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

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 …

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), …

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 …

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 …

Personal Health Questionnaire-9 And Interventions In Adults, Grace Alford

Masters Theses/Capstone Projects

This is an evaluation of the PHQ-9 depression screening and interventions in adults within an urban setting.

Evidence-Based Approaches To Lowering Uti Rates In Skilled Nursing Facilities: A Review Of The Literature And Application To A Local Skilled Nursing Home, Hailey Griffin

Undergraduate Honors Capstone Projects

The purpose of this paper may be divided into two parts. The first part was a literature review that sought to determine the most common risk factors for developing a urinary tract infection in nursing homes, as well as to identify evidence-based practice interventions for decreasing UTI rates within that specific patient population. The second part consisted of a case study that sought to apply the principles gathered from the literature review to the UTI logs of a deidentified local nursing home. It was found that indwelling urinary catheters and age are the two most common precipitating risk factors for …

Type 1 Diabetes In The Classroom, Ursula Herrell

Undergraduate Honors Theses

Type 1 diabetes [T1D] is an autoimmune disease that presents in a pathophysiological disorder as insulin deficiency. Managing this illness during childhood is a constant challenge of maintaining blood glucose levels within a healthy range, resulting in increased stress for children and caregivers. School attendance is one factor that may result in increased stress. Studies have highlighted the fact that teachers of students with T1D may receive little education regarding management of the disease and may be required to make accommodations which can result in confusion, miscommunication, and increased psychosocial stress. The goal of this research was to learn about …

Investigating Students’ Lived Experience With Prebriefing Structure And Elements In Nursing Simulation Education, Meghan Liebzeit

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prebriefing is a growing body of knowledge in nursing simulation education. It is recognized as an important factor in the simulation experience, however the practice of prebriefing varies widely making it difficult to understand what methods best prepare students for the simulation scenario. While research over the last decade has identified prebriefing increases confidence, skills, and clinical judgment, what content is important to include in prebriefing, or how it promotes the achievement of outcomes is under recognized.Implementing an intervention based on a pedagogically sound eight-week simulation clinical course, developed with the theoretical underpinnings of Vygotsky’s Zone of Proximal Development, Kolb’s …

No Scrubs: Nursing Applicant Trajectories After Rejection, Jennifer Torgerson

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is a nursing shortage in the United States which has become even more apparent during the COVID-19 pandemic. Despite qualified applicants, thousands of students are turned away from educational programs each year as programs reach capacity limits. The rejection may have social, psychological, and economic consequences for the student. Students faced with rejection need to make decisions whether to continue their pursuit of nursing or go a different direction. This exploratory quantitative study aims to understand the trajectories of students that are not admitted into a capacity restricted nursing program at a community college in the Southwestern United States. …

Communication Assessment Tools For Emergency Department Nurses Who Interact With Individuals With Intellectual And Developmental Disabilities, Holly Hunt

Doctor of Nursing Practice Scholarly Projects

Abstract/Executive Summary

Problem Statement: Communication is an essential part of every nurse-patient interaction. During the best of times the patient and nurse can clearly understand each other and engage in successful interaction with positive patient outcomes. Individuals with intellectual and developmental disabilities (IDD) often use nontraditional ways of communicating that can complicate the ideal nurse-patient interaction. When a patient presents with a different method of communicating, the nurse must possess tools available to facilitate a successful interaction. Identifying such a tool or if one cannot be found building a sample tool is vital for positive patient outcomes for individuals with …

Effects Of Guided Journaling On Nursing Clinical Judgment During An Externship, Jaclyn Parrill

Undergraduate Theses

Background: There is longstanding discussion concerning the competency of novice nurses who passed the National Council Licensure Exam (NCLEX) and their ability to practice safely. Nursing clinical judgment (CJ), also known as critical thinking or clinical decision-making, accounts for more than 46% of daily tasks nurses perform in their first year (Hensel, 2020, p. 128). Guided reflective journaling is one active learning strategy that encourages students to reflect on what they have learned, anticipate future needs, and enhance clinical judgment skills (Meijer, 2021, p. 9, 11). This qualitative pilot study follows one nursing student throughout a student nurse extern program …

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

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) …

Communication Techniques For Nursing Students, Karlee Coddens

Honors Theses

This thesis will discuss the effects nursing preceptors have on nursing students' clinical experience. This thesis will explore multiple factors that negatively impact nursing student’s communication with their preceptors. It has been found that clinical experiences are extremely important for the future of nursing students. However, there is often a communication barrier between nursing students and their preceptors. This barrier can lead to negative outcomes for new nurses entering the field. Strained communication can also create dangerous situations for patients. Students who fear harsh comments or vertical violence may be reluctant to disclose the limitations of their knowledge. We completed …

Perceptions Of Preparedness Among New Graduate Nurses: Traditional Curriculum Versus Concept-Based Curriculum, Ashley A. Wheeler, Steven Busby, David Phillippi, Tammy Legge

DNP Scholarly Projects

Concept-based curriculum (CBC) is a newer trend in nursing education curriculum aimed at preparing new graduates to enter the workforce as generalist nurses better suited to care for a more medically complex population. Using CBC, students are introduced to concepts in order to build conceptual understandings as they engage in knowledge and skill learning, as opposed to a traditional nursing curriculum that is taught in sections grouped by patient population and medical complexity. At a nursing school housed within a private university in the southeast, the traditional nursing curriculum was replaced with CBC in 2016. To better understand the preparedness …

Formal Unit-Based Shared Governance To Improve Nurse Engagement, Tracey A Larsen

Student Scholarly Projects

Practice Problem: Nurse engagement is a key driver of nurse satisfaction and nursing retention. Shared governance is an evidence-based practice proven to increase nurse engagement through shared decision-making and results in higher work satisfaction.

PICOT: The PICOT question that guided this project was (P) in an ambulatory nursing clinic (I) what is the effect of a shared governance unit-based committee (C) compared to current practice (O) on nurse engagement (T) over 10 weeks?

Evidence: An exhaustive literature search resulted in 61 peer-reviewed articles. Eleven studies were included after filtering for duplicates and keywords and evaluating for strength and quality …

Hypertension, Bethany Stemen

Masters Theses/Capstone Projects

Hypertension is dangerous and known as the silent killer. It can be managed with proper healthy life choices.

Prepare For The Flare: Preparing Georgia Southern College Of Nursing Students On How To Properly Assess And Educate Patients With Atopic Dermatitis, Charlotte V. Moore

Honors College Theses

Atopic dermatitis is a skin disorder commonly known as eczema. This autoimmune disease is common and can appear on multiple parts of the body as dry, itchy skin. This thesis will discuss research on educational programs presented to nursing students in a Bachelor’s of Science nursing program on how to recognize atopic dermatitis and its triggers and be able to properly educate future patients about it. Nurse-led education is beneficial in reducing disease severity and improving quality of life by enhancing self-management, adherence and patient/guardian engagement. Are nursing students aware of the signs and symptoms of the disease, and do …

Cultivating Unit-Based Leaders Through A Tiered, Structured Mentorship Program, Brittney Daley Msn, Rn, Ccrn

Doctor of Nursing Practice Projects

Background: Succession planning and mentorship is an essential need in developing future nursing leaders. The IOM and published literature strongly support the importance of mentorship programs in nursing (IOM, 2021). The current succession plan and mentorship program is not sufficient.

Purpose: The purpose of this project was to create and implement an evidence-based, 3-tiered unit-based leadership mentorship program (LMP) for bedside registered nurses to support growth and professional development between tiers over a 4-month period.

Aims/Objectives: Using the completion of a pre and post survey the mentee was assigned a tier from novice to experienced leaders. Through the program, the …

Perioperative Pain Control: Evaluating Best Practices In Perioperative Pain Measures, Lisa M. Malakowsky

Doctor of Nursing Practice Projects

Background

Postoperative pain is contributing to the nation's opioid epidemic. Pain is an unpleasant sensation felt by the patient. When it is experienced postoperatively, it is a result of the surgical process. Patients up to 80% worldwide state that their pain is not controlled to their satisfaction. When postoperative pain is not treated adequately, it can contribute to chronic pain.

Purpose

Perioperative pain assessment and treatment policy at a rural critical access hospital and compare it to evidence-based guidelines for best practice. The project assessed the patient's pain treatment effectiveness compared to the pain management policy by using the CDC …

Building Resilience In Graduate Nurses Through Online Virtual Simulation, Robert Grant Harmon

Electronic Theses and Dissertations

Resilience has become a popular topic in nursing research. Nurses experience enormous stress throughout their training process that extends into their first employment as they transition into practice. Simulation training is a standard for training nurses and for continuing professional education within academia. Most simulation training for nurses is focused on building critical thinking skills. While critical thinking is an essential quality equipping nurses to meet professional demands, resilience is a crucial quality to overcome the stress of both training and practice. Resilience is believed to play an essential role in the retention of new graduate nurses and preventing burnout …

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Using Education To Improve Timeliness And Efficiency Of Medication Administration In An Inpatient Hospital Setting: A Quality Improvement Project, Kevin Christopher Lane

Master's Theses and Capstones

Background: Timeliness of medication administration is important for optimal patient care. Technology, interdepartmental communication, and nursing workflow influence on-time delivery of medications. Improving knowledge through PowerPoint™ education and visual aids such as medication alert placards improves interdepartmental communication and positively influences nursing workflow leading to improved medication delivery times.

Local Problem: Nurses spend considerable time looking for and administering medications to patients on the unit. A goal was established to reduce the amount of time nurses spent looking for medications by 5% after implementing PowerPoint™ education to improve workflow.

Methods: This project used the Plan-Do-Study-Act (PDSA) strategy for implementation. …

The Clinical Observations Of Nursing Students And Recent Graduates Caring For Lgbtq+ People, Emily E. Roy

Honors Theses and Capstones

Objective: The next generation of nurses have increased educational preparation to provide affirming care to lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people, but an evaluation of the effectiveness of this teaching has not been performed. The purpose of this study was to identify nursing student and recent nursing graduate observations of affirming and non-affirming care of LGBTQ+ people in healthcare settings during clinical experiences. We also sought to understand how those experiences affect their ability and willingness to provide affirming health care to LGBTQ+ people.

Methods: Participants filled out a mixed methods Qualtrics survey that was distributed through school …

Educating Providers And Nurses On Human Trafficking, Valerie Smith

Walden Dissertations and Doctoral Studies

Human trafficking is a global public health problem. Victims of human trafficking experience higher rates of sexually transmitted diseases, reproductive damage, sexual violence, infertility, and mental and behavioral issues. To help end human trafficking, which is potentially deadly, raising awareness about this topic is essential for victim survival. A gap in practice among staff at a community health center regarding recognition of victims of human trafficking and procedures for potential victims was identified. An education program focused on increasing knowledge and awareness was developed to close this gap. Guided by Watson’s theory of human caring, a 30-minute educational session followed …

Nursing Knowledge And Breastfeeding Education, Mary Aguirre

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, the Healthy People 2020 breastfeeding goal immediately after birth of 81.9% was surpassed in 2016, with approximately 83.8% of babies breastfed shortly after delivery. However, by seven days post birth, this number decreased to 82.9%, reduced even more for infants who were exclusively breastfed to 64.7%. Local research has shown that breastfeeding decreases at one week after discharge, which may be due, in part, to the lack of nurses' knowledge related to breastfeeding. This lack of knowledge related to breastfeeding by the nurses, in turn, may negatively impact the support staff …

The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik

Walden Dissertations and Doctoral Studies

The intention to stay in nursing staff working with adult patients in a hospital setting is a major concern for healthcare organizations because of its effect on patient health outcomes. Grounded in the social cognitive career theory, the purpose of this quantitative correlational study was to investigate resilience as a moderating factor in the relationship between burnout and intention to stay for licensed registered nurses with BSN degrees working with adults in a hospital setting. The participants were 80 licensed registered nurses with BSN degrees working with adults in a hospital setting in the United States of America. The results …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney

Walden Dissertations and Doctoral Studies

Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …