Nursing Commons^™

Oncology Nurse Compassion Fatigue Benchmark Project, Jessica R. Hayward

MSN Capstone Projects

Oncology nurses provide care to patients during some of the toughest times in their lives. This care places nurses at risk of developing compassion fatigue which can have negative long-term health impacts. There is currently no formal compassion fatigue education offered to oncology nurses. This lack of training leaves nurses vulnerable to the impacts of unmanaged stress, burnout, and compassion fatigue. This benchmark project was completed to bring awareness to the need for a mindfulness-based compassion fatigue course. This course will provide oncology nurses with the knowledge and skills necessary to manage these difficult emotions.

A Pain Control Optimization Pathway To Reduce Acute Postoperative Pain And Opioid Consumption Postoperatively: An Approach To Battling The Opioid Epidemic, Holly Franson

Student Scholarly Projects

Practice Problem: Healthcare providers worldwide are working to battle the opioid epidemic and reduce opioid-related harm to patients. Utilizing evidence-based acute pain management methods to reduce opioid consumption is critical to combat the problem.

PICOT: The PICOT question that guided this project was: In opioid-naïve adult patients undergoing general anesthesia for out-patient, minimally invasive abdominal wall hernia surgery, how does the implementation of an evidence-based, preventative Pain Control Optimization Pathway (POP) using a multimodal, opioid-sparing acute pain management technique and standardized procedure-specific opioid prescribing, compared to standard treatment, affect postoperative pain scores and opioid consumption, upon discharge from the …

Implementing The Heart Score Guideline To Decrease Length Of Stay In Low-Risk Chest Pain Patients In A Rural Hospital, Tonja D. Walker

The Corinthian

Abstract

This quality improvement (QI) project evaluated the length of stay (LOS) of low-risk chest pain (CP) patients in a rural hospital. A convenience sample of emergency department (ED) physicians and non-physician providers ages 18-75 employed at Navicent Health Baldwin were eligible for recruitment. Pre- and post-surveys were used to evaluate to evaluate ED providers’ knowledge of low-risk chest pain metrics for statistical significance and a comparison of LOS for low-risk chest pain patients was compared for clinical and statistical significance seen at the facility. The mean scores of eight items on the postintervention to preintervention knowledge survey were identical. …

Tailoring Violence Prevention Programming To A Critical Care Area, Jaime Campbell

Dissertations

Abstract

Problem: Rising rates of violence in health care environments signal a need for health care workers, specifically frontline nurses, to be trained in effective de-escalation management skills. Since January 2017, there has been an increase in the number of patients categorized as aggressive with more violent patient events taking place at a selected midwestern hospital facility in the critical care department, particularly the intensive care and transitional care units.

Methods: Using a pre-post design, this project compared nurses’ verbal de-escalation skills using the English Modified De-escalating Aggressive Behaviour Scale (EMDABS) to determine effectiveness of de-escalation strategies in simulated scenarios …

Sustainability Of An Outpatient Antibiotic Stewardship Program, Kristin Smith

Dissertations

Abstract

Problem: Antibiotic stewardship is an effort to evaluate and improve the use of antibiotics by providers and patients. Antibiotic stewardship programs (ASPs) promote the appropriate use of antibiotics. There is increasing evidence that supports the use of antibiotic stewardship programs in reducing antibiotic prescribing rates while continuing to maintain safe patient care. Research supports approaches with multiple interventions and ongoing commitment to antibiotic stewardship. However, information regarding long-term sustainability of antibiotic stewardship programs is lacking. The purpose of this quality assurance project was to assess long-term sustainability of a previously implemented ASP promoting appropriate prescribing of antibiotics for the …

Effect Of Standardized Nurse Teaching On Patient Experience Using Cahps®, Julie Hake

Dissertations

Abstract

Purpose: This quality improvement (QI) project aimed to determine if a standardized nurse teaching approach improved patient understanding of diagnosis and treatment as it relates to women diagnosed with a pelvic floor disorder (PFD) after receiving a standardized nurse education (SNE) session in an urban tertiary care Urogynecology practice.

Methods: Females aged 18 and older with a newly diagnosed PFD and prescribed PFPT for the first time who agreed to receive the SNE and complete the CAHPS® survey were included in the project. Patient perception of PFPT was assessed via phone interview utilizing the Consumer Assessment of Healthcare …

Implementing A Three-Minute Foot Exam For Diabetic Patients In Primary Care, Emilee Laster

Dissertations

Problem- One in four U.S. Veterans have Diabetes Mellitus, and one in four U.S. Veterans with diabetes will develop a diabetic foot complication. There is currently no protocol for healthcare providers to perform foot screenings on diabetic patients at each visit. Utilizing a foot screening at each visit for high risk diabetic patients may help to recognize problems sooner, making treatment easier and less aggressive.

Methods- This quality improvement initiative was a retrospective and prospective record review before and after evidence based three-minute foot exams were implemented. A convenience sample of 50 patient medical records were reviewed to collect demographical, …

Bedside Shift Report: A Way To Improve Patient And Family Satisfaction With Nursing Care, Audriana Pevec

Student Scholarly Projects

Poor communication during the handoff process contributes to approximately 30% of malpractice claims costing up to $1.3 billion annually (Fenner, 2017), which demonstrates the importance of evaluating the quality of information exchange between nurses, patients, and families when associating quality of care to patient satisfaction (Kullberg et al.,2017).

The following question guided this Evidence-Based Project (EBP) project. In adult, progressive care unit patients (P), does the implementation of a nursing bedside handoff (I) compared to current handoff practices (C) improve patient/family satisfaction with nursing care (O) over eight weeks (T)?

The literature revealed evidence from 10 studies answering …

Social Network Centrality, Social Construction Of Knowledge, And Nurse Practitioner Competency In Asynchronous Online Discussions Among Adult Gerontology Acute Care Nurse Practitioner Students, Sharon Schaaf

Organization, Information and Learning Sciences ETDs

The relationships between social network centrality, social construction of knowledge, and nurse practitioner competency among adult gerontology acute care nurse practitioner students participating in asynchronous online discussions were explored. Social network centralities (betweenness, in-degree, out-degree, closeness, and eigenvector) were determined through social network analysis. Social construction of knowledge was assessed by the Interaction Analysis Model (IAM). Nurse practitioner competency was evaluated using the Novice to Expert model. A retrospective exploration of an online discussion board from the College of Nursing at the University of New Mexico was conducted. The centralities of betweenness, closeness, and eigenvector demonstrated a significant relationship with …

Stat-Lock Stabilization, Michelle Hicks

Scholars Week

NUR 412 EBP Project Presentation- Stat-Lock Stabilization

Educating Nurses On Therapeutic Discussion Of Code Status, Alanna Wathen

Scholars Week

My presentation outlines the best ways according to current evidence on how nurses should discuss code status therapeutically with patients.

Peripheral Iv Bundle, Alicia Hanna

Graduate Theses, Dissertations, and Capstones

Abstract

It is estimated that over 90% of hospitalized patients require IV access during their hospitalization. Peripheral IVs (PIVs), while less risky than central lines, are not without risk to the patients. Intravenous (IV) infiltration in pediatric patients is a very common complication associated with IV access, accounting for about 67% of IV catheter removals; a less common complication, but much more serious complication of a PIV can be a blood stream infection (BSI) which can account for up to 35% of BSIs seen in patients. BSIs are associated with increased length of stay, increased morbidity and can result in …

Lowering Perceived Stress Levels In Undergraduate Nursing Students, Caitlin Dodd

Electronic Theses and Dissertations

This project analyzed the effects of guided meditations and a stress management class on undergraduate, prelicensure nursing students’ perceived stress levels. College students and professional nurses are both susceptible to having high stress levels. Mindfulness activities have been shown to lower stress levels. Undergraduate, prelicensure nursing students participated in this project determining the effects of guided meditations and a stress management class on perceived stress levels in a quantitative, pre- and postinterventional study. Participants in the project completed a stress management class and 18 guided meditation sessions in an undergraduate classroom setting. The researcher used the Perceived Stress Scale-10 (PSS-10) …

Presence And Distress Of Chemotherapy-Induced Peripheral Neuropathy Symptoms In Upper Extremities Of Younger And Older Breast Cancer Survivors, Susan Storey, Andrea Cohee, Diane Von Ah, Eric Vachon, Noah R. Zanville, Patrick O. Monahan, Timothy E. Stump, Victoria L. Champion

Journal of Patient-Centered Research and Reviews

Purpose: The purposes of this study were to determine whether the presence of upper extremity chemotherapy-induced peripheral neuropathy (CIPN) symptoms (burning, pins/needles, numbness, pain, and skin crawls) among breast cancer survivors (BCS) varied according to age (≤45 years or 55–70 years) and to examine age group differences in upper extremity CIPN symptom distress.

Methods: The study was a secondary analysis of younger (n = 505) and older (n = 622) BCS. Inclusion criteria were age of ≤45 years or 55–70 years; patient at 3–8 years postdiagnosis; patient received the chemotherapy regimen of paclitaxel, doxorubicin, and cyclophosphamide; and patient did not …

What Are The Nurse’S Perception Of The Effectiveness Of The Electronic Go-Jo Monitoring System On Hand Hygiene Compliance And Hospital Acquired Infection’S?, Patricia James

Seton Hall University DNP Final Projects

Background: The importance of hand hygiene compliance in preventing hospital acquired infections is well known. Yet national averages for compliance rates with hand hygiene among healthcare workers remains unsatisfactory. Noncompliance with hand hygiene practices can contribute to increased patient mortality, prolonged length of hospitalization, increase healthcare costs and decreased reimbursement for hospitals from the Centers for Medicare and Medicaid. Project Aim: The purpose of this quality improvement project was to explore the nurses’ perceptions of the effectiveness of the electronic Go-Jo monitoring system on hand hygiene compliance and hospital acquired infections. Methods: This was a performance …

Simulation: An Effective Tool For Mentoring The Novice Nursing Faculty, Charlene B. Smith, Jeanne Hamner, Carol Hession, Cari Granier, Travis "Pete" Lewis, Ashley Thibodeaux

Journal of Interprofessional Practice and Collaboration

Abstract

The American Association of Colleges of Nursing (AACN) (2019) reported in 2018-2019, U.S. nursing schools turned away more than 75,000 qualified applicants from baccalaureate and graduate nursing programs due to insufficient numbers of faculty and clinical sites. Two-thirds of the nursing schools related a shortage of nursing faculty and/or clinical preceptors as a reason for not admitting qualified applicants (AACN, 2019).

There is a triad of challenges facing nursing today. The evolving triad is a nursing shortage, a lack of clinical facilities and nursing faculty. Nursing education must increase enrollment to fulfill the upcoming nursing shortage. Nursing schools are …

Communicating Confidently: Skills For Nursing Student Clinical Success, Cari Granier

Journal of Interprofessional Practice and Collaboration

Background: Ineffective communication in healthcare has been tied to medical errors and provider stress (Chaharsoughi et al., 2014). Many nursing students struggle when communicating in the clinical setting because they lack confidence. When left unaddressed, this issue can follow students as they begin their nursing careers. Purpose: The study focused on measuring how confident undergraduate nursing students felt communicating with patients, visitors, nurses, and faculty in the clinical setting prior to and after instructor-led interventions. Methods: 17 first-year baccalaureate nursing students from Nicholls State University volunteered to participate. Participants were asked to anonymously complete a survey prior …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Loma Linda Nurse - Vol. 28, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | Faces of the Frontlines

12 | The COVID Effect

16 | Far and Away—Gabriele Stevens

18 | Leveling Up— A View of the Future

LLUSN HIGHLIGHTS

20-27 | ALUMNI NEWS

28-31 | HOMECOMING

32-35 | ACADEMICS

36-43 | FACULTY UPDATES

A Narrative Inquiry Of Associate Degree Nursing Students' Stories About Their Experiences With Academic Misconduct, Bridget Maley

Publications and Research

Academic misconduct is a growing national and global concern. There is a paucity of literature on academic misconduct in nursing. Utilizing the qualitative method of narrative inquiry, this study gives voice to students’ stories of academic misconduct and reveals intimate stories of their experience. The stories contribute to a deeper understanding of associate degree nursing students' experiences with academic misconduct. The findings of the study have implications for future research, nursing education, and practice.

Home Health Care Nursing In The Pandemic: Preliminary Analysis Of Video Interviews, Richard P. Smiraglia, Edmund Pajarillo, Elizabeth Milonas, Sergey Zherebchevsky

Publications and Research

No abstract provided.

Resilience, Moral Distress, And Workplace Engagement In Emergency Department Nurses, Paul Clark, Timothy Crawford, Brandonn Hulse, Barbara Polivka

Faculty and Staff Scholarship

This cross-sectional, correlational study’s purpose was to evaluate the effects of resilience and moral distress on workplace engagement in emergency department nurses providing direct patient care. Data were collected from 175 emergency department nurses using a Web-based survey. The higher the nurses’ resilience and the lower their moral distress, the greater their workplace engagement. Resilience and moral distress were not correlated; furthermore, moral distress did not mediate a relationship between resilience and workplace engagement. Resilience was higher with greater job satisfaction, increased age, and longer tenure as a nurse. Workplace engagement increased with higher job satisfaction and less time seeking …

An Escape Room For Sepsis Education, Brit Voshage, Autumn Leigh Cole

Nursing DNP Projects

Abstract

The desired outcome for this project is to improve nurse’s self-perceived confidence, competence and knowledge in recognizing the early symptoms of sepsis in adult medical patients. Evidence indicates that early recognition and intervention are key to survival.

Overall, the literature regarding sepsis education indicates that education in combination with a screening tool is the most effective in assisting nurses with early recognition of sepsis in hospitalized patients. All studies reviewed on escape rooms focused on nursing knowledge and self-perceived confidence or competence and used a pre/posttest design.

Registered nurses will participate in a high fidelity escape room to help …

The Use Of Tailored Interventions To Prevent Falls: A Quality Improvement Project In The Telemetry Unit, Roda Galang

Student Scholarly Projects

Background: Every year in the United States, hundreds of thousands of patients fall in hospitals with 30 to 50 percent resulting in injury. In Texas, the fall rate in adult patients is 33.9 percent, and in one teaching hospital in South Texas, patient fall rates have been above the national benchmark for two years (2017-2019), despite increased use of sitters for patient safety and multiple fall prevention strategies. The annual direct care cost of all fall events in the United States for individuals more than 65 years old is about $34 billion.

Practice problem: The objectives of the fall initiative …

A Patient-Centered Approach To Fall Prevention, Elmer Esguerra

Student Scholarly Projects

Practice Problem: In 2019, a rural hospital in South Texas reported 102 incidents of patient falls. Although below the corporate fall rate benchmark of 2.2/1000 patient days, the hospital recognized that it was clinically significant and aimed at improving its fall prevention outcomes.

PICOT: The PICOT question that guided this project was: Among adult patients in the acute care setting would the implementation of patient-centered interventions be more effective compared to the usual fall prevention interventions in reducing incidence of falls one month after implementation?

Evidence: Seven pertinent studies, which included a randomized controlled trial and a systematic review, recommended …

Essential Oil Therapy For Alleviation Of Discomfort In Surgical Patients, Nenhuan Huang

Student Scholarly Projects

Practice Problem: Post-surgical pain (PSP) has not been sufficiently managed despite routine opioid use. The adverse effects of opioids led to the search for non-pharmaceutical intervention.

PICOT: The PICOT question that guided this project was, "In an acute hospital surgical setting, does essential oil therapy complement pain and discomfort relief comparing to conventional pain management alone after 6 weeks?”

Evidence: Seven clinical studies, five systematic or integrative reviews, and four conference proceedings were reviewed. The evidence supported lavender essential oil for the alleviation of PSP and discomfort.

Intervention: Patients breathe through a personal lavender essential oil inhaler hourly or …

Patient Controlled Fluid Restriction Monitoring, Christina Tindel

MSN Capstone Projects

Patients are often placed under non-pharmacologic orders such as fluid restrictions during their hospital stay. The following article will discuss a plan to implement a change to have patients take a more active role in their plan of care by being the main ones to monitor their fluid intake.

The Effects Of Guided Meditation On The Stress Levels Of Student Registered Nurse Anesthetists, Olivia Nassoiy, Abigail Hadley

Grace Peterson Nursing Research Colloquium

Background: Student Registered Nurse Anesthetists (SRNAs) cope with both academic and clinical stressors which can lead to an increase in stress, anxiety and depression. ¹ The literature demonstrates that guided meditation is a useful tool that can be integrated into daily life to help decrease stress and improve well-being. ²

Objectives: The purpose of this DNP project was to describe the level of stress among SRNAs and examine the relationship between a guided meditation intervention and self-reported stress, depression, wellness, and self-efficacy among second year SRNAs.

Method: The participants were second year anesthesia students attending NorthShore University School of Nurse …

Improved Representation And Effective Communication Positively Impact The Nursing Education Experience Of Male Student And Certified Registered Nurse Anesthetists, Max Bader, John Gockman

Grace Peterson Nursing Research Colloquium

The purpose of this study was to investigate past experiences with gender barriers among male student registered nurse anesthetists (SRNAs) and Certified Registered Nurse Anesthetists (CRNAs) in their educational and professional careers. Men have been underrepresented in the nursing profession in modern history. To date, no research has been conducted on the gender barriers faced by men in nurse anesthesia. This is a descriptive, quantitative study using a survey methodology. Student and Certified Registered Nurse Anesthetists who are members of the Illinois Association of Nurse Anesthetists (IANA) were recruited via email and voluntarily completed the web-based Inventory of Male Friendliness …

Pressure Injury Documentation And Reporting: A Quality Gap, Mary Ann Laslo

Master's Projects and Capstones

Abstract

Problem: Inaccurate and incomplete pressure injury (PrI) assessment and documentation leads to inaccurate reporting of PrI quality reporting measures to the Centers for Medicare and Medicaid Services. Inaccurate, incomplete documentation of pressure injuries and wounds adversely affects the quality of care, financial reimbursement, and hospital reputation as well as increasing the risk of litigation to medical providers. Barriers to accurate and complete documentation by the nurses were inaccuracy in identification of PrIs Stage 1 or greater and knowing what and where to document the information in the electronic medical record.

Context: This quality improvement project attempted to improve nurse …