Medicine and Health Sciences Commons^™

Admission Handoff Between Emergency Department And Inpatient Units, Amanda A. Briones

Master's Projects and Capstones

When admitting a patient from the emergency department (ED) to an inpatient unit, a handoff report is conducted. There are many ways the ED nurse can go about delivering this report to the inpatient or floor nurse. Each ED nurse tends to this task in their own way, providing the information they deem important. Due to the absence of standardization, handoff reports have the ability to lack important information regarding the patient and can even lead to compromising the safety of the patient.

The purpose of this project was to gain a comprehensive understanding of the current handover process of …

Recovery-Oriented Care And Inpatient Psychiatric Nursing Practice, Julia M. Mclaughlin

Master's Projects and Capstones

For the past 15 years, major organizations such as the World Health Organization (WHO), Substance Abuse and Mental Health Services Administration (SAMHSA), and U.S. federal government have been committed to shifting mental health services from the medical model of care to the recovery-oriented model of care (Moller & McLoughlin, 2013). However, not all identified recovery-oriented practices have been fully implemented throughout mental health services, specifically in acute care settings. In 2015, San Mateo Medical Center’s acute psychiatric nursing staff completed McLoughlin’s (2005) Recovery Self-Assessment- Registered Nurse (RSA-RN). Data showed that 34% of nursing staff did not believe that the nurses …

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects and Capstones

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys were …

An Apn-Led Copd Discharge Education Program To Decrease 30-Day Readmission Rates, Moira Elizabeth Kendra

Seton Hall University DNP Final Projects

The purpose of this project was to implement an APN-led COPD discharge education program to decrease 30-day readmission rates. This Doctorate of Nursing (DNP) project combined strategies obtained in the literature search and blended these into a cutting-edge and state-of-the-art discharge education program at a major medical center. The significance of chronic obstructive pulmonary disease (COPD) readmission rates include financial implications, a large number of Medicare patients who return to the hospital within 30 days, poor quality of patient care, and poorly coordinated discharge processes. An APN-led transitional care COPD education discharge plan was implemented on the pulmonary floor at …

Incidence Of Student Registered Nurse Anesthetists In The United States Who Own And Use Smartphone As Supplemental Learning Tools, Ruoyu Zhao

Doctoral Projects

Background: Smartphones have a great potential for students to learn more efficiently. Students now have the ability to download applications with pertinent information in the palm of their hand for both educational and clinical duties. This descriptive correlational quantitative research examines whether student registered nurse anesthetists own and use smartphones as supplementary learning tools.

Methods: An online survey was sent through AANA to Masters and DNP student registered nurse anesthetists (SRNAs) in the United States. Respondents were asked if they owned smartphones and how often they used smartphones for educational and clinical duties. Data Analysis was conducted using a Chi-square …

Utilizing Culturally Congruent Educational Interventions To Improve Native American Diabetic Outcomes, Laurie Ann Hamilton

Doctoral Projects

Native Americans suffer from diabetes type II at a proportionately higher rate than other populations. Management of diabetes in this population is problematic and compounded by multiple influences such as socioeconomic, cultural and linguistic variables. The purpose of this DNP project was to investigate cultural influences on Native American diabetic outcomes.

Do cultural influences act as barriers to diabetic medication, diet and education understanding? Would a Native American nurse applied education on medication, diet and exercise improve diabetic outcomes in a 3 month period?

A convenience sample of 6 Native American participants obtained at a primary care clinic were given …

The Meaning Of Nursing Education As Described By Students With Learning Disabilities, Jacqueline Lee Reep-Jarmin

Theses and Dissertations

The numbers of students with learning disabilities (LD) in post-secondary education settings is rising (National Center for Education Statistics (NCES), 2016). The Americans with Disabilities Act, Amendments Act was passed in 2008, since that time little research has been done to reflect any impact of the original ADA (1990) being amended. Research is needed about the experiences of students with learning disabilities in higher education, and more specifically nursing education. The purpose of this study was to develop an understanding of the lived experience of nursing education from the perspective of students with learning disabilities, and delineate the essence of …

Health Information System Implementation In A Complex Acute Care Environment: A Sociotechnical Analysis, Maximillian D. Besworth

Electronic Thesis and Dissertation Repository

With the increase of information systems in health care, there is a growing need to better understand factors that contribute to the implementation and use of such technology. This secondary analysis explored the implementation of a health information system in a large acute care hospital from the perspective of hospital leadership and the health information system developers. The purpose of this study was to: (a) explore a group of interprofessional leaders’ perceptions of social and technical factors which impacted an HIS implementation within an acute care hospital organization; and, (b) uncover how the various social and technical forces contributed to, …

Effects Of Pediatric Emergence Delirium Education On Analgesic Administration By Pacu Nurses, Melinda C. Nwanganga

Evidence-Based Practice Project Reports

Emergence delirium (ED) is a behavioral disturbance as a result of general anesthesia that commonly occurs in pediatric patients. Adverse effects of ED lead to a complicated recovery from anesthesia due to the risk of self-inflicted injury of patients, the disturbance of surgical incisions, the development of postoperative maladaptive behaviors, and the increased use of sedatives and analgesics resulting in prolonged recovery time and delayed discharge from the post-anesthesia care unit (PACU). Due to the multiple ramifications of ED, appropriate care is needed to promote a safe recovery from anesthesia and an optimum perioperative experience for these patients. As PACU …

Strategies For Optimizing Online Learning In Nursing Staff Education, Jodi Edlund

Nursing Capstones

No abstract provided.

Malignant Hyperthermia, Aaron Roth

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia is a rare disease trait and can take place in a variety of settings. If not treated in a timely manner, the consequences will be dire. It is recommended that nurses and other healthcare personnel be properly educated on MH crises. By detecting the signs and symptoms associated with the disease, providers can efficiently remedy the crisis and save patient lives (Seifert, 2014). Since the discovery of dantrolene in 1975 and the advancement of genetics regarding MH, death rates dropped from about 80% to about 5% (Schneiderbanger et al., 2014). Today there is a MH group called the …

Amyotrophic Lateral Sclerosis, Emily Stitzel

Nursing Student Class Projects (Formerly MSN)

Amyotrophic Lateral Sclerosis (ALS) is a terminal neurodegenerative disorder affecting an individual’s motor neurons. With a high prevalence affecting people in the United States of America, the progressive disease affects the lives of many. Once a patient is diagnosed, a short survival rate is to be expected. Importance for healthcare workers should be to focus on proper diagnosis, therapeutic communication, and palliative care. The pathophysiology is still under investigation; however, there have been breakthroughs regarding genetic alterations within the Cu/Zn superoxide dismutase gene (SOD1) and a large repeat on the C9ORF72 gene. By examining the signs and symptoms, doing the …

Gram-Negative Bacteria And Sepsis, Christine D. Ridge

Nursing Student Class Projects (Formerly MSN)

Today’s medical world encompasses an environment in which gram-negative bacteria that once were defeated with common antibiotics, have now become resistant. Gram-negative bacteria like Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterobacter, and Acinetobacter are pathogens that are an emerging threat causing sepsis due to multidrug-resistance (Pop-Vicas & Opal, 2014, p.189). The multidrug-resistance mechanisms of gram-negative bacteria coupled with a patient population commonly seen in hospital settings, that consist of immunocompromised adults due to advancing age, comorbidities (e.g. AIDS, history of transplants, diabetes, and chemotherapy), and immunotherapies, create an environment for advanced infection or sepsis to take place.

Complications of multidrug-resistant gram-negative bacteria …

Multi-Symptom Management In Hospice Patients During End-Of-Life Transition, Ashley N. B. Sirianni

Theses and Dissertations

The purpose of this quality improvement project is to compare the provider’s perception following an educational model of using single symptom management versus multi-symptom management during the end-of-life transition in adult patients for improved quality of life outcomes. The appraised evidence indicates that it is critical to have anticipatory medications at the patient’s residence to manage multiple symptoms rather than focusing exclusively on a single symptom management such as pain management. In February 2016, the author conducted an educational model among hospice providers for increasing knowledge and awareness of multi-symptom management. Thirty (n = 30) Clinical Nursing Directors, Licensed Practical …

Remote Hospitals And Hospital Value Based Purchasing, Nicole Adams

Nursing ETDs

The purpose of this study is to identify remote hospitals and then assess their performance in the first three years of the Hospital Value Based Purchasing program. A definition for remote hospital was created using clinical outcome literature and travel time. The hospitals were then identified as those hospitals more than 60 minutes driving time from the next nearest hospital by using geographic information systems software (n = 127). The remote hospitals payment adjustments and raw quality scores were be compared with non-remote hospitals. Remote hospitals have done well in the first three years improving their payments over time. However, …

Nurses' Workplace Social Capital: Development And Validation Of A Self-Report Questionnaire, Emily A. Read

Electronic Thesis and Dissertation Repository

Background: Social capital refers to resources created by and embedded in social relationships and has been identified as an important aspect of nurses’ work life. There is limited empirical evidence regarding its role and currently no valid and reliable self-report instruments to measure workplace social capital comprehensively.

Purpose: This study aimed to develop and test a self-report questionnaire to measure nurses’ workplace social capital and examine the nomologicial network of the concept including authentic leadership and structural empowerment as precursors of social capital and team effectiveness and patient care quality as outcomes.

Methods: A cross-sectional survey of 1,000 Registered Nurses …

Utilizing Tiger Competencies To Improve Informatics Practice, Kwun Ying M. Fung

Doctor of Nursing Practice (DNP) Projects

Nursing Informatics (NI) is quickly becoming an essential part of nursing. From the classroom, to the bedside, and to the boardroom, nurses across the nursing continuum are expected to use NI in their practice with the hopes of delivering better quality care to their patients. However, the training and education of NI provided to all levels of nurses is unable to keep up with the pace of technology. This project seeks to improve the NI competency of the nursing workforce at a pediatric hospital through an educational course using NI competencies identified by the Technology Informatics Guiding Educational Reform (TIGER) …

Quality Improvement: An Update For Outpatient Oncology Education, Nicole R. Gee

Master's Projects and Capstones

This project is focused on quality improvement in patient satisfaction with regard to side effect management after oncology patient education. The global aim of this project is to improve oncology-specific patient education through the development of an evidenced-based educational binder to be given to patients in a hospital outpatient infusion center and used as an educational guide for nursing staff. Effective standardized patient education has been seen to improve: satisfaction, quality of life, adherence, self-management, outcomes, and reduce unnecessary emergency room visits (Dalby, 2013; Mann, 2011; Smith et al., 2013). A rise in patient confidence for nausea and vomiting self-care, …

Developing Therapeutic Communication Skills: Integration Of Standardized Client Simulation In An Associate Degree Nursing Program, Kristine Weber, Timothy Farrell

UNLV Theses, Dissertations, Professional Papers, and Capstones

By the year 2020, it is projected that there will be a shortage of 300,000 to one million registered nurses in the United States (Juraschek, Zhang, Ranganathan & Lin, 2012). Therapeutic communication skills are a fundamental and integral part of any registered nurse’s practice. Despite the importance of therapeutic communication, evidence suggests that the lack of skill development in nursing programs is having an adverse effect on the NCLEX-RN pass rate of graduating registered nurses. Identifying and addressing shortfalls in effective communication offers an opportunity to improve this pass rate. Learning to effectively communicate in a simulated situation will provide …

Adolescent Grief: The Nurse's Role In Promoting Healthy Coping Mechanisms And Preventing Future Hospitalizations, Erica C. Reighard

Senior Honors Projects, 2010-2019

Age and developmental stage directly influence the grieving individual's ability to understand and process death. Adolescents are especially vulnerable to developing negative coping skills such as substance abuse, self-destructive behaviors, and eating disorders. After a loss occurs, nurses can use their role as a caregiver who is neither a parent nor a peer to provide adolescents with an opportunity to express their grief. Nurses can educate grieving adolescents on the differences between positive and negative coping skills and can therefore reduce the number of future hospitalizations related to ineffective coping mechanisms.

Operating Room Nurse To Post Anesthesia Care Unit Nurse Handoff: Implementation Of A Written Sbar Intervention, Erin Long

Evidence-Based Practice Project Reports

The lack of standardized handoff from the operating room (OR) nurse to the post anesthesia care unit (PACU) nurse may result in the miscommunication or omission of patient information, which increases the risk of patient safety events. The goal of this EBP project was to standardize OR to PACU nurse handoff in order to reduce risks to patient safety. A literature review revealed guidelines for handoff which included implementing a standardized protocol and using a mnemonic phrase. The Iowa Model of Evidence-Based Practice and Lewin’s Model of Change guided the EBP project. Handoff quality was evaluated by OR and PACU …

The Effect Of Heart Failure Education On Knowledge And Readmission, Sara A. Golden

Evidence-Based Practice Project Reports

Heart Failure (HF) is a chronic progressive disease affecting over 5 million individuals with an expected increase in incidence as the population ages (Yehle & Plake, 2010). The costs associated with managing HF continue to increase and the Centers for Medicare and Medicaid Services (CMS) have attempted to identify ways to improve patient management of HF to reduce the revolving door of hospital readmissions and decrease expenditures. According to 2006 data, as many as one fourth of the Medicare beneficiaries discharged from acute care to skilled nursing facilities (SNF) were readmitted to the hospital within 30 days and the majority …

The Fourth Color, April Emily Drafts-Johnson

Senior Theses

This thesis centers around short stories based on the student's favorite author, David Sedaris. Sedaris is a modern humor essayist who uses experiences from his daily life to create vivid, “real-ish” stories to entertain his readers. In nursing and in life, there are interesting tales to be told. The following stories are imaginative events that are based on the author’s personal experiences. Stories about family, coming of age, reflections on life, and fictional recounts of time spent working odd jobs in the hospital are all divided into five themes—the human experience, making the best of it, loss, darkness, and light. …

National Institute Of Health Stroke Scale (Nihss) Inter-Rater Reliability And Confidence Among Nihss Certified Nurses: Implementation Of A Standardized Patient Simulation, Kelly J. Trieglaff

Evidence-Based Practice Project Reports

The National Institute of Health Stroke Scale (NIHSS) is the most common stroke assessment used by nurses. Nurses certified on the NIHSS do not consistently demonstrate inter-rater reliability nor are they confident when assessing stroke patients using the tool (Josephson, Hills, Johnston, 2006). This EBP project evaluated a standardized patient simulation for maintaining inter-rater reliability and confidence in NIHSS certified nurses. A literature review showed that a decrease in inter-rater reliability occurs within four weeks to three months of NIHSS certification. A single cohort of intensive care nurses and emergency department nurses used the NIHSS tool in a standardized patient …

Impact Of Emergency Department Sepsis Policy, Lynette Rayman

Evidence-Based Practice Project Reports

Sepsis is a serious concern of key healthcare stakeholders due to high incidence, mortality, and cost. The objectives of this evidence-based project were to 1) identify potential sepsis patients early during the emergency department (ED) triage process and 2) implement Sepsis Order Sets. Kotter’s change model and the Stetler model of evidence-based practice guided this project. An extensive literature search was undertaken to find best practice evidence regarding care of sepsis patients. Recommended care includes a protocolized format utilizing a screening tool and point of care lactate levels for early identification of sepsis, and early treatment with antibiotics and fluid …

Becoming Baby Friendly: Rooming-In For Patient Centered Care In The Maternal Setting, Liana Macdonald

Honors College Theses

This thesis paper discusses the concept of rooming in on the maternity unit while pertaining to the QSEN nursing competency of patient centered care. Through an extensive review of the literature, the following question will be addressed: On the post-partum unit, does having the newborn rooming in with his or her mother improve patient-centered care compared to rooming in the nursery? After an introduction of the problem and its significance to patient-centered care, research that was conducted will be reviewed that discusses the importance of rooming in. A case example of a maternal-newborn couplet is provided, demonstrating the relevance of …

Nurse Educators' Use Of The Affective Domain Of Learning In Critical Instruction, Sarah Wagoner

Nursing (graduate) Student Scholarship

The purpose of this project was to explore the lived experience of nurse educators’ use of the affective domain in clinical post-conference at the baccalaureate level. Five nursing faculty members who provide clinical instruction to undergraduate nursing students were interviewed to explore the experiences and challenges of teaching within the affective domain of learning. Data saturation was reached after transcription and analysis of five participant interviews. Elicited data were coded for identification of common themes with researcher triangulation of raw data themes. Four themes that immerged were lack of knowledge in the affective domain, use of open-ended questions to illicit …

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention in …

The Effect Of Test-Taking Strategy Education On Kaplan Integrated Exam Scores, Nancy Frank

Nursing (graduate) Student Scholarship

Achieving minimum NCLEX-RN® pass rates is problematic for many nursing programs. Much research focuses on determining predictors of NCLEX-RN® success and preventing failure. Schools implement standardized content assessments to provide computerized test taking practice and identify at risk students. Using standardized content assessments as predictors allows for early remediation. Although many studies demonstrate a reactionary, multifaceted approach, proactive remediation potentially prevents a problem. However, current research provides poor indication of effective, generalizable techniques. Test-taking strategies typically combined with other interventions, show potential benefit, but limited research is available on effective methods. Cognitive behavioral test taking techniques and Mayfield’s Four Questions© …

Understanding The Preparation And Support Needed For Undergraduate Clinical Faculty, Sara Mcpherson

UNLV Theses, Dissertations, Professional Papers, and Capstones

ABSTRACT

Even as nursing programs attempt to meet public demands for more registered nurses in the workforce, they are challenged with finding qualified clinical faculty to teach them. Many programs have had to turn away otherwise qualified applicants due to lack of faculty. One solution to the shortage of nursing faculty has been to increase the number of part-time clinical faculty. Many clinical faculty hired for part-time positions hold degrees outside of nursing education. Additionally, new, full-time faculty are frequently expected to immediately begin teaching one or more clinical groups. While those new full-time and part-time faculty enter their role …