Medicine and Health Sciences Commons^™

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

The Effects Of Postpartum Hemorrhage Simulation, Kera Olson

Doctor of Nursing Practice Projects

Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. Evidence supports the importance and impact simulation has had on preparation for postpartum hemorrhage. Preparation with hands-on education is imperative for a safe outcome during a real-life hemorrhage situation. Lack of frequent education and simulation can equate to negative outcomes for all involved. The purpose of this project was to increase exposure to a safe environment to explore knowledge and skills during a postpartum hemorrhage event. This quality improvement project surveyed postpartum nurses pre and post-mock postpartum hemorrhage simulation. The setting allowed for mistakes, discussion, and open …

Improving The Mental Health Nursing Competencies Of Nurses Caring For Patients With History Of Substance Use Disorder In Long-Term Care Settings, Nancyver Lafleur-Omeler

Doctor of Nursing Practice Projects

Background

While nurses are often on the front lines of working with patients with a history of substance use disorders (SUD), most have limited training in this area. Nurses who work in Long Term Care (LTC) settings are often challenged to resolve the practical issue of needing more competency in caring for SUD patients. Horner et al. (2019) agreed that the deficiency of mental health knowledge and skills in healthcare workers is linked to decreased quality of care, which can diminish patient outcomes. This lack of competency must be addressed (Margoliese & Vandyck, 2019).

Purpose

The goal of this project …

Factors Influencing High Nurse Turnover In A Midwestern U.S.A. Community Hospital And A Proposal For Change, Deborah Mokeira Omagwa

Doctor of Nursing Practice Projects

Nurse turnover has become a universal problem in recent years, causing nurses to bear the burden of higher patient loads, working overtime hours, and dealing with unfavorable working conditions. Nurses sometimes feel they have no voice to fight for them while they struggle at the bedside to improve patient outcomes. The purpose of this project was to be a voice for the nurses to inform the hospital administration on data driven results on how nurse turnover can be reduced, with the goal that the proposed nurse retention strategies will be implemented in this community hospital.

This was a qualitative project …

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 …

Implementation Of An E-Learning Module To Increase Rn Knowledge And Skills Of Emergency Preparedness, Kaitlyn Hope Chung

Doctor of Nursing Practice Projects

Background

By failing to prepare, you are preparing to fail. —Benjamin Franklin, writer, philosopher, politician. Having education initiatives for mass casualty incidents and disaster preparedness that are concise and organized is of high importance. This issue is pertinent to the midwestern medical center where this project took place because in the event of a true mass casualty or disaster scenario, many lives could be saved if registered nurses (RNs) in the emergency department (ED) were better prepared. For a hospital to provide adequate and effective care during a crisis, healthcare workers must be effectively trained to do so. However, many …

Training Sexual Assault Nurse Examiners (Sane) And Patient Advocates To Improve Utilization Of The Alabama Crime Victims Compensation Commission (Acvcc) Program For Sexual Assault Victims, Erica Starling

Doctor of Nursing Practice Projects

Background: Sexual assault is a nationwide problem that often goes unreported. According to the Rape, Abuse and Incest National Network (RAINN), every 68 seconds an American is sexually assaulted. One out of every six women has been a victim of sexual assault in their lifetime. Sexual violence has long-term effects on victims including post-traumatic stress disorder, suicidal ideations and/or attempted suicide, substance use disorder, work and/or family life struggles, unplanned pregnancy, and/or sexually transmitted infections (STI).

Purpose: The purpose of this project is to improve the utilization of the Alabama Crime Victims Compensation Commission Program (ACVCC) for victims …

Providing Mbsr Tools To First Year Adn Nursing Students: A Dnp Project, Katherin Brandt

Doctor of Nursing Practice Projects

Abstract

As part of the educational training provided to nursing students it is important to not only provide information regarding stress management, but also to give them tools that they can use to handle stressful situations more effectively. Literature supports the use of mindfulness techniques practiced regularly to decrease stress and anxiety. This DNP project developed, implemented, and evaluated the addition of Mindfulness-Based Stress Reduction (MBSR) techniques into the curriculum of the first-year Medical Surgical nursing course in a prelicensure Associate Degree Nursing program. The project was guided by Watson’s Theory of Human Caring and the Model for Improvement (PDSA …

Policy Analysis Of The Illinois Nurse Practice Act (Aprn Title Section 65/65-50), Sara Kim

Doctor of Nursing Practice Projects

Background

Physician groups claim allowing nurses to use the title "doctor" confuses patients. Nurses assert that the title is common to many disciplines, and nurses should be trusted like other professionals to identify their specialty to patients. Currently, qualified nurses in Illinois using the title "doctor" in clinical areas must introduce themselves to each patient in the following way: "Hi, I'm Dr. Smith, the nurse practitioner taking care of you today. I do not have a degree in medicine, and I am not a physician or medical doctor” (225 ILCS § 65/65-50).

Purpose

This project aimed to evaluate Illinois Nurse …

Reducing Incidence Of Contrast-Induced Acute Kidney Injury Through Nursing Education, Hilarie Rankin

Doctor of Nursing Practice Projects

Contrast-induced acute kidney injury (CI-AKI) occurs commonly in patients following percutaneous coronary intervention (PCI) and has been linked to increased patient morbidity, higher risk for cardiovascular mortality, and a large burden of annual healthcare costs. The implementation of evidence-based care standards by nursing staff has been shown to reduce incidence of CI-AKI. Current discrepancies in nursing care have been linked to increased incidence of CI-AKI; therefore, the need for enhanced nurse buy-in with evidence-based protocols is paramount. The primary investigator sought to increase knowledge of CI-AKI and nursing compliance with an established evidence-based protocol at a single center hospital. After …

Improving Suicide Risk Assessment Through Educational Program Implementation, Timothy Booth

Doctor of Nursing Practice Projects

Background: Unsustainable behavioral health education focused on comprehensive suicide risk assessment performance contributes to decreased registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients.

Purpose: To educate medical-surgical and progressive care registered nurses in assessing patients for suicide risk factors and warning signs comprehensively.

Design Method: A quasi-experimental designed quality improvement project with evidence-based suicide educational program implementation. Project results yielded a 56.7% increase in registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients. Future DNP work will focus on sampling a larger population (N) to decrease opportunities for the skewness of project results …

Quality Improvement Initiative: Implementing A Nurse Peer Mentorship Program, Vepuka E. Kauari

Doctor of Nursing Practice Projects

Introduction: Formal mentoring programs are valuable experiences for the mentor and the mentee. They provide nurses with the ability to develop professional networks while refining their competency. Nurses should be properly mentored in focusing skills in addition to addressing their emotional needs. The purpose of this quality improvement project was to promote and evaluate the effectiveness of an existing mentoring program on intent to stay, perceived competency, and job satisfaction.

Methods: Institutional Review Board approval was obtained. A convenience sample of new nurses with less than 2 years’ experience in an academic medical center was recruited to assess their intent …

Simulation Use In Pre-Licensure Nursing Programs: Assuring Excellence In New Nurse Competence And Confidence, Suzan Griffis Knowles

Doctor of Nursing Practice Projects

Purpose: This program evaluation project aims were to review the current state of simulation experiences in pre-licensure undergraduate nursing programs in Washington State and determine policy recommendations related to the future use of simulation experiences in clinical nursing education. The evaluation compared student outcomes of NCLEX pass rates associated with clinical simulation versus traditional clinical nursing experiences. Programs were evaluated for compliance with INACSL Simulation Standards of Best Practice.

Conceptual Framework: The NLN/Jeffries Theory provided the framework for an analysis of program evaluation data regarding using the INASCL Simulation Standards of Best Practice.

Design/Method: The study design was a descriptive …

Enhancing Teamwork In Nursing Students, Heather Rawson

Doctor of Nursing Practice Projects

Abstract

The purpose of this project was to equip senior practical nursing students (n = 11) with the skills needed to increase their feelings of preparedness to join an intradisciplinary team in the workplace after graduation. This project utilized a pre-test/post-test design using TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) to determine if participation in TeamSTEPPS^® training and a simulation exercise enhanced perception of teamwork in senior practical nursing students. A paired t-test was performed to analyze the data collected from the questionnaires acquired before and after the TeamSTEPPS^® training. The results showed a t-value of 8.49, greater than …

Improving Sepsis Bundle Compliance Through Comprehensive Education, Stacy Mikel

Doctor of Nursing Practice Projects

Purpose: The purpose of this project was to improve emergency department compliance with sepsis bundles by educating registered nurses and licensed practical nurses on the proper use of sepsis screening tools, make changes to screening tools identified through chart reviews, and finally to evaluate the impact of these changes once initiated. This project sought to increase staff knowledge using an educational module.

Methods: This project began with the delivery of a pre-test questionnaire. The facility's target audience was asked to complete this to determine their current knowledge level regarding sepsis. Once these questionnaires were completed, they were reviewed, and information …

Unraveling Sex Trafficking Through Screening And Referrals, Rebecca Sarabia

Doctor of Nursing Practice Projects

Abstract

Human trafficking is a form of modern-day slavery; sex trafficking is one form of human trafficking. Previous research has demonstrated that most trafficking victims encounter the healthcare system at some point during their trafficking experience. Patients who have been sex trafficked may experience profound psychological and physical trauma. Healthcare personnel are in key positions to screen for trafficking and to provide appropriate referrals; if an awareness of the problem exists. The purpose of this project was to increase OB/Gyn office staff confidence with sex trafficking screening and to complete appropriate referrals to address the identified needs. The project began …

Promoting Empowerment And Innovation: A Technology Initiative, Theresa Marcotte

Doctor of Nursing Practice Projects

Improving empowerment through a supportive organizational culture can lead to innovation in practice and promote positive outcomes. Supporting employee empowerment, through a supportive organizational culture and environment, provides opportunities to innovate and creatively meet desired outcomes. Using these concepts, an Associate Degree Nursing Program empowered faculty to address a strategic planning opportunity to improve practice. The innovation, a Technology Initiative, provides opportunities for evidence-based testing practices, leading to improved, first-time pass rates on the National Council Licensure Exam (NCLEX). Technology use in the classroom can improve dissemination of nursing knowledge and retention strategies and therefore improve program retention. The utilization …

Simulation As Staff Development For Competency In Nursing Care Of Patients With Chest Tubes, Jennifer Dent

Doctor of Nursing Practice Projects

There is an estimated 98,000 to 400,000 hospital errors that result in patient harm or death annually (David, Gunnarsson, Waters, Horblyuk and Kaplan, 2013; James 2013). As a member of the health care team nurses coordinate and provide continual care to the hospitalized patient (American Association of Colleges of Nursing, 2011; Parker, 2014). Patient safety is promoted when nurses are competent in their knowledge, skills, attitude, and performance related to evidence-based practice, protocols, and standards of care (; American Nurses Association, n.d; Schroeter, 2009). The purpose of this evidence-based project was to promote patent safety by developing and maintaining competency …

Simulation In Assisting Nurses To Better Recognize Early Signs Of Clinical Deterioration Of Patients, Loretta Elder

Doctor of Nursing Practice Projects

The need to enhance the knowledge and skills of nurses caring for patients who exhibit signs of clinical deterioration has been validated in the literature. The literature has further supported the registered nurse as the key individual expected to recognize signs of clinical deterioration in the patient. The use of simulation as an effective teaching strategy has been well documented in the literature. The purpose of the project was to use simulation as an educational intervention to increase nurse knowledge, self-confidence, and competency when caring for patients exhibiting signs of clinical deterioration. The findings of this project are supported by …

The Effect Of A Facilitated Educational Program And Experiential Learning On Nursing Workplace Incivility, Nancy E. Armstrong

Doctor of Nursing Practice Projects

Workplace incivility is a well-documented issue in nursing. It has the potential to cause emotional and physical distress in victims, and potentially affect the quality of care provided. Research in acute care settings found that facilitated educational training sessions related to workplace incivility, in combination with experiential learning activities, assisted nurses in improving their understanding of workplace incivility and their communication skills. It has also been found to reduce workplace incivility. The purpose of this Capstone Project was to implement a civility training program that included education about incivility through facilitated discussions, as well as teambuilding exercises and experiential learning …

Evaluating The Effectiveness Of A Heart Improvement Toolkit Program: A Pilot Project, Cheryl L. Mitchell

Doctor of Nursing Practice Projects

Heart failure (HF) is a chronic, debilitating disease resulting in over one million hospitalizations with an estimated 30.7 million dollars in total health care cost per year (Go et al., 2014). Evidence shows that HF education programs that promote adherence to pharmacological and non-pharmacological provider recommendations are effective in reducing 30-day HF recidivism rates, increasing self-care behavior, and decreasing adverse clinical events. The purpose of this evidence-based project was to implement the Heart Improvement Toolkit (HIT) Program which is a one-on-one, comprehensive HF-specific education program, for patients with a HF diagnosis who have been admitted to non-cardiac specialty units. Program …