Nursing Commons^™

Early Home Visits By A Registered Nurse Care Manager With Heart Failure Patients, Dana Davis Blake

Nursing Theses and Capstone Projects

Strategies focused on 30 days in the life of a patient with heart failure will have limited impact on the burden that heart failure will have nationally or individually. The broader landscape of readmission risk underscores the need for a more comprehensive approach to heart failure management. Care management with a registered nurse demonstrated efficiently coordinate care. Home visits address the peaks of risk in the post-discharge transition and palliative phase while providing longitudinal support. The purpose of this study is to substantiate that early home visits and telephone followup with a registered nurse after discharge from the hospital will …

Improving Patient Flow Through The Implementation Of A Results Pending Treatment Area, Heather L. Bryant

Nursing Theses and Capstone Projects

Abstract

The purpose of this research study is to retrospectively evaluate whether the implementation of a Results Pending Treatment Area (RPTA) altered patient flow patterns and therefore reduced patient length of stay (LOS) for ambulatory patients in a Level One Trauma Center Emergency Department. The research is justified because a reduction in the length of stay for patients is shown to decrease overcrowding, ED wait times, loss of revenue, and diversion while improving patient safety and patient satisfaction. The Roy Adaptation Model was the overarching theoretical conceptual framework utilized to support the research, with a more detailed emphasis on Swanson's …

Evidence Based Practice: Patient Discharge Education Barriers To Patient Education, Catherine Lyerly Lingle

Nursing Theses and Capstone Projects

Evidence-based guidelines for discharge instructions, when successfully administered, reduce readmission rates in patients, leading to improved quality of life and economic savings. Unfortunately, effective delivery is complex and time consuming, placing a high demand on already overworked bedside nurses. Failure to provide complete discharge instructions can result in non adherence to patient treatment regimens and lack of essential follow-up, the most commonly identified reasons for readmissions. To improve quality of care, hospitals need to adopt a new model that incorporates delivery of intensive, one on one education to patients during the hospital stay with continuing support, guidance, and education throughout …

Floating Nurses To Specialty Areas, Deborah S. Hickman

Nursing Theses and Capstone Projects

As the largest group of health care providers, nurses play a vital role in the safety and satisfaction of patients. Despite this vital role, the nursing shortage continues to grow. As a result of this shortage and to fix staffing insufficiencies, nurses are frequently assigned to work in an area that they are not familiar with. This reassignment of a nurse to a different unit from their normally assigned unit is referred to as "floating." Nurses that are reassigned to a different unit from their normally assigned unit are referred to as "float nurses." Some healthcare professionals believe the use …

A Standardized Wound Care Nursing Education Program, Craig Cardel

Theses and Graduate Projects

Patients with vascular wounds are medically complex and require registered nurses (RNs) with specialized education in vascular disease and vascular wound care to assess and freat their wounds. A standardized vascular wound nursing education program was developed for RNs at affiliate regional clinics to provide specialized education on types of vascular wounds, co-morbid diseases associated with vascular wounds, diagnostic procedr:res used to diagnose vascular diseases, treatments to improve vasculature to the wound, debridement of wounds, and wound care products used to treat the wound and promote healing. An interactive nursing education progrirm containing three nursing education modules was created for …

The Prevalence Of Smoking And The Knowledge Of Smoking Hazards And Smoking Cessation Strategies Among Hiv Positive Patients In Johannesburg, South Africa, Peter Waweru, R. Anderson, H. Steel, Wdf. Venter, D. Murdoch, C. Feldman

Internal Medicine, East Africa

Background: While the detrimental effects of smoking among HIV positive patients have been well documented, there is a paucity of data regarding cigarette smoking prevalence among these patients in South Africa.

Objectives: To establish the frequency, demographics, and knowledge of harmful effects and of smoking cessation strategies among HIV-positive patients in Johannesburg, South Africa.

Methods: A prospective cross-sectional survey, using a structured questionnaire interview, of HIV-positive patients attending the HIV Clinic at the Charlotte Maxeke Johannesburg Academic Hospital between 1 July 2011 and 31 October 2011.

Results: Of 207 HIV positive patients attending an ARV roll-out clinic, 31 (15%) were …

Oncology Nurses' Obstacles And Supportive Behaviors In End-Of-Life Care: Providing Vital Family Care, Renea L. Beckstrand, Joan Collette, Lynn Callister, Karlen E. (Beth) Luthy

Faculty Publications

Purpose/Objectives: To determine the impact of obstacles and supportive behaviors in end-of-life (EOL) care as perceived by hospital-based oncology nurses.

Design: A 69-item mailed survey.

Setting: National random sample.

Sample: 1,005 nurse members of the Oncology Nursing Society who had provided EOL care for patients with cancer.

Methods: Three mailings yielded 380 usable responses from 912 eligible respondents, resulting in a 42% return rate.

Main Research Variables: Size and frequency of EOL care obstacles and supportive behaviors for patients with cancer in a hospital setting.

Findings: Results of this research demonstrate the need for more EOL education and help in …

Emergency Department Nurses' Knowledge Of Evidence-Based Ischemic Stroke Care, Laura Traynelis

Kaleidoscope

No abstract provided.

Improving Outcomes Of Acute Coronary Syndrome Patients Through Disease Specific Care Certification, Terri Ginn Lemon

Doctoral Projects

Cardiovascular disease remains the number one killer of Americans, accounting for over 800,000 deaths in 2008. Improving a hospital’s performance by obtaining and maintaining The Joint Commission Disease-Specific Care Certification is one method of impacting acute coronary syndrome patient outcomes. The purpose of this capstone project was to provide consultation services to ready the cardiology division of a large community hospital in south Mississippi for the process of obtaining Joint Commission Disease-Specific Care Certification in the area of acute coronary syndrome. The activities of the consultation included facilitating an examination of the current organization of ACS patient care; reviewing core …

Emergency Nurses' Suggestions For Improving End-Of-Life Care Obstacles, Renea L. Beckstrand, R. Daniel Wood, Lynn C. Callister, Karlen E. (Beth) Luthy, Sondra Heaston

Faculty Publications

Introduction: More than 123 million ED visits are reported annually. Many patients who arrive for care to help extend their lives instead die while in the emergency department. Emergency departments were designed to save lives rather than to provide optimal end-of-life (EOL) care. Emergency nurses care for these dying patients and their families. The purpose of this study was to determine what suggestions emergency nurses have for improving EOL care.

Methods: Emergency nurses were asked which aspects of EOL care they would like to see changed to improve how patients die in emergency departments. Of the 1000 nurses surveyed, 230 …

The Last Frontier: Rural Emergency Nurses’ Perceptions Of End-Of-Life Care Obstacles, Renea L. Beckstrand, Virginia C. Giles, Karlen E. (Beth) Luthy, Lynn C. Callister, Sondra Heaston

Faculty Publications

Introduction: Caring for dying patients is part of working in a rural emergency department. Rural emergency nurses are prepared to provide life-saving treatments but find there are barriers or obstacles to providing end-of-life (EOL) care. This study was completed to discover the size, frequency, and magnitude of obstacles in providing EOL care in rural emergency departments as perceived by rural emergency nurses.

Methods: A 57-item questionnaire was sent to 52 rural hospitals in Idaho, Wyoming, Utah, Nevada, and Alaska. Respondents were asked to rate items on size and frequency of perceived obstacles to providing EOL care in rural emergency departments. …

Emergency Nurses' Perception Of Department Design As An Obstacle To Providing End-Of-Life Care, Renea L. Beckstrand, Ryan J. Rasmussen, Karlen E. (Beth) Luthy, Sondra Heaston

Faculty Publications

Introduction: Of the 119.2 million visits to the emergency department in 2006, it was estimated that about 249,000 visits resulted in the patient dying or being pronounced dead on arrival. In 2 national studies of emergency nurses' perceptions of end-of-life (EOL) care, ED design was identified as a large and frequent obstacle to providing EOL care. The purpose of this study was to determine the impact of ED design on EOL care as perceived by emergency nurses and to determine how much input emergency nurses have on the design of their emergency department.

Methods: A 25-item questionnaire regarding ED …

Program Evaluation Of Stroke In Rural Nevada Hospital, Starla Cheri Ricks

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall goal of this Doctor of Nursing Practice (DNP) scholarly project is to complete a program evaluation using the Centers of Disease Control (CDC) Framework for Program Evaluation to measure the effectiveness of a stroke protocol in a rural Nevada hospital. This (DNP) scholarly project evaluates program strategies over third and fourth quarters of 2010 as well as the first, second, and third quarters of 2011, that have been initiated to reduce the burden of neurological disease with the application of a stroke protocol that complies with defined evidence-based strategies for assessment and management of stroke victims. As part …

Redesign Of A Medical Crash Cart, Jozey Mitcham, Brittany Ireland, Tyler Towner, Scott Winston

College of Engineering Poster Presentations

For the 2011/2012 school year at Boise State University, the health science department has requested that a Mechanical Engineering senior design project be focused around the redesign of a medical crash cart. A crash cart, more commonly known as a code cart, is a set of trays, drawers, and shelves on wheels used in hospital emergency rooms for the transportation and dispensing of emergency supplies and equipment for use in cardiac emergencies. The current crash cart design is top heavy, unstable, inefficient, unorganized, and unsafe. In an attempt to increase functionality, efficiency, and safety, a new design is being developed …

Geriatric Trauma Patients In The Emergency Department: Length Of Stay, Intensity Of Care, And Post Ed Destination", Elanor Gates, Doris Warner, Meg Bourbonniere, Patricia Williams

Department of Nursing papers and presentations

Background & Purpose: Research on emergency department length of stay (EDLOS) suggests that increased LOS may result in worse patient outcomes and increased overall LOS. Additional research suggests that increased age may not only result in lower intensity of care for some patients but might also increase EDLOS. For geriatric trauma patients, intensity of care and EDLOS may be different from non-geriatric patients. Given the nature of geriatric traumatic injury, it is important to understand if improvements can be made in geriatric trauma services.

Study/Project Design: A retrospective descriptive study utilizing the hospital’s trauma registry data was completed, including patient …

Ventilator Associated Pneumonia Prevention In The Traumatically Injured Patient: Beyond The Bundle!, Cindy Umbrell Msn,Rn,Cns,Ccrn, Kenneth Miller Med, Rrt-Nps

Patient Care Services / Nursing

No abstract provided.

Workplace Violence: Emergency Department Versus Medical Surgical Nurses, Dakeita K. Roakes

Nursing Theses and Capstone Projects

The purpose of this study is to answer the following question: Does a registered nurses department, medical-surgical versus emergency department, change the amount of workplace violence they may experience? To accomplish this, a cross sectional descriptive study using an anonymous web-based Workplace Violence questionnaire survey by Wolters Kluwer Health was used to collect data from nurses working on medical-surgical units and in the emergency department at the facility. The findings indicate more physical violence with more frequent or occasional occurrences in emergency departments. The medical-surgical nurses reported more intimidation or emotional violence and never experience workplace violence.

Nurse's Perception Of Factors Associated With Family Satisfaction In The Intensive Care, Phyllis K. Buie

Nursing Theses and Capstone Projects

In health care, family satisfaction has become one of the most important and challenging competitive elements of the industry. The purpose of this study is to determine the factors associated with the Registered Nurse's perception of family satisfaction with services provided during a patient's hospitalization in the intensive care unit (ICU). Registered Nurses, with critical care experience within the past five years, were asked to rate factors that influenced family satisfaction in the intensive care using the Critical Care Family Satisfaction Survey (CCFSS) developed by Thomas Wasser (2001). Watson's Theory of Human Caring was used as the theoretical framework for …

The Effect Of Education On Healthcare Personnel's Knowledge Of Lymphedema Detection And Prevention, Dolly Wilson

Nursing Theses and Capstone Projects

Secondary lymphedema (SLE) is a serious problem for many of the 2.6 million breast cancer survivors in the United States. It is estimated that 28 - 38% of breast cancer survivors develop lymphedema. The five-year incidence ranges from 43% to 94% (Armer, 2010). The purpose of this study was to evaluate the effectiveness of an education program on healthcare personnel's knowledge of the risk of and preventive measures for upper limb lymphedema in breast cancer patients. A sample of healthcare personnel (N = 32) included both trained healthcare personnel and ancillary staff who are employed in a single oncology center …

Job Satisfaction Among A Multigenerational, Critical Care, Nursing Workforce, Sara Clay

Nursing Theses and Capstone Projects

Despite the slight ease of the nursing shortage due to the current recession, the United States is expected to still have a shortage of approximately 260,000 registered nurses by the year 2025 (American Association of Colleges of Nursing, 2011). Healthcare is an ever changing profession where nurses, no matter their generation, must learn to adapt to their constantly changing environment and expectations. Job satisfaction is a strong and constant predictor of retention and can vary greatly across generations. The purpose of this study was to get insight into generational differences related to job satisfaction and to use these data to …

Medication Errors: It's A Matter Of Time, Thomas D. Smith Jr.

Nursing Theses and Capstone Projects

A retrospective review of medication errors is presented as a measurement tool. Times of medication errors are separated into categories. The numbers of errors are associated with the numbers of medication administrations. The first data set contains errors that occurred within the first 8 hours of a 12-hour shift and the second data set contains errors that occurred during the last 4 hours of a 12-hour shift.

Data was obtained from a 108 bed critical care hospital in the southeastern United States. A time period will be reviewed between the months of September 2010 until August 2011. All reports of …

A Study Of Emergency Room Utilization Related To Poorly Controlled Asthma In Pediatrics, Leistey T. Wortman

Nursing Theses and Capstone Projects

Asthma is a disease of the respiratory system, which causes swelling and narrowing of the airways. Asthma is commonly seen in children. It is the leading cause of hospital stays and school absences. Hospitalization accounts for the single largest portion of the direct health care costs for asthma, estimated at nearly $18 billion a year (Everage, et al, 2010). Children with asthma may be able to breathe normally most of the time but when they encounter a substance that can cause problems (a "trigger"); an asthma attack (exacerbation) can occur (PubMed Health, 2011). The purpose of this study is to …

Neurological Outcomes In Induced Hypothermic States (Post Cardiac Arrest Resuscitation), Shonna Lee Bible

Nursing Theses and Capstone Projects

International studies indicate that induced hypothermia in successful Post Cardiac Arrest Resuscitation improves cerebral perfusion resulting in improved neurological function. Patients undergoing a neurological exam prior to induction of hypothermia may indicate potential mortality prognosis in this population. Literature Review indicated the use of the Glasgow-Pittsburg Cerebral Performance Categories for evaluation of neurological status in this population, but most institutions seem to utilize Glasgow Coma Scoring (GCS) in all patient populations for neurological examination. The purpose of this study was to determine if a neurological evaluation prior to and during the Induced Hypothermia state would affect the mortality outcomes in …

Emergency Departments And Stemi Care, Are The Guidelines Being Followed?, Dawn W. Hendren

Nursing Theses and Capstone Projects

The purpose of this study examined if an Emergency Department (ED) in a small rural hospital in western North Carolina is compliant with the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for obtaining Electrocardiogram's (ECG's), administering fibrinolytics, and performing Primary Percutaneous Coronary Intervention (PCI) on patients with chest pain diagnosed with ST-Elevation Myocardial Infarction (STEMI). The national standards for ECGs is less than 10 minutes from arrival to first medical contact (FMC) with triage nurse; for fibrinolytics, less than 30 minutes from arrival to FMC; and for FMC to PCI, less than 90 minutes. The …

Critical Care Nursing Interventions And Incidence Of Ventilator Associated Pneumonia In The Trauma Population, Kelli R. Moore

Nursing Theses and Capstone Projects

Ventilator Associated Pneumonia (VAP) in the Trauma Intensive Care Unit is the most commonly encountered infection in the intensive care unit and can be linked to increased morbidity, increased mortality, increased mechanical ventilation days, increased hospital length of stay, and increased cost. A retrospective, correlational study examined the effect of compliance with a ventilator bundle protocol in the Neuro-Trauma Intensive Care Unit on aggregate VAP rates. The study's primary focus was to determine if interventions performed by critical care nurses reduced the incidence of Ventilator Associated Pneumonia (VAP) in the Trauma Intensive Care Unit. The study utilized the retrospective collection …

Open Visitation Effects On The Critically Ill Individual, Melissa Mcneilly

Nursing Theses and Capstone Projects

The Intensive Care Unit has been known to be fast paced, stressful, and at times a loud atmosphere. Being a nurse in the ICU can be intimidating and being a patient can be frightening. Critically ill patients require close monitoring and supervision by the nursing staff. Many different aspects of care are crucial to the patients' recovery. Family members are an important part of a critically ill individual's recuperation. Different factors have an effect on the level of stress that a patient may experience while in the hospital. Critical Care Nurses were given a questionnaire to determine the beliefs and …

The Family Experience Of Participating In An Icu Support Group: A Pilot Study, Rebecca Marie Scharpe

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to describe the experience of family members participating in an intensive care unit support group. The family experience of an adult family member's critical illness is filled with emotional distress, suffering, and difficulty coping. Few family nursing interventions to care for family members of ICU patients have been researched. Research is inconsistent regarding the value of a support group in the ICU setting of a hospital. A qualitative design, using hermeneutic phenomenology was chosen. Five interviews were conducted with seven family members. The experience of participating in an ICU support groups was analyzed within …

Program...Validate...Infuse: Developing An Iv Infusion Validation Tool, Nancy Humes Bsn, Rn, Nicole Zimmerman Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

The Relationship Between Staff Nurse Perception Of Nurse Manager Leadership Behavior And Staff Nurse Job Satisfaction In A Hospital Applying For Magnet Recognition Status, Lorraine B. Bormann

Nursing Faculty Publications

Hospitals are challenged to understand factors related to staff nurse retention in the context of the nursing shortage slowdown (Huselid, 1995; Mancino, 2008; Mancino, 2009). Leadership is a major factor in organizational success (Gandossy & Guarnieri, 2008; Gettler, 2003; Wooten & Crane, 2003) and nurse managers are the direct link between the executive nurse leaders and the registered nurses (RN) in the staff position (Taunton, Boyle, Woods, Hansen, & Bott, 1997).

Studies show that nurse manager leader behaviors influence staff nurse job satisfaction (Blegen, 1993; Irvine & Evans, 1995; Lashinger & Finegan, 2005). A primary role of the nurse leader …

Code Simulations And Death: Processing Of Emotional Distress, Jane D. Leavy, Calvin J. Vanderhoff, Patricia K. Ravert

Faculty Publications

It is important for nursing students to be exposed to critical patient care scenarios because high stress clinical situations, such as patient codes, occur unexpectedly and infrequently in the clinical setting. In addition, it is important for nursing students to be exposed to the reality of patient death in order to help them overcome fears associated with death and to develop effective coping strategies. Students may or may not have an opportunity to deal with patient codes or patient death in the clinical setting, therefore simulation labs provide students with the opportunity to practice important clinical skills and discuss emotions …