Medicine and Health Sciences Commons^™

Nursing Care Of Individuals Engaging In Non-Suicidal Self-Injury: Impact Of Dialectical Behavior Therapy Skills Reinforcement, Lucas Bridgens

MSN Capstone Projects

As explained by Linehan et al. (2006b), the seriousness of borderline personality disorder can be highlighted by the manifestations of emotional dysregulation, such as impulsive and suicidal and non-suicidal self-injurious (NSSI) behaviors. As the mental health field grows, so too does the knowledge base from which practitioners derive therapeutic interventions with hopes of effectively and safely treating patients while maintaining a culture of dignity and respect. One such treatment modality that has proven to reduce NSSI and improve interpersonal functioning, specifically in patients with borderline personality disorder, is Dialectical Behavior Therapy (DBT) which is a form of cognitive-behavioral therapy developed …

Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis

MSN Capstone Projects

The significance of appropriate nurse staffing in enhancing patient outcomes and mitigating nurse burnout is well-documented. Inadequate nurse staffing can lead to negative consequences, including burnout, decreased nurse retention, and potential safety risks (Shin et al. 2018; Wynendaele et al. 2019) Research has also established a strong connection between nurse-to-patient ratios, well-being, and job dissatisfaction among nursing staff (Andel et al. 2021; Thompson-Munn et al. 2021).

Given this evidence, there is a compelling rationale for aligning nurse staffing ratios with proposed federal standards to address burnout, improve well-being, and enhance patient outcomes. Implementing these changes necessitates careful planning and assessment. …

The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins

MSN Capstone Projects

In 2023, the National Council of State Boards of Nursing revealed that 100,000 nurses left the workforce during the COVID-19 pandemic and another 900,000 plan to leave by 2027 due to stress, burnout, and retirement. Identifying and implementing practical strategies to reduce voluntary turnover as a result of stress and burnout is a top priority for nursing leaders across the country. Work engagement and job satisfaction have well been documented in the literature as antidotes to occupational stress and burnout in the nursing profession (Schaufeli & Bakker, 2004; Pressley & Garside, 2022). Evidence suggests that implementing shared governance is a …

Improving The Mental Health Of Nursing Students By Utilizing A Serenity Room: A Benchmark Study, Megan E. Taylor

MSN Capstone Projects

Research findings consistently show that even though improvements have been made through the years, there is much more work to be done concerning mental health nationwide, especially in nursing. Nurses are the front-line workers in healthcare and face challenging times daily. Mental health-related issues in nursing have increased on a national level since the COVID-19 pandemic (Xiong et al., 2022). A more significant nursing shortage will likely occur without drastic change and support for nurses’ well-being.

The purpose of this paper is to describe a benchmark Capstone project. This benchmark study was conducted with the goal of improving nursing students …

Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner

MSN Capstone Projects

Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …

Improving Safety In The Emergency Department: Utilizing Metal Detectors To Mitigate Weapon Possession, Jonathan Garcia

MSN Capstone Projects

Today’s high risk-healthcare environment has prioritized patient safety with great initiatives and, unfortunately, placed staff safety second. However, safety for both groups should be equal priorities. Evidence suggests that Emergency Departments (ED) often care for patients with a history of crime and mental health diagnoses, creating an environment where the threat of violence and weapons is increasingly prevalent compared to other clinical settings. (Erlyana, 2019) Risk mitigation is possible if we consider studies by Malka et al. (2015) and Laidlaw et al. (2017) that indicate the efficacy of metal detectors in accurately identifying concealed weapons. To improve clinician and patient …

The Use Of Mindfulness-Based Stress Reduction To Reduce Stress And Burnout In Nurses, Sherri Foreman

MSN Capstone Projects

The Mindfulness-Based Stress Reduction Program (MBSR) has been used effectively in multiple clinical settings to reduce workplace stress and burnout in nurses. The MBSR’s cost-effective approach to stress management can be implemented into any healthcare facility’s policy. The topic of MBSR’s effect on stress and burnout has been identified as essential due to nurses working in fast-paced, stressful work environments. These work environments lead to increased stress and burnout. The International Council of Nurses surveyed nurses before and after the pandemic. There were 40% of nurses that reported symptoms of burnout before the pandemic compared to 70% of nurses after …

Dnp Final Report: Promoting Physical Activity In Nurse Students, Rose Leal Guidry

DNP Final Reports

Undergraduate nursing students experience educational rigor and challenging clinical experiences that potentially affect stress levels and increase the risk for adverse mental and physical health outcomes. Prolonged stress is associated with emotional exhaustion, unhealthy coping mechanisms, unhealthy behaviors, and impaired functioning. This evidence-based practice project aimed to decrease undergraduate nursing students' perceived stress levels by promoting physical activity. The PICOT question that led this project was in undergraduate nursing students (P), how does the promotion of physical activity (I) compare to no promotion of physical activity (C) affect perceived stress (O) across one semester (T)? The evidence supports physical activity …

The Implementation Of A Nurse Residency Program, Jessica Conrad

MSN Capstone Projects

Implementing a nurse residency program in a hospital can be a successful plan to improve nurse retention and the quality of patient care. Nurse residency programs allow new graduate nurses to transition into professional practice and gain skills for safe and effective care. Components of the programs include preceptorship, educational seminars, shadowing days, and support from preceptors, educators, and other leadership members. The program also may provide benefits to hospitals, including improved patient outcomes, nurse job satisfaction, and decreased costs associated with reduced turnover. Successful implementation needs leadership, collaboration, and communication among all stakeholders, including the staff nurses, preceptors, educators, …

Job Satisfaction And Burnout In Nursing, Tasha M. Tovar

MSN Capstone Projects

Job satisfaction, or lack thereof, can directly lead to burnout. Nursing is known globally as a high-stress career, thus leading to an increased level of burnout. Job burnout is among the most important occupational disorders and phenomena which have received great attention in the recent century (Nabizadeh et al., 2020). Multiple studies have proven that subtle, low-cost interventions can decrease the burnout experienced by nurses, leading to reduced turnover rates and an increase in the quality of patient care. Higher quality of care leads to improvement in patient satisfaction scores and also to increased reimbursement rates (Jun et al., 2021). …

Nurse Efficiency & Ultrasound Guided Intravenous Access: Evidence Based Intervention Benchmark, Jacob D. Frost

MSN Capstone Projects

Gaining IV access is this first step into accurate, timely diagnosis and interventions of patients. Nurses are typically the first medical professional a patient sees. If the nurse can establish IV access as early as possible this will lead to faster interventions faster diagnostic results and better management for patients and ultimately better patient outcomes. Ultrasound guided IV can increase first attempt success rates leading to decreased painful IV insertions by multiple nurses. This would increase patient satisfactions scores leading to higher re-imbursement.

Dnp Final Report: Mission Cyborg: An Ebp Project Integrating Hybrid Learning In An Undergraduate Nursing Course, Mary A. Thomas

DNP Final Reports

In modern times it is an expectation of students that technology be incorporated into how they receive their education. The COVID-19 pandemic brought to light how pure reliance on traditional face-to-face (F2F) learning can be detrimental to student learning. Many institutes of higher education had already implemented hybrid/blended learning prior to the pandemic and saw no difference in their NCLEX-RN pass rates. This evidence-based practice project gathered, reviewed, and synthesized evidence in order to determine if implementing different teaching strategies would maintain or improve student performance on both unit exams and end of course exit exams.

Benchmark Study On The Impact Of Nurse Managers’ Leadership Style On Job Satisfaction And Retention Of Nurses, Khatrina Swarup

MSN Capstone Projects

Nurse managers play a crucial role in the healthcare system as they ensure that quality care is maintained and provide the necessary support for the nursing staff to perform their responsibilities well, amongst other duties. Nurses want patients to receive quality, cost-effective care, and these patients want the same. If nurses are happy with their jobs, they provide quality patient care, improving overall patient outcomes. Also, job dissatisfaction predicts how individuals perform at work and whether they intend to leave their position or not.

The current standard of practice does not specify what leadership styles nurse managers or leaders should …

Aspects Of The Physical Work Environment And Nursing Work, Yolanda Keys

Nursing Theses and Dissertations

Objective: The purpose of this body of work is to inform nurse leaders and design professionals of opportunities to leverage the physical environment to enhance the overall work environment for nurses.

Background: The environments in which nursing work takes place need to support the staff who work within them. Healthy work environments have been shown to improve outcomes for patients, nurses, and organizations; however, the contribution of the built environment to the overall work environment for nurses is not fully understood.

Methods: Included in this portfolio are three studies: 1) a descriptive study exploring the experiences of …

A Mixed-Methods Approach To Investigating The Influence Of Education On Nurses’ Attitudes Toward Sex Trafficking Victims, Tabitha Mcdaniel

Nursing Theses and Dissertations

Significance of problem: Sex trafficking (ST) impacts victims of all ages, genders, races, and ethnicities. It is a significant public health issue which is shrouded in secrecy. Although victims are typically isolated by their trafficker, they will still seek out health care services. Nurses are frontline staff with rare access to victims in a setting where help can be given.

Purpose: The primary purpose of this mixed-methods study is to explore targeted education about sex trafficking and its influence on nursing attitudes and knowledge about sex trafficking and its victims. This study also analyzes demographic information and how those variables …

Dnp Final Report: Practice Change Compliance, Laura Duran

DNP Final Reports

Healthcare professionals in acute care hospital settings at the frontline of patient care affect many aspects of the patient's hospital stay, including infection prevention. The wearing of artificial nails by healthcare professionals in direct patient care is against best practice, although it is often seen. Therefore, the following PICOT question arises: In direct patient care providers who fail to adhere to policy (e.g., artificial nail use per hand hygiene policy) (P), how does a multimodal approach (I) compared to a single approach (education) (C) affect compliance with policy (0) within six months (T)? A systematic review was conducted using CINAHL, …

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 …

Emergency Department Workplace Violence Against Nurses, Adam Johnson

MSN Capstone Projects

Emergency room nurses are often thought of as the adrenaline junkies of the nursing world. Emergency nurses interact with a wide array of patients and visitors and are often the first clinician a patient may see upon arriving at an emergency department. With this wide array of patients and visitors, also comes a volatile environment with the increased risks of violence against nurses. This violence could include verbal, physical, and emotional violence from patients, visitors, and even fellow staff members. As violence increases, nursing longevity decreases and thus further increases the expense of nursing on a facility. Therefore, this has …

Dnp Final Report: The Flipped Classroom: An Evidence-Based, Course Redesign To Increase Retention Rates In A Vocational Nursing Program, Jennifer P. Hauger

DNP Final Reports

Over the past three decades, Vocational Nursing has been taught using a conventional didactic method that is content heavy and lecture focused. Despite having a group of highly qualified professors and an excellent student pass rates on the National board examinations, student retention in a Vocational Nursing Program in central Texas remains below the National benchmark. With a unique student demographic that is identified as non-traditional (over 21, full-time working adults, English Second Language and single parents), we embarked upon the redesign of a Medical-Surgical Nursing course using the flipped pedagogical framework to increase retention rates. Therefore, in 2019 we …

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 …

Mitigating Burnout In The Pediatric Intensive Care Unit, Katelyn O. Mcgaughy

MSN Capstone Projects

Burnout is defined as a “prolonged response to chronic emotional and interpersonal stressors on the job leading to a combination of physical and emotional exhaustion” (Lachman, 2016). The effects of burnout syndrome among nurses are well documented in the literature. Burnout is associated with an increased incidence of a variety of physical and psychological symptoms, including weight loss or gain, lethargy, headaches, sleep issues, anxiety, depression, and difficulty concentrating (Lachman, 2016). As a result of these symptoms, nurses experiencing burnout are more prone to provide poorer quality care to patients and are at heightened risk of commission of errors in …

Acuity-Based Staffing: Improving Patient Outcomes And Staff Satisfaction, Natalie Long

MSN Capstone Projects

Traditionally, nurse staffing practices have been based on a nurse-patient ratio model and have not incorporated patient acuity. More recent literature has shown that acuity-based staffing can improve patient outcomes and staff satisfaction. The Emergency Department (ED) is an area that has fluctuating patient acuity and volume. To incorporate acuity in to staffing in the ED, the acuity mix over the past year can be used to calculate required nursing hours, therefore providing the number of required nurses for that facility. The calculated number of staff can then be distributed over a 24 hour period. By incorporating acuity in to …

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 …

When Care Becomes Futile: Perspectives Of Acute Care Medical-Surgical Nurses, Angela Mulcahy

Nursing Theses and Dissertations

Caring for patients at end-of-life is a difficult patient assignment for a nurse. Possessing the knowledge, skills, and means to communicate with and advocate for patients is key to providing quality care. A concept analysis of death literacy identified one specific challenge for nurses, futile care. Futile care has been linked to increased patient suffering, increased health care costs, use of scarce resources, and moral distress. Futile care exists in the medical-surgical acute care setting, but the concept has not been explored within this population. More knowledge from bedside nurses was needed to explore the concept and identify ways to …

Spiritual Perspectives, Spiritual Care, And Recovery-Oriented Practice In Psychiatric Mental Health Nurses, Melissa Neathery

Nursing Theses and Dissertations

The prevalence of mental illness is well documented with 450 million people suffering with a mental illness worldwide. Nurses are integral to the delivery of mental health services and can influence the provision of individually focused, evidence-based, and culturally competent care. Spiritual care has been shown to enhance coping, improve well-being, and increase satisfaction with care for those in mental health recovery. Three manuscripts presented in this dissertation portfolio explored and addressed the concepts spirituality and spiritual care for those in mental health and substance use recovery. The Recovery Practice Model was examined and how spiritual care can be integrated …

Effect Of Metacognitive Strategy On Nursing Students’ Achievement And Engagement In An Active Learning Exercise, Theresa M. Naldoza

Nursing Theses and Dissertations

Nurse educators are responsible for producing nurse graduates that are competent, safe, and prepared to manage the complex clinical situations they will face. These graduates must possess sound clinical judgment skills that ensure safe and effective delivery of patient care. The decreasing capacity of clinical placements available for students to acquire hands-on experience presents an additional challenge. Educators must develop and implement innovative, effective teaching strategies to address these issues. An initial comparative concept analysis of engagement and reciprocity focused on the educator-student relationship as one in which all members contribute to the learning atmosphere is included in Chapter 2. …

Impact Of Podcasting On Learning Outcomes In Associate Degree Nursing Students, Daira D. Wilson

Nursing Theses and Dissertations

The dawn of the Information Age has provided rapid advances in technology that have improved lives and produced better tools for caring for each other. Nursing has begun to employ many of these new technologies and nurses are at the forefront of deciding how these innovations might best help patients. New technologies have made their way into schools of nursing and students are benefitting from improved learning experiences. Nursing faculty are leading the way in providing new learning opportunities to students through a multitude of technological advances. One of these advances is podcasting. Podcasting provides students the ability to listen, …

Effect Of Activity Trackers And Text Messaging On Exercise, Fitness, And Physical Activity Self-Efficacy Of Middle School Students, Alison F. Pittman

Nursing Theses and Dissertations

A decrease in physical activity as children age is a contributing factor to the U.S. obesity epidemic. Middle school children are particularly vulnerable to sedentary activities. Activity trackers show promise as a means to motivate children and adults to increase physical activity (PA). This study examined the effect of a text messaging intervention and use of activity trackers with a companion social website on the body mass index (BMI), body fat percentage, physical fitness, and PA self-efficacy of middle school children. Children aged 11-14 (n=102) were randomly assigned to one of three groups for a 10-week intervention: activity tracker group; …

Cultural Competence Of Pre-Licensure Nursing Faculty, Colleen Marzilli, Beth Mastel-Smith

Nursing Faculty Publications and Presentations

The purpose of this study was to determine the level of cultural competence (CC) in Texas pre-licensure nursing faculty and examine the relationships between demographics and CC scores. The researchers conducted a study to determine if demographics predicted the level of CC and explored the perceptions of CC. A convergent parallel mixed-methods design used data from a 2014 online survey with a qualitative interview component. Demographics were evaluated with descriptive statistics and CC was measured with The Nurses’ Cultural Competence Scale (NCCS). Qualitative data were analyzed using a constant comparative method. The level of CC was low to moderate. Three …