Nursing Commons^™

Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport

Senior Honors Theses

The average emergency room patient is not receiving the compassionate nurse-patient communication that patients experience on other hospital floors. Fewer positive nurse-patient interactions prompt patients to state that they feel uncomforted and dissatisfied on hospital exit surveys, inciting hospital management to investigate how to reverse this trend to retain their federal funding. Emergency room nurses cite multiple barriers inherent in their work environment that prevent them from building rapport with their patients, including a layout not conducive to private conversations, strict time constraints, and a fluctuating workload. Working for a prolonged period under these conditions is driving many nurses to …

Polycystic Ovarian Syndrome And Insulin Resistance: An Evaluation Of Treatment Modalities And Complication Prevention, Sarah Mann

Senior Honors Theses

Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine disorder in women of childbearing age. This disorder includes multiple clinical manifestations, namely insulin resistance (IR) and infertility related to hormonal imbalances and anovulation. Despite being a common condition, its etiology and treatment modalities remain poorly defined. Without proper understanding and management of the condition, women may suffer numerous complications besides infertility such as diabetes mellitus type II (DMII), endometrial cancer, and cardiovascular disease. Therefore, further research is critical. This integrative review will create a comprehensive understanding of PCOS' pathophysiology, potential complications, treatment methods, and nursing considerations to promote the health …

To Implement Or Not To Implement: Safe Opioid Injection Sites As A Solution To The Opioid Crisis, Kayla Keister

Senior Honors Theses

The opioid epidemic has been a crisis in the United States for the last 30-40 years but is just now being popularized by the American public. One potential up-and-coming solution to the opioid crisis is the implementation of safe opioid injection sites, which are locations where individuals may bring drugs to inject under the supervised care of medical professionals. They are currently being used in Canada as well as several Western European countries. The question remains, however, as to whether or not the United States is ready for the implementation sites in regard to public opinion, finances, and ethics.

Exploring Therapeutic Nurse-Patient Communication: Techniques And Barriers, Pierina Rossini

Senior Honors Theses

Effective nurse-patient communication, also described as therapeutic communication, is essential for providing high quality nursing care. It increases patient satisfaction and health, decreases patient anxiety and disease symptoms, and increases patient cooperation and compliance to treatment. Some therapeutic communication techniques include attentive listening, empathy, silence, focusing, open-ended questions, clarification, exploring, clarifying, and summarizing. Unfortunately, there are barriers to therapeutic communication that have been identified. Research regarding nurse-patient therapeutic communication, consisting of secondary, qualitative, descriptive data, points to several barriers to therapeutic communication. Some of the barriers to therapeutic communication include nurse-patient gender difference; patient physical discomfort; nurse-patient language, culture, and …

Pain Management: A Flowsheet For Providers, Lisa Swezey

Doctoral Dissertations and Projects

Many different factors led to the trend of providers prescribing opioids for chronic pain. However, the misuse of and many deaths related to opioid prescriptions have caused the trend to reverse its direction. National organizations call for providers to stay clear of opioid medication and increase the use of nonpharmacological pain management, but also to treat pain adequately. There are still many barriers to decreasing the use of opioids and increasing the use of nonpharmacological methods. This scholarly project hoped to use an educational flowsheet to assist providers in meeting the demands from national organizations to decrease the use of …

Knowledge And Attitude Of Nurses In A New Rn Graduate Residency Program Regarding Pain Management, Kathryn Lee Wampole

Doctoral Dissertations and Projects

Most people have encountered pain at some point in their lives. It is a very common complaint nurses hear from patients. When assessing patients, nurses are taught to take what the patient says as his or her pain level as fact. Pain is not a vital sign that can be measured with medical equipment like temperature or blood pressure. Therefore, many nurses find assessing pain challenging. Adding to the complexity of pain management is the current opioid crisis. To help combat some of these issues, the project leader worked with healthcare administrators at a regional teaching hospital in the southeastern …

Implementation Of A Screening Protocol To Improve Provider Assessment Of Depression In Patients With Psoriasis, Marlee Bryant

Doctoral Dissertations and Scholarly Projects

Patients with psoriasis are at an increased risk for depression. Despite this risk, many dermatology care providers do not screen for depression in practice, including providers at the target practice for this project. This evidence-based practice pilot project was purposed to increase dermatology providers’ assessment of depression in patients with psoriasis. This project involved implementing a depression screening protocol at one private dermatology practice and educating providers on the use of the protocol including the embedded depression screening tool, the Patient Health Questionnaire-9. The project leader used a quasi-experimental design and collected data utilizing retrospective chart reviews completed pre- and …

Implementation Of A Scripted Education On Comfort Goals To Improve Patient Perception Of Pain Control, Vicki F. Mclean

Doctoral Dissertations and Scholarly Projects

Pain management is the culmination of physician, nurse, and patient expectations. Successful pain management is impacted by the patient’s perception and expectation of the provided interventions, as well as the perception of the care provider of the patient’s pain. Pain assessment tools have been utilized for decades and still pain control is rated as inadequate. Providing scripted education to the patient on the purpose and utilization of these tools impacts the patient’s perception of pain management. This project implemented the evidence-based practice intervention of education to improve the relationship of comfort goals to pain management. Nurses’ knowledge of pain management …

Impact Of Utilizing The Nurse Practitioner Role In Trauma, And The Effect It Has On Healthcare Utilization And Patient Satisfaction, Jason Pilkerton

Doctoral Dissertations and Scholarly Projects

The addition of Nurse Practitioners (NPs) on the trauma service at night was examined to see if it has positively impacted healthcare utilization and satisfaction in trauma patients. This four-month evidence-based, quasi-experimental project took place on the Trauma Medical Surgical Unit (TMSU) at a level II trauma center in California. Retrospective analysis of medical records and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) satisfaction surveys were performed for those trauma patients located on the TMSU 60-days prior to NPs starting at night and 60-days after. The measured outcomes were LOS, readmissions within 30-days of discharge, LOS after readmission, …

Evaluating Impedance Monitoring To Reduce Hospital Readmissions For Patients With Heart Failure With Reduced Ejection Fraction: An Integrative Review, Abigail Newton

Doctoral Dissertations and Scholarly Projects

Congestive Heart Failure (HF) is a chronic progressive cardiac disorder with high mortality rates and is the number one reason for hospital readmission in the United States. More than 5 million Americans live with HF with more than 900,000 new diagnoses annually. The likelihood of developing HF increases with age making it the most common primary diagnosis for patients over age 65. HF has a significant impact on quality of life, with depression being a common comorbid condition. Thoracic impedance monitoring has shown to reduce exacerbations and hospitalizations in patients with HF. This project evaluated the literature related to impedance …

Teach-Back Methodology To Improve Patient Satisfaction In An Urgent Care Setting, Candi Payne

Doctoral Dissertations and Scholarly Projects

The project used teach-back methodology to provide an evidence-based approach to improve patient satisfaction scores in an urgent care clinic. The teaching plan should include evaluation of patient teaching to determine effectiveness and patient understanding per The Joint Commission (TJC) for Ambulatory Care Center standards. The project was developed to assist nurses (N=12) with an evidence-based method to improve patient understanding and provide an opportunity to ensure comprehension to increase patient satisfaction scores from a one or two to a level three at the end of 30 days following implementation of teach-back. The scores revealed an increase of patient satisfaction …

Pots: Educating School Nurses, Stephanie Sherwood

Doctoral Dissertations and Scholarly Projects

The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident …

Knowledge And Attitudes Of Orthopedic Nurses Regarding Pain Management, Matthew Neumann

Doctoral Dissertations and Scholarly Projects

Nurses are at the forefront in the care of patient pain management; however, many nurses do not possess the knowledge, skills, and attitudes required for best pain management outcomes. Adequate pain management education is often infrequent in academic settings and in post-graduate health care environments. That shortcoming suggests a need to improve pain management education as advocated by The Joint Commission and U.S. Department of Health and Human Services. The purpose of this study is to measure 20 nurses’ knowledge and attitudes regarding pain and pain management while working in an orthopedic setting. It was an evidence-based practice project utilizing …

Comparative Look At The Depression Treatment Modalities Of Cognitive, Teresa M. Page

Doctoral Dissertations and Scholarly Projects

This integrative review provides a comparative view of cognitive behavioral therapy (CBT) and pharmacotherapy (PCT) as treatment modalities for adult depression. The foci of this integrative review are to examine research articles on CBT and PCT to determine which therapy, monotherapy or combination therapy, provide a higher level of therapy for depression. The metrics utilized are depression symptom remission, response to therapy, recovery from depression, and quality of life. Individual preference and response to treatment vary. This makes the reader more aware that specific populations may be more receptive to one therapy instead of the other.

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 …

Faith Community Nursing: Bridging The Gap Between Effective Healthcare And Biblical Ministry, Moriah Kenna

Senior Honors Theses

The United States’ traditional health care system is unprepared to combat the growing rates of chronic illness in its population. With over 90% of those aged 66 years and older living with a chronic illness, an emphasis on preventative care must be enacted. Faith community nursing is a viable and effective option for long-term preventative management of chronic illnesses in the community. Faith community nursing fits both the mission of the Christian church and the needs of the healthcare community and greater awareness of this must be achieved in both the faith and healthcare sectors to bring about maximum results.

Is Dietary Intervention A Viable Method For Improving Outcomes In Adult Patients With Asthma?, Jennifer Grolimund

Senior Honors Theses

Asthma is a disease process characterized by episodic inflammation of the lower airway in response to various triggers. Those with asthma have trouble breathing effectively during an acute episode, making asthma a potentially life threatening condition. Standard medical treatment of asthma, including medications and environmental changes, can be effective at reducing or eliminating negative outcomes in patients with asthma. However, a holistic approach to patient care, including an examination of dietary influence, may also be useful for patients trying to manage the course of their illness. Variations in intake of individual nutrients or in total dietary patterns may play a …

Implementation Of Teamstepps, Trynequa S. Jones

Doctoral Dissertations and Scholarly Projects

This scholarly project focused on implementing Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) in an emergency room (ER). The aim of TeamSTEPPS is to improve patient outcomes by educating healthcare professionals on communication and teamwork skills. TeamSTEPPS teaches healthcare professionals leadership skills, shared mental models, mutual trust, and closed loop communication. The purpose of the scholarly project was to improve teamwork and communication. The study method was descriptive analysis of 51 pre and posttest questionnaires, specifically looking for increased knowledge of TeamSTEPPS tools. The participants included: ER physicians, ER nurses, ER certified nursing assistants/health unit coordinators, …

Osteoporosis In Men, Seunggee Hong

Senior Honors Theses

Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass and density. Osteoporosis can occur in both genders. Women are more likely to be diagnosed with osteoporosis. Since men have larger bones than women, it is difficult to diagnose osteoporosis. However, presently, the occurrence rate of osteoporosis in men is increasing. It is very important to be aware of an increase of the true frequency of osteoporosis in men which is essential for prevention and long-term health. The purpose of this thesis is to examine pathogenesis of osteoporosis, hormone-related factors, lifestyle, diet, and exercise habits …

The Challenges And Blessings Of Missionary Nursing In Africa, Jordan E. Woosley

Senior Honors Theses

Nursing is a popular career choice in the twenty-first century, and there are many opportunities within the profession to serve. An American nurse has the ability to utilize nursing skills in Africa and share knowledge with the locals. The American nurse may face challenges when adapting to the African culture and healthcare but also may be blessed by the work and ministering to the people. The American nurse faces specific challenges such as educational differences, lack of facilities and equipment, unique diseases, and poor sanitation. In spite of these challenges, the American missionary nurse is able to grow through this …

Surgical Delay For Hip Fracture Clients And The Use Of Clopidogrel: An Integrative Review, Phoebe Genevieve Waller

Senior Honors Theses

Abstract

Hip fractures in elderly patients have very high postoperative mortality rates and the number of hip fractures in the United States is expected to increase exponentially before 2030. Early surgery is essential to improve outcomes, but patients on clopidogrel (Plavix) have a high risk for increased bleeding if surgery is performed within the usual 72 hour window. This paper presents literature and research addressing the dangers of delaying surgery versus undergoing surgery before the effects of the clopidogrel are gone. Based on articles published after 2006, most researchers advocated earlier surgical intervention than previously recommended and emphasized an individualized …

A Study Of Expressed Emotion In Psychiatric Nurses And Its Relation To The General Role And Effects Of Emotions In Nursing, Lauren A. Buck

Senior Honors Theses

Nurses play a vital role in the health and care of a patient. Through that care, the nurse has the ability to improve the patient’s experience or ruin it. A vital component influencing the care provided are the emotions the nurse displays toward her coworkers, patients, and patients’ family members. The emotions of a nurse may positively or negatively impact a patient. The studies that examine the impact of the nurse’s emotions on patient’s outcomes are varied and few. The communication and emotion of nurses are likely to impact their care and, from that, the patient’s outcome; however, there is …

A Literature Review: Current Trends In Holistic Nursing, Angela J. Wolf

Senior Honors Theses

There is scarcity of documentation that seeks to define spirituality relating to holistic nursing; consequently, a literature review was formulated to define spirituality and guide nursing practice towards recognizing the importance of and implementation of spiritual care. By researching the current trends in peer-reviewed journals from the past three years and analyzing associated articles, this paper addresses the need for a comprehensive definition of spirituality. Key concepts such as belief, values, interconnectedness with self, others and God, energy, hope and transcendence will be analyzed, and the accumulated data will be complied into a framework that is easy for a nurse …