Medical Education Commons^™

Enhancing Education Of Medication Side Effects To Improve Patient Outcomes, Kyle R. Woolley

Master's Projects and Capstones

Patient satisfaction scores regarding how effectively staff educates patients about possible side effects of new medications are not consistently above the national average at a large metropolitan hospital in California (MHC). The results of these patient satisfaction scores shed light on the need for evidence-based strategies to improve a patient’s perception of the medication education provided to them. The basis of the incentive to improve care is ultimately increased safety and better patient outcomes. From the Root Cause Analysis, it became apparent that a few common barriers need to be addressed, but the one most frequently reported by everyone that …

Reinforcing Teach-Back Method Regarding Pain Management For Non-Verbal Patients And Their Families, Renee Krystle Doll Lazaro

Master's Projects and Capstones

Pain has been known to have physiologic, psychologic and emotional consequences. Education in pain management has been part for standard care for nurses. The purpose of this study was to reinforce teach-back techniques with nurses when delivering pain management education with non-verbal patients in order to improve patient outcomes in the adult ICU. By using the teach-back method, the nurse will be able to hone a more collaborative approach in dealing with pain, encourage autonomy and include the patient/family in making informed decisions regarding treatment for pain. Reinforcement regarding teach-back was focused on teaching points, and rewording teach-back cues to …

The Effectiveness Of A Preoperative Multimodal Antiemetic Regimen On Reducing Early Postoperative Nausea And Vomiting In Total Joint Arthroplasty Patients, Jerry Mosley

Doctoral Projects

Postoperative nausea and vomiting (PONV) occurs frequently in all types of surgeries including after total joint orthopedic procedures. The resulting PONV can lead to many unwanted occurrences including immobilization, distress, and many serious adverse health complications. These unwanted occurrences may then lead to increased cost to the patient and healthcare facility. Administration of a preoperative multimodal regimen known to reduce PONV has the potential to reduce such unwanted anesthetic side effects influencing a reduction in overall healthcare cost. The purpose of this study is to determine the effectiveness of the preoperative kit which includes the administration of metoclopramide, famotidine, ondansetron, …

A Simulation To Improve The Clinical Nursing Instructor’S Teaching Of Ethics To Students In The Clinical Setting, Cynthia S. Randall Dnp

All Student Scholarship

Ethical knowledge and skill is crucial to the discipline of nursing and is considered foundational knowledge for nursing practice (American Nurses Association [ANA], 2008). Nurses who assume roles in clinical teaching may be clinically competent but may have limited nursing education experience or knowledge in clinical instruction. The purpose of this project was to improve the educational experience of clinical instructors in the teaching of ethics to students in the clinical setting. This DNP capstone was a quality improvement project with a mixed method design using simulation as a teaching strategy. Eight clinical instructors from a university based baccalaureate nursing …

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Telephone Calls To Reduce 30-Day Readmissions For Older Adults With Heart Failure, Juanette G. Clark

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this evidenced based practice project was to evaluate the effectiveness of discharge follow-up calls for heart failure (HF) patients recently discharged from a private hospital.

Background: HF is the number one discharge diagnosis among patients 65 years and older. It affects 5.8 million people in the United States. HF admissions total (1) million annually, however, 24% of these patients are readmitted within 30 days of discharge. Re-hospitalizations are associated with high mortality rates and expenditures approximated at $13,000 per patient contributing to the overall annual expenditure of $33.7 billion. In 2012, the Centers for Medicare …

Implementation Of An Evidence-Based Educational Workshop And Toolkit: Menopausal Women's Healthcare Needs For The Primary Care Provider, Pamela Doerr-Kashani Dnp, Rn

Doctor of Nursing Practice (DNP) Projects

This evidence-based change of practice project involved the development of an educational workshop for primary care providers (PCPs). The intent of the project was to improve PCP’s knowledge of menopausal health, and to create their comfort level when discussing menopausal healthcare with clients. The workshop Menopausal Women’s Healthcare Needs for the Primary Care Provider (Doerr-Kashani, 2014) was created in response to an identified gap in knowledge among PCPs nationally on menopause-related health issues. The workshop was designed as a resource to support PCPs to competently address women’s menopause-related health issues, and enable them to provide comprehensive, evidence-based care within the …

In-Patient Self-Management Diabetes Education, Amy Matthews

Master's Projects and Capstones

The diabetes program strives to provide diabetes self-management education to the in-patient with diabetes. The specific aim is to improve and standardize diabetes education for the inpatient with diabetes by June 2015. The microsystem is a medical surgical unit for patients 18 years and older who present with diabetes as either a primary diagnosis or secondary diagnosis. Fifty percent of the diabetes patients on this unit are ages 65-89 years old, twenty nine percent are ages 50-64. The unit has 32 beds and is filled to capacity ninety five percent of the time. The fishbone diagram revealed our microsystem lacked …

Implementation Of Educational Program For Nurses To Improve Knowledge And Use Of Discharge Planning Best Practices, Eric C. Snyder

Doctor of Nursing Practice Scholarly Projects

Abstract

Problem Statement: The frequency and severity of hospital post-discharge events has become a national problem. The increase in readmission rates post-discharge has a negative impact on the patients overall morbidity and increases healthcare costs (Jack, 2012). Non-comprehensive discharge planning contributes to post-discharge events such as less than 30-day readmissions (Jack, 2012). Best practices for discharge planning should be utilized.

Purpose: The purpose of this project was to evaluate the impact of Project Re-engineering Discharge (RED) education to increase nurses' knowledge and use of best practices on discharge planning. An adapted Project RED educational intervention, using Knowles' adult learning …

Oral Wellness: Using Occupational Therapy To Enhance Oral Hygiene Delivery In Long-Term Care, Lauryn J. Banovitz, Liberty Bellah, Rosemarie Lion

Dissertations, Masters Theses, Capstones, and Culminating Projects

Based on current literature, oral health in long-term care (LTC) facilities is frequently of low priority and does not follow evidence-based best practices. Poor oral health reduces the quality of life of older adult residents and patients and can lead to systemic diseases, such as cardiovascular disease, stroke, and pneumonia, the leading cause of death in LTC. Occupational therapists can play an instrumental role as oral care consultants, and educators, and can act as resource guides to raise the standards of oral care in LTC facilities.

This capstone project explored ways in which occupational therapy, a profession traditionally designated for …

Efficacy Of Behavioral Interventions In African-Americans With Type Ii Diabetes: A Comparative Effectiveness Analysis, Tangela Nicole Hales

Dissertations

Context: The efficiency and effectiveness of the healthcare system are prime foci for nursing research.

Objective:The purpose of this study was to review and critically appraise the current state of the evidence in the treatment of African American adults with type II diabetes. To address this objective, a systematic review was undertaken that investigated the comparative effectiveness of behavioral interventions in improving glycemic control.

Methods: Robust methodological approaches to comparative effectiveness research (CER) serve to improve the transparency, consistency, and scientific rigor of the research. The methods for this systematic review of literature followed those recommended in the Agency …

Interprofessional Collaboration Between Occupational Therapists And Nurses In An Acute Care Setting: An Exploratory Study, Bethany Loy, Holly Micheff, Kelly Nguyen, Vincent O'Brien

Dissertations, Masters Theses, Capstones, and Culminating Projects

Background. Collaboration between occupational therapists and nurses is key to a positive prognosis for their patients. Currently, there is a gap in the research on professional relationships between occupational therapists and registered nurses in acute care settings.

Purpose. To examine interprofessional collaboration between registered nurses and occupational therapy in an acute care setting.

Methods. A phenomenological, qualitative design with use of semi-structured interviews was used. Interviewees were four occupational therapists and four registered nurses who currently work in acute care settings in Northern California and were recruited through a snowball, convenience and purposive sampling. Themes and subthemes that emerged from …

Clinical Effectiveness Of Inr Patient Self-Testing: Adults On Warfarin Therapy In Private Practice, Anisa Munshi

Doctor of Nursing Practice Final Manuscripts

Background: Warfarin is the most commonly prescribed oral anticoagulant for the prevention and treatment of venous thromboembolism. Due to its narrow therapeutic index, warfarin requires close monitoring of the international normalized ratio (INR) to ensure proper anticoagulation control and safety. INRs outside of this range are strongly associated with an increased risk of major bleeding, thromboembolic events, and death. Patient self-testing (PST) using a point-of-care device allows patients to monitor INR results at home. Evidence shows that PST improves the clinical outcomes of warfarin therapy compared to usual care, which includes laboratory INR monitoring. Purpose: To compare the clinical effectiveness …

I'Ve Been Diagnosed: A Champion! Crohn's & Colitis Family Day, Samantha M. Goldberg

Honors College Theses

This Honors thesis outlines the creation of “I’ve Been Diagnosed: A Champion! Crohn’s & Colitis Family Day”—an experience designed to provide Southeast Georgia children and families affected by inflammatory bowel disease (IBD) an opportunity to enhance community involvement and build a support network through therapeutic recreation, team-based activities, education, and a positive family-centered environment. Following the nursing process focusing on the community as the patient, this paper is organized by assessment, diagnosis, planning, intervention, and evaluation. A literature review was conducted and interviews with a medical professional and a patient were completed. Specific interventions were planned using the nursing process …

Diffusion Of Inclusion: Measuring Willingness, Janet A. Levey

Dissertations (1934 -)

The purpose of the study was to: (1) examine psychometric properties of the Willingness to Adopt Inclusive Teaching Strategies (ITSinNE) instrument and (2) measure factors influencing a nurse educator's willingness to adopt inclusive teaching strategies based in universal design for instruction (UDI). Universal design for instruction (UDI) is one approach to facilitate multiple ways of learning and evaluation in various learning environments for all learners; however, it is not well known or researched in nursing education. Diffusion of innovation theory (Rogers, 2003) and universal design for instruction (McGuire & Scott, 2006) provided the theoretical framework for the study. A cross-sectional …

The Effect Of In Situ Simulation On Teamwork Attitudes In Nursing Students, Janice Kaye Fuson

Nursing Theses and Capstone Projects

Nursing students are not adequately trained in teamwork principles. Positive teamwork has been identified by governmental and accrediting bodies of healthcare to be an essential element in patient safety. TeamSTEPPS© is a program developed by the Department of Defense adapted to healthcare as a cost effective method to change the culture of healthcare organizations. A capstone project that implemented in situ simulation using a TeamSTEPPS© tool was conducted in a rural North Carolina nursing program. Eighteen students participated in the simulation and completed a pre and post TeamSTEPPS© Teamwork Attitude Questionnaire. Mean scores were noted to be considerably lower post …

Evaluating Chain-Of-Command Self-Efficacy Through High Fidelity, Student-Directed, Obstetrical Simulation, Michelle Mcewen-Campbell

Nursing Theses and Capstone Projects

The purpose of this quasi-experimental capstone project was to evaluate the impact of high fidelity, student-directed, obstetrical simulation upon chain-of-command self-efficacy of baccalaureate nursing students. The convenience sample, composed of 48 junior nursing students, was randomly divided into four simulation groups, and then further randomly divided into active or observational status. Active participants planned interventions and participated in high fidelity obstetrical simulations related to patient safety and chain-of-command initiation. Active and observational students participated in a combined debriefing session. A pretest posttest design utilizing the General Self-Efficacy Scale (GSES) was utilized to measure chain-of-command self-efficacy in relation to both active …

The Impact Of Simulation-Based Learning Experience On Student Satisfaction, Perceived Self-Confidence, And Anxiety, Michelle Britt Warren

Nursing Theses and Capstone Projects

Nurse educators are faced with the challenges of facilitating student learning in shorter time frames along with decreasing student opportunities to further their learning experiences in real-world clinical situations (LaFond & Van Hulle Vincent, 2012; Smith & Barry, 2013). There is an identifiable need for safe environments where students can practice and apply the knowledge they have learned in the didactic component of the course to the clinical situations (LaFond & Van Hulle Vincent, 2012; McClure & Gigliotti, 2012). The capstone project, "The impact of simulation based learning experience on student satisfaction, perceived self-confidence and anxiety" examined the implementation of …

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 …

Academic And Non-Academic Variables As Predictors Of Nclex-Rn Success Among Traditional Associate Degree Students At Southern Adventist University, Christine Moniyung

Dissertations

Problem

The School of Nursing at Southern Adventist University offers both Associate of Science and Bachelor of Science in nursing degrees. A majority of the students who sit for the NCLEX-RN are associate of science in nursing graduates. The pass rate dropped from 94.9% in 2010 to 88.8% in 2011. The pass rate went up to 93.3% in 2012, but dropped again by almost 5% in the following year, and to an all-time low of 76.5% in 2014.

Unlike most AS nursing program student populations in the nation, the majority of SAU students are young and considered traditional-age college students. …

The Use Of Peer Video Via M-Learning To Teach Essential Nursing Skills, Elizabeth Hall Carver

Nursing Theses and Capstone Projects

The purpose of this project was to compare adding an additional educational intervention (the use of an instructional peer video on a mobile device) to standard practice in the skills lab to teach the skill of male and female urinary catheterization and the removal of a urinary catheter. The project had a quasi-experimental design, without control, and utilized a convenience sample of 31 pre-licensure nursing students. Failure rates at skills evaluation were compared between the previous semester A (fall 2014) and semester B (spring 2015). Semester B was subdivided into two groups, with approximately half in the traditional instructional B1 …

Improving Attitudes Toward Interdisciplinary Collaboration Between Nursing And Medical Students In Simulation, Kristy H. Williams

Nursing Theses and Capstone Projects

This capstone project assessed whether a curriculum change for senior nursing students could have an impact on improving attitudes toward physician-nurse collaboration. A convenience sample of 60 senior level nursing students and eight residents were enrolled in the study. The nursing students and residents participated in a high-fidelity simulation scenario, and were given a pretest and posttest using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. There was strong evidence (t= -1.971, p=.05) that the attitudes of physician-nurse collaboration improved for nursing students through a simulation based scenario with residents. The confidence interval for the difference was (-0.22, 0.002). Although …

Navigating Independent Double Checks For Safer Care: A Nursing Perspective, Danielle D. Grant

Honors Theses and Capstones

Abstract

The purpose of this study was to explore registered nurses’ understanding and practice of “independent double-checks” prior to administration of high-alert medications. The study used a qualitative descriptive design for data collection and data analysis. It included thirteen participants from a hospital located in southern New Hampshire. Results of the study revealed a core theme of navigating independent double checks (IDC) for safer care. Two major themes stemming from the core theme were also uncovered. Navigating IDC through knowing and navigating IDC through nurse partnership both focused on the perception and practice on IDC prior to administration of high …