Medicine and Health Sciences Commons^™

The Effects Of Staffing Practices On Safety And Quality Of Perioperative Nursing Care – An Integrative Review, Nick Nijkamp, Paula Foran

Journal of Perioperative Nursing

Problem identification
Patients undergoing invasive procedures are highly vulnerable to adverse outcomes. From 2012 to 2013, 5.5 per cent of all inpatient admissions reported an adverse event. Perioperative nurses play an important role in providing safe patient care and acting as the patient advocate. This review of literature aims to examine the effects of perioperative staffing and patient safety. Three common staffing themes that impact the safety and quality of patient care were identified; namely, nurse-to-patient ratios, staff training and staff fatigue.

Literature search
An integrative literature search to identify empirical data surrounding perioperative nursing staffing was conducted via the …

The Impact Of A Change In Leadership, Taylor Collins

DNP Projects

Abstract

Background: Unmitigated stress in nursing results in moral distress, burnout, turnover and poor patient outcomes. Authentic leaders can improve the nurses’ work environment and satisfaction by improving communication and implementing supportive measures.

Purpose: The purpose of this study was to determine whether a change in executive leadership at BSW Grapevine Medical Center reduced nursing job stress as evidenced by improved nurse satisfaction, nurse retention, nurse engagement, patient satisfaction and care outcomes.

Conceptual Framework: Watson’s Theory of Human Caring

Design: This study is a quantitative, descriptive retrospective measurement of two points in time, before and after …

Baccalaureate Nursing Students' Lived Experiences Of A Leadership Role During Clinical Practicum, Gisela E. Schmidt

Dissertations

Problem

Leadership is an essential component of professional nursing practice used in many aspects of the Registered Nurse (RN) role. Baccalaureate nursing (BN) programs have the responsibility of preparing graduating nursing students with leadership orientation and practice. Excellent professional preparation of RNs starts with their education during nursing school. The fast-paced and high-demand healthcare environment needs RNs who can be accountable for patient care that enables excellent patient outcomes and sound patient-centered care. Taking this into consideration, nursing educators are in a special position to promote nursing education which prepares their students with leadership education and training. The purpose of …

Exploring Therapeutic Nurse-Patient Communication: Techniques And Barriers, Pierina Rossini

Senior Honors Theses

Effective nurse-patient communication, also described as therapeutic communication, is essential for providing high quality nursing care. It increases patient satisfaction and health, decreases patient anxiety and disease symptoms, and increases patient cooperation and compliance to treatment. Some therapeutic communication techniques include attentive listening, empathy, silence, focusing, open-ended questions, clarification, exploring, clarifying, and summarizing. Unfortunately, there are barriers to therapeutic communication that have been identified. Research regarding nurse-patient therapeutic communication, consisting of secondary, qualitative, descriptive data, points to several barriers to therapeutic communication. Some of the barriers to therapeutic communication include nurse-patient gender difference; patient physical discomfort; nurse-patient language, culture, and …

Improving Clinical Communication And Collaboration Through Technology, Michelle Machon

Doctor of Nursing Practice (DNP) Projects

Problem: Over the last 30 years, clinical communication methodologies in healthcare have evolved to become such disparate systems that they lead to confusion, wasted time, and clinician dissatisfaction. The Joint Commission (2016) reports up to 78% of sentinel events in hospitals are linked to communication failures, which have obvious implications for hospital systems in the quality and safety of their current communication systems.

Context: The purpose of this project was to determine the effectiveness of implementing a unified clinical communication technology platform in an acute care hospital setting and to make recommendations from that implementation to the organization’s larger health …

Creating A Thriving Informatics Culture, Nicholas Webb

Doctor of Nursing Practice (DNP) Projects

Nurses thrive best when they are empowered to make decisions that can positively impact healthcare delivery. Knowledge and application of nursing informatics principles can influence clinical, quality, operational, and financial outcomes in ways that were not available in previous professional nursing generations.

If nursing informatics is the solution, what is the problem? A survey regarding use and attitudes about nursing informatics was taken of chief nurse executives (CNEs) at an integrated, not for profit healthcare system in the Northern California region, where the author oversees the electronic health record (EHR). The results were surprising. Half said they did not know …

Creating An Educational Intervention To Combat Nursing Incivility Benchmark Study, Kathleen P. Melancon

MSN Capstone Projects

When most people reflect on the nursing as a profession, the term compassionate typically comes to mind. The association with compassion is no surprise as nursing is considered to be the most compassionate profession in the world. Nurses, by trade and in all areas of practice, have an ethical and professional responsibility to create and uphold an environment of mutual respect and civility. However, the notion of “nurses eat their young” and the behaviors that stem from this mindset are causing detrimental effects not only to those organizations employing nurses but to patients and the nurses themselves.

Over the last …

Workplace Violence: An Urgent Call For Integrated Staff Education In Acute Care Hospitals, Nicole Bellisario

Doctor of Nursing Practice (DNP) Projects

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change.

Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression …

A Multimodal Analgesic Virtual Reality Program To Reduce Opioid Exposure, Jessica Hovland

Student Scholarly Projects

The opioid crisis continues to be a public health concern. Traditionally, an opioid-centric approach treats postoperative pain.

The following PICOT question guided this project: Will initiating a multimodal analgesic virtual reality quality improvement program (I) compared to current practice (C) decrease opioid requirements (O) in robotic hysterectomy patients (P) during the postoperative period (T)? Several articles promote non-opioid analgesia and non-pharmacological interventions, such as multimodal analgesia and virtual reality (VR) for pain management.

This project reviewed pre- and post-implementation data after implementing new evidence-based multimodal analgesia and VR protocols. The project captured a total of 64 patients in the pre-implementation …

Simulation: An Effective Tool For Mentoring The Novice Nursing Faculty, Charlene B. Smith, Jeanne Hamner, Carol Hession, Cari Granier, Travis "Pete" Lewis, Ashley Thibodeaux

Journal of Interprofessional Practice and Collaboration

Abstract

The American Association of Colleges of Nursing (AACN) (2019) reported in 2018-2019, U.S. nursing schools turned away more than 75,000 qualified applicants from baccalaureate and graduate nursing programs due to insufficient numbers of faculty and clinical sites. Two-thirds of the nursing schools related a shortage of nursing faculty and/or clinical preceptors as a reason for not admitting qualified applicants (AACN, 2019).

There is a triad of challenges facing nursing today. The evolving triad is a nursing shortage, a lack of clinical facilities and nursing faculty. Nursing education must increase enrollment to fulfill the upcoming nursing shortage. Nursing schools are …

Pressure Injury Documentation And Reporting: A Quality Gap, Mary Ann Laslo

Master's Projects and Capstones

Abstract

Problem: Inaccurate and incomplete pressure injury (PrI) assessment and documentation leads to inaccurate reporting of PrI quality reporting measures to the Centers for Medicare and Medicaid Services. Inaccurate, incomplete documentation of pressure injuries and wounds adversely affects the quality of care, financial reimbursement, and hospital reputation as well as increasing the risk of litigation to medical providers. Barriers to accurate and complete documentation by the nurses were inaccuracy in identification of PrIs Stage 1 or greater and knowing what and where to document the information in the electronic medical record.

Context: This quality improvement project attempted to improve nurse …

Preceptor Education And Structured Onboarding Process, Charles Morato

Master's Projects and Capstones

Problem: Staff nurse retention is an ongoing problem for this intensive care unit (ICU). Through exit interviews from staff who left, inadequate onboarding and education made them feel unprepared for their job and not part of the team. The preceptors on the unit have never been trained on the roles and responsibilities of being a preceptor. The current onboarding process consists of pairing new hires with a preceptor who either happens to be willing to do it that day or someone who has been there the longest. There is no consistency or personalizing the orientation information to the new hire. …

Pediatric Bullying Education In Arkansas Baccalaureate Nursing Programs, Jasmine Jackson

McNair Scholars Research

Over the years, there has been an ever-increasing spotlight on the issue of bullying among adolescents. Nurses are another adult-figure, in addition to parents and teachers, that can help identify and address bullying if educated properly. The purpose of this study was to examine pediatric bullying education in Arkansas baccalaureate nursing programs. Through the use of a mixed-method approach, the newly created survey was to be completed by one faculty member from each of the 12 BSN programs in Arkansas (12 participants; 6 respondents). The paper describes the quantitative and qualitative data analysis from this non-experimental descriptive pilot study. Results …

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …

A Multifactorial Intervention To Reduce Weight Bias In Healthcare Providers, Rose M. Flinchum

Evidence-Based Practice Project Reports

No abstract provided.

Point-Of-Care Reminders To Prompt Provider Adherence With Diabetes Care Guidelines For Adults, Eric E. Spohn

Evidence-Based Practice Project Reports

Diabetes is a complex, chronic illness, and a leading cause of morbidity and mortality (ODPHP, 2019). Gaps in diabetes care exist between clinical guidelines and interventions provided in the clinical setting (ADA, 2015; Chauhan et al., 2017; Renders et al., 2001; Worswick et al., 2013). Improved diabetes management strategies and interventions among healthcare providers are essential to close the quality gap. The purpose of this evidenced-based practice (EBP) project was to prompt providers to adhere to diabetes care guidelines using a paper point-of-care reminder over a 12-week period. Provider performance rates covering four specific guidelines were measured: HbA1c, microalbuminuria, diabetic …

Bedside Shift Report Improves Patient Safety, Scott Meyers

MSN Capstone Projects

In the inpatient setting, Parkland Health & Hospital System has continued to have patient falls with injury above its target goal. This occurred every month throughout 2019. Additionally, multiple egregious IV medication administration errors occurred over the last year related to nurses bypassing established safety practices.

An evaluation of evidence-based literature reveals that the practice of bedside shift report (BSR) leads to a reduction in both patient falls and medication administration errors. Indeed, BSR is evidence-based practice (EBP) that promotes an overall environment of safety, quality care, and improved communication between nurses and patients. Additionally, there is virtually no risk …

Official Mentor Program Benchmark Project, Gabriela O'Hara

MSN Capstone Projects

Nursing shortage, turnover, and low job satisfaction are constant issues that often trouble healthcare organizations. These issues have led organizations to implement programs, such as externship, internship, and preceptor programs to strengthen new nurses’ professional practice and skills. However, these issues continue to be organizational challenges. Considering the need for new nurses to have a supportive foundation for their career and to further encourage workplace satisfaction and retention, the following PICOT question was developed: In a healthcare organization, how does an official mentor program, compared with not having a mentor program, influence nursing retention and nursing job satisfaction over 2 …

Dnp Final Report: Changing Admission Criteria In A Vocational Nursing Program To Decrease Attrition, Gabrielle O. Davis

DNP Final Reports

By the year 2030 Texas will have a shortage of 33,500 Licensed Vocational Nurses (LVN). The LVN is responsible for providing safe, compassionate and focused nursing care to assigned patients with predictable health care needs. Most LVNS work in settings caring for our ever increasing and aged population. To combat the coming shortage VN programs need to graduate safe, competent, and compassionate nurses, but programs across the state are experiencing high student attrition rates. Admission criteria is a common method to determine student success in nursing programs. This evidence-based practice improvement project synthesized evidence and integrated best practices along with …

Disruptive Innovation: Impact For Practice, Policy, And Academia, Heather V. Nelson-Brantley, K. David Bailey, Joyce Batcheller, Laura Caramanica, Bret Lyman, Francine Snow

Faculty Publications

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US States, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.

Measuring Nurse Competence In The Emergency Department, Matthew Lojo

University of the Pacific Theses and Dissertations

Background: “Nurses provide essential care to the millions of people who are hospitalized each year as a result of illness or injury” (Smith, 2012, p. 172). The Institute of Medicine reported approximately 44,000-98,000 patients die annually resulting from a medical error, and health care errors ranked among the top 10 for the leading causes of death in the United States (Smith, 2012).

Problem: Nurse competence impacts safe and quality nursing, and several research studies investigated the measurement of nurse competence among nurses in various nursing settings (Flinkman et al., 2016). However, a review of the research revealed limited studies in …

Emergency Nurse Perceptions Of Disaster Preparedness After The Implementation Of A Department Emergency Operations Plan, Angela R. Gentry

Theses and Dissertations from 2019

Emergency departments (ED) are the entryway into the healthcare system during a disaster event and patients often arrive in the first thirty minutes after an event has occurred. This creates unique challenges for ED nurses. The purpose of the Quality Improvement (QI) project was to measure the impact of a Department Emergency Operations Plan (DEOP) on the ED nurse’s perception of disaster preparedness. This study included a convenience sample of 126 full time and part time registered nurses working in the ED at a Level 1 Trauma hospital. Institutional Review Board (IRB) approval was obtained by both Arkansas Tech University …

Attitudes Of New Graduate Rns Regarding Their Readiness For Practice Before And After Hospital Orientation, Diane Young

Dissertations

The acuity level of patients continues to increase making it more vital than ever that new graduate Registered Nurses (RNs) be prepared to give safe, quality care when leaving their hospital’s orientation program (Spector et al., 2015). Today, new graduate RNs need orientation programs that will ensure a smooth transition into nursing practice. This involves the ability to apply higher-level knowledge and skills in everyday practice situations, thereby, maintaining quality care (Henderson, Ossenberg, & Tyler, 2015).

The purpose of this study was to identify differences between new graduate RNs’ opinions on readiness for practice, as measured by the Casey-Fink Readiness …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

Just Culture: It's More Than Policy, Linda Paradiso, Nancy Sweeney

Nursing Faculty Publications

[Description] Paradiso and Sweeney discuss the relationship between trust, just culture, and error reporting in medical care. Errors rarely occur in a vacuum, rather they're a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. Just culture is a safe haven that supports reporting. In a just culture environment, organizations are accountable for systems they design and analysis of the incident, not the individual. The shift to a just culture is a slow process that takes years to develop and hardwire. Hospital-wide policies that incorporate …

Catheter-Associated Urinary Tract Infection Reduction: A Quality Improvement Project, Wallace Kramm

Master's Projects and Capstones

Abstract

Problem: Hospital-acquired infections are preventable harm that occurs to patients while in the hospital. Catheter-associated urinary tract infection (CAUTI) is a preventable hospital-acquired infection that continues to plague hospitals nationwide. The Centers for Disease Control and Prevention estimates that there are more than 13,000 CAUTI related deaths in the United States annually (Scanlon, 2017). In addition to the harm caused to patients by CAUTIs, the estimated $500 million yearly cost for CAUTI treatment has created a fiscal burden on healthcare systems (Scanlon, 2017). Decreasing the rate of CAUTI by decreasing overall number of catheters is the goal of this …

On The Nature Of The University And What It Means For Nursing Education - La Nature De L’Université Et Ses Implications Pour La Formation En Sciences Infirmières, Jacinthe I. Pepin, Florence Myrick

Quality Advancement in Nursing Education - Avancées en formation infirmière

No abstract provided.

Nur 3110 The Nurse Leader Within, Syllabus, Linda Ann Paradiso

Open Educational Resources

Syllabus for NUR 3110 The Nurse Leader Within - a 15 week semester course for pre-licensure nursing students or nurses earning their baccalaureate degree. Every nurse is a leader, regardless of title or position within an organization. In this course you will learn to develop your voice and skills in order to lead teams of people who care for persons in need of any type of medical care.

The Effects Of Authentic Leadership And Organizational Commitment On Job Turnover Intentions Of Experienced Nurses, Alexis E. Smith

Electronic Thesis and Dissertation Repository

High levels of turnover continue to pose a challenge to the nursing workforce amidst growing patient acuity and budget constraints. The presence of strong nursing leadership may address the need for healthy work environments that contribute to retention outcomes. The purpose of this study was to examine the effect of authentic leadership of managers, on experienced nurses’ affective, normative, and continuance organizational commitment, and ultimately job turnover intentions. This study used secondary analysis of data collected in a non-experimental survey of 478 registered nurses in Canada. Hayes’ PROCESS version 3 SPSS macro for mediation analysis was used to test the …

Promoting Empowerment And Innovation: A Technology Initiative, Theresa Marcotte

Doctor of Nursing Practice Projects

Improving empowerment through a supportive organizational culture can lead to innovation in practice and promote positive outcomes. Supporting employee empowerment, through a supportive organizational culture and environment, provides opportunities to innovate and creatively meet desired outcomes. Using these concepts, an Associate Degree Nursing Program empowered faculty to address a strategic planning opportunity to improve practice. The innovation, a Technology Initiative, provides opportunities for evidence-based testing practices, leading to improved, first-time pass rates on the National Council Licensure Exam (NCLEX). Technology use in the classroom can improve dissemination of nursing knowledge and retention strategies and therefore improve program retention. The utilization …