Nursing Commons^™

Parental Nutrition Health Literacy, Sheila F. Towson

Regis University Student Publications (comprehensive collection)

Executive Summary

Parental Nutrition Health Literacy and Children’s Health

Problem: The problem identified in the following study is that overweight and obesity is associated with comorbidities that contribute to chronic diseases such as depression, decreased academic performance, type 2 diabetes, cardiac disease and others (Allesio, 2018; Barlow & Expert Committee, 2007). Demographics reveal obesity prevalence among children and adolescents to be 18.9% in the lowest income group, 19.9% in the middle-income group, and 10.9% in the highest income group (CDC, 2018). School and home environments are especially influential in affecting school-age children’s health behaviors (Luesse, Paul, Koch, Contendo, & Marsick, …

Enhancing Patient Portal Usage, Patricia Pawling

West Chester University Doctoral Projects

Abstract

The patient portal was created to offer the opportunity for patients to become more involved with their health care outcomes. However, it has been identified that patient portals are not being widely used. The portal can increase a patient’s knowledge about their health care and provide significant communication exchanges with their health care providers to help improve and understand their care needs. This quality improvement project was implemented to evaluate whether using an educational intervention of the benefits of the portal would increase usage of the portal and patient-provider communication utilizing the portal. Each patient, upon checking in with …

Adults On The Autism Spectrum: A Quality Improvement Project To Develop A Patient-Centered Nursing Care Guideline For The Acute Care Setting, Elizabeth Cirelli

DNP Scholarly Projects

Abstract

Background: Incidence of autism spectrum disorder is increasing. Current prevalence rate is 1 in 59 people, which translates to roughly 1% of the U.S. population. These adults have higher rates of epilepsy, gastrointestinal disorders, obesity, cardiac dysfunction, and mental health disorders. Healthcare system utilization is resultantly greater than their neurotypical counterparts, coupled with longer lengths of stay and decreased patient satisfaction reports.

Purpose: Most nurses report little to no formal training about the disorder or how to develop interventions sensitive to the needs of this population yet are crucial care givers to ensure patient-centeredness. A guideline to …

Timely Follow Up Care After Initiation Of Adhd Medication In Children: A Quality Improvement Project, Rebecca Haas

DNP Scholarly Projects

Background: Enhancing medication safety, strengthening compliance and mitigating side effects requires close monitoring. A child, defined by Centers for Medicare and Medicaid Services, as being between the ages of 6 years and 12 years of ages, with Attention Deficit Hyperactivity Disorder (ADHD) must have an initial medication visit within 30 days of a first-time trial of ADHD medication. Increasing staff awareness of organizational policy of expected timeframe for medication checks and annotating appointment slots as initial medication checks will decrease the number of days between the first-time trial of ADHD medication and a child’s medication assessment. Methods: The Model for …

Engaging Patients With Dementia In The Acute Care Setting: A Quality Improvement Initiative For Staff, Andrea Lee

DNP Scholarly Projects

Caring for dementia patients in the acute care setting can be challenging. Staff is trained to manage the acute illness and the symptoms of dementia can impact that care. Training for the care and management of the patient with dementia is not routinely provided for the acute care setting. According to the Alzheimer’s Association (2018), 5.7 million people are living with Alzheimer’s Dementia with the numbers projected to continue to rise. Training in the management of symptoms can alleviate stress and complications for not only the patient but staff members as well. The goal of this project is to educate …

Moving A Licensed Practical Nurse To A Registered Nurse In New Hampshire: A Health Policy Initiative, Vicki Gamez

DNP Scholarly Projects

Background: The United States is expected to experience a shortage of Registered Nurses (RN) due to a demand for more nurses to care for an aging population. Not only is there a current deficit in the number of RNs, but there is also a lack of ethnic and racial diversity among RNs. Licensed Practical Nurse (LPN) transition programs increase workforce mobility and allow LPNs to build upon their education and clinical experience as they transition to the RN roles. Therefore, the aim of this DNP project was to implement a health policy change initiative that addresses the barriers of workforce …

Caring For Young Adults With Cancer: A Systematic Review, Sarah M. Pelletier

All Graduate Theses, Dissertations, and Other Capstone Projects

Young adulthood is unique period of life in which critical developmental milestones are achieved amid dynamic physical, emotional, and social changes. During this period of life, young adults are charged with establishing personal and social independence. When challenged with a cancer diagnosis, the already turbulent late teens, twenties, and thirties are dramatically and permanently altered. Hence, the needs of young adults vary from that of their pediatric and older adult counterparts. The aim of this systematic review of the literature was to identify what age-specific needs must be addressed by healthcare professionals to enhance quality of care and outcomes for …

Nursing Student Stress, Ruthanne Emily Hawks, Hannah Rae Wilson, Carly Marie Gillota, Taylor Anne Hall, Edward William Mccain

Williams Honors College, Honors Research Projects

Nursing students deal with a variety of stressors, including difficult curriculum and new endeavors such as clinical and lab experiences. The purpose of this study was to identify the relationship between stress levels and coping mechanisms and readiness to change unhealthy coping mechanisms in baccalaureate nursing students. The Transtheoretical Model of Change guides this non-experimental, correlational study and measured readiness for change. The Student Nurse Stress Index was used to measure stress. The abbreviated COPE Inventory was used to measure coping. Online recruitment, consent forms, and surveys were distributed to nursing students via the Student Success Center in the College …

Student Experiences With Engagement In A Nursing And Physical Therapy Interprofessional Education Simulation, Sarah Koplow, Melissa Morris, Shari Rone-Adams, Heather Hettrick, Bini Litwin, Lisa B. Soontupe, Archana Vatwani

Internet Journal of Allied Health Sciences and Practice

Purpose: Interprofessional Education (IPE) incorporated into healthcare discipline instruction has been shown to be successful in improving the understanding perceptions of complimentary professions. The purpose of this mixed method study was to measure differences in perceptions of early Baccalaureate of Science in Nursing (BSN) students and Doctor of Physical Therapy (DPT) with participation in a immersive interprofessional education experience. Method: Students completed a pre and posttest survey consisting of the Readiness for Interprofessional Learning Scale and several short answer qualitative questions. Cohorts of BSN and DPT students participated in a computerized mannequin simulation experience or a hybrid simulation. Results: Students …

The Impact Of Clinical Reasoning Seminars On Medical-Surgical Specialty Hesi Exam Scores, Stephanie Fugate

DNP Projects

Abstract

Background: Clinical reasoning and clinical judgement have been identified as essential skills for the delivery of quality patient care. Nursing education relies heavily on standardized exams like the HESI to predict success on the national licensure exam.

Purpose The purpose of this study was to determine the impact of clinical reasoning seminars (CRS) on medical-surgical specialty HESI exam scores of first semester junior BSN nursing students.

Methods: A retrospective correlational design was used for this study, which involved a review of medical-surgical HESI scores for 115 junior level baccalaureate nursing students who were identified as academically high-risk and who …

Device Related Concerns Pertaining To Primary Caregivers Of Lvad Patients, Nicole Smith, Carissa Smith

DNP Projects

Abstract

PURPOSE: The purpose of this project was to focus on caregiver education with an emphasis on caregiver concerns regarding the LVAD; additionally, evaluating the efficacy of an educational video acknowledging those device-related concerns identified by caregivers. The goal of this project is to improve caregiver knowledge and decrease the rate of device related concerns among the primary caregivers.

METHODS: This project is a single center cross-sectional, pre-post-test implementation design to determine the efficacy of device related concerns education on primary caregivers’ knowledge and concerns. A 16-point device related concerns scale was designed to appraise primary caregiver concerns. The scale …

Evaluation Of The Care And Communication Bundle To Improve Palliative Care In Intensive Care Units, Angela Susan Bohon

Graduate Theses, Dissertations, and Problem Reports (ETD)

Review of local data and concerns from nursing staff revealed the need to improve palliative care in a local, community hospital Intensive Care Unit (ICU). This effort was mobilized by implementing the Care and Communication Bundle within evidence-based time frames, into this local, community ICU, using Lewin’s Change theory as a guide for implementation. The Care and Communication Bundle is a grouping of nine palliative, quality measures found to improve palliative care in the ICU. A pre/post-educational intervention evaluated if the implementation of the Care and Communication Bundle in the ICU improved palliative care by reviewing the documentation of the …

Women Veterans’ Descriptions Of The Patient-Provider Interaction With Civilian Providers, Billie S. Vance

Graduate Theses, Dissertations, and Problem Reports (ETD)

BACKGROUND: Women veterans require care for unique gender, and war-related health issues. Concerns exist regarding non-Veterans Health Administration (VHA), civilian healthcare providers’ preparedness to deliver care to the veteran population. Health outcomes are influenced by the quality of care provided to patients. There is a significant gap in the literature with regard to woman veterans’ perspectives about the quality of the patient-provider interaction between women veterans and non-VHA, civilian providers.

PURPOSE: The purpose of this study was to describe women veterans’ perspectives about interactions between themselves and civilian providers and to critically analyze the veterans’ data to further inform the …

Nutritional Strategies For Nurses In A Fast Paced Occupation, Zachary Christman

Department of Agronomy and Horticulture: Dissertations, Theses, and Student Research

The foundation of the medical system are the nurses and certified medical assistants. Their personal health condition affects how well diseases and other medical conditions are handled. This article will begin with an overview of the eating behavior of nurses. Three different interventions which have been shown effective in a fast paced workplace are presented in order to improve the health of nurses and certified medical assistants. The first intervention is organizational changes that would increase the amount of time nursing staff have to eat. The second is the use of a messenger bag delivery system to provide needed food, …

Measuring Nurse Competence In The Emergency Department, Matthew Lojo

University of the Pacific Theses and Dissertations

Background: “Nurses provide essential care to the millions of people who are hospitalized each year as a result of illness or injury” (Smith, 2012, p. 172). The Institute of Medicine reported approximately 44,000-98,000 patients die annually resulting from a medical error, and health care errors ranked among the top 10 for the leading causes of death in the United States (Smith, 2012).

Problem: Nurse competence impacts safe and quality nursing, and several research studies investigated the measurement of nurse competence among nurses in various nursing settings (Flinkman et al., 2016). However, a review of the research revealed limited studies in …

The Situational Context Of Safety Culture From The Perspective Of Medical-Surgical Staff Nurses And Nurse Leaders In A Hospital, Lisa Harton

Dissertations

People enter into healthcare facilities to maintain or restore health; however, often times those seeking health are harmed during the process by avoidable medical errors. Since the Institute of Medicine report on patient harm, safety culture continues to be the largest barrier in realizing safer patient care. Staff nurses' comprise the largest component of the health care workforce in hospitals and consistently have the lowest perceptions of a safety culture. Leaders who play a key role in creating and sustaining a safety culture consistently have the most favorable perception of safety culture. The development of a safety culture and safer …

Improving Low Health Literacy In Poststroke Patients By Educating The Health Care Staff, Marthilde Brzycki

Electronic Theses and Dissertations

Abstract

Lack of health literacy in the poststroke patient population is a serious issue; with the addition of the homeless population to that group, the result may be devastating. According to the American Heart Association and American Stroke Association (AHA/ASA, 2016), stroke is considered the primary cause of death and one of the chief reasons for disability in the United States, and nearly75% of strokes occur in those who are 65 years of age or older. Nurse practitioners are vital, providing necessary training and stroke education to the nursing and other health care staff. This DNP project was initiated to …

The Effect Of Dyad Rounding On Collaboration And Patient Experience, Amy Christensen, Korby Miller, Jason Neff, Rusty A. Moore, Sharee Hirschi, Katreena Collette Merrill

Faculty Publications

Communication among the healthcare team is essential to providing high-quality patient care. In the hospital, nurses care for multiple patients during their shift. Physicians or advanced practice clinicians (APCs) visit hospitalized patients daily to update orders, complete assessments, and contribute to care plans. One method to ensure that healthcare providers communicate effectively is interdisciplinary, or dyad, rounding in the hospital. This consists of purposeful rounding on each patient by the nurse and the physician or APC together to review the patient's status and update the care plan. When healthcare providers and nurses round together, it improves communication, patients are more …

The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early

Theses and Dissertations

Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level …

Determining Nurse Practitioner Core Competencies Utilizing A Delphi Approach, Tracey Chan

Electronic Theses and Dissertations

Background: Competency-based education (CBE) has been recommended for nurse practitioner (NP) education. To implement CBE, existing NP core competencies need to be reduced in number and refined.

Purpose: This study refined and reduced redundancy in the National Organization of Nurse Practitioner Faculties (NONPF) and American Association of Colleges of Nursing (AACN) NP core competencies through the consensus of experts in NP practice. This study used the current NP Core Competencies (NONPF, 2017), the Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006), and the Common Advanced Practice Registered Nurse Doctoral-Level Competencies,(AACN, 2017a) …

Implementing A Fall Prevention Program: A Quality Improvement Project To Promote Patient Mobility On The Medical-Surgical Unit, Alba Araiza

Master's Projects and Capstones

Abstract

Implementing a fall prevention program is imperative in acute healthcare settings. Falls are one of the top reported events that occur in hospitals and it is a patient safety concern that requires the implementation of evidence-based practices to reduce falls. This quality improvement project will be developed by a master’s prepared clinical nurse leader (CNL) on a medical-surgical unit to improve patient safety.

Problem

Maintaining patient safety is the most important priority in health care. Health care organizations implement protocols, policies and procedures to ensure that care is provided in a safe manner to minimize preventable harms. However, falls …

Implementing A Fall Prevention Program: A Quality Improvement Project To Promote Patient Mobility On The Medical-Surgical Unit, Alba Araiza

Master's Projects and Capstones

Implementing a fall prevention program is imperative in acute healthcare settings. Falls are one of the top reported events that occur in hospitals and it is a patient safety concern that requires the implementation of evidence-based practices to reduce falls. This quality improvement project will be developed by a master’s prepared clinical nurse leader (CNL) on a medical-surgical unit to improve patient safety.

Problem

Maintaining patient safety is the most important priority in health care. Health care organizations implement protocols, policies and procedures to ensure that care is provided in a safe manner to minimize preventable harms. However, falls are …

Reducing Pressure Ulcers In Emergency Department Boarding Patients, Youa Yang

Nursing and Health Professions Faculty Research and Publications

CRMC is a level one trauma and teaching hospital in Fresno, California. CRMC’s emergency department (ED) is licensed for 84 beds. When hall beds are added this ED can go up to 110 beds. CRMC sees over 9,000 patients a month. Due to an increase in hospital census and length of stay, this ED has a daily average of 30 inpatients boarding. In December of 2018, this ED had one hospital acquired pressure ulcers (HAPU). Barriers to preventing HAPU’s in the ED are rooms that are not big enough to accommodate hospital beds, inexperienced new nurses who are unaware of …

Nurse-Driven Protocol To Reduce Urinary Catheter Infections: A Quality Improvement Project, Sara Burrington

Master's Projects and Capstones

Costs of healthcare are astronomical, not only in the financial sense, but in many aspects of life for both patients and healthcare providers. Costs include those accompanying healthcare associated infections (HAI), where as a result of environmental factors, a patient acquires an infection during their admission. Since 2008, Medicare and Medicaid no longer reimburse hospitals for infections deemed ‘reasonably preventable.’ The biggest offender of this type of HAI is overwhelmingly, catheter associated urinary tract infections (CAUTI) (Kennedy, Greene & Saint, 2013). With approximately 31% of the inpatient population requiring an indwelling catheter at some point throughout their stay, risk of …

Compounding Effects Of Reducing Nurse Burnout And How It Can Produce An Increase In Patient Safety And Satisfaction, Alexander Mua

Master's Projects and Capstones

The reduction of nurse burnout has shown to have an increase in patient satisfaction and quality of care. It also has shown a decrease in patient-related or sentinel events. Accordingly, with the reduction of nurse burnout, there has also been a reduction of compassion fatigue. This project has illuminated the benefits of acuity-based caseload at the micro-level, including the cost-effective nature of overtime pay, including HCHAPS benefit score. The method of obtaining, planning, and implementing was based on the Plan, Do, Study, Act (PDSA), which required collaboration amongst multiple disciplines, groups, departments, and executives. The process and goals concluded to …

Expanding Magnetic Resonance Imaging Access For Patients With Cardiovascular Implantable Electronic Devices, Rosalie Geronimo

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem. Patients with non-conditional cardiovascular implantable electronic devices (CIEDs), which lack magnetic resonance imaging (MRI) components, are unable to undergo MRI.

Context. The Heart Rhythm Society guidelines for patient device management and Centers for Medicare and Medicaid Services requirements for persons with specific expertise in implanted permanent devices to manage CIEDs during MRI spurred policy, procedure and staffing changes.

Interventions. The evidence-based change-of-practice project comprised of workflow development, policy and procedure changes, implementation of required staffing support to manage the CIED during an MRI.

Measures: The outcome measure was to improve access to MRI for patients with CIEDs, measured …

Nurse Manager Succession Planning: Building A Leadership Pipeline For The Future, Katie Stephens

Doctor of Nursing Practice (DNP) Projects

Problem. This academic medical center was increasing bed-capacity and needed to hire 12 additional nurse managers (NM) to meet these new requirements. Promoting assistant nurse managers (ANM) to the NM role saves time and money, supports leadership and cultural continuity, and demonstrates a strong organizational commitment to internal human capital.

Context. Formal nurse manager succession planning (NMSP) programs have been shown to increase nurse manager competency and retention rates, while also helping to identify and develop new generations of nurse leaders. To mitigate the recent loss of ANMs and strengthen the remaining leadership bench strength, the organization is developing, implementing, …

Adopting Complex Case Management Competencies, Phyllis Stark

Doctor of Nursing Practice (DNP) Projects

Improving disposition management of complex hospitalized patients is crucial to the success of acute care facilities. Most hospital patients discharge in less than 5 days, but there is a cohort of complex patients whose length of stay far-exceeds the norm (Centers for Medicare and Medicaid Service Website, n.d.). Today’s case managers are focused on patients who are discharging today or tomorrow in order to keep hospital census cycling through. This phenomenon known as “throughput” drives daily operations and is a measure of success. When case managers are faced with complex patients whose length of stay measured in weeks, months, or …

Assessment Of Structural Competency In Baccalaureate Nursing Students: A Descriptive Study, Elle J. Del Gallo

Senior Honors Projects, 2010-2019

Cultural competence has been investigated extensively in nursing education to better prepare nurses to care for individuals of diverse backgrounds. While developing cultural competence is important to address individual care needs, it may not address the social and structural factors that influence health. Structural competency describes the ability to assess not only cultural factors that affect health disparities, but also structural inequalities and stigmas that can alter a patient’s presenting symptoms and risk for certain diseases.

A Formal Hcahps Teaching Program Targeting Communication Improves Hcahps Scores, Bobbie Davis

Master's Projects and Capstones

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey given to patients after discharge from an inpatient unit is a validate tool used to determine the level of patient experience. Organizations across the country, including the Northern California Academic Medical Center, have implemented many initiatives aimed at improving these scores. HCAHPS scores for the hematology/oncology unit at this medical center remain low even after previous education efforts. The aim of this quality improvement project was to improve the patient experience, as evidenced by HCAHPS scores, with the implementation of an HCAHPS teaching program for nursing staff, focusing on …