinzadeh, 2021). Telehealth has offered a promising approach to improve the management of diabetes(Bellman, 2021). People with diabetes are less likely to manage their diabetes through the usual care because of risk of contracting COVID-19 (CDC, 2022). The purpose of this EBP project was to evaluate the effectiveness of T2DM management through a telehealth approach. This project has addressed …
A Prescription For Diabetes Self-Management Education: Best Practice For Persons With Type Ii Diabetes Mellitus, Ashley J. Milcarek
A Prescription For Diabetes Self-Management Education: Best Practice For Persons With Type Ii Diabetes Mellitus, Ashley J. Milcarek
Evidence-Based Practice Project Reports
Diabetes self-management education and support (DSMES) programs have been shown to improve patient outcomes and lower hemoglobin A1c (Hgb A1c) levels in those who are diagnosed with type two diabetes mellitus (T2DM). However, these programs are often underutilized and have low referral rates, despite the known benefits (Powers et al., 2020). The purpose of this patient-centered EBP project was to evaluate the effectiveness of a patient-driven questionnaire, completed by patients with T2DM during routine office visits, in increasing the percentage of patients referred to DSMES by their provider. Specifically, this project addressed the following PICOT question: In adults who have …
A Multimodal Smartphone Application Intervention To Achieve Target Weight Goals In Overweight Adult Diabetics, Michael Thomas Schwuchow
A Multimodal Smartphone Application Intervention To Achieve Target Weight Goals In Overweight Adult Diabetics, Michael Thomas Schwuchow
Evidence-Based Practice Project Reports
Obesity is the leading risk factor for developing type 2 diabetes mellitus (American Diabetes Association, 2022). Diabetes mellitus (DM) and obesity put individuals at higher risk for developing heart disease, stroke, and hypertension, therefore, it is essential to properly manage both conditions. The purpose of this project is to determine if the implementation of an evidence-based weight loss intervention, MyFitnessPal© will result in reduction in body mass index (BMI) and lower hemoglobin A1c (HbA1c) levels in overweight adults with DM. A comprehensive literature search of six databases, hand searching, and citation chasing yielded 13 pieces of moderate to high quality …
Meditation-Type Exercise For The Management Of Chemotherapy Related Cognitive Impairment In Breast Cancer Patients, Christine Cain
Meditation-Type Exercise For The Management Of Chemotherapy Related Cognitive Impairment In Breast Cancer Patients, Christine Cain
Evidence-Based Practice Project Reports
Chemotherapy-related cognitive impairment (CRCI), or “chemobrain”, is one of the most troublesome side effects of chemotherapy (Dijkshoorn et al., 2020). Ongoing CRCI may negatively affect relationships, confidence, sleep, fatigue, anxiety, and the ability to return to work activities leading to a decreased quality of life (Johns et al., 2016; Gokal et al., 2018). The purpose of this evidence-based practice (EBP) project was to assess the efficiency of a meditation-type exercise intervention, chair yoga, on decreasing perceived cognitive impairment (PCI) in breast cancer patients. The PICOT question for this project was: In breast cancer patients with chemotherapy related cognitive impairment (P), …
Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska
Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska
Evidence-Based Practice Project Reports
The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …
Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder
Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder
Evidence-Based Practice Project Reports
It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …
The Effect Of Implementing Behavioral Counseling For Elevated Ldl Levels, Blake L. Hansen
The Effect Of Implementing Behavioral Counseling For Elevated Ldl Levels, Blake L. Hansen
Evidence-Based Practice Project Reports
Hyperlipidemia is a key risk factor in cardiovascular mortality, and is prevalent in approximately 38% of American adults (CDC, 2022b). Cholesterol levels are intensified by unhealthy lifestyle choices, which means a change in lifestyle behaviors could prevent cardiovascular related deaths (WHO, 2022). The PICOT question for this project was: In adults aged 20 years or older in the primary care setting who have elevated low-density lipoprotein (LDL) levels (P), does the implementation of behavioral counseling on lifestyle modifications (I) compared to current practice (C) decrease LDL levels (O) over a 10- to 12- week period (T)? Fourteen participants from a …
Effect Of Covid-19 On Icu Nurse Burnout, Kayce Sheppard
Effect Of Covid-19 On Icu Nurse Burnout, Kayce Sheppard
Honors College Theses
Burnout is becoming increasingly worse for those in the nursing field after the height of the COVID-19 pandemic. While all nurses are at risk, ICU nurses are seen as at a higher risk for this increased burnout due to the already high stress environment they are subjected to in their unit. Without proper intervention of this issue, the levels of burnout are expected to continue to remain high, leading to job dissatisfaction, short staffing, and reduced patient satisfaction. The objective of this study is to review the level of burnout among ICU nurses. A burnout study was conducted on ICU …
Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey
Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey
Evidence-Based Practice Project Reports
Advance care planning (ACP) is a topic that can be difficult for patients and providers to discuss due to lack of time, knowledge, communication skills, and discomfort surrounding the subject (Barkley et al., 2019; Hafid et al., 2021; Halpert et al., 2022; Marin, 2022). Delayed or absent ACP discussions may lead to nonbeneficial care, increased healthcare costs, end of life suffering and increased post-death family distress (Halpert et al., 2022; O’Hanlon et al., 2018). The purpose of this evidence-based practice (EBP) project was to increase the discussions and documentation regarding ACP in a family practice setting. The PICOT question guiding …
Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia
Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia
Evidence-Based Practice Project Reports
Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …
Exploring Factors Influencing Nursing Engagement In 4ms Initiatives On An Inpatient Older Adult Unit, Sarah Nelson
Exploring Factors Influencing Nursing Engagement In 4ms Initiatives On An Inpatient Older Adult Unit, Sarah Nelson
DNP Scholarly Projects
Background: The older adult population is growing, and these individuals often have health challenges that require complex nursing care. On an older adult unit in Tennessee, a 4Ms (What Matters, Medication, Mentation, and Mobility) Age-Friendly care initiative was implemented to improve care and outcomes. Early data showed inconsistent nursing engagement with 4Ms initiatives and qualitative data on engagement factors was needed to increase nursing support and improve patient outcomes. Purpose: Therefore, this scholarly project explored factors influencing nursing staff engagement with the 4Ms initiative on an older adult unit. Methods: Nurses and …
Job Satisfaction And Burnout In Nursing, Tasha M. Tovar
Job Satisfaction And Burnout In Nursing, Tasha M. Tovar
MSN Capstone Projects
Job satisfaction, or lack thereof, can directly lead to burnout. Nursing is known globally as a high-stress career, thus leading to an increased level of burnout. Job burnout is among the most important occupational disorders and phenomena which have received great attention in the recent century (Nabizadeh et al., 2020). Multiple studies have proven that subtle, low-cost interventions can decrease the burnout experienced by nurses, leading to reduced turnover rates and an increase in the quality of patient care. Higher quality of care leads to improvement in patient satisfaction scores and also to increased reimbursement rates (Jun et al., 2021). …
Nursing Faculty Perceptions Of Stress, Coping, And Intent To Leave The Profession In The Ongoing Covid-19 Pandemic: A Quantitative Study, Lynlee Morgan
Dissertations
The COVID-19 pandemic impacted all of society to varying degrees; this impact was especially true in higher education due to an overnight transition to distance learning and incessant pivots to meet new guidelines and overcome obstacles. Nursing faculty were significantly impacted due to the responsibility of producing safe, qualified, competent practitioners to provide care in the clinical setting. The limitations in or exclusions from clinical experiences combined with the fact that faculty were managing personal concerns and had never encountered these unprecedented conditions exacerbated the challenge of preparing new nurses. This study was critical due to the faculty role and …