Nursing Commons^™

Developing Clinical Judgment Through The Implementation Of Information And Communication Technology, Such As The Electronic Healthcare Record (Ehr), Sherri Carter

Nursing Theses and Capstone Projects

Graduate nurses are expected to enter a technology-rich workforce with an understanding of the electronic health record (EHR) and how it is used to guide patient care. Limited access to EHRs in clinical settings may result in students entering professional practice with limited ability to understand the full potential of the EHR. Over a seven-week term, students enrolled in the Patient-Centered Care I course, during the 2018 Spring I term, participated in high-fidelity simulation and seminar activities that included an educational electronic healthcare record (EEHR). These activities were integrated into the course to guide students when making clinical decisions regarding …

Identifying Nurse’S Perspectives And Practices About Clinical Monitor Alarm Burden And Alarm Fatigue., Doreen M. Legere

DNP Projects

PURPOSE: To obtain insight into the nursing culture of the University of Kentucky Medical Center (UKMC) regarding alarm fatigue, measure nuisance alarm events, and identify the practices nurses at UKMC engage in to manage alarm pollution and mitigate alarm burden. Moreover, this practice improvement project identified how innovations like the introduction of a monitor watcher has impacted the rates of nuisance alarms and influenced nursing culture.

METHODS: A online survey based on the 2011 Healthcare Technology Foundation Alarms Survey (HTF) was sent to nurses in two intensive care units at UK Healthcare (UKHC). The results of the 2017 UKHC Alarm …

Data Aggregation Reporting Tool For Implementation In Home Health Fall Reduction Program, Jose Alberto Cruz

Master's Projects and Capstones

Abstract

Falls are a major preventable problem in healthcare that affects people of all ages but disproportionately affects the frail and elderly. Fall reduction programs play a significant role in reducing falls and fall related injuries and are a critical component in Home Health settings. This project takes place in a home health and hospice services agency. The purpose of the project consisted of aggregating fall data for benchmarking metrics to bring the agency’s Fall Reduction Program closer to compliance with state and national fall prevention guidelines. Two hundred and three fall event reports were analyzed and a problem arose …

Implementing Computerized St-Segment Analysis Utilizing 5-Lead Ecg Cables During The Perioperative Period For Myocardial Ischemia Detection In Patients At Risk For Cardiovascular Disease, Lauren Robertson

Doctoral Projects

Cardiovascular disease (CVD) is one of the leading causes of death in the United States (U.S.) annually (Centers for Disease Control and Prevention, 2011). Mississippi has a disproportionately higher percentage of citizens likely to have CVD (Mississippi State Department of Health [MSDH], n.d.). The numerous stressors related to surgery are alone enough to increase the demand of the heart and lead to ischemia of the myocardium. Surgical stressors combined with preexisting CVD can exponentially increase the risk of ischemia. It is estimated that over a third of all surgical patients have ischemic heart disease. Puelacher et al. (2015) reported 40% …

The Development Of A Wayfinding Smart Phone Application As A Large Healthcare Facility Investment Opportunity, Jessie Fortson Marshall

Doctoral Projects

Health care is a continually growing field. New hospitals are constantly being built, while older facilities are experiencing renovation and expansion. With this growth comes a set of difficulties for patients as they try to navigate through large, multi-building facilities. Most large facilities have multiple parking garages, numerous buildings, and medical towers with an unending number of floors. Patients are forced to rely on directional signage to find their destination that is often insufficient. Attempting to navigate through large facilities is often overwhelming for visitors leading to frustration and stress.

New technology has allowed a convenient solution to this problem …

Burnout Syndrome In Hospital's Nurses: Causes And Consequences, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse, David P. Paul Iii

Management Faculty Research

PURPOSE: The purpose of this research was to examine the causes and consequences of Burnout Syndrome among RNs in U.S. hospitals to identify solutions to this problem.

METHODS: The methodology was the review of the literature and a semi-structured interview. There were seven primary databases and two websites used in this research, and 35 articles were used for this literature review.

RESULTS: Causes and risk factors of burnout syndrome among RNs have been categorized into four major areas: individual, management, organizational, and work characteristics. Burnout syndrome rate among RNs with age under 30 years was 43.6% higher …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Implementing The Weefim System In Outpatient Pediatric Rehabilitation, Chelsea Ratilainen

Master's Projects and Capstones

Abstract

This project was designed to achieve an unmet criteria in the accreditation process for the outpatient pediatric rehabilitation program at a local, community hospital in the greater Bay Area. The clients range from 6 months old to 20 years old with functional disabilities. The Commission of Accreditation of Rehabilitation Facilities (CARF) requires that applicants demonstrate outcome measure data over a 6 month time period. During the self-evaluation process this was noted to be a deficiency in the department’s efforts. The WeeFIM system was chosen as the first tool to implement in the department. This is a functional improvement measurement …

Business Intelligence Competencies: Making Healthcare Data Come Alive, Christina Bivona-Tellez

Doctor of Nursing Practice (DNP) Projects

Business Intelligence Competencies: Making Healthcare Data Come Alive While a wealth of healthcare related data exists, nurse leaders (NL) have yet to understand its implications and adopt analytical skills to lead in the transformation of care delivery. Information science is at a new frontier for nursing to embrace. It is critical for nursing leadership to advance and support business intelligence (BI) and interactive data visualization (IDV) skills across the organization and advocate for greater engagement of nurses in health system decision making. With these new tools and competencies, nursing and other health professions can innovate best practices, providing enhanced quality, …

Implementation Of An Innovative Early Warning System: Evidenced-Based Strategies For Ensuring System-Wide Nursing Adoption, Shirley S. Paulson

Doctor of Nursing Practice (DNP) Projects

Early deterioration in adult medical-surgical patients is associated with increased intensive care unit and hospital mortality (Goldhill, 2001). Failure to recognize deterioration is a preventable patient safety and quality issue. To address this problem, since 2013, Kaiser Permanente Northern California (KP NCAL) has piloted Advance Alert Monitor (AAM) at two hospitals. This early warning system employs a set of predictive models developed by the KP NCAL Division of Research, which automatically predicts patient deterioration within the next 12 hours based on a complex algorithm of laboratory and clinical data points. Improvements in mortality and length of stay have been realized …

Text Messaging Appointment Reminders To Increase Patient Appointment Adherence Within A Prevention And Wellness Program, Janel Willingham

Graduate Theses, Dissertations, and Capstones

Abstract

Healthcare organizations want to provide quality care, decrease costs, and promote preventative services for the communities they service. Mobile health units have become an extension of many healthcare organizations and provide different types of services, such as mammography. Providing mammography and wellness exams on a mobile unit presents several challenges; appointment adherence is one of them. Mobile units typically travel to underserved areas to serve people at risk for various health conditions such as breast cancer. Breast cancer is estimated to affect over 250,000 women in the United States during 2017; women have a 1:8 lifetime risk of being …

Implementation Of Best Practice Of Simulation Design, Sharon Faye Creed-Hall

Nursing Theses and Capstone Projects

The use of simulation has increased in the academic setting. The placement for nursing students for clinical sites has become increasingly difficult. In order to meet the demands of clinical sites, State Boards of Nursing have created standards where simulation can replace clinical rotation. Most State Board of Nursing require the school of nursing to meet the International Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: SimulationSM, use a theory for debriefing, and show proof of current simulation education for the educators. The Simulation Design project implemented the National League for Nursing (NLN) Jeffries Simulation Theory, the …

The Calm Project: Teaching Mindfulness Meditation In Primary Care Using Computer-Based Application, Vanessa Norton

Nursing Theses and Capstone Projects

Mindfulness-based interventions (MBI) have been studied extensively and the evidence is now credible that even brief techniques, delivered electronically using web-based applications (apps), easily accessed by smart phone, computer, or tablet, are consistently effective at anxiety reduction as well demonstrating efficacy in other commonly occurring comorbidities such as depression, stress, and panic symptoms. The purpose of this DNP project was to examine feasibility and the effect of the app, Calm.com, on anxious adult patients in primary care, using the Recovery Alliance Theory as its theoretical foundation. This pilot study was longitudinal, using a pre-test/post-test measurement of the Generalized Anxiety Disorder …

Telehealth And Ehealth In Nurse Practitioner Training: Current Perspectives, Carolyn M. Rutledge, Karen Kott, Rebecca Poston, Christianne Fowler, Tina S. Haney

Ellmer School of Nursing Faculty Publications

Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this …

The Effect Of A Culturally Tailored Web-Based Physical Activity Promotion Program On Asian American Midlife Women’S Depressive Symptoms, Wonshik Chee, Sangmi Kim, Xiaopeng Ji, Sooyoung Park, Eunice Chee, Hsiu-Min Tsai, Eun-Ok Im

Asian/Pacific Island Nursing Journal

The benefits of physical activities on depressive symptoms have increasingly been reported in the literature, but the effect through which a Web-based physical activity promotion program alleviates depressive symptoms is not clearly known, especially among ethnic minority midlife women. The purpose of this pilot randomized control study is to examine the preliminary efficacy of the Web-based physical activity promotion program in enhancing the depressive symptoms of Asian American midlife women through increasing physical activity. This study adopted a randomized repeated measures pretest/posttest control group design. This study consisted of two groups of research participants: 18 in an intervention group and …

Electronic Communication Among Anesthesia Providers, Joseph K. Wells

Doctoral Projects

Facilities in the United States are utilizing electronic communication devices (ECDs) for their nursing staff on intensive care units, general medical-surgical floors, and chemotherapy floors, but it is underutilized in the operating room where seconds truly matter (Wu et al., 2012). Situations arise daily within operating rooms that require quick and decisive communication to avoid poor patient outcomes. The ultimate goal is to prevent poor patient outcomes by enhancing communication among anesthesia providers.

This doctoral project evaluated an anesthesia group in southeast Mississippi regarding their satisfaction with current devices used for communication. This anesthesia group utilized smart phones and public …

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 …

Bedside Nurses' Perceptions Of Intensive Care Unit Telemedicine In A Rural Setting, Susan Parker

Nursing Theses and Capstone Projects

Healthcare is a rapidly changing and continuously advancing field. Currently, virtual care technology (e-ICU) is moving into many rural healthcare facilities in an effort to improve patient care outcomes and bridge physician and nursing shortages. The purpose of this Masters of Science thesis is to determine the impact that electronic telemedicine has on the quality of nursing care at the bedside. The study done by Mullen-Fortino et al. (2012) in an urban academic center was replicated to compare the bedside nurses’ perception of ICU telemedicine in a rural hospital setting. Thirty-eight rural ICU nurses working with ICU telemedicine responded to …

Transitioning Novice Nurses To Expert Nurses In Progressive Telemetry Care, Timothy E. Fraley

Nursing Theses and Capstone Projects

New nurses do not possess the clinical skills necessary to thrive in a fast-paced, rapidly changing telemetry unit. The study explores the idea that nurses with less than two years’ experience may not have the self-confidence or experience to begin a career on a telemetry unit. A search of the literature was performed to identify the skills needed to be successful in a critical care telemetry unit. Established orientation programs, nurse internships, and nursing experience were the keywords researched. Patricia Benner’s Theory: From Novice to Expert Excellence and Power in Clinical Nursing Practice (1984) serves as the foundation for this …

Ua61/1 Nursing Spirit, Volume 1, Neal Chambler, Dean, Mary Bennett, Director, Susan Megahee, Editor, Creative, Wku School Of Nursing

School of Nursing Publications

No abstract provided.

Use Of High-Fidelity Simulation Training For New Cardiothoracic Intensive Care Unit Nurses, Bryan Boling

DNP Projects

Critical care nursing is one of the most challenging, high-stress fields in healthcare. This is especially true for nurses in the highly specialized environment of the cardiothoracic intensive care unit (CTICU). The experience level of nurses in critical care is positively linked with patient outcomes; however, with older nurses retiring or moving away from the bedside and younger nurses increasingly moving into advanced practice or management and leadership roles it is becoming more difficult to maintain a high degree of nursing experience in the ICU. Simulation training has been used to provide safe, effective training, and it is even possible …

Meaningful Use: Secure Electronic Messaging And The Use Of Mychart, Dava O. Helton

DNP Projects

Purpose: The purpose of this project was to understand providers’ views of electronic messaging through MyChart and find out the essential tools needed to comply with Stage 3 criteria of Meaningful Use. The objectives were to: 1) Discover providers’ current thoughts/opinions about electronic messaging, 2) Identify perceived benefits and barriers to using secure electronic messaging between providers and patients, and 3) Discover the perceived essential tools needed to meet Stage 3 criteria.

Methods: A needs assessment was performed through a provider survey. Providers at primary care offices with reliable Wi-Fi were approached about the project. Volunteer participants were given a …

Factors Influencing Perceptions And Attitudes Of Nurses Towards The Use Of Ict In Patient Care In Kwazulu Natal Province, South Africa, Stephen M. Mutula

The African Journal of Information Systems

This paper presents the results of a study to determine factors influencing perceptions and attitudes of nurses towards the use of ICT in 16 hospitals in KwaZulu-Natal (KZN) province, South Africa. Data were collected through a survey questionnaire and factor analysis performed to extract relevant variables. Overall, results revealed positive dispositions of nurses towards the use of ICT. Results further revealed self-efficacy, adoption of computers to improve nursing care, confidence in using computers; usefulness; interactability and knowledgeability were major factors influencing perceptions and attitudes of nurses towards use of ICT at the work place. Findings may inform institutional and provincial …

Videoconferencing For Improved Access To Care, Alana L. Hernandez

Master's Projects and Capstones

The aim of this project is to increase the amount of education visits completed by pharmacy nurses in an outpatient infusion clinic for patients receiving 5-fluoracil chemotherapy. Two approaches have been applied: securing additional nursing staff; and implementing a telehealth delivery system that utilizes asynchronous video and videoconferencing. The intervention will employ an internet-based application to secure a videoconferencing session between patients and nurses that are 25 miles apart; and offer a patient education video that will be used and an adjunct to videoconferencing. Microsystem data obtained by auditing schedules and patient charts showed pharmacy nurses completed 0% of pharmacy-patient …

The Effect Of Education On Portal Personal Health Record Use, Imke Casey Dnp, Crna, Rhit

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

The purpose of this study was to assess the computer-use attitudes among chronically ill adult primary care practice (PCP) patients. The goal was to examine the rate of portal personal health record (PHR) use of middle-aged and older adults, to evaluate the effectiveness of an educational intervention in improving PHR adoption, and to identify patients’ thoughts about the PHR. The quasi-experimental, pre-test/post-test design with a paired matched set was performed with a convenience sample of 50 subjects from a primary care group practice in Central Florida.

Participants were recruited on the day of their provider appointment. After participant’s consent …

Process Change At An All-Volunteer Run Clinic With Pcmh Level 1 Recognition, Erin Flynn

Master's Projects and Capstones

This project directly involves the Clinical Nurse Leader (CNL) essential Informatics and Healthcare Technologies, and the CNL role function will be to act as a Team Manager. (AACN, 2013). The global aim of this process improvement is to improve the clinic workflow to increase patient and provider satisfaction in a Patient-Centered Medical Home (PCMH). The need for this project was discovered during the process of applying for PCMH recognition (of which the clinic has now earned level 1), and successful implementation of this project will meet PCMH guidelines. While applying for PCMH recognition, a clinic workflow document had to be …

Designing An Effective User Interface For A Mobile Application, Cynthia N. Kim

Graphic Communication

The purpose of this study was to determine the best user interface design practices for an iOS mobile application created for Pre-R, a local start-up company that offers physician house calls and telemedicine services throughout San Luis Obispo. The study included initial background research on best user interface design practices, mapping out and implementing the entire process of designing for mobile applications, conducting usability tests on potential users, and making changes according to the test results. Usability tests allowed for a greater understanding of the effectiveness of Pre-R’s mobile interface design prototype. Results from the usability tests have indicated a …

Instituting Patient-Self Test Meters In Adults On Warfarin In A Cardiology Practice, Melvyn Grace Manzano Rabanal

Doctor of Nursing Practice Final Manuscripts

Background: Warfarin is the oral anticoagulant that is most commonly used to control and prevent thromboembolic disorders. It requires meticulous testing and dosing adjustments to attain therapeutic international normalized ratio (INR) levels. Patient self-testing (PST) is associated with a reduced risk of all-cause mortality and lower rates of thromboembolism and bleeding. PST meters offers convenience and promotes self-initiative of care.

Purpose: The purpose of the project is to evaluate the effectiveness of INR PST in adult patients diagnosed with atrial fibrillation, deep vein thrombosis, and mechanical heart valve on warfarin therapy in a Cardiology practice compared to traditional …

Diabetes Type 2 Self-Management Education Program: Short Messaging From Patient Portal To Web-Enabled Device, Lynn S. Holcomb

Evidence-Based Practice Project Reports

Only one in eight adults with diabetes reaches target goals for disease management, which can lead to clinical complications, costly both economically and in quality and duration of human life. The standard of care is a quarterly 15-minute face-to-face visit-- arguably inadequate to impart self-care knowledge. The purpose of this EBP project was to deliver a 30-day diabetes self-management education program (DSMEP) utilizing widely accessible web-based technology to facilitate adults with diabetes to reach targeted goals. Using the Chronic Care Model as a framework, the DSMEP design was based on an extensive literature review of the delivery of DSMEP in …

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 …