Nursing Commons^™

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

Implementation And Evaluation Of A Registered Nurse Pre-Eclampsia Education Program Within A Women's Urgent Care Center, Amber Vetter

Doctoral Projects

Pre-eclampsia can be a serious development for both mother and fetus during pregnancy. Increased mortality and morbidity rates have been shown in women diagnosed with pre-eclampsia. Higher education for registered nurses on a Women’s Urgent Care (WUC) center will help diagnose the mother more quickly and inevitably receive treatment sooner leading to better outcomes for the birth of her newborn. The educational tools used in the study were a pre-and post-test and an educational video for the registered nurses to watch. A retrospective chart review before and after the intervention will help to see if there is any decrease in …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Safe Patient Handling, Aubrey Graves

Honors College Theses

Introduction: Nursing is a high-risk occupation for musculoskeletal injuries due to the strenuous activity of patient handling. These tasks include, assisting a patient in bed, moving a patient from the bed to a wheelchair, and assisting with walking. These work-related tasks can create a large amount of stress on the body, especially the back if proper technique is not utilized and/or if excessive loads are applied. The purpose of this study is to examine if teaching proper body mechanics and the dangers of not performing the tasks properly is an effective way of reducing musculoskeletal injuries.

Methods: The NUR 202 …

Partnering With Hospital Providers To Facilitate Handoff For Persons With Dementia In The Acute Care Setting, Vanessa Jeune

Student Scholarly Projects

Practice Problem: Individuals with Alzheimer's disease and related dementias cannot verbalize their care needs during transitions of care (TOC) and rely on their home caregivers (HCs) for advocacy. The lack of communication between clinicians in one setting and HCs can lead to detrimental health outcomes for the length of stay.

PICOT: The PICOT question that guided this project was: With the assistance of family nurse consultants (P), how does the implementation of standardized care needs communication tool for support persons of persons with dementia (I) vs. no standardized process (C) enhance the ability for the support person to …

Implementation Of An Interprofessional Fall Prevention Program To Reduce Falls On An Older Adult Inpatient Psychiatric Unit, Teresa Woodson

Doctor of Nursing Practice

Background. Falls are the most reported incidents in the hospital setting, especially among older adults. According to the National Database of Nursing Quality Indicators (NDNQI), the number of falls in inpatient psychiatric units is 13-25 per 1,000 patient days, compared to 4 per 1,000 days for medical-surgical units. This DNP project aims to implement an interprofessional fall risk team to reduce falls in an older adult inpatient psychiatric unit. Problem. The psychiatric inpatient units had a total of 31 falls, with 13 (40%) occurring on the older adult unit. Interventions. Education of nursing staff, providers, and physical therapy (PT) …

Debriefing With Pearls & Watson’S Caritas, Heather A. Uccello

Seton Hall University Dissertations and Theses (ETDs)

Debriefing, an important aspect of students’ clinical experience, is a reflective, critical thinking analysis and communication strategy that provides rapid feedback after either a simulated or genuine clinical event. To teach this higher-level critical thinking skill throughout the learning process, nursing programs require specific methodology and faculty expertise. The National League for Nursing supports nurse educators having a theory-based strategy, formal training, and ongoing competency evaluation. Informed by Jean Watson’s Theory and the Promoting Excellence and Reflective Learning in Simulation standardized debriefing tool methodology, this project outlines a framework that nursing schools can use to potentially improve the debriefing process …

The Holistic Self-Care Learning Experience Of Rn-To-Bsn Students: A Phenomenological Study Of Meaning And Value, Elaina C. Mahlan

Doctor of Education (Ed.D)

The health of the nursing workforce is a critical aspect of high-quality health care and community health promotion, but extensive research indicates that too many nurses neglect selfcare and suffer negative health outcomes. While nursing education must provide self-care learning experiences to improve the health of nurses, the value and influence of a learning experience must be interpreted from the learner’s point of view. The purpose of this phenomenological study was to elicit the personal value that RN-to-BSN students ascribed to a self-care learning experience within a holistic nursing course at a public university. The holistic nursing paradigm offers a …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

Improving Onboarding And Role Transition For Advanced Practice Providers, Leighann Ebenezer

Nursing (graduate) Student Scholarship

BACKGROUND: APPs are increasingly being integrated into various health care settings and the role continues to gain popularity and utility as a solution to the shortage of physicians. Successful onboarding of APPs has been identified as an important factor in the role transition and integration of APPs into their team and organization.

PROBLEM: When hired, APPs are often not onboarded successfully to the detriment of the provider and the organization. Despite the evidence for comprehensive onboarding programs, APPs continue to receive insufficient onboarding that ignores their unique scope of practice.

METHOD: The Ottawa Model of Research Use, a knowledge translation …

Examining Predictors Of Attitudes And Knowledge Of Registered Nurses And Nursing Students In Tennessee Toward Pregnant And Perinatal Women With A Substance Use Disorder, Jessica Patrylo

Electronic Theses and Dissertations

Substance use disorders (SUDs) among pregnant and perinatal women continue to be a national public health crisis. Furthermore, nursing students and perinatal nurses have historically negative and punitive attitudes toward this vulnerable population of women. As nurses are primary care providers for pregnant and perinatal women, this is troublesome as perinatal patients express feeling stigmatized by nurses whom they should be able to trust. This contributes to the reluctance of women to seek needed medical and prenatal care. Tennessee was the first state to criminalize drug use in pregnancy and has higher neonatal abstinence syndrome (NAS) rates, which were more …

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …

Transition Of Care Program: A Quality Improvement Project, Sara Gigliotti

Nursing (graduate) Student Scholarship

BACKGROUND: Unplanned hospital readmissions are a burden on healthcare expenditure. There is a paucity in research at the sub-acute level of care, where many patients receive services following a hospitalization, to decrease readmission rates. This project aimed to determine whether a formal transition of care program (TCP) in a sub-acute rehabilitation (SAR) center decreased unplanned hospital readmissions of adults within 30 days of discharge to home.

METHODS: A literature review identified evidence-based interventions used to develop a formal TCP in a SAR center. The Ottawa Model of Research Use was used for the quality improvement (QI) project. Data was collected …

A Multimodal Educational Approach For Caregivers Of A Febrile Child: A Quality Improvement Project, Claire Catherine Jones

Nursing (graduate) Student Scholarship

Background: Insufficient caregiver knowledge regarding the physiology and correct management of fever in children contributes to adverse health outcomes in children.

Problem: Lack of multimodal education and resources for caregivers on the management of febrile children leads to medication dosing errors, overutilization of medical resources, and caregiver ambiguity when caring for their child.

Methods: A multimodal educational approach (MEA) on discharge education for the care of a febrile child directed towards caregivers who presented to a pediatric emergency room in Eastern PA, was implemented, and caregiver knowledge and caregiver’s perception of preparedness at time of discharge was measured.

Intervention: The …

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …

Treatment Anxiety Education For Pediatric Cardiac Neurodevelopmental Patients, An Evidence Based Project, Mary Nagel

Doctor of Nursing Practice Final Manuscripts

Abstract

Background

Congenital heart disease (CHD) is the most common birth defect and affects almost 1% of all live births. Treatment anxiety is common among children with CHD who undergo multiple procedures early in their lifetime. Dramatically increased life spans for this cardiac population has led to a shift from focusing on survival to their long-term health outcomes.

Methods:

Administration of the Peds QL Cardiac Module 3.0 assesses health related quality of life (HRQOL) during annual visits to a Cardiac Neurodevelopmental (ND) Clinic by evaluating the level of Treatment Anxiety a patient experiences during healthcare appointments. The questionnaire scores are …

Achieving Advance Care Planning In Diverse Populations Via Teleconferencing With Skilled Nursing Facility Residents, Tania Huezo

Doctor of Nursing Practice Final Manuscripts

Background: Advance care planning (ACP) has always been a priority in healthcare, and even more crucial during the COVID-19 pandemic. It has been extremely challenging for ACP to occur in the skilled nursing facility (SNF) population once social distancing restrictions were put in place to protect residents and staff.

Purpose: The purpose of this evidence-based project was to assess the effectiveness of ACP via teleconferencing with skilled nursing facility (SNF) residents in the hope of increasing completion of high-quality Physician’s Orders for Life-Sustaining Treatment (POLST) forms.

Methods: The San Diego Coalition for Compassionate Care developed an ACP community outreach program …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

Get America Talking: Implementing Advanced Care Planning In Primary Care, Sasha Recht

Doctor of Nursing Practice Final Manuscripts

Advanced Care Planning (ACP) is an essential part of providing adequate care in the primary care setting. Discussing end of life with patients can be a tedious and uncomfortable conversation for many providers, however, its continued avoidance contributes to the stigma of end of life care and may also result in significant healthcare cost expenditure with the use of unwanted invasive treatments. All providers should engage in consistent advanced care planning in order to improve patient and provider communication, improve patient satisfaction, increase advanced directives on file, reduce the stigma of the topic, and improve quality of life.

A Guide To Vaccine Policy Change At A National Level, Janelle Bird

Doctor of Nursing Practice Final Manuscripts

Abstract

Health policy is in a near constant state of improvement. In order to solidify those improvements, health policy requires assistance from the upcoming generations of healthcare workers to push for those changes. Due to the outdated vaccination policy in the American Nurses Association (ANA), many states continued to issue exemptions based upon unsupported religious preferences. This helped to worsen the outbreak of measles in 2018-2019. The Previous ANA Policy on Vaccinations as of July 21, 2015 stated the ANA supports immunization exemptions only for the following reasons: Medical contraindications and Religious beliefs. Educate and train future health care professionals …

Strategies For The Improvement Of Healthcare Through Simulation, Roger Lankheet

Dissertations

Title:Strategies for the improvement of healthcare through simulation

Background: Medical errors continue to plague the healthcare industry. The annual rates of morbidity are approximately 2.69 million (AHRQ, 2019), while mortality rates exceed 400,000 per annum (Makary & Daniel, 2016). There may be no panacea to combat these egregious rates. However, simulation of patient care events may better prepare healthcare professionals to prevent medical errors as it has been proven to be an effective learning strategy (Kirkham, 2018), enhancing skills while gaining experiential knowledge, without risk to actual patients.

Purpose: The purpose of this qualitative study was to gain a …

Standardized Education On Physician Orders For Life Sustaining Treatment (Polst) Conversations, Venessa Oteniya

Doctor of Nursing Practice Final Manuscripts

According to research literature, 15% of Medicare beneficiaries spend more than 7 days in the intensive care unit before they die. These Medicare beneficiaries receive aggressive, life-prolonging medical treatments that might not be in agreement with their wishes. Approximately 13% of SNF residents have improperly completed POLST forms that can result in intensive treatments that patients did not want. One barrier to the lack of POLST completion in SNFs is staff difficulty with understanding and explaining the form, a result of inadequate education.

In August 2020, the San Diego Coalition for Compassionate Care formed an education program to provide virtual …

Improving Vaccination Uptake In The Latinx Community Through Standardized Outreach, Vanessa M. Arteaga

Master's Projects and Capstones

Vaccine hesitancy during the COVID-19 pandemic has been an issue in the Latinx and Black community since the initial discussions of the emergency use of the experimental Moderna and Pfizer vaccines. The aim of this project is to standardize the patient outreach process to increase COVID-19 vaccine uptake. Patients at a community clinic in Oakland have expressed hesitance of the COVID-19 vaccine. They also exhibited increased frustration with the staff who are contacting them to schedule vaccine appointments and provide information. This resulted in refusal of the vaccine and less than desirable number of vaccine appointments. The objective of this …

Continuing Education Preferences Amongst Crnas, Jamie Nichting

Doctor of Nursing Practice Projects

The Illinois Association of Nurse Anesthetists (IANA) is a professional organization representing Certified Registered Nurse Anesthetists (CRNAs). To ensure compliance with high standards of care in the profession, CRNAs are required to obtain continuing education units (CEUs) for each 4-year certification period. The IANA offers conferences in both fall and spring, however, a loss in attendance and revenue at state meetings concerns the board members as to how state members are complying with the educational requirements to remain certified. It was imperative that the IANA needed to implement new educational opportunities that actively engaged CRNAs resulting in an increase in …

Genetics In The Nicu: Nurses’ Perceived Knowledge And Desired Education, Kathleen Shields

Dissertations & Theses (Open Access)

A large proportion of infants admitted to neonatal intensive care units (NICUs) have genetic conditions. NICU nurses play an important role in providing comprehensive care to these patients and their families. Previous research has demonstrated gaps exist in the genetics knowledge of nurses and that they lack comfort applying genetics information to clinical practice, but no research has been done assessing the knowledge of or comfort with genetics of NICU nurses specifically. NICU nurses (n=122) completed an online survey assessing their perceived knowledge of genetics, comfort with clinical scenarios involving genetics, and desired genetics education. Participants reported the highest levels …

Holistic Admissions, Anna Kam

Theses and Graduate Projects

As patient populations of Minnesota and the nation become more diverse there is much work to do in preparing a nursing workforce that has the experiences and attributes to provide holistic and culturally congruent care. The process of holistic admissions admits the most qualified applicants into schools of nursing who bring with them life experiences and crucial attributes. These holistic aspects of the applicants support both academic success and promote quality nursing practice. Holistic review aims to align the mission and vision of academic institutions with the admissions process ensuring that both the applicant and organization are clear in their …

A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard

Dissertations

There is a need to understand the influences and outcomes related to loneliness in veterans living with complex illness. Patients require self-care to manage complications and exacerbations associated with complex illness. Deficits in self-care result in negative health outcomes and drive resource utilization upward. The identification of potential factors related to self-care is important. Loneliness may be one factor that influences patients’ ability and desire to care for themselves. Descriptive correlational design was used to evaluate loneliness both as a predictor and outcome in veterans admitted to the hospital for three complex respiratory illnesses (heart failure, chronic obstructive pulmonary disease, …

Disruptive Communication Among The Interdisciplinary Team: Gaining Insight And Providing Nurse Education, Kristen Marie Anderson

Doctor of Nursing Practice Scholarly Project

The purpose of this study is to identify what types of disruptive behavior nurses are experiencing, discuss outcomes of disruptive behavior, and educate healthcare providers and administrators of disruptive communication. Understanding the consequences of disruptive communication can help educators articulate the need for training in conflict management and therapeutic communication methods. It can also aid healthcare providers to be more conscious of their behavior in the professional setting. Seven research questions related to communication were developed and analyzed in this study. The author developed a pre-education survey that included demographics, multiple-choice questions, and open-ended questions to assess the nurses' knowledge …

Development And Implementation Of Computer-Based Learning Modules On Alternative Communication For Pediatric Nurses And Nursing Students, Amanda Kaye Simmons

Theses and Dissertations (ETD)

Purpose and Rationale. To develop, implement, and assess computer-based learning modules (CBLs) on augmentative and alternative communication (AAC) with pediatric nurses and nursing students for knowledge outcomes, self-efficacy, and perceived relevance and effectiveness. Effective communication ensures all parties can understand and express themselves clearly, through any means necessary, often including AAC tools, supports, and strategies. Communication is essential in healthcare but there is limited research with pediatric nurses. Previous research with a single hospital indicated a need for nurse education on AAC. This research used focus groups and interviews to understand pediatric nurse and nursing student knowledge about AAC. The …

Barriers To Healthy Births At Nigerian Hospitals, Caroline Johnston

Senior Theses

Maternal mortality is a problem everywhere, but it is especially dangerous in Nigeria where the average woman experiences pregnancy six times during her lifetime (Population Reference Bureau, 2001). Many researchers focus on the medical complications associated with labor, such as hemorrhage, eclampsia, or infection. Although these birth complications are the direct sources of maternal death, it is also important to recognize how maternal mortality is a multifaceted issue influenced by local cultural groups, religions, politics, poverty level and the absence of basic infrastructures. Although maternal mortality is interconnected with social and geographical elements, my paper concentrates on Nigerian hospitals and …