Medical Education Commons^™

Experiences Of Nurses And Nurse Leaders During The First Year Of The Covid-19 Pandemic: An Integrative Review, Jessica Powell

Nursing Research and EBP Day 2022

This research aimed to examine the experiences of nurses and nursing leadership who worked through the COVID-19 pandemic. Understanding their experiences will help better support those suffering from burnout. An integrative review was done by searching three databases in February 2022. Search terms included: burnout, compassion fatigue, Nurs*, leadership, and COVID-19. A total of 288 studies were retrieved, with 11 eligible for review. Seven themes were identified: information, safety, psychological and physical impacts on nurses, patient needs vs. pandemic needs, acknowledgment, protective factors and positive things from their experience, and changes in responsibilities. Understanding the nurses’ and nurse leaders’ experiences …

Ehealth@Home: Avoiding Readmissions For Heart Failure Patients, Krysta Harrington

Nursing Research and EBP Day 2022

The purpose of this evidence-based project was to reduce readmission rates for congestive heart failure (CHF) patients. It was hypothesized that targeted, nursing led care would reduce readmission rates. To test the hypothesis, we engaged patients post-discharge to enroll in eHealth@Home. eHealth@Home is a program at Rochester Regional Health (RRH) that serves high need CHF patients with frequent acute care utilization. These patients receive intensive monitoring and follow-up from a dedicated eHealth nurse, nurse practitioner and community health worker who work in tandem with a patient’s RRH provider to ensure that seamless and quality care is delivered. Visits were done …

Lost In Translation: Mitigating The Effects Of Language Barriers On Patient Outcomes, Megan R. Van Dorp

Nursing Research and EBP Day 2022

The purpose of this research was to describe the development, implementation, timeline, and future evaluation of an evidence-based initiative to improve the outcomes of limited English proficiency patients. It was hypothesized that bridging the communication gap between patients of lesser English proficiency and their healthcare providers would increase patients' participation and understanding of their hospital stay. Improving discharge instructions and ensuring comprehension would promote well-being and health as patients are adequately equipped at discharge to assume their own healthcare needs. To test the hypothesis, a literature search was conducted of professional databases. Fifteen scholarly articles contributed to the research base …

Development And Implementation Of An Ambulatory Nursing Shared Governance Council, Patricia K. Fioravanti, Maria Larner

Nursing Research and EBP Day 2022

The purpose of this work was to research, develop, and implement an ambulatory nursing shared governance council (ANSGC) to support the pursuit of Magnet designation within the Primary Care and Specialty Institute (PCASI) ambulatory care nursing environment at Rochester Regional Health. PCASI is comprised of over 115 practices located throughout 8 counties. Literature supports shared governance as a mechanism to increase nurse engagement, nurse retention, improve patient outcomes and promotes partnership between front line nurses and administration. Nursing Shared Governance is a pillar of the American Nurses Credentialing Center (ANCC) Magnet culture and a critical component of Magnet designation.

PCASI …

Nurse Driven Early Mobility In The Intensive Care Unit: Mobility Protocol And A Designated Mobility Champion, Intensive Care Unit, Newark-Wayne Community Hospital, Newark, Ny

Nursing Research and EBP Day 2022

Decreased mobility in hospitalized patients can lead to various health consequences, including increased morbidity and mortality. In the Intensive Care Unit (ICU), patients are not mobilized as frequently or as often as possible. Barriers to mobilization include limited resources such as time and staffing, perceived risk, and insufficient training in safe patient handling. This quality improvement initiative aimed to increase out-of-bed mobility in ICU patients, address activity orders at interdisciplinary rounds, and trial a designated mobility champion. The America Association of Critical-Care Nurses (AACN) Early Progressive Mobility (EPM) protocol and Bedside Mobility Assessment Tool (BMAT) were adopted and used to …

A Depression Screening Protocol For Acute Stoke Patients: A Quality Improvement Project, Celia Mcintosh

Nursing Research and EBP Day 2022

Background: Depression after stroke is common and is associated with poor functional recovery, suicidal ideation, decreased quality of life, and increased mortality. Despite this knowledge, poststroke depression (PSD) is often underdetected and thus undertreated. PSD is clinically important for the caregiver, the family, and the stroke survivor. Inconsistencies in screening and treatment practices may further contribute to these negative outcomes.

Purpose: The purposes of this evidence-based clinical scholarship project were to (1) determine the efficacy of an evidence-based depression screening protocol in improving early detection and treatment of PSD and (2) identify if there were any relationships between the protocol …

Rn Managed Warfarin Therapy Improves Patient Outcomes, Beth Ormsby, Stacee Marvin, Viktoria Leblanc, Ashley Harris

Nursing Research and EBP Day 2022

Warfarin, an oral anticoagulant, is a “high-risk” medication with narrow therapeutic range and risks for serious complications if not carefully managed. Therapeutic effect is determined using a blood test called the International Normalized Ratio (INR). Evidence shows a higher percentage of Time in Therapeutic Range (TTR) decreases the risk of adverse events including bleeding, hemorrhagic stroke, and death. An optimal TTR is 60 – 70% or higher. Improving TTR by 2.5 - 5% could significantly impact outcomes.

It was hypothesized that an algorithm based approach to Warfarin management by a consistent team of RN’s would improve TTR and outcomes.

To …

Immune-Related Adverse Event Management For Oncology Patients, Mary Beth Casselbury, Lori Davis, Sharon Wilson

Nursing Research and EBP Day 2022

Rapid advances in cancer immunotherapy using Immune Checkpoint Inhibitors have led to significantly improved survival of patients. Immunotherapy is also associated with multiple immune-related adverse events (irAE’s). The purpose of this research is to determine if reinforced patient education regarding early recognition/management of side effects/adverse events decreases serious immune-related events. It is hypothesized that utilizing a patient education plan may determine if these interventions can manage immune-related adverse events and thereby decrease the severity of these events.

Our team reviewed literature addressing follow-up care for Oncology patients receiving Immunotherapy. To promote efficient management of immune-related adverse events several major oncology …

Licensed Practical Nurses Working To Maximum Scope Of Practice, Lindsey Sippel, Lauren Sicker, Jessie Schiffhauer, Kristee Aliten

Nursing Research and EBP Day 2022

BACKGROUND: Nurses on 4800, a medical-surgical unit, were feeling overwhelmed by an increasing patient load due to Registered Nurse (RN) vacancies. No not only was staff morale at a low, but the staff was concerned about the impact on patient care. Nursing staff on 4800 consists of RNs as well as Licensed Practical Nurses (LPNs). As the team contemplated the high nurse:patient ratio, they identified that LPNs were not working to the full scope of their practice. The team began to wonder if ensuring that LPNs could work at the highest level of their scope of practice if this would …

The Safe Stay Program: For Care Of The Pediatric Patient Boarding In The Emergency Department, Kellie Rorke

Nursing Research and EBP Day 2022

The purpose of this evidence-based project was to explore alternative methods to address the process for admitted patients boarding in the pediatric emergency department. It was hypothesized that creating an intentional program of vigilance for safe care of the boarding pediatric patient via a pediatric admission care RN (PAC-RN), supported by interventions including on time medication administration, monitoring, and admission process education. Could reduce adverse events, total inpatient length of stay, morbidity and mortality and improve overall patient/family satisfaction.

A systematic literature search to review patient boarding in the emergency department was conducted. The literature reviewed supported the implementation of …

Early Mobilization For Critically Ill Adults: An Integrative Review, Jarvis Mcgrath

Nursing Research and EBP Day 2022

Objectives: Despite emerging evidence on the health benefits of early mobilization (EM) among critically ill patients, immobility and perceived barriers to EM persists. This integrative review aimed to summarize existing data on nurse-led EM, including how EM is defined, how EM protocols were developed, and key components of their protocol.

Methods: The protocol for this integrative review was developed in consultation with a trained librarian. A comprehensive search was conducted using the databases CINAHL, Embase, and ProQuest Nursing and Allied Health in April 2021. 6% of results were independently screened by 2 reviewers and the remaining were screened by a …

Evidence-Based Practice Liaisons: Supporting Ebp Across The Health System, Tami A. Hartzell, Susan Stell

Nursing Research and EBP Day 2022

No abstract provided.

Development Of Share: Supportive Holistic Anxiety Reducing Experience In Critical Care, Benjamin Lindsay, Judith V. Treschuk

Nursing Research and EBP Day 2022

The purpose of this research/EBP was to develop an evidence-based Interdisciplinary Family-Centered Communication and Support Program in the Surgical/Neuro Intensive Care Unit intended to provide the support that family members and patients need when admitted to the Surgical/Neuro Intensive Care Unit.

It was hypothesized that there is a way to support patients and their family members during their admission to the RGH SICU/NCCU through evidence-based practice decreasing their anxiety and dissatisfaction with communication with the interdisciplinary team. To test the hypothesis, an electronic literature review was completed in March 2021 and May 2021 for the most current research on family-centered …

Nicu Discharge Readiness, Sarah Kiley, Megan Adams, Jennifer Pacheco-Leyva, Paula Sedita, Brooke Swinton, Michele Wells

Nursing Research and EBP Day 2022

After days, weeks or months in the neonatal intensive care unit (NICU), families can be overwhelmed by the discharge preparation and the transition to home. Literature supports that inadequate preparation for discharge from the NICU increases family anxiety, risk for hospital readmission and emergency room visits, as well as infant care issues at home such as feeding difficulty. This quality improvement project was identified to improve and enhance discharge readiness in the NICU.

The project started with the development of a discharge readiness committee. After reviewing the literature, the committee met to identify areas in need of improvement which included …

Prioritizing Training Needs For Nurses In The Government Hospitals Of The Ha’Il Region, Saudi Arabia: Future Directions For Educational Developers, Eddieson Pasay-An, Hatem Homoud Alsrour

Makara Journal of Health Research

Background: The assessment of training needs can help establish the current performance or knowledge levels related to certain essential nursing activities. The purpose of this study is to determine the training needs of the staff nurses of the government hospitals in Ha’il Region, Saudi Arabia.

Methods: This study employed a cross-sectional–correlational approach with 230 staff nurses of the government hospitals in the City of Ha’il. Random sampling was used to ensure the representativeness of the sample.

Results: The nurses perceived training activities as very important (6.22 ± 1.09) in their work but performed the necessary activities only …

Evidence Based Practice Confidence In Nurse Residents, Cari Shaver, Stefanie Anderson, Emy-Lee Marie Anglo Ricafrente, Sandy Martir

2022 Southern California Nursing Research Conference

No abstract provided.

Exploring The Lived Experiences Of New Graduate Nurses During The Covid-19 Pandemic, Julie Youn

2022 Southern California Nursing Research Conference

Background

New graduate nurses (NGNs) in acute care settings are particularly vulnerable to the stressors inherent in nursing, due to the immense amount of experiential learning required at the bedside during the first year of practice. The high amount of stress experienced by NGNs is reflected in high turnover rates. Nurses with less than two years of experience accounted for almost half (47.5%) of all nurse turnovers in 2019. Furthermore, the COVID-19 pandemic has caused much physical and emotional turmoil in the nursing profession due to the increased workload and emotional distress. However, there are limited studies exploring the experiences …

Improving The Delivery Of Discharge Instructions On The Postpartum Unit By Increasing The Nurses' Knowledge, Judy Anne Settles

Master's Projects and Capstones

Abstract

The field of nursing prides itself on two critical functions: safety and patient education. One of the mechanisms for both education and safety is the discharge process. Improvements in the discharge process have been shown to increase patient comprehension and safety. This study is grounded in the (Barach & Johnson, 2006) healthcare organizational framework called the 5 Ps microsystems assessment to explore the impacts and improvements in the discharge instruction process on a postpartum unit in a large organization. It was found that HCAHPS scores regarding discharge instructions were 55-60%, which is below what is considered satisfactory. Utilizing the …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Multicomponent Approach To Delirium Prevention In The Acute Care Setting: An Evidence-Based Quality Improvement Project., Kelley James

Doctor of Nursing Practice Papers

Background: Acutely ill, hospitalized individuals are at an increased likelihood of developing delirium. Between 30-35% of those patients admitted to the hospital will develop delirium, and as a result, these individuals will face an increased risk of mortality, adverse medical events, restraint usage, and incur a more extended hospitalization. The literature supports early screening utilizing the Confusion Assessment Method (CAM) tool and nurse-driven, multicomponent interventions to aid in preventing its development.

Environment: This project was implemented in a long-term, acute care facility specializing in patients requiring long-term mechanical ventilation, advanced wound care, pulmonary and respiratory care, and the rehabilitation of …

Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason

Innovations in Health Sciences Education Journal

Due to workforce demands, new undergraduate nurses are hired directly into fast-paced units and are expected to manage complex patients with rapidly changing conditions and respond to time-sensitive situations. It is important for nurse educators to prepare undergraduate nurses for transition into clinical practice upon graduation. Simulation has been a valuable tool to provide experiential learning and promote clinical decision-making. The next iteration of improving clinical simulation as an experiential learning modality for nursing students is Immersive Virtual Reality (IVR): a realistic, immersive simulation in a 3-dimensional environment that is experienced by body movements and hand controllers. IVR can incorporate …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

Evaluation Of A Process Change Using An Updated Sedation Protocol, Rachel Allen

Dissertations

Problem: Pediatric delirium is continuing to increase intensive care environments and for patients who require mechanical ventilation and continuous sedative medications. Delirium is harmful to the patient creating lasting neurologic and mental health issues along with prolonged hospitalization and increased healthcare cost

Method: For this quality improvement (QI) project, a descriptive observational study was used to evaluate the implementation of a sedation protocol for patients who are mechanically ventilated and on continuous sedative medications. This was completed with the use of retrospective chart reviews three months prior to implementation and three months after the new protocol was implemented. Nurses were …

Reflection Of Mentors And Mentees At Initiation Of Faculty Mentorship Program At Aga Khan University: A Perspective, Rehana Rehman, Fauzia Khan, Naila Kayani, Tazeen Saeed Ali

Department of Biological & Biomedical Sciences

Objectives: To explore perception of mentors and mentees about 'Mentorship Program at Aga Khan University Medical College (AKU-MC) from a structured feedback form.
Methods: A retrospective study was conducted for evaluation of mentorship program at AKU-MC during the period from Jan 2019 to March, 2021. Responses on validated "Pre-intervention Probe Forms", from forty-seven mentors and fourteen mentees inducted in the program were reviewed. Confidentiality and anonymity of data were deliberated. All replies to each question were entered in a separate worksheet to determine the frequency and percentage of answers. Responses conveying same message, but worded differently were then grouped.
Results: …

Perioperative Risks Of The Patient With Heart Failure, Gabrielle Metoyer

Nursing Student Class Projects (Formerly MSN)

Perioperative Risks of the Patient with Heart Failure

Gabrielle Metoyer

Department of Nursing, Otterbein University

NURS 6810 – Advanced Pathophysiology

Dr. Deanna Batross and Dr. Shivani Bhatnagar

August 5, 2022

Abstract

According to the CDC (2020), heart failure occurs when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is an epidemic disease affecting 1-2% of the population worldwide (Schwinger, 2020). It is one of the leading causes of morbidity and mortality worldwide with an estimated 6.5 million adults with heart failure in the United States (Lo et al., 2021). Medical advances …

Implementing Antimicrobial Stewardship For Healthcare Providers In An Urgent Care Setting To Reduce Antibiotic Misuse For Respiratory Infections, Ashley Pauldin

Doctor of Nursing Practice Projects

Background: Antimicrobial resistance has been identified as a major threat by the World Health Organization (WHO), and antimicrobial stewardship is a key strategy to overcome resistance. A major contributing factor to this crisis is the inappropriate use of antibiotic prescriptions in outpatient settings. Although evidence-based guidelines on appropriate treatment for acute upper respiratory infections (URIs) have been developed, the need for improving provider and patient awareness and knowledge in the urgent care setting is critical.

Purpose: The purpose of the DNP project was to implement antimicrobial stewardship guidelines in the urgent care facility to decrease the misuse of antibiotic prescribing …

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …

Stroke Care: Achieving Recommended Door To Computed Tomography Times In Ambulatory Patients Presenting To The Emergency Department Of A Rural Hospital Through The Application Of American Stroke Association Guidelines, Ricardo Paitz

Doctor of Nursing Practice Projects

Background: Time matters in stroke care, and every second counts because the extent of irreversible neuronal damage increases over time (Saver, 2006). Therefore, the American Stroke Association (ASA) recommends a door to computed tomography time of 20 minutes or less for patients presenting with signs of acute ischemic stroke. This time metric in stroke care is often not met, resulting in the delay of care of patients which translates to poorer outcomes, including death and a decreased quality of life in patients who have suffered an acute ischemic stroke (Kamal, Sheng, et al., 2017).

Purpose: The purpose of this DNP …

Podium Presentation: The Positive Impact Of Attending A Regional Nursing Conference On Master Of Science Students Employed At A Magnet Designated Hospital, Elena M. Ybarra, Crystal Kahlich, Joann Long

2022 Providence Nurse Research Conference

No abstract provided.

Podium Presentation: Exploring The Lived Experiences Of New Graduate Nurses During The Covid-19 Pandemic, Julie Youn

2022 Providence Nurse Research Conference

No abstract provided.