Medicine and Health Sciences Commons^™

Dedicated Vascular Access Team Benchmark Study, Rachel Davis

MSN Capstone Projects

Hospitals see a rise in the critically ill population. These patients present with multiple comorbidities resulting in frequent emergency department trips. Unfortunately, with each visit, these patients require a vascular access device. Over time their veins will no longer be easily accessible. Patients with veins that are no longer visible, palpable, or require special techniques to obtain access are considered to be difficult intravenous access (DIVA) patients. They will likely experience multiple attempts with each admission to the hospital, resulting in physical and emotional pain, not to mention being costly. The purpose of this paper is to compare the advantages …

Constant Observation The Benchmark Study, Kalana Sanders

MSN Capstone Projects

Constant observation is defined as “an increased level of observation and supervision which continuous one-to-one monitoring techniques are utilized to assure the safety and wellbeing of an individual patient in the patient care environment. In the hospital setting constant observation has become the most used resource for mental health patients. The use of constant observation has significantly improved patient safety outcomes reducing falls and suicide rates drastically. With one study in Pennsylvania showing a vast improvement in patient safety in simply one-month times. As fall rates decreased from 53,966 falls occurring without the implementation of constant observation to only 323 …

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.

Implementing A Medication App For Transplant Recipients, Allison Arnold

MSN Capstone Projects

The purpose of this benchmark, evidence-based practice project is to evaluate the utility of medication adherence app for transplant recipients to reduce rejection. Studies have shown that medication apps can improve adherence, reduce transplant rejection, and be helpful to patients. The Perx Health app rewards patients for taking their medications, provides patients with reminders, and provides healthcare providers with data from patients. The Perx app will be implemented at a single, large volume, pediatric transplant center. Historical data related to rejection rates and medication level variability indexes will be compared to data collected after app implementation. In addition, patient surveys …

Adjustable Velcro Compression Devices, Spring Reed

MSN Capstone Projects

Venous Ulcers and edema are expensive to treat and chronic conditions that are a strain on home health care companies and decrease patient quality of life. The standard treatment is expensive multilayer compression wraps that time consuming requiring three weekly visits, a strain on home health care agencies and are often not successful in resolving edema and venous ulcers. Adjustable Velcro compression devices are proven to be successful compression therapy due to low one-time cost, patient's increased comfort and the patient or patients' family self-sufficient in their application.

Retention Drivers Post-Pandemic, Maria Charles, Christina Gonzalez

MSN Capstone Projects

The Covid pandemic influenced the world in many ways that we still witness a need for recovery. One significant concern that remains apparent is the culture change within the healthcare system. This study is directed to cover only one aspect of this culture change but remains to be a very significant topic for the nursing workforce (AHC Media, 2021). Even though we have managed to find a downward trend of Covid cases, the pandemic has devastated nursing retention to well established facilities. There is currently an exodus of nurses in high acuity departments or simply bedside nursing entirely. This causes …

Congestive Heart Failure Educational Approach Benchmark Study, Sheridan B. Westmoreland

MSN Capstone Projects

Heart failure continues to burden the American healthcare system. Disease management programs and transitional care services are used by hospitals to help patients living with congestive heart failure (CHF) transition from the hospital to home life. Twelve articles were chosen to evaluate the effectiveness of a multidisciplinary approach in reducing hospital readmission rates, cost, and death. One article was chosen to see how a nurse-led 1:1 patient educational approach was effective, and one article evaluated patients’ perception on living with CHF. This paper aims to evaluate the best educational approach on reducing hospital readmission rates, death, and cost in CHF …

Meeting The Needs Of Gen Z Nurses To Improve Nurse Retention, Ronna M. Best

MSN Capstone Projects

This benchmark project explores the unique learning styles and generational characteristics of Generation Z nurses (those born between 1995 - 2012). The need exists for a change in traditional orientation and onboarding processes to meet the needs of Gen Z nurses. Gen Y and Gen Z nurses are expected to make up 50% of the workforce by 2024. Retention of these nurses is critical to a hospital organization as it is an effective strategy in dealing with the nursing shortage. Specific strategies for engaging the gen Z nurses include incorporating more digital platforms in the orientation and onboarding process, face …

Bedside Nurse Shift Length: Evidence-Based Intervention On Nursing Burnout, Natalie Suzanne Medina Bsn, Kristen Morreale Bsn, Bryanna Whitehurst Bsn

MSN Capstone Projects

With the aging baby boomer population, employee burnout, and lack of quality medical training, the United States is facing one of the most detrimental nursing shortages in history. Before the COVID-19 pandemic, the United States Health and Human Services projected the demand for nurses to be much higher than the actual number of employed registered nurses through 2030. Since 2016 the nursing population was widely composed of nurses between 25 to 34 years old. After the global pandemic hit, the number of nurses in that age group declined by 5.2 percent, and nurses aged 35 to 44 have reduced by …

Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux

MSN Capstone Projects

Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …

Changing Hand-Off Communication In The Pacu Setting, Alisa M. Berndt

MSN Capstone Projects

Through extensive research on the importance of hand off communication in the PACU setting a correlation between patient safety and hand off report was found. Lack of a standardized hand off communication report in the PACU setting may lead to compromised patient safety and negative patient outcomes. In year 2021- 2022, the PACU there had several occurrences of miscommunication that were considered “near misses” in their incident reporting system. The objective of this capstone project is to investigate if utilizing a standardized hand off communication tool to guide healthcare professionals when transferring patient care to the next provider will mitigate …

Using Debriefs To Reduce Nursing Burnout In Nurses Caring For The Oncology Population, Courtney M. Wilkes

MSN Capstone Projects

Nurses are a critical part of healthcare and make up the largest section of healthcare professionals in the United States. According to the World Health Organization (2020), there are approximately 29 million nurses and midwives globally. The increasing need for nurses is not a new discovery. According to the American Association of College of Nurses, more registered nursing jobs will be available through 2022 than any other profession in the United States. The number of nurses leaving the workforce each year has been growing steadily from around 40,000 in 2010 to nearly 80,000 in 2020. Nursing burnout is a known …

Regional Anesthesia In Outpatient Total Joint Arthroplasty, Laci Caesar

MSN Capstone Projects

Within the past five years, outpatient total joint arthroplasties have increased three-fold due to the change in insurance companies’ reimbursement plans. After continuous literature research collection, support for spinal anesthesia was higher than compared to general anesthesia (GA) for outpatient total joint arthroplasty procedures. Healthy patient who receives regional anesthesia showed decreased post-operative pain, increased rehabilitation, and, most of all, a decrease in facility stays (Macfarlane et al., 2009). This has allowed healthy patients who meet physician, anesthesia, and facility requirements to transition from hospitals to ambulatory surgery centers for total joint replacement procedures. With this new transition comes change …

Promoting Sleep To Decrease Delirium, Stephanie Mayne

MSN Capstone Projects

Delirium is potent risk factor for complications, an increase length of stay, and mortality. Hospital acquired delirium is a prevalent and serious health condition that can occur in patients, especially the older adult population, when admitted to the hospital. It has the ability to be prevented if properly addressed and interventions are set in place to help reduce the occurrence of hospital acquired delirium. Many factors can contribute to the development of delirium, including a disruption of one’s circadian rhythm. Sleep is not always a high priority in the hospital, therefore there are little interventions and goals aimed at improving …

Iris Nursing Strong Program: Benchmark Study, Sonia Bunyard, Keviesha Lacy

MSN Capstone Projects

The change project we are presenting is the IRIS-Nursing Strong program. IRIS stands for: Increasing, Reason & Relaxation, Implementation, Strategies all aimed to prevent nursing burnout. The Iris flower symbolizes hope and strength as nurses are healthcare providers who constantly provide that hope and strength to their patients. We plan to develop this program in the workplace to infuse that hope and strength back into the nurses who spend so much time taking care of others. The goal is to offer a non-judgmental environment, recognize early signs of distress in ourselves and our peers, provide …

Palliative Care In The Icu, Grace Cunningham

MSN Capstone Projects

Death and dying is an evident part of being admitted to the intensive care unit. However, too many times, the end-of-life conversations and palliative care team introduction are done when it is too late. The PICOT question is “In ICU patients (P), how does early palliative care involvement in the death and dying process (I) compared to later palliative care involvement in the death and dying process (C) affect positive patient outcomes (O) within the ICU hospital stay (T)?” The objective of this change project is to instill a sense of urgency in providing palliative consults upon admission as this …

Multi-Disciplinary Biopsychosocial Approach In Low Back Pain Benchmark Study, Liza Beth Cocanougher Short Rn, Ms

MSN Capstone Projects

Low back pain (LBP) is the third most common reason people seek care in America and is the primary reason for missed work days. Working in a pain clinic for eight years and managing research studies directed toward improving low back pain in patients was the motivation for choosing the evidence based intervention in this population. The health care professionals (HCP) in the pain clinic usually have a conversation with the patients who have acute or subacute onset of LBP about their disease and give them a written handout with exercises and ask them to perform these exercises at home. …

End-Of-Life Simulation Education, Lucas Farris

MSN Capstone Projects

In the current healthcare workforce, there exists a lack of comfort and knowledge about providing end-of-life (EOL) care that will only continue to worsen without prompt changes to the delivery of education (Jablonski et al., 2020). The lack of knowledge and comfort expressed in providing EOL care leads to a nurse’s moral and physical difficulty when a patient chooses palliative care or hospice. This is a detriment to patients and should be a consideration for schools of nursing when developing curriculum and clinical activities. By promoting changes in curriculum and the addition of an EOL simulation at the undergraduate level, …

How Covid-19 Changed New Nurse Orientation, Lindsey Js Sanders

MSN Capstone Projects

Universities were no longer able to do in person learning for nursing students. Nursing students were being taught vital skills like inserting an IV catheter via online simulation. The number of hours nursing students had to participate in clinical hours at the hospital was diminished due to the hospitals not allowing in nursing students. This created a huge educational deficit in nursing students. The nursing students who graduated during the COVID-19 pandemic are arguably less skilled than their predecessors before them. To fill this educational gap, additional training and orientation time must be provided to allow for fully competent new …

Impact Of Self-Care Techniques On Nurse Burnout, Macie Mayrell

MSN Capstone Projects

Nurse burnout is a serious, widespread problem in the healthcare arena. Registered nurses need to understand the importance of self-care to prevent or alleviate nurse burnout. An Evidence-Based Practice Benchmark Study implements a relaxation room on a nursing unit to encourage and promote self-care among acute care nurses.

Impact Of Resiliency Training On Combating Burnout, Kimberly Labinsky

MSN Capstone Projects

Occupational burnout has long since been a problem but has only recently been acknowledged as the spark behind the fire that has led to our critical nursing shortage. Considering the emotional aftermath of the pandemic and the hardships that a strained economy will bring, we must learn how to extinguish these flames rather than adding fuel to this complex problem. Burnout is causing a vicious cycle within the healthcare workforce that will lead to detrimental effects on quality patient care. We must learn how to break the cycle.

The cycle starts with experienced nurses leaving unprecedented numbers and units primarily …

Polypharmacy Teaching In The Acute Setting, Brandy Marie Duncan

MSN Capstone Projects

Within stable economic societies, polypharmacy has become a phenomenon that can be more harmful, although medications prescribed are with good intentions. Education is integral to nursing responsibilities; it is an intervention tool to help patients affected by polypharmacy. The interest in polypharmacy stems from witnessing the lack of patient education within the acute setting, and the lack poses a greater risk for adverse drug events (ADEs). The healthcare industry’s responsibility is to help alleviate the adverse effects that polypharmacy causes, such as falls, adverse drug reactions, hospitalizations, mortality, and cognitive mental (Fried, 2014).

A new performance improvement project (PI) will …

Adolescents With Depression Capstone Benchmark Project, Myeshia Salter

MSN Capstone Projects

This change project promotes the inclusion of adolescent involvement within the informed consenting process for recommended treatment plans for symptoms of depression. This project proposal will include the adolescent throughout the development of the treatment plan to promote compliance. The incorporation of this plan will encourage autonomy in the adolescent and aid with developing a plan that the adolescent agrees with. The current process does not include the adolescents' desires or opinions, which results in poor efficacy of the treatment plan, thus exacerbating the symptoms of depression.

Preoperative Education For Cardiac Surgical Patients Benchmark Study, Jackson W. Payne

MSN Capstone Projects

Heart surgery is a term that scares a lot of people and rightfully so, as the heart is one of, if not the, most vital organ in the human body. So naturally, one can imagine the amount of fear and anxiety that patients feel when they are told they need heart surgery. This fear and anxiety is not unwarranted, either. Heart surgery, in most cases, is a major and highly complex operation with a lot of potential complications and negatives. Despite this, the majority of the time the benefits do outweigh the risks and patients elect to go forward with …

Medical Cannabis: Alternative To Opioids For The Treatment Of Chronic Pain, Brenda F. Seaton

MSN Capstone Projects

There is a growing body of evidence to suggest that cannabinoids (CBD) are beneficial for a range of clinical conditions, including chronic pain, sleep disorders, osteoarthritis inflammation, anxiety, depression, and enhanced quality of life. For patients with chronic pain and arthritis inflammation, traditionally pain-relieving medications, including opioids, have been prescribed for pain relief but with increased risks of addiction and adverse effects with poor outcomes. Medical cannabis use is an emerging treatment alternative to prescription opioids and as an adjunctive to diminish the use of opioids addiction. This project objectively reviews the works of literature on the challenges of proposing …

Central Line Associated Blood Stream Infection (Clabsi) Prevention Through Designated-Nurse Peripherally Inserted Central Catheter (Picc) Line Dressing Change, Belinder Atabongafac

MSN Capstone Projects

The goal of this review is to show ways in which a nurse can have influence in the patient’s life by caring for their PICC line. The rate of hospital-acquired infections is related to the care that patients get while admitted in the hospital. All hospital acquired infections can and should be prevented. This is also true for central line associated blood stream infections (CLABSI). The care provided to a patient with a PICC line, including how their line is taken care of, decides if the line gets infected, and if the patients get an infection. When patients get a …

Asthma Education With Asthma Action Plan, Lois K. Sanders

MSN Capstone Projects

MSN capstone project in which pediatric asthma patients were given audio visits for the purpose of formulating asthma action plans.

Alternating Pressure Overlay Systems, Maris Rathgeb

MSN Capstone Projects

Although preventable, pressure injuries are an overwhelming problem in the healthcare system and can lead to poor quality of life, increased length of hospitalization, and unsatisfactory patient outcomes. Many cardiac surgeries take anywhere from six to twelve hours, and patients are completely immobilized for the entire length of time. Alternating pressure overlays placed on the operating room table provide tissue offloading with inflating and deflating nodes, leading to micro-movements on high pressure bony prominences. The intervention PICO question to be answered in this paper is: In intraoperative patients (P), how does the use of an alternating pressure surface (I) compared …

Benchmark Project Cryotherapy To Prevent Chemo Induced Peripheral Neuropathy, Stephanie Davis

MSN Capstone Projects

As a nurse working in chemotherapy infusion, I have a direct role in symptom management. For patients receiving Taxanes, the most common adverse effect reported by patients is peripheral neuropathy. According to one meta-analysis, Taxane-induced peripheral neuropathy (TIPN) has very high incidence ranging from 11 to 87% and severely impairs patients’ quality of life (Jia et al., 2021). Patients may experience pain, weakness, loss of sensation, decrease in ability to perform ADLs, increased falls among many other impairments as a result. We understand the importance of performance status in oncology patients. This can lead to dose reductions or held treatments …

Appointment Reminder System Benchmark Study, Anthony Rawlinson

MSN Capstone Projects

The average appointment “no-show” rate is 23% across 105 studies (Dantas et al., 2018). These “no-shows” cost an estimated 150 billion dollars a year to the American healthcare industry (Ruiz-Hernandez et al., 2020). Previous estimates place the cost of one no-show event at a primary office in the range of $125 to $274 (Aysola et al., 2020). These missed appointments not only cause a loss in office revenue, but also harm the patients missing the appointment (Marbouh et al., 2020). Some of the repercussions patients suffer from are longer wait times for appointments, higher Emergency Room (ER) admission rates, and …