Nursing Commons^™

Barriers To Preoperative Teaching In A Culturally Diverse Healthcare Environment, Rancelle Ablan

Doctoral Projects

The role of the professional nurse is integral in educating and ensuring that patients understand essential components of their plan of care. This is especially true for patients who are to undergo surgical interventions; evidence has demonstrated that preoperative education provided to patients is linked with positive patient outcomes and a decrease in post-operative complications (Blackstone, Garrett, & Hasselkus, 2011). This qualitative study investigated the barriers that nurses experience in providing preoperative education to diverse patients in a multicultural healthcare environment. Ten registered nurses at a private community hospital in the San Francisco Bay Area participated in an hour long …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention in …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

Implementation Of A Nursing Workload Tool To Reduce Nurse Burnout, Nicole K. Greives

Evidence-Based Practice Project Reports

Nursing burnout and workload is a complicated issue with far-reaching effects. Nursing burnout and inappropriate nursing workload have been linked to increased risk of urinary tract infection, respiratory infections, decreased patient satisfaction, decreased quality and safety of care, and increased mortality. The purpose of the project was to decrease nursing burnout on a Medical Progressive Care Unit (MPCU) by moving patients with high workloads and medical instability to a higher level of care. Within this project, Rosabeth Kanter’s Theory of Structural Power was used for the theoretical framework, and the Stetler Model guided the implementation. The intervention consisted of a …

The Effects Of Education On Compassion Fatigue Experienced By Oncology Nurses, Ina Wilson

Evidence-Based Practice Project Reports

Oncology nursing is widely viewed as a rewarding and emotional challenging specialty. Oncology nurses witness terminal illness, death, physical, and emotional suffering which increases their risk of developing compassion fatigue. The purpose of this evidence-based practice (EBP) project was to increase awareness of compassion fatigue among oncology nurses by providing them with knowledge, effective coping skills, and self-care management skills. The Theory of Human Caring was used as the theoretical framework to support this EBP project and the intervention was guided by The Iowa Model of Research-Based Practice to Promote Quality Care. The project used a pre-test and post-test design. …

Patient Complexity Factors And Their Influence On Nurses' Perception Of Staffing Adequacy, Margaret M. Duffy

Theses & Dissertations

Nurse leaders must consider the influence of nurse-specific and patient-specific factors on nursing workload and nurses’ perception of staffing adequacy when developing nurse staffing plans. All of the factors that influence individual nurses’ perception of staffing adequacy are not known. Using a synthesis of the Roy Adaptation Model (RAM) and economic theory as a guiding model, the purpose of the current study was to determine if selected patient complexity factors that are not consistently captured in the measurement of patient acuity by an automated workforce management system influence nurses’ perception of staffing adequacy. The current study employed a complex predictive …

The Evolution Of The U.S. Catholic Hospital: From Sisters In Habits To Men In Suits, Michael Greenstein

Celebrating Scholarship & Creativity Day (2011-2017)

In today’s ever-changing healthcare landscape, Catholic U.S. hospitals have undergone a change in their mission and thus their identity. This paper argues that Catholic hospitals need to rediscover the origins of their ministry. This can be accomplished by refocusing their efforts away from mergers with secular entities that deal strictly with life and death issues to mergers that more fully engage the care for the poor and vulnerable. To provide the context for this paper, Part One will present an overview of Jesus’ ministry, which is the foundation for Catholic health care. Part Two will address the history of the …

Enhancing Nurse-Physician Communication And Collaboration, Pamela D. Missi

Graduate Theses, Dissertations, and Capstones

In healthcare organizations today, creating a culture of safety is critically important. Communication failures among healthcare providers have been linked to 70% of annual sentinel events. Seventy-six percent of individuals experiencing a sentinel event die (Joint Commission, 2009). Lack of good communication behavior between nurses and physicians has been recognized as a cause of preventable harm to patients (Institute of Medicine, 2004; Zwarenstein & Reeves, 2006). In hospital settings, communication failures are linked to increases in length of stay, patient harm, resource utilization, more rapid turnover, and caregiver dissatisfaction (Dingley et al., 2008). Numerous national organizations and commissions have officially …

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.

The Effect Of A Multifaceted Reminder Intervention On Nursing Documentation Completeness, Meredith A. White

Evidence-Based Practice Project Reports

Nationwide, nurses must withstand growing patient assignments and increased workloads. The consistency between nursing documentation and technical nursing interventions performed indicates that registered nurses provide much more care than they record. This incongruence has the potential to impact patient safety, but also has significant financial implications, since reimbursement is linked to documented services. The purpose of this EBP project was to implement a multifaceted reminder intervention (including a 10-minute PowerPoint and visual reminder) in an IMCU setting to assist the nursing staff (n = 38) in completing the HAPU documentation components. John Kotter’s Eight-Stage Process and the Iowa Model of …

A Causal-Comparative Inquiry Into The Significance Of Implementing A Flipped Classroom Strategy In Nursing Education, Rhonda Faretta

Doctoral Dissertations and Projects

The purpose of this causal-comparative design study was to examine the application of the theory of Vygotsky’s social constructivism (1978) and McMillan and Chavis’s (1986) definition of sense of classroom community in the context of a flipped classroom. The researcher aimed to determine if a pathophysiology course taught with the flipped classroom method would result in a statistically-significant difference in nursing students’ academic performance and sense of classroom community when compared to a pathophysiology course taught with the lecture classroom method. Two questions were addressed during this study: (a) Is there a statistically-significant difference in nursing students’ academic performance (as …

Flight Nurses’ Narratives Of Traumatic Patient Care Events: Why Do They Stay?, Joanne Booth Newton

Graduate Dissertations and Theses

As frontline providers of care, flight nurses are continuously exposed to traumatic patient care events; they are, accordingly, highly vulnerable to the injurious effects of compassion fatigue. Flight nursing is an exclusive nursing specialty in which highly trained registered nurses provide comprehensive pre-hospital, emergency, and critical care to patients with urgent or life-threatening conditions aboard helicopter or fixed wing aircraft or, when necessary due to unfavorable weather conditions, by ground ambulance. The purpose of this study was to explore the lived experiences of five flight nurses; to better understand the factors they perceived to be contributors or barriers to compassion …

Sustainable Cost Models For Mhealth At Scale: Modeling Program Data From M4rh Tanzania, Emily R. Mangone, Smisha Agarwal, Kelly L'Engle, Christine Lasway, Trinity Zan, Hajo Van Beijma, Jennifer Orkis, Robert Karam

Nursing and Health Professions Faculty Research and Publications

BACKGROUND: There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania.

METHODS: We delineated 2014 m4RH program costs and considered three …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John

Honors Undergraduate Theses

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.

Methods: A total of 768 articles were found in a literature search including all literature from 2005 to …

An Analysis Of Reinforcers Maintaining Caregiving Behaviors Of Long-Term Care Facility Staff, Sandra Garcia

All Graduate Theses, Dissertations, and Other Capstone Projects

Traditionally, the medical model has been the standard level of care in long-term care facilities. However, many facilities are transitioning from the medical model to a person-centered approach. The core of person-centered care is the relationship between frontline staff and residents. Empirical research has found person-centered care to reduce depressive and behavioral symptoms, levels of loneliness, and increase quality of care in residents; person-centered care has increased job satisfaction in nursing staff. Unfortunately, little is known about what motivates caregiving behavior in nursing staff and whether these motivators are consistent with principles of person-centered care. The current study attempted to …

Impact Of Health Information Technology Patient Education With "Teach-Back" On Patient Satisfaction And Hospital Readmissions, Judi Dunn

DNP Projects

Background: With the advances in medical care, patients are being asked to manage more complicated self-care regimens, and there is often a gap between what the nurse teaches and what the patient understands. This can lead to re-hospitalizations that are burdensome for patients and are costly to the American healthcare system. The Department of Health and Human Services (DHHS) challenged healthcare organizations to leverage technology that engages patients in self-management support and encourages clinician use of patient-centered communication techniques, such as teach-back.

Purpose: The purpose of this project is to evaluate the use of health information technology along with an …

Aligning Religious And Culturally Relevant Clinical Practice With Policy, Amanda F. Hopkins Phd, Rn, Wendy C. Kooken Phd, Rn, Sana Shafiuddin

Students' Professional Presentations and Publications

This poster was presented at the Midwest Nursing Research Society conference in 2016. The purpose of this study was to evaluate cultural considerations in clinical and educational policies when working with female Muslim nursing students who wear hijab, and to suggest changes to dress code policies within academic and clinical agency settings.

Partnership, Maine Medical Center

Annual Reports

Biennial Report on Nursing, 2015-2016

The Effect Of Nurse Dose On Breastfeeding Exclusivity - A Patient Level Analysis, Gwen Moreland

DNP Projects

Background: Breastfeeding is strongly associated with health benefits for children and their mothers. Despite this knowledge, breastfeeding rates in the United States have increased only slightly. Current research examines the relationship between nurse characteristics and patient outcomes in adult intensive care and acute care settings. To date there is very limited research examining nurse variables and outcomes in women and children, and very little knowledge regarding the characteristics of the nurse in relation to patient’s breastfeeding success.

Purpose: The purpose of this practice inquiry project was to evaluate the relationship between the attributes of nurse dose and the immediacy and …

Post Foley Removal Guideline Process And Outcome Evaluation, Sarah E. Gabbard

DNP Projects

When patients are admitted to a hospital patient safety should be a priority in all aspects of the care they receive. Preventing patients from acquiring hospital infections (HAIs) is one example of patient safety. All hospital employees have the responsibility to ensure that standard workflow and processes are in place to ensure this safety. The purposes of this Practice Inquiry Project (PIP) were to examine and develop interventions to decrease the risk of catheter associated urinary tract infections (CAUTIs), incorporate an effective process and standard workflow to implement evidence practice practices (EBP), and to evaluate the effectiveness of implementing the …

Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter

DNP Projects

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …

Preventing Delirium Through The Implementation Of The Abcde Bundle And Pad Guideline Into Everyday Care In A Community Hospital Intensive Care Unit: Opportunities For Practice Improvement, Mary Zody

DNP Projects

This DNP project focuses on the reduction of delirium through improvement of nursing knowledge of delirium and implementation of evidence based bundle ( Awake, Breathing, Coordination, Early Mobility, and Pain, Agitation, Delirium) into a twelve bed intensive care unit located in a 150 bed community hospital. Specifically, this project will review the literature supporting the evidence based bundle and report on a comprehensive gap analysis which was done to determine areas for practice improvement to reduce delirium and improve patient outcomes. The gap analysis included a comparison of current practice to the evidence, a review of administrative policies/ statements of …

The Impact Of Adding Assistants In Nursing To Acute Care Hospital Ward Nurse Staffing On Adverse Patient Outcomes: An Analysis Of Administrative Health Data, Diane E. Twigg, Helen Myers, Christine M. Duffield, Judith Dianne Pugh, Lucy Gelder

Research outputs 2014 to 2021

Objectives:

The aim of this study was to assess the impact of adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient outcomes using administrative health data.

Design:

Logistic regression modelling was used with linked administrative health data to examine the association between seven adverse patient outcomes and use of assistants in nursing utilising a pre-test/ post-test design. Outcomes included were in-hospital 30-day mortality, failure to rescue, urinary tract infection, pressure injury, pneumonia, sepsis and falls with injury.

Setting:

Eleven acute care metropolitan hospitals in Western Australia. Sample: Patients were retained in the dataset if they …

Canadian Nurse Leaders' Experiences With And Perceptions Of Moral Distress: An Interpretive Descriptive Study, Jodi-Rae Kortje

Antioch University Dissertations & Theses

Moral distress in nursing has been studied across many care contexts, yet there is a paucity of research on the experience among health care leaders.The purpose of this study was to understand the experiences and perceptions of moral distress in nurse leaders.This study used an interpretive description approach interviewing 32 Canadian nurse leaders about their experiences and perceptions of moral distress within their role as a leader and nurse.A constant comparative and thematic analysis process revealed three thematic patterns:(a) leaders suffer moral distress in similar and different ways from their employees; (b) relationships matter in the midst of coping and …

Resilience As Resistance To The New Managerialism: Portraits That Reframe Nursing Through Quotes From The Field, Vicki Cope, Bronwyn Jones, Joyce Hendricks

Research outputs 2014 to 2021

Aim:

This paper acknowledges the relationship between resilience and the new managerialism of contemporary nursing.

Methods:

Qualitative portraiture methodology.

Discussion:

The new managerialism in hospital settings results in a rapidly increasing turnover of acutely ill or comorbid patients, which directly relates to retention and quality service. In education settings, the management imperative to recruit more students into the profession combined with financial cutbacks leads to similar tensions. In aged care the trend equates care directly with funding, with the same effect. Yet despite this, many registered nurses remain working. Portraiture explored 'why' nurses remain in workplaces often described as awful. …

Closing The Gap In Nursing Education: Comparing Nursing Registration Systems In Australia And China, Carol Wang

Research outputs 2014 to 2021

Aim:

To provide a better understanding of how the nursing registration process in China compares to that of Australia and to identify common features and potential barriers that may affect or facilitate the development of China's ever-demanding need for healthcare and nursing education.

Background:

Chinese nursing graduates are increasingly being used to augment the shortage of nurses in other countries, including Australia. However, China is desperately in need of strategies to cope with its current challenges in healthcare and nursing education. There is little discussion concerning the differences in nursing registration systems between countries, such as China and …

Using A Strategic Model For Professional Development: The Importance Of Evidence-Based Competencies As A Foundation For Professional Practice., Peggi B. Winter

Doctor of Nursing Practice (DNP) Projects

Abstract

A nursing professional practice model (PPM) is designed to provide a framework for how nursing practices, communicates, leads, collaborates, and provides the highest quality of care as we navigate the complex healthcare system. An infrastructure for learning, competency, and performance needs to be integrated into this model as a foundation for accelerating business and clinical initiatives, promoting standardization, and sharing successful practices. It is now, more than ever, a necessity to have a well-trained, highly competent nursing workforce. Simply having the knowledge and the skill to do a job is insufficient; rather, it is implied that a competency has …

Building A Framework For Professional Nursing Practice Across The Continuum Of Care, Elizabeth S. Bigby

Doctor of Nursing Practice (DNP) Projects

Nursing professional practice models are designed to unite and align nurses under one vision, set of values, and a professional practice model. The goal of this project was to implement and enculturate a professional practice model of nursing with assistant nurse managers and leaders across the continuum of care at an urban medical center and associated ambulatory medical offices. Staff engagement has been shown to improve satisfaction and decrease turnover and implementation and enculturation of a professional practice model improves engagement. The target population was nurse managers and leaders as they needed to embrace professional practice before the project was …