Nursing Commons^™

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 …

The Effects Of In-Service Education On Workplace Incivility For Crnas, Tran King

Doctoral Projects

Workplace incivility (WPI) affects many healthcare providers, including Certified Registered Nurse Anesthetists. This project was an exploration of the prevalence, nature, and sources of WPI affecting CRNAs. The project’s intervention was an in-service education on WPI for CRNAs. The purposes of the project were to measure the effectiveness of the in-service education in increasing awareness of CRNAs about WPI; and to offer a practice change proposal in terms of a policy against WPI in the anesthesia department.

A Needs Assessment Survey and Demographic Data Information form were distributed from Survey Monkey to participants’ email by way of blind copy. Data …

Loma Linda Nurse - Vol. 25, No. 01, Loma Linda University School Of Nursing

Loma Linda Nurse

Contents

FEATURES

4 | Full Circle – Dexter Emoto and Mao Kimura

6 | Mentorship

8 | A Place for Excellence

10 | New Scholarships at the School of Nursing

LLUSN HIGHLIGHTS

12-17 | ALUMNI NEWS

18-23 | HOMECOMING

24-27 | COMMENCEMENT

28-32 | ACADEMICS

33-35 | FACULTY UPDATES

Implementing The Use Of Intracuff Alkalinized Lidocaine Among Certified Registered Nurse Anesthetists: A Practice Change Proposal, Shawn Taylor

Doctoral Projects

Patients today are experiencing comorbidities predisposing them to increased risk under general anesthesia. Emergence cough reflex is a response that can lead to hemodynamic alterations occurring during emergence and the postoperative period for many patients requiring general endotracheal tube anesthesia (GETA). It is proposed that 38% to 96% of patients receiving GETA will experience coughing during emergence (As, Iqbal, & Ali, 2009; Watkins, Lee, White Jr, & Mundy, 2012).

The use of intracuff alkalinized lidocaine is an intervention shown to be effective in previous studies at blunting this response during anesthesia emergence. Through verbal communication with CRNAs, it was discovered …

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 …

A Whooping Cough Education Module For Wic Clients In Utah, Karlen E. Luthy, Alicia Anderson, Janelle L. B. Macintosh, Renea L. Beckstrand, Lacey M. Eden, Ryan Amy, Christopher I. Macintosh

Faculty Publications

Background: Clients in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are required to complete education modules quarterly to maintain eligibility. The purposes of this project were to: (1) create a whooping cough vaccination education module for WIC clients; (2) evaluate baseline perceptions of WIC clients on the whooping cough vaccine and disease; and (3) evaluate whooping cough knowledge following completion of the module. Problem: A decline in vaccination rates among infants and children using WIC services was reported by a local WIC program director who requested whooping cough vaccination education materials. This quality improvement project included …

The Lived Experience Of Feeling Disrespected, Nadine Donahue

Dissertations, Theses, and Capstone Projects

The purpose of this study is to explore the lived experience of feeling disrespected. The participants were registered professional nurses, with at least two years of clinical experience. A phenomenological approach utilizing Giorgi’s method was used to analyze the data and interpret the findings for this study. New knowledge about feeling disrespected contributes to nursing science and may help nurses and organizations that employ them, provide a healthy work environment that supports and retain them. The experience of feeling disrespected was illuminated by the following themes; “Powerless, feeling like a “nobody,” treated like you are “stupid,” utter discouragement and broken …

Exploration And Description Of Faith Community Nurses’ Documentation Practices And Perceived Documentation Barriers., Susan M. Dyess, Donna M. Callaghan, Andra S. Opalinski Dr.

International Journal of Faith Community Nursing

Purpose: Documentation within Faith Community Nursing is an expected aspect of the professional specialty but is under-studied. Findings in previously published studies suggest there is a lack of consistent documentation practices among FCNs. Therefore, the aim of this research study was to explore and describe documentation practices of FCNs, and identify the perceived barriers to documentation.

Methodology: This mixed methods research had both qualitative and quantitative components. The qualitative inquiry involved three live focus groups and three telephonic key informant interviews (n = 28). Conventional content analysis was used to examine all qualitative data. The quantitative inquiry involved a survey …

Reflection On Retention: An Evaluation Study On Minority Students’ Success In An Online Nursing Program, Amanda Hawkins, Elizabeth Frander, Melissa Young, Kaylen Deal

Perspectives In Learning

The United States nursing workforce faces a health care challenge for providing culturally competent care to the growing number of racial and ethnic minority groups. According to Gertner et al (2010), cultural competency in health care is defined as providing care to patients with diverse backgrounds to meet the social, cultural and linguistic needs. Research has shown that patients receive a higher level of culturally competent care from nurses who are from their own cultural background. Administrators and faculty working in Schools of Nursing must recognize this important fact and take action to ensure the admissions, progression, and graduation of …

Identification Strategies For The Very High Fall Risk Patient In An Acute Inpatient Psychiatric Unit, P6 Inpatient Geri-Med Psychiatry, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

Patients falling as a result of geriatric and psychiatric impairments are at a much higher risk than the average patient population. An acute care inpatient psychiatric team used baseline metrics to demonstrate increasing fall rates per month that surpassed the unit’s target number. As a result, a quality improvement project around falls was felt to be warranted.

The overall goal of this study was to improve patient safety by reducing falls for their very high risk fall population. A root cause analysis determined that this population was not being properly identified and several tools were developed and employed to better …

Rates Of Autoimmune Disease Increasing In Women, Rosa De La Cotera

Grace Peterson Nursing Research Colloquium

Abstract

Autoimmune disorders (AD) are a group of highly disabling pathological conditions that are growing at an alarming rate affecting approximately 8% of the population. These disorders occur more frequently in women, as 78% of those diagnosed are women. Little conclusive research has been conducted as to determine why there is a tremendous sex disparity when looking at the rates. Due to the overall poor health that results from these disorders, there is an increase in the societal burden in terms of health care costs, loss of work productivity and reduced quality of life. The aim of this integrative literature …

Identifying The Factors For Acute Cardiac Arrest For Establishing A New Recognition Protocol In Detecting Pre-Arrest Symptoms, Sarah Power

Grace Peterson Nursing Research Colloquium

Abstract

Background: Worsening physiological symptoms can easily go overlooked or unmanaged. The early detection of clinical signs that precede cardiac arrest can reduce the risk of worsening condition or death. Determining a nursing protocol to recognize pre-arrests symptoms would allow a systematic way to evaluate patients and their health status before adverse events occur.

Objectives: The purpose of an integrative literature review was to identify signs and symptoms that precede cardiac arrest, and to specify a recognition protocol that ameliorates patient care outcomes.

Method: An integrative literature review was conducted undergoing an extensive search to identify acute cardiac arrest and …

Evaluation Of A Video-Based Left Ventricular Assist Device Education Program For Certified Registered Nurse Anesthetists And Student Registered Nurse Anesthetists, Andrew Gause, Zain Rehman

Grace Peterson Nursing Research Colloquium

No abstract provided.

Intra-Operative Awareness With Recall Under General Anesthesia, Kelly Lannert, Dulcie Schippa

Grace Peterson Nursing Research Colloquium

Abstract

Background: Anesthesia practitioners are familiar with awareness with recall (AWR) as a phenomenon, however, research has shown it is inadequately assessed, evaluated, and treated in patients receiving general anesthesia leading to significant undesired sequela.

Objectives: The purpose of this quality improvement project (QIP) was to attempt to improve the perceived knowledge and comfort of anesthesia practitioners relative to the assessment, evaluation, and treatment of patients with AWR, thus, closing the gap between knowledge and practice.

Method: The sample consisted of 150 anesthesia practitioners from the Northshore University HealthSystem. Pre-and post-test Likert-type surveys were used and uploaded into Qualtrics to …

Programs That Can Support Nurses To Reduce Compassion Fatigue And Secondary Traumatic Stress: An Integrative Literature Review, Molly Gruettner

Grace Peterson Nursing Research Colloquium

Compassion allows a nurse to empathize with their patient and their family, but it does not prepare the nurse to cope with stressful events. Repeatedly being exposed to traumatizing events, pain, distress, and suffering can lead to nurse burn-out and fatigue. Compassion fatigue is a unique form of burnout and secondary traumatic stress (STS) encompasses ideas of compassion fatigue and the two terms are often used interchangeably. Objective: The goal of this systematic integrated literature review is to discover interventions to reduce compassion fatigue and STS in trauma nurses Methods: A systematic integrated literature review study was conducted using Ebscohost …

Effective Methods For Domestic Violence Screening In The Emergency Department, Megan Bryan

Grace Peterson Nursing Research Colloquium

Abstract

Background: The CDC reports that one in four women and one in ten men will experience some form of domestic violence in their lifetime that will have either a short-term or long-term impact on their well-being. Often the first place these victims are seen where they can receive help is the emergency department. Objectives: The goal of this systematic integrative literature review was to explore existing literature on domestic violence screening methods used in the emergency department and determine which methods prove most effective. Concurrently, this review examined the barriers to effective domestic violence screening and how nursing education …

Personality Traits, Perceived Stress, And Coping Mechanisms Of Emergency Department Nurses, Brittany Knipp

Grace Peterson Nursing Research Colloquium

No abstract provided.

Barriers To Advance Directives, Anna Malia Connor Ticknor

Grace Peterson Nursing Research Colloquium

Abstract

Background: Advanced directives (ADs) are legal documents that allows an individual to document their specific wishes for medical care should they be unable to speak for themselves. The use of advanced directives has implications directing the course of end-of-life care affecting both the cost and direction of care. Advance directives can clarify confusion and provide guidance, but their implementation is not clearly defined within the healthcare system. Despite their implications, multiple surveys indicate these documents have limited use within the United States for reasons that are not easily isolated including lack of knowledge of advanced directives and lack of …

Reduction In Delayed Patient Care On The Medical-Surgical Unit, Lina Tran

Master's Projects and Capstones

The focus of this project is to improve daily bedside rounds through utilizing the BRT, which could enhance patient safety and satisfaction by reducing delayed patient care on 3 North medical-surgical department at CPMC. The data retrieved from nurses in the past 3 months has shown that 30% of the patients had delayed care due to daily bedside rounds. By utilizing late medication as an indicator, my goal is to observe a reduction in late medication documentation due to daily bedside rounds by 10% by the end of August 2017. CPMC Davies campus adult medical-surgical department holds 44 inpatient beds. …

Mentor Program, Nicole Van Aken

Master's Projects and Capstones

Stanford Health Care- Valley Medical Oncology Consultants (SHC-VMOC) treats patients diagnosed with cancer or hematology disorders at multiple doctor’s offices and infusion centers across the Bay Area. Presently all five locations with nurses employed in the infusion centers are understaffed. The mentor program was created to train nurses to become mentors. Additional to train new hires and foster relationships between new hires and established nurses while investing in each individual. The clinical nurse leader theme that is being addressed is organizational and system leadership. The first step to implementing the program was to talk to management about the additional cost …

Improving Stress Echocardiogram Access For Patients With Low-Risk Chest Pain In The Emergency Department Clinical Decision Unit, Rosalie Geronimo

Master's Projects and Capstones

This paper attempts to demonstrate improved stress echocardiogram scheduling access for patients with low-risk chest pain in the Emergency Department Clinical Decision Unit.

Understanding The Blogging Practices Of Women Undergoing In Vitro Fertilization (Ivf): A Discourse Analysis Of Women’S Ivf Blogs, Elizabeth Orr, Susan M. Jack, Wendy Sword, Sandra Ireland, Lois Ostolosky

The Qualitative Report

Infertility and its associated treatments, including in vitro fertilization (IVF), can have a profound impact on the emotional health and well-being of women desiring to become mothers. Researchers have measured the impact of infertility and described the experience of infertility and its treatment, leaving the rich descriptions of the IVF experience as captured in women’s blogs to be explored. This discourse analysis describes the blogging practices of women undergoing IVF, exploring both the content and function of the IVF blog discourse. Data were collected from the text of seven women’s blogs (n=1,149 blog posts) and resulted in four main functions …

Cultivating A Culture Of Compassion Among Newly Graduated Registered Nurses: An Evidence-Based Mobile Learning Toolkit, Benson Yeung

Doctor of Nursing Practice (DNP) Projects

Empathy, kindness, and compassion are some of the humanistic values essential to nursing practice particularly in today’s patient and family-centric healthcare environment. A genuinely empathetic and caring relationship between a nurse and a patient not only enhances the quality and safety of care but also contributes to patient satisfaction, compliance to treatment, and overall health outcomes. Debate amongst educators and researchers continues to grow as to whether these uniquely humanistic values are innate or if they can be taught. How do nurses acquire the knowledge, skills, and attitudes towards the delivery of compassionate patient care? What strategies are best suited …

Implementing Risk Tools To Prevent Hospital Readmission, Tara O'Connor

Master's Projects and Capstones

Implementing Risk Tools to Prevent Hospital Readmission

Tara O’Connor

Abstract

Background: Readmission reduction is one of the most important opportunities for reducing cost in today’s health care system.

Global Aim: To operationalize risk tools to reduce hospital readmissions by 5 percent by the end of 2017.

Project Aim: To develop new transitions program (TP) processes that operationalizes the risk tools and ensures 70 percent of all readmission risk score patients referred receive a post discharge phone call within 48 hours, and are assessed for their risk of medication management issues as part of their initial assessment, by August 1^{st, …}

Cnl As Educator In The Emergency Department: Improving Hand Hygiene Outcomes, Michelle Batz

Master's Projects and Capstones

Prevention of hospital acquired infections (HAI) is a National Patient Safety Goal. Proper and frequent hand hygiene (HH) prevents HAI and various cross-infections in any setting. Audits of visual adherence for HH generates low compliance scores. During a yearlong improvement project, low monthly compliance scores of 52% in the Emergency Department (ED) of a community hospital, were reported by hospital auditors and found to be inaccurate by ED staff due to lack of visibility of HH actions because they occurred behind curtains or closed doors. Low scores and challenges were associated with behavioral change among ED team members, requiring multiple …

Improving Pain Management In The Cardiac Procedure Unit, Marisol Aquino

Master's Projects and Capstones

Abstract title: Improving Pain Management in the Cardiac Procedure Unit (CPU)

Unit: Cardiac Procedure Unit

Author: Marisol Aquino RN, BSN

Institution: University of San Francisco; Kaiser Permanente Nurse Scholars Academy; Kaiser Permanente Hospital, San Francisco (CNL practicum site).

Background Information

Cardiac Procedure Unit (CPU) specializes in the care of patients who are undergoing various cardiac procedures. The day-to-day operations are composed of Registered Nurses (RNs), Patient Care Technicians (PCTs), Unit Assistant (UA), and Nurse Practitioners (NPs) with an oversight from the Medical Director and Department Managers.

Patients’ perception of pain in the CPU has continually followed a “see-saw” pattern and …

Pursuing Equity In Diabetes Population, Aisha Rawlinson

Master's Projects and Capstones

Abstract

Background

Poor glycemic control (HbA1c >8) overtime leads to microvascular and macrovascular complications after the first and third years respectively, ultimately resulting in death after five years (Karter, 2016). Current Kaiser Permanente (KP) data stratified by race, ethnicity, age, and gender shows a significant disparity gap between Hispanics/Latino and Caucasian populations. The Pursuing IHI initiative is over a 2-year period completed at a microsystem that is focusing on health equity practices to reduce disparity gaps.

Project aim

KP Riverside, microsystem selected has a large population of Hispanic/Latino KP members, with focus on health equity. The project aim is to …

Aligning Theory And Evidence-Based Practices To Enhance Human Flourishing In Nurse Executives, Jim D'Alfonso

Doctor of Nursing Practice (DNP) Projects

Today’s nurse executives lead highly complex and bureaucratic organizations undergoing sweeping reform at an unprecedented rate of change. Change and high levels of stress are the norm in health care, and ineffective stress management can hinder organizational performance and adversely impact personal wellbeing. The risks of nurse executive burnout and unprecedented turnover led to the development of a 4-hour program to teach theory-guided and evidence-based stress management techniques. The program was intended to increase awareness, enhance effective stress management skills, and improve the nurse executive’s ability to flourish in high stress environments. A pre-intervention and 6-month post-intervention assessment (n …

Acute Bronchospasm Under General Anesthesia, Cody Rasmussen

Nursing Student Class Projects (Formerly MSN)

An acute bronchospasm during general anesthesia can become a life-threatening intraoperative condition for any patient. Bronchospasm occurs when the bronchial smooth muscle constricts which makes ventilating the patient difficult, and can ultimately lead to hypoventilation, hypoxemia, and metabolic acidosis. It’s imperative for any anesthesia provider to understand what a bronchospasm is, its pathophysiology, differential diagnosis, and algorithm of treatments. This poster presentation provides a summary based discussion of acute bronchospasm under general anesthesia.

Should Nurse Practitioners Be Required To Record Immunizations In Immunization Information Systems?, Donald Gardenier, Lacey Eden, Karlen E. (Beth) Luthy

Faculty Publications

The United States Centers for Disease Control and Prevention (CDC)’s Vaccines for Children (VFC) Program, which provides the majority of childhood immunizations, has been in existence for over 20 years. The CDC also created the Immunization Information Systems (IIS) program in which states were allocated funding to create statewide immunization databases. The goal was to maintain a reliable immunization tracking system to keep children on schedule and avoid unnecessary immunizations. In most states, however, only health care providers who are enrolled in the VFC Program are required to enter data into the IIS. Should all providers be required to enter …