Medicine and Health Sciences Commons^™

Enhancing Clinical Judgment In Nursing Students, Mark Tanner

Health Sciences Education Symposium

Background/Objectives: Nurses need to be able to think critically and to use clinical judgment in order to competently do their work required of them in the clinical environment. The National Council of State Boards of Nursing (NCSBN) recognized this and developed the NCSBN Clinical Judgment Measurement Model (CJMM) in order to assess and measure clinical judgment on the NCLEX exams. This model was designed to give guidance to faculty so that they can help students develop the desired skills in critical thinking and clinical judgment. The faculty in a senior-level Adult Medical-Surgical Nursing used the CJMM to redesign the clinical …

Using An Interdisciplinary Case Study To Incorporate Quantitative Reasoning In Social Work, Nursing, And Mathematics, Elizabeth Post, Mischelle Stone, Lauren Cavner Williams, Mary Beaudry

Journal of Mathematics and Science: Collaborative Explorations

Through the national consortium, SUMMIT-P, Ferris State University faculty collaborated to develop and scaffold mathematics and quantitative reasoning across disciplines to reduce math anxiety. Participants in this collaborative group included faculty from social work, nursing, and mathematics who developed a case study on a Hurricane Katrina scenario that necessitated calculating the need for emergency shelter, water, food, and medicine, and as a response to the potential for a Malaria outbreak. This particular case study allowed faculty to use the lens of social justice to teach mathematical concepts and provided an avenue for nursing and social work students to engage in …

Violence Prevention Task Force: A Health System’S Journey Towards Zero, Lisa Davis, Denise Holyoak

VCU Health Nursing

VCU Health's mission is to be the safest most caring hospital with zero events of preventable harm to patients, team members, and visitors. Our goal cannot be achieved if our staff suffer from workplace violence injuries thus, our executive leaders sponsored a Violence Task Force in 2017 comprised of leaders and bedside staff from all disciplines to implement evidence-informed strategies to aid in the prevention, response or recovery to a violent event. Review of data and measures of our outcomes are based on our worker's compensation, behavioral rapid response, and safety culture surveys. Event drill-downs are achieved by our post-assault …

Climate Change And Mental Health: What Can We Do?, Ann N. Welch

VCU Health Nursing

Climate change has been described as the defining health issue of this century. Many aspects of mental health are affected by the events related to the earth's warming climate. This poster presentation will identify ways in which climate change affects mental health and suggest concrete actions that can be taken to help to mitigate these effects.

Literature Review: Covid-19'S Impact On Violence, Jean Cheek, Laura Ashworth

VCU Health Nursing

Violence has been exacerbated by the pandemic, resulting in a plethora of research that can be complementary and contradictory. A preliminary thematic literature search was performed using keywords such as human trafficking, IPV, sexual assault, pandemic, covid, and child abuse. This resulted in over 100 articles between 2019 and 2021. The literature review revealed common themes such as pandemics and natural disasters increase the risk for violence in women, children, and marginalized populations. Stay-at-home orders put vulnerable populations in closer proximity to the abuser. A low socioeconomic standing increases the propensity to abuse and be abused. Calls to human trafficking …

The Evidence Based Practice Question Development & Search Tips Checklist (Revised), Roy E. Brown

VCU Libraries Faculty and Staff Publications

The Evidence Based Practice Question Development and Search Tips Checklist is a tool that is used in instructional sessions with nurses in reference to evidence-based practice and literature searching. It is intended as a reference handout. The revised handout contains information related to the databases that may be searched as well as about Google Scholar.

It is under a creative commons license. If you would like a version that can be rebranded for your organization to use, please contact the author for an editable version.

Post Procedural Care Of Patients Receiving Percutaneous Transhepatic Biliary Drainage Catheter Placement, Erin Pacelli, Jennifer Almeda, Christina Graham, Malcolm Sydnor, Kunal Patel

VCU Health Nursing

A recent review of patients undergoing transhepatic biliary drainage catheter placement showed a 30-day readmission rate of 28%. New post-procedural processes were created to standardize the care of this patient population to decrease readmission rates and improve patient satisfaction.

Deleting A Sacred Cow From The Emr: Removing Gastric Residual Volume Assessments, Christoph Lecznar

VCU Health Nursing

Purpose: The purpose of this Evidence-based practice (EBP) project was to implement current guidelines related to gastric residual volume (GRV) assessments for monitoring of feeding intolerance.

Background: Metabolic support of patients is critical for the survival of critical illness and optimal recovery. Enteral nutrition is the preferred method of delivery, but its success is dependent upon the bedside clinician₂. Current clinical practice guidelines do not support the practice of monitoring GRVs however₂; greater than 98% of critical care nurses utilize GRV monitoring to assess for feeding intolerance₁. In our urban Academic Level I Trauma …

Successful Mentorship In Perioperative Surgical Services Can Happen! Developing The M.A.P.P. (Mentorship Amongst Peers Program), Natalie Sorensen, Diane Hanson-Johnson

VCU Health Nursing

Description of Team: Multidisciplinary team consisting of Nurse Educators, Registered Nurses, Certified Surgical Technologist, Administrative Staff, and a Health Care Partner. This team came together with a common goal of improving morale, breaking out of silos, and ultimately increasing retention throughout Perioperative Surgical Services.

Preparation and Planning: Research was performed previously on retention by Clinical IV Registered Nurse as part of her Master’s in Nursing program thesis. She presented the research to department leaders as a method to improve satisfaction and in turn, increase retention. In April 2018 a mentoring planning workshop was held with team members from each unit …

Infection Prevention In Patients Receiving Continuous Renal Replacement Therapy Through Proper Hemodialysis Line Care, Nicole Ingram, Susan Mckenna

VCU Health Nursing

The goal was to reduce Continuous Renal Replacement Therapy (CRRT)-related Central Line-Associated Bloodstream Infection (CLABSI) rates by introducing a just-in-time re-education toolkit for proper hemodialysis (HD) line care in adult Intensive Care Units (ICU).

CRRT requires specialized expertise delivered in the ICU setting with the support of HD nurses. Problem-solving when cartridges clot or clog requires ICU nurses to return the blood and notify HD to restart therapy. Current evidence supports the use of white Curos^TM caps and Tego^TM connectors when deaccessing lines in order to prevent CLABSIs, air emboli, and bleeding. A learning needs assessment revealed inconsistent …

The Clinical Inquiry Process Diagram, Roy E. Brown

VCU Libraries Faculty and Staff Publications

This diagram outlines the nursing inquiry process to help answer questions that arise in the clinical setting. The diagram further helps a nurse understand how to distinguish whether a situation calls for evidence-based practice, performance improvement, or research. It also guides a nurse through clarifying the initial question, gathering the evidence, and through each step in the subsequent process.

An updated version (Version 4) of this diagram is now available at https://scholarscompass.vcu.edu/libraries_pubs/78/

This is an update of the VCU Health Nursing Inquiry Process Diagram (version 2) that was created in 2018. This is the third version of the diagram and …

Promoting Cultural Humility: Lgbtqia+ Education For Healthcare Providers, Lexi Robertson, Lauren Connelly

VCU Health Nursing

Abstract:

Purpose:

LGBTQIA+ patients experience devastating mental health and substance abuse disparities. While our organization has a broad non-discrimination statement that includes gender identity and sexual orientation, there is no guidance for how to best serve these patients. Evidence suggests training sessions are a successful means of increasing LGBTQIA+ cultural competency, with “Safe Zone” identified as being especially successful on college campuses. The Healthcare Equality Index also calls for education to demonstrate healthcare organizations’ commitment to LGBTQIA+ patients.

Intervention:

We developed an educational workshop - Safe Zone – with university psychologists. This workshop included interactive exercises that focused on increasing …

Own Your Outcomes: Driving Down Hapis In The Cardiac Surgery Intensive Care Unit, Linda Currie

VCU Health Nursing

Abstract:

Purpose (What): To achieve sustainable reduction of pressure injury (PI) rates through systematic culture change, in a quaternary, level 1, urban academic medical center cardiac surgery intensive care unit (CSICU).

Relevance/Significance (Why): The CSICU is a high-risk patient population, hosting multiple potential barriers to pressure injury prevention. Prior to 2012, the CSICU pressure injury rate was 17% higher than the National Database of Nursing Quality Indicators benchmark, negatively impacting patient outcomes and organizational goals. Leveraging Magnet principles of Evidence-Based Practice, CSICU advanced practice nurse leaders empowered and motivated bedside nurses to lead and sustain unit culture change.

Strategy and …

Creating A Clinical Ladder Education Program For Perioperative Surgical Services (Clepps), Velma Davis, Natalie Sorensen

VCU Health Nursing

Problem Statement:

Low participation in challenging the Clinical Ladder within the Perioperative Surgical Services was observed. The period 2016-2017, only five nurses from the department challenged and were successful on the ladder. As a process improvement initiative, the department implemented CLEPPS, using the organization’s clinical ladder program as a tool.

Background:

It is documented in the literature that a robust Clinical Ladder Program increases staff satisfaction, enhances professional development, and improve patient outcomes.

The Perioperative Surgical Services has a total of 102 Clinical Nurse II within the department who were eligible for advancement on the clinical ladder. An internal survey, …

Perceived Stress, Salivary Cortisol, And Depression In Adults Diagnosed With Postconcussion Syndrome; A Pilot Study, Christine Fish-Huson

Theses and Dissertations

Traumatic Brain Injury (TBI) affects approximately 1.7 million persons in the United States annually, 75% are categorized as mild (mTBI). Most persons who experience mTBI will recover, however an estimated 10% will develop Postconcussion Syndrome (PCS). Evidence supports a relationship between perceived stress, salivary cortisol, and depressive symptoms in persons after TBI; however, there are no known studies exploring these relationships in the PCS patient population. A sample of 17 men and women diagnosed with PCS were recruited from Southwest and Central Virginia. Data collection included the Rivermead Postconcussion Questionnaire, Perceived Stress Scale-10, Center for Epidemiological Studies-Depression Scale and the …

Vcu Health Nursing Inquiry Process Diagram (Version 2), Roy E. Brown

VCU Libraries Faculty and Staff Publications

This diagram outlines the nursing inquiry process to help answer questions that arise in the clinical setting. The diagram further helps a nurse understand how to distinguish whether a situation calls for evidence-based practice, performance improvement or research. It also guides a nurse through clarifying the initial question, gathering the evidence, and through each step in the subsequent process.

Vcu Health: Adult & Pediatric Inpatient Pain Communication Guide (Algorithm), Veronica Nolden, Jessica Keiser

VCU Health Nursing

Abstract Related to Algorithm:

Description/Background

Improving pain management is a priority for all healthcare providers, yet the process for how pain is assessed, reported and resolved often lacks a defined process. This lack of structure can lead to delays in pain control for patients and frustrations within healthcare teams. In an effort to facilitate patient-centered care, an interdisciplinary workgroup was constructed to address this process.

Action

In order to eliminate delays and define a process for pain management, an interdisciplinary workgroup utilized performance improvement processes to develop a communication algorithm. The group membership included nurses, physicians, advanced practice providers, nursing …

Decreased Pain Severity And Differential Gene Expression Following Calmare Therapy, Jeffrey Petraco, Angela R. Starkweather, Amy Heineman

Undergraduate Research Posters

We present the results of a double-blinded randomized sham-controlled research study of a non-pharmacologic low back pain intervention. Calmare therapy is an neurocutanous electrical stimulation approach for pain management. The intervention group received Calmare therapy and the other received sham. Differences in pain severity and interference scores, pain sensitivity measures and gene expression profiles are reported. Patterns of downregulated gene expression suggest that Calmare may alter proteins involved in pain transduction may have implications for the treatment of other chronic pain conditions.

Exploring The Relationships Between Mindfulness And Biobehavioral Factors Associated With Cvd In Women, Susan Ghodrat, Jo Lynne W. Robins

Undergraduate Research Posters

Purpose: This study examined the relationship between mindfulness and specific biobehavioral factors associated with increased cardiovascular disease risk in women. Design: A secondary data analysis was conducted on baseline data collected in a larger study examining the effects of tai chi on cardiovascular disease risk in women. Subjects: 96 women aged 35-50 years with increased waist circumference and a family history of cardiovascular disease. Measures: Biological measures included: fasting glucose, insulin and lipids, as well as C-reactive protein and cytokines. Behavioral measures included: mindfulness, fatigue, perceived stress, depressive symptoms, social support, self-compassion and spiritual thoughts and behaviors. Results: Mindfulness was …

A Proud Heritage : 100 Years Of Nursing Education, Virginia Commonwealth University

VCU University History Books

In the late 1980s, nursing alumni, faculty, and students began planning for the one hundredth anniversary observance of the founding of the Virginia Commonwealth University School of Nursing. The school traces its rich heritage back to the organization of the Virginia Hospital Training School for Nurses which opened in 1893. Betsy A. Bampton (MCV Class of 1960) undertook the writing of a school history published as the centennial celebration was set to begin. In this abundantly illustrated work, Bampton and her collaborators chronicle the development and growth of the eight diverse schools and programs that formed the foundation of the …

An Analysis Of The Values Influencing Neonatal Nurses' Perceptions And Behaviors In Selected Ethical Dilemmas, Deborah A. Raines

Theses and Dissertations

The purpose of this research was to identify the values influencing the nurse's perception and choice of behavior in a hypothetical clinical situation. The theoretical framework was Rokeach's (1973) Theory on the Nature of Human Values and Value Systems. A descriptive study using a mailed survey was conducted on a random sample of 331 members of the National Association of Neonatal Nurses. Data on individual nurses' values, perception of information and behavioral choices were collected with an investigator developed questionnaire, consisting of a values scale (alpha =.82) and an information scale and choice alternatives related to three hypothetical vignettes: a …