Medicine and Health Sciences Commons^™

Increasing Patient Initial Visit Compliance In An Outpatient Setting, Zackery Cooper

Master of Science in Nursing Theses and Projects

Outpatient healthcare clinics make revenue based on patient visits and productivity is based on the number of visits seen per provider. When patients do not attend their scheduled appointments, practices lose the revenue from the visit, plus have the added cost of a potentially unproductive provider. The current practice in the project facility is to send reminder text messages through the electronic health record scheduling system. The system sends reminder texts 48 and 24 hours prior to the appointment date. The proposed change to the practice is to add telephone calls to patients the morning of their scheduled visit. The …

Hand Hygiene Compliance In Nursing Staff Of Long-Term Care Facilities, Lindsay Clontz

Master of Science in Nursing Theses and Projects

Elderly residents of long-term care facilities are most at risk to acquire serious infections. Because of the relationship with nursing staff members, they are most likely to get an infection from a member of the nursing team. It is imperative that nursing staff members receive proper training related to hand hygiene in order to adhere to infection prevention and control guidelines. The goal of this project is to improve hand hygiene in nursing staff to reduce the number of resident infections recorded on the monthly infection surveillance report. This project utilizes a multi-faceted approach including a pre-test, presentation, post-test, return …

Prevention Of Infection During Hemodialysis Treatment Initiation, Jessica Stroupe

Master of Science in Nursing Theses and Projects

Infection in the dialysis access of a patient can be detrimental to the health of a dialysis patient. For this reason, infection control is extremely important in the outpatient hemodialysis setting. The goal of this project is to prevent infection during dialysis treatment initiation. This goal will be achieved during a 5-week project in which staff of an outpatient hemodialysis unit will be directly observed and then educated on the importance of infection control during treatment initiation. Staff will be given education on areas that need improvement regarding infection control during treatment initiation. The staff will be able to use …

The Importance Of Skin-To-Skin Initiated In The Operating Room, Katina Miller

Master of Science in Nursing Theses and Projects

The benefits of skin-to-skin contact has been well documented for both infants and mothers. Out of all the different modes of delivery a pregnant patient can have, skin-to-skin contact is performed the least amount for mothers who delivery via cesarean section compared to mothers who have a vaginal delivery. All mothers, should they choose, should be allowed to have skin-to-skin contact with their infant in the operating room. This project was designed to increase skin-to-skin contact between a mother and their infant shortly after birth via cesarean section at least 75% of the time. Education was conducted during team huddles …

Fluid State And Diet Control In Patients With Acute Kidney Injury On Hemodialysis, Carolyn Evans-Howard

Master of Science in Nursing Theses and Projects

Prolonged hospitalization, high number of readmissions, and high mortality rates are associated with patients diagnosed with Acute Kidney Injury (AKI). The purpose of this quality improvement proposal is to address the need for more education for nurses caring for these patients. If the kidneys shut down temporarily due to acute illness or medication taken, fluid and toxins will build up in the body with no way of being released. It is proposed that if dietary and fluid restrictions are followed it may help the patient recover faster. The method proposed is to have nurses learn the necessary dietary and fluid …

Patient Satisfaction, Amber Bowman

Master of Science in Nursing Theses and Projects

This thesis project reviews how nursing care, specifically that of nursing assistance, impacts patient satisfaction. Care provided to patients during hospitalization is scored by post-discharge surveys. For this project, the HCAHP survey is specifically referred to and discussed. The survey data obtained from the HCAHP survey is available to the public for review. This data can affect the population's outlook on healthcare organizations. Research has found that care provided by nursing assistants has an impact on the satisfaction of patients. Research in the area of improving patient satisfaction is lacking in data and tools for improvement.

Proposal For A Formal Pediatric Abuse Screening Tool For The Emergency Department, Christina Bolin

Master of Science in Nursing Theses and Projects

Implementation of a quick, reliable pediatric child abuse assessment tool for use in the emergency department is of great importance. A thorough assessment of all pediatric patients presenting to the emergency department (ED), regardless of complaint, should become second nature in order to recognize the signs of child abuse. Because a tool of this nature is lacking in many ED's, the Escape Instrument is needed. This instrument is a successful, efficient screening tool that can be applied to all pediatric patients during triage in the emergency department. This tool will allow the emergency department staff to quickly identify children under …

Case Manager Discharge Planning For Safe Discharge Of Homeless Patients, Melody Jenkins

Master of Science in Nursing Theses and Projects

Acute care case managers are continually challenged with the task of identifying discharge barriers and preparing a discharge plan that facilitates successful recovery and healing. Planning a discharge for a patient that is homeless can be extremely challenging. This MSN Nursing project addresses the complex discharge barriers involved in planning a safe discharge for homeless patients. The project goal was to create a Case Management Resource Algorithm that will organize available community resources to meet the social determinants of health deficits to prevent the progression of disease processes, prevent repeat visits to the emergency room, decrease inpatient admissions, as well …

Bedside Reporting, Morgan Sanford

Master of Science in Nursing Theses and Projects

Bedside reporting can directly correlate with preventing errors in the healthcare setting. The three main errors that occur are falls, medication errors, and sentinel events. These errors have a vast number of different outcomes, even resulting in death in some cases. Despite The Joint Commission directly stating that bedside reporting is best practice, this is not always what is conducted in many hospital organizations. Literature has suggested the problem that exists with implementation is the longevity of the implementation from staff. Identifying a feasible and conducive way to implement bedside reporting that is both favorable for the patient and staff …

Reducing The Number Of Patients Leaving Before Evaluation From The Emergency Department, Myranda Dills

Master of Science in Nursing Theses and Projects

Boarding patients in the emergency department (ED) can lead to several adverse events and errors that can prolong the patient’s hospitalization and delay discharges from the inpatient floors. These excessively long hospital stays decrease the number of bed available to patients being admitted from the ED, creating a bottleneck effect of patients backflowing in the ED. When this occurs, there are less available beds and resources for new ED patients, creating long wait times, and eventually an increase in the number of patients leaving before provider evaluation. This MSN project serves to create a new job role in the ED …

Promoting Alternative And Evidence-Supported Birthing Options In Healthcare Facilities, Ashley Johnson Ross

Master of Science in Nursing Theses and Projects

The project examined the standard birthing process for low-risk, natural labor, and births at healthcare facilities. All deliveries should not be treated the same with the supine-lithotomy birthing position or over-medicalized, obstetric practices, as evidence-based research advises against such practices. The goal of the project intended to deviate from standard birthing practices and implement alternative, evidence-supported birthing options at healthcare facilities. The goal of promoting alternative, evidence-supported birthing options in healthcare facilities by maternity staff, would come after thoroughly educating maternity staff and providers with intel and benefits affiliated with alternative birthing options. Evidence reveals alternative birthing options, such as …

Smoking Cessation: A Nurse-Led Approach To Address Gaps In Patient Care, Katie L. Durham

Master of Science in Nursing Theses and Projects

Currently, the rate of smoking in the US is 13.7%. While this value represents the lowest rate of smoking in documented US history, cigarette smoking remains the leading cause of preventable death, disease, and morbidity. Healthy People 2030 has set a goal to reduce the rate of smoking to 5%. Though many patients report wanting to quit smoking, nearly half report they did not receive advice from a healthcare professional to do so. Many recommended smoking cessation tools and resources remain underutilized by both clinicians and patients. To help mitigate this issue, this project sought to develop a nurse-led smoking …

Reducing The Use Of Physical Restraints Of The Elderly In The Acute Care Setting, Rachael Malone

Master of Science in Nursing Theses and Projects

The aim of this MSN project is to identify and improve the gaps in education regarding physical restraint use in the acute care setting on the elderly patient population. When admitted into hospitals, elderly patients are at much greater risk for being placed in physical restraints due to little education regarding alternative measures to physical restraints and inappropriate assessments. The purpose of this project is to implement education about the detrimental factors and consequences patients may suffer once placed in physical restraints and improve the use of alternative measures to physical restraints. This project will be evaluated by acute care …

Promoting Organ Donation Among Adults, Susan Hammitt

Master of Science in Nursing Theses and Projects

Organ donation is an important component of the American healthcare system however, the issue of low organ donation rates among the average American population is an ever-growing problem. In the United States, more than 135,000 people are waiting for an organ transplant, and as of 2019, only 39,000 donors have consented to donation. The purpose of this project is to develop an evidence-based approach to promote organ donorship among adults. The goal is to promote organ donation through hospital-based educational intervention to give patients, their families, and hospital staff the information to help promote consent for donation.

Medication Reconciliation: Protecting The Geriatric Population, Charles Jennings

Master of Science in Nursing Theses and Projects

This project was designed to address the issue of medication errors that occur during the transition from an acute care setting to an assisted living setting. Geriatric adults are often supported by a complement of medical specialists and subspecialists. As a result, reconciling medications following a hospital discharge can be challenging. To further complicate the problem, oftentimes, the primary care provider is not highly engaged with the specialists and subspecialists. The World Health Organization (WHO) has prioritized this issue through the introduction of the Medication Without Harm initiative. This initiative is focused on reducing adverse drug reactions (ADRs) and adverse …

Improving Communication Skills Of New Graduate Nurses: Using Sbar Format, Meredith Lyanne Parker

Master of Science in Nursing Theses and Projects

New graduate nurses face many challenges as they transition to professional practice (Mongale et al., 2018). Support from transition to practice (TTP) programs can have a tremendous impact on the success of a new graduate nurse and improve retention rates (Silvestre, 2017). Research identifies a gap in new graduate knowledge of communication skills (Song & McCreary, 2020). Education on improving communication using a standard format can impact patient outcomes and improve provider confidence (Marshall et al., 2008). Research also links provider confidence and proficiency to improved outcomes (Owens & Keller, 2018). Benner’s Novice to Expert Theory provides a theoretical foundation …

Implementing Rapid Response And Medical Emergency Simulation Training For Medical-Surgical Nurses, Brandon Burnett

Master of Science in Nursing Theses and Projects

This project is based on the problem of nursing competence and confidence within medical emergency and rapid response scenarios. This problem affects all patients, but specifically the medical-surgical patient population of which rapid assessment and intervention can lead to a change in patient mortality. The goal of the project is to use simulation, a common tool in undergraduate nursing education, to improve nursing competence and confidence after participation. The nurses will be cycled through three simulated scenarios, followed by a debriefing, and then moved to the next simulation. The nurses’ performance will be evaluated using evaluator checklists for each of …

A Day In The Life Of A Hospital Bedside Nurse: A Different Look At Nurse Stressors, Angela R. Higdon

Master of Science in Nursing Theses and Projects

This project is intended to be an example of the affects on the nursing work environment after years of technological advancement, healthcare reform, and process improvement. The bedside nurse work environment is riddled with a multitude of interruptions, intricate processes, and complicated documentation to prove quality care and compliance to regulatory agencies and for tracking purposes. These demands are significant as nurses are continuously reprioritizing work to meet the needs of the patient while also meeting the organizational and regulatory demands. The demands on nurses often lead to delays in patient care and sometimes omission of certain less acute patient …

Combating The Challenge Of Maintaining Active-Duty Military Medical Force Readiness, Thomas Jones

Master of Science in Nursing Theses and Projects

The United States of America’s military involvement in conflict is at one of its lowest points in over 2 decades. This presents a challenge for members of the military medical force to maintain the medical readiness skills they are expected to be proficient at in a moment’s notice to care for casualties in the nation’s next crisis or conflict. In addition to other pre-established methods, this project seeks to provide a unit-level training opportunity for Air Force active-duty medical members such as those in the United States Indo-Pacific region to practice certain medical readiness skills while continuing their steady-state daily …

Dnp Project Active Anson, Melissa C. Griffin

Doctor of Nursing Practice Projects

Objectives: To implement and evaluate the effectiveness of using a mobile app to encourage hospital workers to increase their physical activity.

Methods: Project was open and advertised to all hospital employees in a small rural community hospital in the south-eastern United States through flyers, bulletin boards, emails, banners and in-person registration assistance. Registered participants completed a 30-day walking challenge and recorded their daily step counts. Participants received a gift bag with fitness items such as water bottles. The three highest step count participants were awarded prizes. Weekly prize drawings were conducted for participants with 10,000 steps per day. Post challenge …

Implementing Obesity And Comorbidity Education In A Faith-Based Setting, Tammy Lynn

Doctor of Nursing Practice Projects

The aim of the study was to increase knowledge of the damaging consequences of obesity and related comorbidities. Obesity has reached epidemic proportions on a global scale and increases the potential health risk of many associated diseases. Faith-Based organizations have been found to be optimal resources for public health education. The shared beliefs and comradery are a source of support and encouragement for those who face many of life’s challenges, as well as life’s joys. The purpose of the project was to investigate the effectiveness of education delivered in a Baptist church on the topics of obesity and related comorbidities. …

Changing The Ways Bedside Nursing Staff Think About ‘All Things Urinary Catheters, Angela Foard

Doctor of Nursing Practice Projects

The purpose of this project was to bring attention to the importance of the bedside nursing staff’s "back to the basics" approach to nurse-led interventions to help reduce the number of increasing hospital-acquired infections (HAI), specifically catheter-associated urinary tract infections (CAUTI). The motivation to address this problem was due to the bedside nursing staff under-utilizing best practice interventions to prevent insertions and re-insertions of urinary catheters. A high number of urinary catheter insertions and re-insertions increases the risk of a CAUTI. Evidence-based interventions should be reinforced and utilized by bedside nursing staff to prevent insertions and re-insertions. Evidence-based nurse-led practices …

Enhancing Knowledge And Confidence In A Retail Clinic Setting Of Practitioners In Treating Primary And Secondary Hypertension, Ravon Mckoy

Doctor of Nursing Practice Projects

Many adult and adolescent patients in primary care settings are diagnosed with primary hypertension, however the workup often does not include an evaluation of secondary causes. The purpose of this Doctor of Nursing Practice (DNP) project was to improve the diagnosis and treatment of hypertension for patients seeking health care in a retail clinic setting. The PICOT question was, what is the effect of an educational offering on hypertension standards of care in enhancing knowledge and confidence for providers working in a retail health clinic setting? The sampling frame was 40 Nurse Practitioners and Physician Assistants employed at CVS Minute …

Faith-Based Approach: Reaching The Rural Population To Increase Diabetes Awareness, Regina Ledford

Doctor of Nursing Practice Projects

With diabetes at an epidemic level in the United States, more awareness needs to be brought surrounding prediabetes and diabetes prevention. This DNP Project consists of implementing a faith-based educational informational event at a local rural church to increase diabetes awareness. Findings within this DNP project suggest that the rural population can increase knowledge of diabetes awareness through faith-based education. With a sample size of 21 participants, positive statistical significance was found on analysis of pre-test and post-test Likert style questions regarding diabetes prevention, risk factors, and diabetic resources.

The Use Of A Code Lavender Space To Promote Self-Care, Em Toe

Doctor of Nursing Practice Projects

The nursing shortage has been an ongoing issue across the nation. The workforce has lost valuable employees, especially in rural areas, due to staff shortages and lack of self-care. Implementing therapeutic interventions such as a Code Lavender Room aims to implement self-care during working hours to increase nursing retention in the long term. The goal of this quality improvement project was to provide a safe place for employees to go to relax and reset during working hours. A survey was used to analyze the Code Lavender Room's effectiveness in self-care and how likely the staff are to continue to use …

Enhancing The Accuracy And Effectiveness Of The National Institute Of Health Stroke Scale In A Rural Emergency Departmennt, Emily Nicole Addington

Doctor of Nursing Practice Projects

A rural facility in the foothills of North Carolina found a need for process improvement regarding the emergency department and completion of the NIHSS. The DNP student and the Stroke Coordinator along with the Quality Improvement Coordinator agreed with the need for education of staff concerning accurate assessment and documentation of the NIHSS. The DNP project implemented additional training for the emergency department nurses and paramedics in the form of face-to-face classes with a PowerPoint. A pre-and post-survey was conducted to gauge the comfort level of staff with the NIHSS and stroke processes of the rural emergency department. The Stroke …

Incentive Spirometer Use In Trauma Patients 65 Years And Older With Rib Fractures/Chest Trauma, Sharon F. Ali

Doctor of Nursing Practice Projects

Geriatric patients 65 years old and older admitted to the medical surgical trauma unit with rib fractures had increased readmission rates to the trauma ICU, due to respiratory insufficiency within the last 12 months. This DNP project followed all patients admitted to the trauma service of a Level I trauma hospital with rib fractures/blunt chest trauma during the months of February 2-April 30, 2022. The focus was on the nurse-driven protocol, which included providing incentive spirometer education to the trauma patient for aggressive pulmonary hygiene and documenting patients’ achievements and goals into the medical record. Registered nurses (RN) were asked …

Standardized Daily Family Updates To Improve Patient Satisfaction Scores On A Pulmonary Medical Progressive Care Unit, Quentin Butterfield

Doctor of Nursing Practice Projects

Communication remains one of the most challenging aspects of healthcare. COVID-19 added another layer of communication breakdown in the form of visitor restrictions that limited or removed visitation for hospital-positive patients. Guided by the principles of Jean Watson’s theory of human caring, a literature review was performed to determine best practice evidence related to improvements in communication.

A daily family update form was drafted to guide the nurses of a pulmonary medical progressive care unit in providing standardized daily family updates to improve communication through consistency of information shared. Patients identified family members they would like to receive daily updates …

Increasing Cancer Survivorship Knowledge Through Individualized Cancer Survivorship Packets, Ashley Atkins

Doctor of Nursing Practice Projects

This project was developed with the aim of formulating an individualized educational packet that would improve patients’ knowledge of their initial cancer diagnosis and provide additional information to facilitate a smooth transition from treatment to remission. Using a pretest and posttest, quantitative data was collected pertaining to 10 different types of patient education. The pretest survey collected eight questions that related to gathering information about their cancer diagnosis, resources, and knowledge level. The DNP Project Leader secured a Cancer Survivorship Guide through the American Society of Clinical Oncology that was added to the initial cancer survivorship education for all patients. …

Improving Care Of Women Experiencing A Pregnancy, Belinda T. Ferguson

Doctor of Nursing Practice Projects

The purpose of the Doctor of Nursing Practice (DNP) project was to provide evidence-based staff education at a pregnancy resource center to increase staff/patient engagement and communication by implementing a clinical practice change and use of a DNP student-developed discharge summary referral form (DRF) to assist with assessing patient’s needs, evaluating access to services and utilization of medical care and health promotion services. The overall aim of this project is to increase care with medical follow-up and seek to address improving engagement and communication with patients during their care and after discharge from the Pregnancy Resource Center (PRC). The major …