Medicine and Health Sciences Commons^™

Implementation Of An Education Program To Decrease Inpatient Falls, Elizabeth M. Carpenter, Jewyl Gibson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Inpatient falls are affecting 1 million patients across the United States every year with 25% of fall resulting in injury. Approximately 25% of falls are preventable with accurate assessment and appropriate fall precaution interventions. According to the literature, obtaining an accurate fall risk assessment is the first step in inpatient fall prevention.

LOCAL PROBLEM: Patient falls increased on 2 cardiac stepdown units in a level III trauma center in Knoxville, Tennessee. From 2020- 2022, the combined units experienced a 48% increase in patient falls. Nursing leadership identified staff knowledge deficits and inaccurate scoring of fall assessments as primary contributors …

Implementation Of An Evidence-Based Guideline To Improve Vital Sign Assessment And Documentation In The Emergency Department, Mary Darden Mason, Jennifer Lynn Smith, Laura Sturla

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: The emergency department (ED) is a fast-paced area at risk for medical errors. Studies have found that patients with abnormal vital signs (VS) experience preventable adverse events and worse process outcomes, such as extended length of stay (LOS) times and increased readmission rates. Despite ongoing reports of VS inconsistencies, there remains a lack of evidence-based VS assessment and documentation standards across healthcare, which results in missed opportunities to mitigate deficits in quality of care.

LOCAL PROBLEM: The project site, a 19-bed rural ED in Maryland, lacked a standardized process delineating VS assessment frequency for the ED nurses, …

Evaluation Of Registered Nurses’ Knowledge And Confidence In Encouraging Cardiac Surgery Patients To Participate In Digital Education, Katelin A. Welch, Jewyl Gibson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Background: Cardiac surgery remains a necessary means of medical management for cardiac disease. Patient anxiety is a common mental health challenge experienced by cardiac surgical candidates. Preoperative educational videos can reduce anxiety and improve the surgical experience.

Local Problem: This project was conducted for hospital nurses caring for cardiac surgery patients. Cardiac patients are assigned digital education to educate them about their procedures. Regardless of availability, nurse and patient engagement of the material is low. Competing nursing priorities prevent nurses from disseminating education to cardiac surgery patients, thus increasing patient anxiety. Educating nurses on utilizing digital surgery …

Psychosocial Consequences Of Diagnosed Malignant Melanoma, Savanna Eve Smallwood-Corcoran, Mary Johnson, Lindsay Frazier

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Psychosocial consequences frequently accompany the diagnosis of malignant melanoma (MM), such as fear, anxiety, burden, and distress. Patients are not receiving the proper psychiatric care needed to address the psychosocial consequences they are experiencing. Patients diagnosed with MM have expressed a lack of assessment and supportive care by providers to address psychosocial consequences they are experiencing.

LOCAL PROBLEM: The setting for the quality improvement project was a private dermatology clinic in Knoxville, Tennessee. There was no standard procedure for anxiety screening at the site. Comparable to published studies, there is a lack of procedures for screening patients …

Initiating A Skin-Care Bundle In The Emergency Department To Decrease Hospital-Acquired Pressure Injuries In Geriatric Patients, Suzanne Babcock, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Adults 65+ comprise 15.2% of the United States (U.S.) population and 17.9% of Emergency Department (ED) visits. Aging causes changes to skin, including thinning and loss of elasticity. Annually, in the U.S., 2.5 million individuals develop Pressure Injuries (PI), causing 60,000 deaths. Hospital acquired PIs in the U.S. cost $26.8 billion annually, over $10,000/patient and increase the length of stay by greater than four days.

LOCAL PROBLEM: This project occurred in a 27-bed Geriatric Accredited Emergency Department in a southeastern U.S. city where patients 65+ comprise 40% of the patient volume annually. PIs can begin developing within two hours. …

Reducing Hopelessness In Patients With Parkinson’S Disease: Educational Intervention, Kara R. Callear, Pamela Hardesty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Reducing Hopelessness in Patients with Parkinson’s Disease: Educational Intervention

BACKGROUND: Parkinson’s disease (PD), features several non-motor manifestations, including cognitive dysfunction, which impacts patients and their families. Depression, hopelessness, and anxiety are all prevalent in the psychiatric conditions of PD. In fact, at least 50% of those diagnosed with PD will experience some sort of depression, hopelessness, or anxiety disorder after diagnosis (Ray & Agarwal, 2020). The specific purpose of this project was to help patients with PD diagnosis feel less hopeless and more resilient when coping with their symptoms of PD.

LOCAL PROBLEM: The project setting was a …

Improving Oncofertility Discussions And Referrals: Implementation Of A Formal Fertility Preservation Program, Mackenzie Danielle Browning, Melissa Marie Hessock

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Impaired fertility is a risk of life-saving cancer treatment in adolescents and young adults (AYAs). Despite this known risk and clinical practice guidelines that stress their importance, treatment-associated fertility risk education and preservation referrals are often neglected in this population.

LOCAL PROBLEM: The site of this evidence-based practice improvement project is an outpatient hematology-oncology clinic serving adults with varying cancer diagnoses. The site did not have a standardized approach to ensure treatment-associated fertility risk education and fertility preservation referrals were provided to AYAs with newly diagnosed cancer. The purpose of this project was to implement a formal fertility preservation …

Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange

Doctoral Dissertations

As the U.S. older adult population increases and diversifies, healthcare providers need innovative, cost-effective, and culturally congruent approaches to gerontological nursing care. Decades of multidisciplinary evidence demonstrate that spirituality enhances older adult holistic health. However, although research about spirituality and nursing has become more culturally diverse, little is known about spirituality-health linkages of rural Appalachian older adults (RAOAs). This knowledge gap is significant because Appalachia leads the country in mortality related to chronic comorbidities such as heart disease, cancer, and depression. Given age, poverty, limited transportation, and health provider shortage areas, RAOAs experience severe health disparities. Moreover, spirituality is an …

Feasibility Of A Mindfulness Education Module For Nurses: An Evidence-Based Practice Project, Executive Summary, Emily Looper, Palmer Gleason, Dr. Katherine Newnam

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Nurse burnout is a well-defined problem that has been exacerbated by the COVID-19 pandemic and negatively affects nurses’ mental health, nursing shortages, patient safety, and quality of care. Evidence shows that mindfulness is an effective strategy for managing stress and decreasing burnout in nurses. This article describes an evidence-based practice project that translated this evidence into practice via a vetted mindfulness educational intervention for nurses in intensive care and acute care settings. The purpose of this project was to assess the feasibility of this educational intervention, processes, and outcomes with the goal to extend the project hospital-wide. Pre-intervention levels of …

How Stress And Coping In Nursing Affect Burnout In The Transition To Practice: A Literature Review And Proposed Study, Natalie Elizabeth Meade

Chancellor’s Honors Program Projects

No abstract provided.

Improving Patient Health Literacy: Implementation Of Health Literacy Tool & Hematology Oncology Patient Education Checklist, Ala'a Samih Mitoubsi

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Purpose: Increase health literacy and communication using a tool with a discharge checklist to facilitate communication and understanding among patients, physicians, and nursing staff.

Background and significance: In the United States, 90 million people are affected by low health literacy impairing their ability to understand and comprehend health information (Institute of Medicine et al., 2004). Another 40 million Americans have difficulty reading complex texts that makes reading health information difficult (Institute of Medicine et al., 2004). The Affordable Care Act emphasizes the need for increased self-care as a key strategy for improving health care costs and improving the quality …

Testing A Musical Game Activity For Community-Dwelling Older Adults, Jordan Riggins, Susan Mclennon Phd Arnp

Chancellor’s Honors Program Projects

No abstract provided.

Rural Appalachian Person And Family Decision Making At End Of Life, Mary Lou Clark Fornehed

Doctoral Dissertations

The dynamics of delivering care to persons at end of life (EOL) have dramatically changed in the last twenty years. Improved management of chronic illness and provision of aggressive life sustaining measures for an illness once deemed fatal are more common, significantly increasing longevity. While it is estimated that more than 40 million persons with life-limiting illness worldwide are candidates for some form of palliative or end-of-life care (EOLC), less than 14% of them will receive it.

When coping with life-limiting illness, people and their families are asked to make many complex and difficult decisions about EOL, palliative, or hospice …

A Grounded Theory Inquiry Into Crying In Women Dealing With The Emotional Stress Of Personal Crisis, Mary Bess Griffith

Doctoral Dissertations

The belief that crying leads to healing is so widely held and of such longstanding that many healthcare professionals—including nurses, physicians, psychiatrists, and psychologists—accept it as fact even though there is little substantiating scientific evidence. Crying is commonly believed to be an essential factor in restoring mind-body equilibrium after physical and/or emotional trauma has been experienced. If, as has been hypothesized by many scientists and healthcare practitioners, emotional crying is a biopsychosocial healing modality, then specifics of its therapeutic praxis, including limitations and ambiguities, should be incorporated into nursing education and practice. In this grounded theory study, the meaning and …

Newly Licensed Registered Nurses' Experiences With Clinical Simulation, Carrie Ann Bailey

Doctoral Dissertations

The purpose of this study was to understand how new graduate nurses perceive the value of simulation in making the transition into professional practice. This study will use a descriptive qualitative approach with a sample of first year nurses. Kolb’s Experiential Learning Model serves as this study’s conceptual framework. For the current study, the sample consisted of 10 newly graduated, female nurses with less than one year of experience working in the hospital setting were interviewed. Data analysis included interviews and transcription by the researcher. Finally, participants were asked about themes to increase rigor. Four themes emerged from this research: …

"I Saved The Iguana": A Mixed Methods Study Examining Responder Mental Health After Major Disasters And Humanitarian Relief Events, Suzanne Marie Boswell

Doctoral Dissertations

The purpose of this mixed methods study was twofold. The first was to use Hobfoll’s (1989) Conservation of Resources theory to predict psychological stress based on responders’ perceptions of resource adequacy. The second was to use qualitative interviewing to gain a more comprehensive understanding of the disaster/humanitarian responder experience.

The study is significant given the expanding role of nurses within disaster/humanitarian response organizations. Furthermore, psychological stress results in increased turnover of human resources in these organizations. This turnover is detrimental to humanitarian systems that already lack adequate coverage and sufficiency because funding and human/material resources grow at a slower pace …

Exploring Perceptions Of Staff Registered Nurse Preceptors For Undergraduate, Pre-Licensure Nursing Students, Katherine C. Hall

Doctoral Dissertations

Staff nurses are increasingly called upon to accept more responsibilities and roles in addition to provider of patient care, including that of preceptor. Aside from dealing with demands of high acuity patients, working long hours with inadequate staffing, and carrying heavy workloads, nurses may view teaching and supervising students as an additional burden, time-consuming, and not part of their role. The purpose of this dissertation was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students. Emphasis was placed on exploring RN’s perceptions of the role, specifically the preparation for, support in, and understanding of what the role …

Experiences Of Er Nurses Caring For The Homeless, Evelyn Marie Gaddis, Gregory Stafford, Thien Dang, Cynthia Carole Smith

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

No abstract provided.

Enhancing Critical Thinking Disposition And Clinical Judgment Skills In Senior Bsn Students Via Electronic Interactive Simulation, Deborah Lynne Weatherspoon

Doctoral Dissertations

Problem
The problem investigated in this study was the lack of empirical evidence available regarding the effectiveness of electronic interactive simulation (EIS) for developing critical thinking disposition and clinical judgment skills in the senior baccalaureate nursing student.

Aim
The aim of this study was to identify an effective method of experiential learning simulation that may be independently accessed by the learner with a goal of enhancing critical thinking disposition and clinical judgment skills of senior baccalaureate student nurses (BSN).

Purpose
The purpose of this experimental study was to compare the effects of EIS to traditional paper case studies on the …

Decreasing Hospital-Related Complications Using Hourly Nurse Rounding Focused On The 4 P'S, Chad Morgan Phillips, Tiffany C. Dixon, Amanda N. Bessey, Dale E. Cuva

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

This review of literature sought to find the best practice for nurse rounding in hospitals in an effort to reduce hospital-related complication (falls, pressure ulcers) and improve patient satisfaction. Current research shows a growing trend toward hourly rounding centered on addressing basic patient needs, also known as the 4 P's (pain, potty, position and presence). See abstract for more details.

Increasing Resilience In Adolescent Nursing Students, Teresa Maggard Stephens

Doctoral Dissertations

Nursing students not only face the same developmental challenges as other college students, but also experience unique stressors that contribute to increased risk for negative outcomes. The intimate nature of patient care, the exposure to workplace adversity, death and dying, and the chaotic nature of healthcare can have cumulative negative effects on students’ health and well-being. Increased resilience could prove useful in helping students confidently face challenges and successfully move forward. The lack of empirical evidence regarding resilience-enhancing interventions with nursing students supports the need for examining the effectiveness of an educational intervention to increase resilience in adolescent baccalaureate nursing …

The Effect Of Reflective Writing Interventions On Critical Thinking Skills, Jessica L Naber

Doctoral Dissertations

The importance of critical thinking as an outcome for students graduating from undergraduate nursing programs is well-documented by both the American Association of Colleges of Nursing (AACN) and the National League for Nursing (NLN). Graduating nurses are expected to apply critical thinking in all practice situations to improve patient health outcomes. Reflective writing is one strategy used to increase understanding and ability to reason and analyze. The lack of empirical evidence regarding the effectiveness of reflective writing interventions on increasing critical thinking skills supports the need for examining reflective writing as a critical thinking strategy. The purpose of this study …

When The Diagnosis Is Disaster: Ethics And Human Rights, Susan Speraw

Faculty Publications and Other Works -- Nursing

The quality of disaster response is impacted by the quality of training and education of professionals. In contemporary society, where disaster frequency is increasing, and threats such as avian flu hold the potential to impact the wolrd irrespective of borders, responders need to be trainined not only in the mechanics of safety, triage and treatment, but also working among people who hold customs and traditions very different from our own. This presentation examines the following questions: What is essential content in disaster education? At what level of practice should such education ideally occur? Of special emphasis are issues related to …

The Meaning Of The Death Of Adult Child To An Elder, Latricia Diane Weed

Doctoral Dissertations

The purpose of this inquiry is to develop an initial understanding and description of the meaning of the experience of an elder after the death of an adult child. A significant research gap exists in studying elder bereavement and the death of an adult child. The research sample was obtained from elderly participants who were known by the researcher to have had the experience of the death of an adult child. A snowball

Responses to the qualitative questions in this study were analyzed using the existential phenomenological method as described by Thomas and polio (2002). Data was reviewed by the …