Nursing Commons^™

Efficacy Of Technology-Based And In-Person Health Education For Behavior Change In College-Aged Women, Madeline Bremel

All College Thesis Program, 2016-2019

Purpose: The purpose of this study was to determine whether an in-person or technology based bone health intervention improved bone health knowledge and behaviors in college-aged women. Methods: 30 college-aged women were randomly divided into three groups: personal intervention (n = 10), technological intervention (n = 10), and control (n = 10). Both intervention groups received identical information regarding the importance of bone health and the appropriate behaviors for maintaining strong bones including weight-bearing exercise, calcium consumption, and vitamin D consumption. The technology group received the information via an online video, and the personal group via a one-on-one …

A Multi-Faceted Intervention To Improve Naloxone Co-Prescription Rates Among Primary Care Providers, Jolane S. Conklin

Evidence-Based Practice Project Reports

It is estimated that 91 Americans die every day due to opioid overdoses, with at least half of those overdoses involving an opioid prescription (CDC, 2016d). To address this issue, the U.S. Department of Health and Human Services (USDHHS) has initiated an opioid initiative, and the Centers for Disease Control and Prevention (CDC) has released a clinical guideline, both of which include a focus on increasing use of naloxone. Despite these recommendations, providers often fail to co-prescribe naloxone to patients at increased risk of opioid overdose. The purpose of this evidence-based practice (EBP) project was to evaluate the effect of …

Effects Of Incorporating Patient Acuity Into The Rn Assignment Process, Melissa L. Forton

Evidence-Based Practice Project Reports

As the largest sector of healthcare, nurses are the primary providers of patient care. By 2025, it is estimated that there will be a shortage of over 250,000 registered nurses (RNs) (American Association of Colleges of Nursing, 2011). Factors contributing to the nursing shortage include increased complexity of patients and decreased staffing that leads to decreased job satisfaction (Fox & Abrahamson, 2009). Over half of neonatal intensive care nurses reported missing at least one nursing task per shift when staffing was inadequate or patient acuity was high (TubbsCooley, Pickler, Younger, & Mark, 2015). The purpose of this evidence-based practice (EBP) …

An Exploration Of Patients’ Experience Of Nurses’ Use Of Point-Of-Care Information Technology In Acute Care, Leigh Mcnicol, Anastasia F. Hutchinson, Beverley Wood, Mari Botti, Bernice Redley

Patient Experience Journal

The rapid introduction of technology into acute healthcare settings, specifically the presence of point-of-care health information technology at patients’ bedsides, is expected to impact patients’ healthcare experience by altering nurse-patient interactions. This research was a multi-method naturalistic pilot study designed to explore patients’ perception of their interactions with nurses using bedside point-of-care health information technology in acute care. Data were collected using observation, interviews and surveys. Twenty-four participants were purposefully recruited from medical and surgical wards, to capture variability in their self-reported confidence with information technology; 29% were not confident, 38% were somewhat confident and 33% were completely confident with …

Hospital Nurse Burnout: A Continuing Problem, David P. Paul Iii, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse

Management Faculty Research

RNs are a critically important component of the U.S. healthcare system. RN burnout – the feeling of exhaustion from working long hours without rest – is a real concern, having been reported in many hospitals. We examine the background, causes and consequences of burnout among RNs in U.S. hospitals, in order to identify solutions to this problem. Findings indicate that Burnout Syndrome in RNs can be analyzed in terms of four clusters of characteristics: individual, management, organizational, and work. The consequences of burnout include increased RN turnover rates, poor job performance, and threats to patient safety. RN burnout in hospitals …

Incorporating Just Culture Principles Into Clinical Learning Experiences, Paula Gendreau, Dnp, Msn, Rn, Cne

Doctor of Nursing Practice Projects

Background: Although nursing student’s confidence regarding patient safety is influenced by both clinical faculty and environments in which they learn, faculty seemed to have the most influence in shaping student’s attitudes surrounding a culture of safety. Objectives: To explore and support faculty culture of safety practices that promote meaningful learning experiences for students surrounding patient safety in clinical learning environments.

Methods: An embedded mixed method design was utilized for this pilot study. Quantitative data was collected both pre- and post-semester utilizing an adapted Health Professional Education in Patient Safety Survey, and post-semester qualitative data further expanded on faculty perceptions and …

Evaluating Transfer Of Continuing Education To Practice: A Retrospective Mixed-Methods Study, Tiffany Bryant, Dnp, Msn, Rn-Bc

Doctor of Nursing Practice Projects

Background: Continuing education (CE) is an essential component of building and maintaining the competence and performance of health professionals. Evidence of its impact on practice is lacking. Organizations need evidence of CE transfer to the practice setting to demonstrate its value and inform CE practice.

Objectives: The purpose of this study was to provide evidence of CE’s impact on practice by analyzing nurses’ reports of intent to change practice, actual practice change, and examples of practice change. Research assessing the effects of CE on nursing practice across multiple courses involving different topics, levels of nursing practice and location supports generalizability. …

Evaluation Of Disparities In Healthcare Experiences Between Racial Identities And Age Cohorts, Christopher Ruckman, Dnp, Mba, Msn, Rn, Cen

Doctor of Nursing Practice Projects

Background: Healthcare consumers have their own perspectives and expectations of what should occur during an encounter of care; these unmet expectations create healthcare disparities. However, there is limited data regarding healthcare experiences among racial and aging groups.

Objectives: To compare the physical and emotional responses of healthcare experiences among racial/ethnic and aged cohorts in the United States.

Methods: Applying a descriptive-correlational design, secondary data from the 2014 Behavioral Risk Factor Surveillance System related to healthcare experiences among racial groups (White, Black, Hispanic, and Asian) and aged cohorts (18-39, 40-54, and 55- 69 years) were assessed.

Results: In the sample, there …

Nurse Managers And Hospital Nurse Educators’ Views Related To The Knowledge, Skill And Attitude Requirements Of Newly Licensed Nurses In The Las Vegas And Salt Lake Valleys, Delos Jones, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: In 2017, approximately 230,569 new Registered Nurses (RNs) were licensed in the United States. Of these, over a quarter will leave their first position in less than a year. While 90% of academic leaders feel nursing graduates are ready for practice, only 10% of clinical leaders agree. Recent changes in health care, and an intensifying theory-practice gap hint that newly licensed nurses (NLNs) may not be equipped for today’s workplace.

Objective: This qualitative project asked, “What do nurse managers and hospital educators perceive as required knowledge, skills and attitudes (KSAs) for NLNs to ensure successful and safe orientation or …

Missed Nursing Care Reported By Medical-Surgical Rns In A Community Hospital, Anne Schmidt, Dnp, Msn, Rn, Aprn-Bc, Cenp

Doctor of Nursing Practice Projects

Background: Missed nursing care is defined as any lapse in essential patient care. It is a previously studied, persistent phenomenon. If unrecognized, it can compromise patients’ recoveries, trigger adverse events, and increase healthcare costs.

Objectives: To examine the prevalence of missed nursing care reported by medical-surgical registered nurses (RNs) and contributing factors for its occurrence.

Methods: The project used a cross-sectional, correlational design. A convenience sample of 96 RNs, recruited from three medical-surgical units, completed the MISSCARE Survey between September and October 2017. An analysis of survey responses quantified the frequency, nature, and common contributing factors for care omissions. The …

Evaluation Of The Associations Between Unplanned Readmissions And The Lace Index And Other Variables, Cathy Stankiewicz, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: Unplanned readmissions, within 30 days following an inpatient hospital admission, are common and costly. Research has identified factors that predict readmissions, and predictive algorithms, such as the LACE index, have been studied and widely adopted by hospitals despite demonstrated variability in predictive ability.

Objectives: To examine the associations between unplanned readmissions and the LACE index, and other variables that reflect patient- and encounter-level factors not currently incorporated in the LACE index.

Methods: A retrospective analysis was conducted utilizing data from electronic health records of inpatients discharged from a large quaternary hospital located in the southeastern United States between January …

Evaluating Patient Outcomes When Adding Licensed Practical Nurses To The Staffing Mix, Isabel C.M. Shephard, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: An incorporation of licensed practical nurses (LPNs) in the RN staffing mix was made in a small community hospital. Research shows that RNs at the bedside equates to less adverse patient outcomes such as falls, pressure ulcers and an increase on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

Objectives: To evaluate the effects of incorporating LPNs in the staffing mix on the number of patient falls, pressure ulcers and HCAHPS survey results.

Methods: A Pre and Post study design was used to compare baseline data obtained four months prior to implementing and four months during …

Creation Of A Diabetic Health Literacy Program For Staff Of A Rural Federally Qualified Healthcare Center, Cathy Jones

Walden Dissertations and Doctoral Studies

Adult residents in rural communities have a higher incidence of chronic diseases. This fact coupled with low health literacy and a lack of primary and specialty care services makes the management of diseases such as diabetes difficult. The purpose of this doctoral project was to develop a diabetic health literacy program for staff of a rural federally qualified health care center (FQHC) that is the largest primary care center within a 5-county area in a rural mid-Atlantic region of the United States. Most residents have difficulty understanding diabetic information as it is presented to them, which leads to an increase …

Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth

Walden Dissertations and Doctoral Studies

Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …

Implementing Lean Daily Management System To Improve Cvor First Case On-Time Starts, Haley Borchers, Kelly Fehlhafer, Barbara Mueller, Jessica Nichols, Sarah Talken, Mary Hunter, Kenneth Sam

Posters

No abstract provided.

Increasing The Value Of Medicare Annual Wellness Visits For Patients And Providers, Stephanie Hope Turner

Walden Dissertations and Doctoral Studies

The Medicare Annual Wellness Visit (AWV) has been available to Medicare beneficiaries since 2005; however, most eligible individuals have not taken advantage of this benefit. The literature supports that patients are willing to schedule and complete an AWV if urged to do so by their primary care provider; however, providers are reluctant to advise patients to pursue the AWV due to the lack of perceived value and overall health benefit. The integrative theory of health behavior change was used as the theoretical framework for the project. By increasing patient self-management skills through education, engagement, and support, the project was designed …

Factors Influencing Emergency Registered Nurse Satisfaction And Engagement, Catherine Larock-Mcmahon

Walden Dissertations and Doctoral Studies

Employee satisfaction and engagement have a direct impact on customer satisfaction. Dissatisfaction and disengagement lead to an increased intent to leave a job, poor patient outcomes, and decreased productivity. The retention and recruitment of qualified staff becomes an urgent priority to ensure safe and prudent patient care. The purpose of the qualitative research study was to better understand the beliefs, attitudes, perceptions, and reasons for emergency department registered nurses (ED RN) satisfaction and engagement in the workplace focusing on Herzberg's, Vroom's, Yetton's, Maslow's, Benner's, and Kahn's motivation and engagement theoretical frameworks. The qualitative case research study focused on satisfaction and …

Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda

Walden Dissertations and Doctoral Studies

Adolescents with Type I and Type II diabetes need to monitor blood glucose and food intake, administer insulin, and participate in activities including physical education during school hours to maintain glycemic control. Glycemic management programs (GMPs) exist for the improvement of diabetes management during school hours. The purpose of this project was to evaluate a GMP in a school system in a rural area in the Southeastern United States. The goal was to determine if the existing GMP met objectives and to make recommendations for continuation, revision, or discontinuation of the GMP. The logic model provided the basic framework for …

Graduate Bulletin, 2018-2019, Minnesota State University Moorhead

Graduate Bulletins (Catalogs)

No abstract provided.

Preventing Emergency Department Overutilization For Florida’S Seasonal Resident Population, Amanda Garcia

DNP Scholarly Projects

Background/Local Problem: Seasonal migration of elderly patients to Lee County, Florida result in overcrowding and prolonged wait times in emergency departments. Many of these seasonal residents dissociate the management of their chronic health conditions with a local provider, therefore utilizing the emergency department for non-urgent needs. Purpose: The Seasonal Resident Navigator Program was intended to enhance the coordination of primary care services for elderly seasonal residents by establishing appointments with local primary care providers (PCP) in order to reduce the overutilization of emergency services and improve patient throughput. Methods: A residency and provider assessment tool was incorporated into the Healthpark …

Successful Strategies For Financial Sustainability In Nursing Homes, Renee Walthour

Walden Dissertations and Doctoral Studies

From 2014 to 2015, deficiency fines cost Pennsylvania nursing homes more than $2.5 million. Costs associated with adhering to increased health care regulations can reduce profit and affect the financial sustainability of the nursing home industry. Some nursing home administrators (NHAs) lack successful strategies to improve state and federal regulation compliance and promote financial sustainability. Drucker's management by objectives theory was the conceptual framework for this study. The purpose of this qualitative multiple case study was to explore successful strategies NHAs use to improve state and federal regulation compliance to mitigate deficiencies and derivative fines to promote financial sustainability of …

Nurse Manager Span Of Control And The Impact On Employee Engagement, Jene' M. Kendall

DNP Projects

PURPOSE: The purpose of this study was to assess nurse manager span of control in medical- surgical, intermediate care, and progressive care units at Norton Healthcare and determine correlations between nurse manager span of control and employee engagement.

METHODS: For this descriptive, correlational study, the researcher analyzed data to identify relationships in span of control and employee engagement data for 19 nurse managers leading 23 inpatient care units. A survey to evaluate the role of the nurse manager and the assistant nurse manager also was done.

RESULTS: The average span of control for nurse managers was 52.2 full time equivalent …

Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist

Walden Dissertations and Doctoral Studies

Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …

Educational Training Of Staff Nurses For Evidence-Based Practice, Tina June Theriaque

Walden Dissertations and Doctoral Studies

Translating research into practice takes 10 to 20 years or more. Evidence-based practice (EBP) integration remains at 10% to 20%, despite recommendations requiring EBP-guided decisions. Up to 30% decreases in health care system spending, improved quality outcomes, and increased staff satisfaction result from EBP integration. Nurse leaders, who rate quality and safety as the highest priority but EBP as the lowest, are accountable for EBP enculturation; a desire to support bedside registered nurses in EBP exists, yet this EBP use knowledge gap supersedes this goal. The purpose of this project was to provide an EBP education program introducing the use …

Coping With Sickle Cell Disease Using Cognitive Behavior Therapy, Helen Alexander

Walden Dissertations and Doctoral Studies

This project focused on identifying the best evidence available on the use of cognitive behavior therapy (CBT) for pediatric patients and families with sickle cell disease (SCD) to improve their coping skills with pain management. This resulted from an identified gap in nursing practice regarding psychosocial support for this subset of hospitalized pediatric patients. The practice-focused question was whether there was evidence in the literature on the use of CBT techniques to improve parental coping skills with children who have chronic and life-threatening illness that could be utilized with sickle cell disease. The theory of stress and coping guided the …

Utilizing A Situation Awareness Huddle Tool To Decrease Code Blue Events, Matthew B. Johnson, Lisa Carney, Cheryl Powers, Bradley Bishop, Natalie Masters, Becky Paulsen, Andrea Raymond, Paul N. Bauer

Posters

No abstract provided.

Reducing Clabsi Rate Among Icu Patients, Rita L. Walker

Walden Dissertations and Doctoral Studies

Approximately 55% of intensive care unit (ICU) patients require the use of a central venous catheter (CVC). CVCs are often an essential component of care; however, CVCs can create avenues for pathogens to enter the bloodstream and cause a central line-associated bloodstream infections (CLABSI), which can lead to increased mortality and morbidity, prolonged length of stay, increased cost of care, decreased patient satisfaction, and increased workload. In 2017, the CLABSI rate at the project site was 4.3 per 1,000 catheter days as compared to the national rate of 0.8 per 1,000 catheter days. Based on Piaget's theory of constructivism, a …

Methods To Improve Interprofessional Collaboration In Administrative Dyads, Julie Lee Hudson

DNP Projects

Abstract

PURPOSE: The primary objective of this project was to determine if specific interventions, to include education, rounding, and regular meetings, improved collaboration and communication for nurse/physician dyads working in acute care hospital administrative roles.

METHODS: The study employed a prospective pre-test and post-test comparison of participants’ scores on a validated survey tool. This tool (JeffSATIC) measured perception of collaboration between nurses and physicians. The objective was to evaluate the differences in these scores in participants before and after an intervention.

RESULTS: This study sought to discover if specific interventions impacted scores on a tool measuring collaboration among dyad pairs. …

Increasing Medication Adherence In Hypertensive Patients With Million Hearts® Health Literacy Program, Tammy Ross

Walden Dissertations and Doctoral Studies

Healthy People 2020 identified hypertension (HTN) as a controllable risk factor to prevent cardiovascular disease and stroke. Adhering to regular antihypertensive (AHT) medications improves outcomes in patients diagnosed with HTN by controlling blood pressure, reducing hospital visits, and promoting patient wellness. Medication adherence occurs when prescribed medicine regimens are utilized by the patient as directed to manage illness or disease, as evidenced by patients receiving medications at their pharmacy. The practice-focused question for this quality improvement project asked whether implementation of health literacy tools from Million Hearts® HTN Control: Action Steps for Clinicians, increased medication adherence as evidenced by regular …

The Impact Of Diabetes And Obesity In The African American Population, Andrea Lynette Swails

Walden Dissertations and Doctoral Studies

Within the 21st century, Type II diabetes has emerged as a public health crisis. African Americans and Hispanic Americans have the highest rates of Type II diabetes and obesity compared to European Americans. The purpose of this DNP project was to teach medical assistants (MA) to provide self-management of diabetes and obesity for the African American population in the local clinical setting. An educational tool kit for health providers was developed to guide the educational project. The chronic care model was used to guide the development of the educational toolkit. A pretest posttest design was incorporated into the educational program. …