Medicine and Health Sciences Commons^™

Mentoring Infection Preventionists: An Infection Prevention Practice Fellowship Program, Sejal Naik

DNP Qualifying Manuscripts

Background: The COVID-19 pandemic created enormous demands on infection preventionists (IPs). It seriously taxed IPs and required hiring new IPs to support these demands. It is highly competitive to hire experienced IPs, and it can take up to two years for new IPs to demonstrate proficiency before pursuing their certification. A gap analysis revealed that current infection prevention (IP) programs did not provide formal training or mentoring.

Methods: The fellowship program will use the Association for Professionals in Infection Control and Epidemiology (APIC) competency model to train and build IP competency. The APIC accelerated training program will provide training to …

Effects Of Resilience Coaching On Behavioral Health Nurse Burnout, Dalila Franklin

Dissertations

Abstract

Background: Inpatient, staff nurse burnout negatively impacts nurses’ mental and physical health, hospital nurse retention and turnover, and patient care. The Stress First Aid for Health Workers program attempts to bolster resilience and subsequently reduce burnout among mental health nurses in this project.

Method: This quality improvement (QI) project was an observational pre-post survey design and was conducted on a cohort sample of inpatient, behavioral health nurses at an urban, mid-sized, Midwestern hospital psychiatric unit to assess personal, work-related, client-related, and overall burnout utilizing the Copenhagen Burnout Inventory (CBI) tool to quantitatively measure burnout pre- and three months post-implementation …

Evidence-Based Best Practice For Transitions Of Care: A Policy Review On Medication Reconciliation Standards, Lovelyn Chizoba Ogbennah

Student Scholarly Projects

Practice Problem: Medication reconciliation (MR) is crucial in care transitions among healthcare facilities. Developing evidence-based discharge planning strategies, improving communication, optimizing electronic health record intelligence interoperability, and stakeholder engagement will promote a better transition process for patients and healthcare providers.

PICOT: The PICOT question that guided this project was: In an urban-based adult skilled nursing facility, how does an evidence-based structured review, and revision of current MR policy and procedures, compared to the existing MR policy, affect the clarity of the process for communication between clinicians during transitions of care over a 10-week review cycle?

Evidence: Fifteen …

Ed To Telemetry Bed: Optimizing Nurse Communication & Decreasing Team Frustration, Harmandeep (Harm) S. Madra

Master's Projects and Capstones

PROBLEM: According to the Institute of Medicine, boarding inpatients in the emergency department (ED) can result in an increased risk for medical errors, delay in treatments, and decreased quality of care. The goal is to move the patient to the hospital bed within 60 minutes from when an order is written for admission. The current average monthly compliance for ED throughput and admission to the inpatient bed is at 45% compared to the target of 70%. Lack of standardization during handoff can lead to delays, miscommunication and causes team frustration.

CONTEXT: In 2022, this community hospital’s ED microsystem had limited …

Implementation Of Provider Education Regarding Exercise As Adjunctive Treatment For Common Mental Health Diagnoses, Lauren Grace Martin

Doctoral Dissertations and Projects

Mental and physical health are inextricably linked. The advent of the Covid-19 pandemic reduced physical activity levels while worsening mental health symptoms. Pharmacological treatments are frequently used to treat mental health conditions; however, side effects can worsen metabolic issues. There is significant evidence that exercise can improve mental health conditions. The purpose of this project was to utilize provider education as an intervention to increase the use of exercise as an adjunctive treatment in the psychiatric treatment plan. This project was implemented at Nevada Mental Health, an outpatient behavioral health clinic in Las Vegas, Nevada. The investigator conducted a chart …

Focused Group Meetings To Promote Job Satisfaction For Emergency Department Advanced Providers, Kendra Osei-Wusu

Doctoral Dissertations and Projects

Objective: Over the last few years, the pattern of increased burnout, operating under adverse environments, and being under- appreciated as led to a decrease in job satisfaction among emergency room providers(physicians, advanced practicing nurses, and physician assistants). Therefore, this scholarly project examined if small focused group discussions among emergency room providers will help combat poor job satisfaction scores and increase the well-being of the practitioners that keep the emergency room functioning. Methods: Using a quasi-experimental design, 10 providers that work in the emergency department at Lifebridge Health were randomly selected. Baseline well-being and job satisfaction rates were measured prior to …

Constant Observation The Benchmark Study, Kalana Sanders

MSN Capstone Projects

Constant observation is defined as “an increased level of observation and supervision which continuous one-to-one monitoring techniques are utilized to assure the safety and wellbeing of an individual patient in the patient care environment. In the hospital setting constant observation has become the most used resource for mental health patients. The use of constant observation has significantly improved patient safety outcomes reducing falls and suicide rates drastically. With one study in Pennsylvania showing a vast improvement in patient safety in simply one-month times. As fall rates decreased from 53,966 falls occurring without the implementation of constant observation to only 323 …

An Education Intervention Project In Community Clinics To Improve The Identification Of Patients With Pulmonary Alveolar Proteinosis And To Correctly Identify The Type Utilizing The Differential Diagnostic Algorithm, Catherine J. Poisson

Doctoral Dissertations and Projects

With over 7000 types, rare diseases affect 25-30 million Americans and contribute to over one trillion dollars in healthcare-related costs. Prescribers lack the knowledge to improve awareness, identification, and treatment of rare diseases. Pulmonary alveolar proteinosis is a rare disease in which patients present with symptoms such as dyspnea, fatigue, and respiratory infections. Diagnosis can take four to 92 months. A differential diagnostic algorithm published in the literature can guide clinicians in identifying the type of pulmonary alveolar proteinosis the patient has. In addition, if the clinicians perform a laboratory test called the granulocyte-macrophage autoantibody test, this test provides 100% …

Nursing Considerations For Elderly Adults With Urinary Tract Infections In Nursing Homes, Mary Marlett

D.U.Quark

No abstract provided.

Nurse Efficiency & Ultrasound Guided Intravenous Access: Evidence Based Intervention Benchmark, Jacob D. Frost

MSN Capstone Projects

Gaining IV access is this first step into accurate, timely diagnosis and interventions of patients. Nurses are typically the first medical professional a patient sees. If the nurse can establish IV access as early as possible this will lead to faster interventions faster diagnostic results and better management for patients and ultimately better patient outcomes. Ultrasound guided IV can increase first attempt success rates leading to decreased painful IV insertions by multiple nurses. This would increase patient satisfactions scores leading to higher re-imbursement.

Congestive Heart Failure Educational Approach Benchmark Study, Sheridan B. Westmoreland

MSN Capstone Projects

Heart failure continues to burden the American healthcare system. Disease management programs and transitional care services are used by hospitals to help patients living with congestive heart failure (CHF) transition from the hospital to home life. Twelve articles were chosen to evaluate the effectiveness of a multidisciplinary approach in reducing hospital readmission rates, cost, and death. One article was chosen to see how a nurse-led 1:1 patient educational approach was effective, and one article evaluated patients’ perception on living with CHF. This paper aims to evaluate the best educational approach on reducing hospital readmission rates, death, and cost in CHF …

Adjustable Velcro Compression Devices, Spring Reed

MSN Capstone Projects

Venous Ulcers and edema are expensive to treat and chronic conditions that are a strain on home health care companies and decrease patient quality of life. The standard treatment is expensive multilayer compression wraps that time consuming requiring three weekly visits, a strain on home health care agencies and are often not successful in resolving edema and venous ulcers. Adjustable Velcro compression devices are proven to be successful compression therapy due to low one-time cost, patient's increased comfort and the patient or patients' family self-sufficient in their application.

Implementing A Medication App For Transplant Recipients, Allison Arnold

MSN Capstone Projects

The purpose of this benchmark, evidence-based practice project is to evaluate the utility of medication adherence app for transplant recipients to reduce rejection. Studies have shown that medication apps can improve adherence, reduce transplant rejection, and be helpful to patients. The Perx Health app rewards patients for taking their medications, provides patients with reminders, and provides healthcare providers with data from patients. The Perx app will be implemented at a single, large volume, pediatric transplant center. Historical data related to rejection rates and medication level variability indexes will be compared to data collected after app implementation. In addition, patient surveys …

Meeting The Needs Of Gen Z Nurses To Improve Nurse Retention, Ronna M. Best

MSN Capstone Projects

This benchmark project explores the unique learning styles and generational characteristics of Generation Z nurses (those born between 1995 - 2012). The need exists for a change in traditional orientation and onboarding processes to meet the needs of Gen Z nurses. Gen Y and Gen Z nurses are expected to make up 50% of the workforce by 2024. Retention of these nurses is critical to a hospital organization as it is an effective strategy in dealing with the nursing shortage. Specific strategies for engaging the gen Z nurses include incorporating more digital platforms in the orientation and onboarding process, face …

Retention Drivers Post-Pandemic, Maria Charles, Christina Gonzalez

MSN Capstone Projects

The Covid pandemic influenced the world in many ways that we still witness a need for recovery. One significant concern that remains apparent is the culture change within the healthcare system. This study is directed to cover only one aspect of this culture change but remains to be a very significant topic for the nursing workforce (AHC Media, 2021). Even though we have managed to find a downward trend of Covid cases, the pandemic has devastated nursing retention to well established facilities. There is currently an exodus of nurses in high acuity departments or simply bedside nursing entirely. This causes …

Nursing Students’ Perceptions Of Using Branching Simulation: A Qualitative Descriptive Study, Mohammad Rababa, Dania Bani-Hamad, Shatha Al-Sabbah

The Qualitative Report

Previous intervention studies have shown that branching simulation (BS) unfolds the complex multidimensional aspects of challenging health problems. The present study aimed to examine graduate nursing students’ perceptions of using BS in professional training. This study used a qualitative descriptive design with semi-structured interviews with a sample of 20 graduate nursing students. Four main themes emerged from the results: (a) BS as a support to students’ professional training, (b) BS leads to changes in clinical practice, (c) whether BS is a stressful learning experience, and (d) BS versus traditional lecturing. The participating students perceived BS as a valid learning tool …

Mental Health Navigators Bridging The Gap Of Care For Clients With Schizophrenia: A Review, Valentina Loreto-Ashley, Valentina Loreto-Ashley

DNP Qualifying Manuscripts

Background: Schizophrenia is a thought disorder. As such it affects an individual level of function, and often leads to acute hospitalization. When clients with schizophrenia disorders are discharged, they are a great risk for suicide and danger to others. Services aimed at bridging patients from an acute facility to their community setting could be essential in helping the client in treatment to reach functional recovery and avoid relapse.

Objective: This article explores the role of mental health peer navigators in improving treatment adherence for adult clients with schizophrenia spectrum disorder being discharged from a psychiatric facility into their unique community …

Nursing Considerations For Post-Traumatic Amnesia After A Traumatic Brain Injury, Hannah Grant

Senior Honors Theses

A period known as post-traumatic amnesia (PTA) often follows a traumatic brain injury (TBI). PTA is characterized by anterograde and retrograde amnesia, confusion, disorientation, and agitation. The duration and severity of PTA is a key indicator of the long-term prognosis after a TBI, so proper assessment and nursing care of a PTA patient is crucial. TBIs range from mild to severe, but primarily affect the fronto-temporal lobes. In PTA, both neural lesions and white matter damage within the parahippocampal region can cause PTA. A nurse must perform a thorough assessment of a TBI patient, but, since PTA is a key …

Bedside Nurse Shift Length: Evidence-Based Intervention On Nursing Burnout, Natalie Suzanne Medina Bsn, Kristen Morreale Bsn, Bryanna Whitehurst Bsn

MSN Capstone Projects

With the aging baby boomer population, employee burnout, and lack of quality medical training, the United States is facing one of the most detrimental nursing shortages in history. Before the COVID-19 pandemic, the United States Health and Human Services projected the demand for nurses to be much higher than the actual number of employed registered nurses through 2030. Since 2016 the nursing population was widely composed of nurses between 25 to 34 years old. After the global pandemic hit, the number of nurses in that age group declined by 5.2 percent, and nurses aged 35 to 44 have reduced by …

Changing Hand-Off Communication In The Pacu Setting, Alisa M. Berndt

MSN Capstone Projects

Through extensive research on the importance of hand off communication in the PACU setting a correlation between patient safety and hand off report was found. Lack of a standardized hand off communication report in the PACU setting may lead to compromised patient safety and negative patient outcomes. In year 2021- 2022, the PACU there had several occurrences of miscommunication that were considered “near misses” in their incident reporting system. The objective of this capstone project is to investigate if utilizing a standardized hand off communication tool to guide healthcare professionals when transferring patient care to the next provider will mitigate …

Using Debriefs To Reduce Nursing Burnout In Nurses Caring For The Oncology Population, Courtney M. Wilkes

MSN Capstone Projects

Nurses are a critical part of healthcare and make up the largest section of healthcare professionals in the United States. According to the World Health Organization (2020), there are approximately 29 million nurses and midwives globally. The increasing need for nurses is not a new discovery. According to the American Association of College of Nurses, more registered nursing jobs will be available through 2022 than any other profession in the United States. The number of nurses leaving the workforce each year has been growing steadily from around 40,000 in 2010 to nearly 80,000 in 2020. Nursing burnout is a known …

Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux

MSN Capstone Projects

Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …

An Integrative Review: The Experiences Of Stress, Burnout, And Compassion Fatigue By Ambulatory Care Nurses, Rajean Adams

Master of Science in Nursing Final Projects

Abstract

Aim: One aim of this integrative review is to highlight workplace issues outpatient (ambulatory care) nurses experience, related to stress, burnout, and compassion fatigue. Another aim is to bring awareness to and discuss recently implemented tools and strategies to help alleviate these manifestations.

Background: Stressors in the outpatient setting date back to the 1970s when psychologist Herbert Freudenberger mentioned the burnout he experienced while in a Free Clinic. In modern-day, half of nurses experiencing workplace burnout, confess to feeling emotional exhaustion. Various studies discuss the challenges nurses endure in the inpatient setting, but only a few focus on ambulatory …

Reducing 30-Day Hospital Readmission Among Mentally Ill Homeless Men With Substance Use Disorder, Chibuogwu Ugbana

DNP Qualifying Manuscripts

Abstract

Background: Psychiatric inpatient readmission of mentally ill homeless men is greater than that of the overall population. Substance use disorders co-occur with high prevalence in patients diagnosed with mental illness. For mentally ill homeless individuals discharged after inpatient treatment, substance use disorder negatively impacts health behavior, and medication non-compliant, resulting in hospital readmission.

Problem: In an acute care psychiatric facility in Northern California, the greatest readmission after inpatient hospitalization occurs at 53.9% in a week and 74.8% in two weeks of discharge. For homeless individuals, substance use disorder complicates personal problems and decreases the likelihood of a long-term …

Remote Patient Monitoring: Decrease Rehospitalization For Spinal Cord Injury Patients, Abegail Cabunoc-Garcia

Student Scholarly Projects

Practice Problem: The lengthy distance required to access specialty care, the overall higher cost of SCI/D care, complications associated with SCI, and the potential negative impact of shortened hospital stays are all compelling reasons to use telehealth technologies to deliver specialty services for medical issues.

PICOT: The PICOT question that guided this project was in adult spinal cord injury patients with chronic disease receiving primary care at a spinal cord injury center (P), how does the implementation of a remote patient monitoring home telehealth for SCI patients recently discharged from acute-care setting (I) compared to the usual practice …

Contributing Factors And Solutions For Inappropriate Use Of The Emergency Department, Lesia M. Kozych

Honors Capstones

Emergency departments are overwhelmed with the sheer quantity of patients, many of which are there for the non-emergent reasons. The purpose of this project is to identify factors that contribute to emergency department (ED) misuse, initiatives or programs that have been successful in decreasing ED misuse, and ED personnel’s opinions on contributing factors and potential solutions. A literature review followed by semi-structured interviews of ED personnel produced the necessary information. Common themes were drawn from participant responses in the interview portion. A major barrier to appropriate use of the emergency department is access to primary care. Others include: lack of …

Promoting Sleep To Decrease Delirium, Stephanie Mayne

MSN Capstone Projects

Delirium is potent risk factor for complications, an increase length of stay, and mortality. Hospital acquired delirium is a prevalent and serious health condition that can occur in patients, especially the older adult population, when admitted to the hospital. It has the ability to be prevented if properly addressed and interventions are set in place to help reduce the occurrence of hospital acquired delirium. Many factors can contribute to the development of delirium, including a disruption of one’s circadian rhythm. Sleep is not always a high priority in the hospital, therefore there are little interventions and goals aimed at improving …

Regional Anesthesia In Outpatient Total Joint Arthroplasty, Laci Caesar

MSN Capstone Projects

Within the past five years, outpatient total joint arthroplasties have increased three-fold due to the change in insurance companies’ reimbursement plans. After continuous literature research collection, support for spinal anesthesia was higher than compared to general anesthesia (GA) for outpatient total joint arthroplasty procedures. Healthy patient who receives regional anesthesia showed decreased post-operative pain, increased rehabilitation, and, most of all, a decrease in facility stays (Macfarlane et al., 2009). This has allowed healthy patients who meet physician, anesthesia, and facility requirements to transition from hospitals to ambulatory surgery centers for total joint replacement procedures. With this new transition comes change …

Nursing Students' Knowledge Of And Attitudes Towards Near-Death Experiences, Laura Lee Varela

Theses & Dissertations

Incidence of reported near-death experiences (NDEs) has increased over decades; however, they continue to be inappropriately pathologized or dismissed. These types of responses to disclosures of NDEs by patients can potentially lead to them having problems integrating the experience into their lives. The purpose of this study was to assess undergraduate nursing students’ levels of accurate knowledge of and attitudes towards NDEs and to determine the predictors of nursing students’ knowledge of and attitudes toward NDEs. Additionally, I explored the sources in which nursing students acquire NDE knowledge. I accomplished this by using a cross-sectional, correlational research study design. I …

Implementing Evidence-Based Adult Psychiatric Inpatient Depression Assessment, Treatment, And Post-Hospitalization Referral, Lucy Flores

Doctor of Nursing Practice

Purpose: This project was designed to strengthen the quality of depression assessment with evidence-based depression assessment tools in inpatient psychiatric units.

Background: Missed diagnosis and treatment of depressive disorders contribute to the most severe outcome of depression: suicide. A crisis stabilization facility with inpatient psychiatric units had significant opportunities to improve clinical outcomes by screening for depression in adults and to monitor symptoms with evidence-based tools.

Methods: The 12-week quality improvement project included implementation of staff education sessions of evidence-based tools to screen, monitor, interpret scores, and detect risk modifiers. The design and build with Information …