Medicine and Health Sciences Commons^™

Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …

Feasibility And Measurement Of Bedside Pumping In The Nicu: A Mixed Methods Study, Jessica Gomez

Dissertations & Theses (Open Access)

Abstract

Background: Supporting preterm infants with mother’s own milk (MOM) can improve health outcomes and decrease mortality.¹ Freshly pumped MOM, within four hours of expression, has the highest availability of bioactive components versus stored MOM. However, fresh milk is often not readily available due to the disconnected process of breastfeeding that occurs with preterm infants in the NICU. One convenient solution to improve access to fresh MOM is for the mother to pump at the infant's bedside. This intervention could improve the mother's pumping experience and provide the infant access to fresh MOM.

Purpose: This study aimed to evaluate …

Surgical Fire Prevention And Management: An Objective Structured Clinical Examination For Nurse Anesthesia, Tate Fazio, Kaleb Killens

Doctoral Projects

Sentinel events in health care are rare events, often corresponding with permanent injury or death. Fires in the operating room (OR) are one type of sentinel event. Although rare due to possible life-threatening injuries to patients and staff, appropriate surgical fire education is critical in nurse anesthesia education, as anesthesia providers play a significant role in surgical fires (Wunder et al., 2020). The development of simulation exercises has the potential for students to experience and become competent in managing high-acuity, low-frequency events, such as surgical fires (Wunder et al., 2020). The Nurse Anesthesia Program (NAP) at The University of Southern …

Moral Distress As A Predictive Variable Of Perceived Job Retention In Senior Nursing Students, Rebekah L. Barber

Honors College Theses

New Bachelor of Science in Nursing (BSN) graduate nurses are leaving careers within inpatient healthcare facilities presumably because of moral distress related to the anticipated workload of registered nurses (RN). BSN curriculums are responsible for providing practical education through clinical instruction; however, many students experience inconsistencies in best practice recommendations. The inconsistencies predominantly originate between didactic nursing instruction and clinical learning within inpatient healthcare facilities. Using a cross-sectional descriptive research design, this thesis utilized the validated Moral Distress Scale-Revised (MDS-R), a 21-item instrument that assesses the frequency and intensity of moral distress experienced by healthcare workers. Student responses to the …

Postpartum Visitation Policies, Jenna B. Holderman, Morgan E. Matthews

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Continual support for the birthing person during labor improves delivery outcomes and overall childbirth experiences. How many support people are present and their relation to the birthing person varies based on individual preference, family dynamics, and sociocultural expectations. During the Covid-19 pandemic, many hospitals implemented a one-visitor policy for deliveries. With these new guidelines in place, the length of hospital stays significantly decreased, and there were a variety of opinions towards these restrictions.

Purpose: The purpose of this study was to explore birthing persons’ overall sentiment towards visitors in the immediate postpartum period.

Methods: The current study analyzed …

Moral Distress In Critical Care Nursing: A Literature Review, Anna Tindell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Moral distress is a pressing concern in the healthcare field with significant implications for all areas of nursing and patient outcomes. However, those within the specialty of critical care nursing experience moral distress more frequently than those in other specialties. It arises from the complex ethical dilemmas nurses in critical intensive care units face as they work in these high-pressure environments. The purpose of this literature review is to discuss moral distress in critical care nursing and how it affects a nurse’s ability to provide quality care. Furthermore, this review will determine factors contributing to moral distress and potential interventions …

Attention-Deficit/Hyperactivity Disorder And Teachers, Samantha Ann Tierney, Samantha Ann Tierney

Honors College Theses

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common disorder, estimated to affect 5% of all children and adolescents. The current rate of diagnosis is steadily increasing. This increase in the number of students with ADHD affects educators, who have a large role in the success of students with ADHD. Despite this, many teachers are not prepared to deal with the extra challenges that come with teaching students with ADHD. Teachers may not be properly taught how to deal with children who have ADHD in their classrooms or the role they have in these children’s lives. The purpose of this study is to …

Transformational Leadership Training For Leaders, Kristie Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Exploring The Lived Experience Of Significant Other Caregivers Providing Care To Partners Surviving A Spinal Cord Injury, Lisa Ann Lumley

Theses & Dissertations

According to the World Health Organization, 250,000 to 500,000 people worldwide have suffered a spinal cord injury. Significant others may become caregivers responsible for meeting the needs of the dependent partner. The focus of this study is on significant other caregivers’ experiences providing care for partners after a spinal cord injury. The effects of stress from providing care may be detrimental to caregivers' psychological and physical well-being. Psychological distress, such as anxiety and depression in caregivers, is a significant public health issue that affects the quality of life for millions of individuals. There is a lack of studies focusing on …

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 …

Nursing Perspectives On Intimate Partner Violence Screening In The Emergency Department, Justin Cabrera

Dissertations, Theses, and Capstone Projects

Using descriptive and quality descriptive (QD) analysis, emergency department nurses from around the country completed a modified version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool to gain insight on their attitudes, knowledge, and preparedness about working with patient survivors of intimate partner violence (IPV) regarding their willingness to and comfort in engaging in IPV screening practices. In total, 1,523 responses were received from emergency department nurses currently or formerly in practice.

Findings show that there was no correlation between emergency department nurses’ education and training on IPV and willingness and comfort with IPV screening with …

Mandatory Child Abuse And Neglect Reporting Behaviors Among Registered Nurses In New Mexico: A Statewide Comparative Study, Ingrid Ann Wilson

Nursing ETDs

Child abuse and/or neglect (CAN) is a global problem. Although nurses are mandated CAN reporters, a lack of reporting has been an issue. New Mexico (NM) is faced with higher child poverty and CAN-related substance-abuse compared to other U.S. states. This quantitative study aimed to explore factors influencing intended/actual CAN reporting behaviors among NM registered nurses (RN)s, examine relationships of these factors, and compare differences in reporting behaviors between rural and urban locations. A survey to a sample of RNs (N=146) showed factors associated with CAN reporting intended behaviors were work status (r=.21, p < .05), cues to action (r=.20, …

Perspectives Of Home Care Nurses On Frailty And Resilience In Older Adults Living At Home, Lisa Foley

Seton Hall University Dissertations and Theses (ETDs)

The population of older adults is growing rapidly in the United States. As more people are living to an advanced age, they are often managing a multitude of chronic illnesses and disabilities while continuing to live at home. Frailty is a common condition that affects how one ages and the condition is associated with dependency and poor health outcomes. Resilience is considered to be a protective factor against health stressors that lead to frailty in older adults. Perspectives of home care nurses were obtained by semi-structured interviews which described how older adults live at home with frailty and demonstrate resilience. …

Utilizing A Reminder Tool To Improve Post-Hypoglycemia Recheck Rates On A Medical Surgical Unit., Laken Heitz

Doctor of Nursing Practice Papers

Diabetes is a growing epidemic with profound implications on the healthcare system. One of many possible complications is hypoglycemia, which is any value below 70 mg/dL. Inpatient hypoglycemia is a patient safety concern, and its treatment requires nursing adherence to strict protocols including a recheck within 15 to 30 minutes after treatment. However, evidence from the literature and project site demonstrated low rates of timely post-hypoglycemia rechecks. The purpose of this project was to provide education to all MIPS nurses regarding the utilization of a reminder tool for post-hypoglycemia rechecks. The intervention plan included reviewing the current hospital-wide hypoglycemia policy, …

Balancing Nurture And Rigour: Seeking Effective Support For Nursing Students In Distress, Marti Harder

The Dissertation in Practice at Western University

As higher educational institutions face a growing demand to graduate more nurses, and mental health and life stresses are recognized as increasing obstacles to student success, the timing is right for nursing programs to evaluate their traditionally rigorous program cultures. At Sunrise University in Western Canada, nursing students make up a large population seeking support services, and there is an increasing need for capacity building in faculty to support learners who are in distress. In this organizational improvement plan (OIP), I explore what can be enhanced or further developed to create more effective support for students who are in distress …

Shared Governance And Transition Into Practice: Impact On Work Engagement, Gudrun M. Reiter-Hiltebrand

Student Scholarly Projects

Practice Problem: High turnover rates, particularly in new graduate nurses, and poor organizational commitment and engagement negatively affect staffing, operational performance, and patient outcomes. A negative trend for nurse engagement indicators was noted in previous staff engagement surveys of this organization.

PICOT: The PICOT question that guided this project was: In transition-into-practice (TIP) nurses (P), how does the implementation of shared governance (I) compared with no shared governance participation (C), affect their engagement with the hospital (O) within eight weeks (T)?

Evidence: Literature has shown that nurse engagement is one of the nurse indicators positively affected by shared governance …

Evaluation Of Simulation On Medication Errors In The Pediatric Intensive Care Unit, Carrie Clark

Dissertations

Problem: Medical errors are the third leading cause of death in the United States, the most common medical error being medication error. Pediatric patients are at an increased risk of medication error due to medication dosage calculation and the use of frequent high hazardous drugs.

Methods: The quality improvement (QI) project implemented the use of descriptive observational design using retro and prospective data. The data was collected over a 4-week and 4-week period by gathering data via safety and environmental management survey (SEMS).

Results: The data gathered consisted of an increase in medication errors of 150%. The data collected yielded …

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 …

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

Implementation Of Clinical Institute Withdrawal Assessment: Alcohol Revised (Ciwa-Ar) Education Program In A Crisis Stabilization Unit, Amanda Dehart

Doctor of Nursing Practice Final Manuscripts

Background: At this time the crisis stabilization Units do not currently utilize the Clinical Institute Withdrawal Assessment: Alcohol Revised tool with patients who may experience Alcohol Withdrawal Syndrome. Patients with alcohol use disorders have a high comorbidity rate with psychiatric disorders (Butterfield, et al, 2020). The Clinical Institute Withdrawal Assessment: Alcohol Revised or CIWA-Ar is currently the most widely used assessment tool in the psychiatric setting when assessing patients who may be experiencing Alcohol Withdrawal Syndrome (Pribék, et al, 2021) .

Purpose of Project: The purpose of this project is to measure pre and post -education knowledge of the registered …

The Dedicated Education Unit: Increasing Capacity And Confidence, Heather Marie Van Housen

Doctor of Nursing Practice (DNP) Projects

Background: In the American Association of Colleges of Nursing (AACN) 2020 annual survey, nursing schools turned away 66,274 entry-level applications to baccalaureate nursing programs in the United States due to a faculty shortage and clinical placement sites (AACN, 2021).

Local Problem: Hospitals need more qualified nurses to meet community needs. The need for clinical faculty and additional clinical placement sites disrupts the workforce pipeline through local nursing schools. A new approach to clinical education is needed to prepare more students for the growing complexities of independent nursing practice.

Methods: Dedicated Education Unit (DEU) implementation to expand pre-licensure nursing student clinical …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Jillian J. Abinader

Master's Projects and Capstones

Problem: A sepsis protocol and bundle has been implemented in an urban Emergency Department to help screen patients and treat sepsis efficiently and effectively. The benchmarks from the bundle are not being met consistently every month and are below the targeted 90%.

Context: A microsystem assessment and a gap survey sent out to nurses, helped determine that there is room to improve nurses’ knowledge and confidence about sepsis and the sepsis bundle workflow. Sepsis is one of the most expensive and burdensome conditions in U.S. hospitals. Literature supports staff education to improve sepsis bundle compliance.

Intervention: A video was created …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Christopher N. Guinto

Master's Projects and Capstones

Problem: Results from a voluntarily anonymous pre-survey about sepsis revealed that a majority of the seventeen nurses assessed themselves below an "expert knowledge '' level. The survey results present an opportunity to improve the nurses’ knowledge and confidence in nursing response and improve patient outcomes with sepsis.

Context: The quality improvement (QI) project was conducted on a medical-surgical unit in a large Northern California hospital.

Intervention: A QI team initiated evidenced-based practice research and created an educational sepsis handout for nurses to increase sepsis knowledge and confidence.

Measures: The self-assessment pre-survey would be compared to the responses from the post-survey. …

Implementation And Evaluation Of A Diabetic Education Program, Brianna Cole

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to help create and evaluate a diabetes education program that was accessible to diabetic patients over the age of 18. This project was conducted through Enhanced Healthcare of the Ozarks clinic with the guidance and approval of the American Diabetes Association. There is currently one other diabetic education program available in Northwest Arkansas. The theme of this project was to provide education in individual and group settings regarding medication use, emergency situations, nutritional choices, and self-management techniques. These patients learned meal planning strategies, proper nutrition choices, functions of the body, self-management techniques, emergent situation …

Promoting Safety Through Advocacy And Practice: Nurse Input And Beliefs Regarding Hospital Fall Prevention Policies In The Inpatient Setting, Jimmy Milano

Doctor of Nursing Practice Scholarly Project

Throughout the evolving healthcare system, many issues in the hospital setting pose significant risk to patient safety and outcomes. Falls occur at detrimental rates that inevitably impact both the patient and the nurse. Of the several reasons one would choose to join the profession, nurses often seek the satisfaction of knowing the care they have provided impacted a patient, physically and spiritually. The healthcare system has allotted for variables in patient safety to promote safe outcomes and the reduction of fall risk, such as evidence-based practices and tools like cameras and assessments. However, the lack of nursing involvement in these …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

The Importance Of Charting And Documentation In The Nursing Profession, Charlotte J. Bradshaw

Honors Capstones

Honors Capstone Abstract

Nursing is a profession that can take you to endless different directions, not just in the hospital. Some may decide to work in a clinic, a school, or even laser hair removal centers. Although the setting and workday are different, one thing remains the same: charting. Charting is an everyday, every patient requirement for all nurses. Although this is unarguably one of most important skills to learn before becoming a nurse, most nursing schools do not have a class dedicated specifically to charting. This can create many problems for newer nurses who lack the experience and knowledge …

A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is a debilitating psychological condition that affects 3.1% of the American population and is one of the leading causes of disability (Anxiety and Depression Association of America, 2022; Baxter, 2014). The purpose of this evidence-based practice project was to implement a multimodal intervention to decrease GAD symptoms in adults in the primary care setting. The PICOT question that guided this project was: In adults, over the age of 18, who have been diagnosed with generalized anxiety disorder (GAD), does the combination of digital cognitive behavioral therapy (CBT) through a smartphone application, lifestyle modification education, and pharmacotherapy …