Nursing Commons^™

Improving The Nurse Patient Assignment Process On A Medical Surgical Unit, Kevin K. Mcewan

Doctor of Nursing Practice Projects

Background: Nurse patient assignments on an adult medical surgical unit at a community hospital are often accomplished with inconsistent processes and rationales. Each charge nurse utilizes individualized processes to determine which patients will be best teamed-up and assigned to the available nurses. There are frequently no acuity measurements system or set criteria by which the number or types of patients can or should be assigned to any given nurse, nor are staff skill or competency considered in the assignment process.

Project Design: A pilot project was conducted on a medical/surgical unit. The project utilized the American Association of Critical Care …

A Faith-Based Quality Improvement Project To Increase Awareness, Prevention, And Management Of Coronary Heart Disease In African Immigrants, Temitope S. Okpebho

Doctor of Nursing Practice Projects

Problem Description: Coronary heart disease (CHD) affects people globally, and it is the leading cause of death in the United States. Despite increased CHD awareness, evidence shows the increased prevalence and low CHD awareness among African Immigrants. According to Boateng et al. (2017), African immigrants are more likely to have CHD risk factors and be unaware. This may be due to changes in eating habits, lack of physical activity, increased stress level, and the adaptation of the Western diet.

Rationale: This project included implementing a culture care theory in a faith-based organization to increase awareness, management, and prevention of CHD …

Pilot Project: Developing A Standardized Evidence-Based Education Process For Nurses To Enhance New Medication Eduction Of Hospitalized Patients With Heart Failure, Michele Ann Crotteau

Doctor of Nursing Practice Projects

Problem Description: Research has shown that health information is difficult for the average adult to understand while clear communication helps patients feel involved and increases adherence to treatment. The Joint Commission recommends Health Literacy (HL) assessment and the use of the Teach Back Method (TBM). Medication errors that occur between the RN and elderly patient are preventable when the RN communicates effectively about the patient’s medications. A paucity of research exists evaluating TBM for nurse-patient communications. This Quality Improvement (QI) Pilot Project (PP) took place over 3-months, aimed to improve new medication education to elderly patients with Heart Failure (HF). …

Implementation Of A Nurse-Led Transitional Care Model For Older Adults With Copd Admitted To Home Health, Michelle Ryan Hunt

Doctor of Nursing Practice Projects

Problem Description: The importance of management of chronic disease and preventing rehospitalization has been identified at national and local levels. Chronic obstructive pulmonary disease (COPD) is one of the chronic diseases with notable rates of emergency department use and recurrence of hospitalizations.

Rationale: Implementation of transitional care models have been successful for health care organizations in chronic disease management.

Interventions: The health-social partnership transitional care management program (HSTCMP) was used to design a transitional care model process pilot for a home health agency (HHA) within a health system. This process used a multidisciplinary team led by a registered nurse for …

Increasing Physical Activity In Hispanic Adults To Reduce Complications Of Type 2 Diabetes, Linda C. Valenzuela

Doctor of Nursing Practice Projects

Problem Description: Adults in the United States do not exercise sufficiently to meet the specifications outlined in the 2018 Physical Activity Guidelines (U.S. Department of Health and Human Services, 2018). The Office of Disease Prevention and Health Promotion’s (2018) Healthy People 2020 aims to eliminate health disparities and achieve health equity among all population groups in the United States. However, statistics from the U.S. Office of Minority Health (2014) indicate that Hispanics are twice as likely to be diagnosed with type 2 diabetes as non-Hispanic whites. According to a Centers for Disease Control and Prevention (CDC) report in 2015, …

Evaluating Adn Faculty Job Satisfaction, Karen M. Thies

Doctor of Nursing Practice Projects

Background

The U.S. is facing a critical shortage of nurses as the aging baby boomer generation is requiring more nursing care. Contributing to the nursing shortage is the inability to educate larger numbers of nurses, attributable to a lack of nursing faculty. Insufficient numbers of nursing faculty results in qualified applicants being turned away from nursing programs.

Project Design

This project evaluated faculty job satisfaction in 703 accredited Associate Degree Nursing (ADN) programs in the U.S. The Index of Work Satisfaction (IWS) (Stamps, 1997), was designed to measure specific factors of nurses' job satisfaction and was emailed to all full …

A Quality Improvement Project: Adopting The Standards Of Best Practice In Simulation: Debriefing With Pearls, Rebecca Lea Hooper Keesee

Doctor of Nursing Practice Projects

Background

There is evidence the best practices of simulation, specifically, the use of debriefing, will assist the new graduate nurse’s transition into the profession by increasing their clinical judgment. This quality improvement (QI) project explored the pedagogy of High Fidelity Simulation and Debriefing as a solution for the lag in New Graduate Nurse (NGN) practice readiness. The specific aims of this project were: 1) to teach the NGN residency educators how to implement Standard: Debriefing of the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practices: Simulation^SM by focusing on the role of the debriefer; …

Organizational Improvement Readiness Assessment (Oira) Tool Evaluation, Leslie Hough Falk

Doctor of Nursing Practice Projects

Background: Research shows that despite an increase in the number of organizational improvement initiatives there is a lack of consistent, sustained outcomes. Organizations struggle with how to reliably and accurately measure their readiness to drive and sustain outcomes. A search of the literature failed to identify a comprehensive, evidence-based tool that has been developed or evaluated to assess organizational improvement readiness. The objective of this project was to evaluate a newly developed Organizational Improvement Readiness Assessment (OIRA) Tool.

Project Design: Guided by two theoretical models, Delphi-Based Systems Architecting Framework (DB-SAF) and the Rogers Diffusion of Innovation Model, a 3-round, modified …

Creating A Rural Nursing Workforce, Heidi Johnston

Doctor of Nursing Practice Projects

Background: Nursing students living in rural areas often encounter barriers, real or perceived, to receiving education. These students may be unable to leave home to obtain higher education due to expectations, financial issues, and geography (Robert Wood Johnson Foundation, 2010), thus contributing to a shortage of qualified nurses in rural communities. Great Basin College (GBC) recently implemented synchronized distance education Synchronized Distance Education (SDE) for the (AAS) nursing program, and there was a need to conduct a program evaluation in order to maintain/improve program quality. One goal of Healthy People 2020 (2014) is improving access to comprehensive, quality healthcare services. …

Factors Affecting Student Success In Oregon Associate Degree Nursing Programs, Tracy Fawns

Doctor of Nursing Practice Projects

Background: Multiple factors contribute to student retention and attrition rates in undergraduate nursing programs. Attrition rates are rising, which affects society as the population is aging and there is a need for more nurses. Identifying attrition risk as a method to increase student success is imperative in order to produce more nurses. The purpose of this project was to analyze and evaluate predictive factors and academic issues that affect student success at Oregon Consortium of Nursing Education (OCNE) schools in order decrease attrition rates in the science courses and increase associate degree of nursing (ADN) program completion.

Methods: This records-based …

Facilitating The Sustainability Of Health Behaviors In The Phase Iii (Graduated) Cardiac Rehabilitation Population, Andrea C. Lambe

Doctor of Nursing Practice Projects

Cardiovascular disease (CVD) develops in the setting of poor health behaviors often secondary to hypertension, dyslipidemia and hyperglycemia or diabetes (Spring et al., 2013). In the United States, it is estimated that health care costs associated with CVD management will triple to $818 billion in 2030 (Spring et al., 2013). Cardiac rehabilitation (CR) is a secondary/ tertiary prevention program aimed at reducing modifiable risk factors for CVD in a patient population who has already experienced a “qualifying” cardiac event and may be at an increased risk for sustaining another, possibly life-threatening, event (Lucan, 2010). Existing evidence points to a 45-47% …

Prehabilitation Impact On Post-Operative Risk, Readmission Rates And Patient Satisfaction, Pamela Fields

Doctor of Nursing Practice Projects

Background: Prehabilitation programs may improve 30-day readmission rates, post-operative infections and patient satisfaction in obese total joint replacement (TJR) patients. Joint replacement patients who participate in prehabilitation have improved physical function and patient satisfaction. In an effort to improve TJR patients’ mobility and recovery, a prehabilitation performance improvement project was implemented at a local wellness center.

Method: The Institute of Healthcare Improvement, Triple Aim Initiative (IHI, TAI) and Centers for Medicare and Medicaid (CMS) performance improvement goals provided the project foundation (IHI, 2015; CMS; 2015). The physical exercise routine utilized in this program was identified as appropriate for use with …