Nursing Commons^™

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. …

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; …

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 …

Risk Of Medication Errors In The Home: An Integrative Literature Review, Maria M. Crescenzi

Honors Undergraduate Theses

Regardless of the setting, medication errors are of great concern when associated with an individual’s health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant …

Exploring The Relationship Between Symptom Management And Distress In Pediatric Oncology Nurses, Amanda M. Schultz

Honors Undergraduate Theses

Pediatric oncology is known to be a stressful work environment due to the difficult aspects regarding patient care. This known stress related to work and caring for pediatric oncology patients can negatively impact nurses, patients, and families. The purpose of this study is to examine: relationships between patient symptom management and nurse distress; strategies used by nurses to manage symptoms in pediatric patients with cancer; nurse perceptions of the effectiveness of non-pharmacologic or nursing interventions; and nurse distress related to managing symptoms in pediatric patients with cancer. Registered nurses (N=13) at a local children’s hospital participated in an online survey. …

What Are The Most Commonly Used Tools To Screen Depression In Hiv-Infected Gay And Bisexual Men?, Michael Isner

Honors Undergraduate Theses

Gay and bisexual men infected with human immunodeficiency virus (HIV) comprise a sizable, medically vulnerable population. Depression is the most commonly experienced mental health disorder affecting this group of people, lending itself to a host of risks associated with depression. As screening of depression in this population can be challenging, it is vital that clinicians have the best available tools and guidelines to detect depressive symptomology. This focused, comprehensive review of the literature examined current data describing the clinical instruments used to detect depressive symptoms in HIV-infected gay and bisexual men. The aim of this analysis was to seek out …

The Effect Of Alcohol Prep Pads And Blood Drop Number On Capillary Blood Glucose Values, Joanna E. Foos

Honors Theses and Capstones

Capillary blood glucose monitoring is a common nursing procedure. However, no consensus exists regarding which drop of blood to test (drop 1 vs. drop 2) and whether using alcohol pads to prepare the fingertip affects blood glucose values. The purpose of this study was to evaluate the impact of these factors and contribute to the development of evidence-based nursing protocols for capillary blood glucose monitoring. A quantitative, quasi-experimental study was conducted in a laboratory at the University of New Hampshire. 96 volunteers were randomly assigned to one of three groups. Each group underwent a pair of capillary blood glucose tests …

Public Policy And The Legislative Process, Sheila A. Leander, David F. Walz

Book Chapters

No abstract provided.

Organizational Learning In A Cardiac Intensive Care Unit: A Learning History, Bret Lyman, Kalene M. Ethington, Carly King, Jonathan D. Jacobs, Hayley Lundeen

Faculty Publications

Introduction: Providing high-quality care to every patient is challenging, particularly in critical care units (CCUs). However, this standard can be achieved through organizational learning. Unfortunately, the process of organizational learning in CCUs is not well understood.

Objective: The objective of this study is to describe the developmental progression of a cardiac intensive care unit (CICU) to reach its current state of reliably excellent clinical performance.

Methods: The method selected for this study was a learning history. A total of 43 individuals with experience working on the CICU participated in small group interviews. Participants included nurses, surgeons, unit clerks, administrators, nursing …

Honoring Motherhood: The Meaning Of Childbirth For Tongan Women, Shelly J. Reed, Lynn Clark Callister, 'Ana Kavaefiafi, Cheryl A. Corbett, Debra Edmunds

Faculty Publications

Purpose: The purpose of this ethnographic study was to describe the meaning of childbirth for Tongan women.

Study Design and Methods: In this qualitative descriptive study, 38 Tongan women, 18 from Tonga and 20 from the United States, who had given birth in the past year were invited to share their perceptions of childbirth. Themes were generated collaboratively by the research team.

Findings: The overarching theme was honoring motherhood; other themes include using strength to facilitate an unmedicated vaginal birth, describing the spiritual dimensions of birth, adhering to cultural practices associated with childbearing, and the influence of the concept of …

Stand At Ease, Then Forward, March!, Janice E. Hawkins

Ellmer School of Nursing Faculty Publications

(First paragraph) I enlisted in the U.S. Army in 1985. After reporting for basic training, I learned to execute military formation maneuvering commands. Military formations help organize ceremonial parades, gain tactical advantage, and create discipline. It occurs to me that the same elements that contribute to effective functioning of a military unit- ceremony, tactical planning, and discipline- also contribute to achieving one's goals after completing graduate school.

Hyperammonemia After Lung Transplantation: Best Practice Recommendation, Kathryn Bradley

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

The Meaning Of Giving Birth: Voices Of Hmong Women Living In Vietnam, Cheryl A. Corbett, Lynn Clark Callister, Jamie Peterson Gettys, Jacob R. Hickman

Faculty Publications

Increasing knowledge about the sociocultural context of birth is essential to promote culturally sensitive nursing care. This qualitative study provides an ethnographic view of the perspectives of birthing of Hmong mothers living in the highlands of Vietnam. Unique cultural beliefs exist in Hmong culture about the spiritual and physical wold as well as ritual practices associated with childbearing. This includes variations of ancestor worship, reincarnation, and healing practices by shamans. Traditionally, Hmong families take an active role in childbirth with birth frequently occurring in the home. Situated within a large collaborative anthropology project, a convenience sample of 8 Hmong women, …

An Evaluation Of Critical Resources In Nurse Anesthesia Educational Programs, Lois E. Stewart

Theses and Dissertations

Advanced practice nurses fill a vital need in the U.S. by increasing access to needed healthcare. Certified Registered Nurse Anesthetists (CRNAs) are one type of advanced practice nurse with a long history of safe and effective peri-anesthetic care. Nurse anesthetists have a rich tradition of providing anesthetic care for rural and underserved communities, and are a primary provider of anesthesia for active and retired military personnel. CRNAs comprise over one-half of the actively practicing U.S. anesthesia workforce currently, and are able to function in any anesthetic care model. Nurse anesthesia educational programs (NAEPs) are the single source for new graduate …

Nursing Student Work-Study Internship: Partnering To Bridge The Education-To-Practice Gap, Jonalyn M. Wallace

Doctor of Nursing Practice (DNP) Projects

Abstract

Discussed for decades, the need for transitional experiences bridging educational and practice settings gained momentum in the mid-1970s with the release of Kramer’s groundbreaking book Reality Shock: Why Nurses Leave Nursing. Nursing student internship programs were developed in the 1970s as one effort to address this issue. The Northern California Region of Kaiser Permanente partners with five universities to conduct the Nursing Student Work-Study Internship Program (WSP). The program provides senior level nursing students with a paid internship in clinical practice settings, working under the supervision of RN preceptors. The aim of the program is to improve the …

Approach To Safety Improvement: Focusing On Better Care (Fall Prevention In Medical Surgical/Intermediate Care Unit), Jose Fox Caballes Jr

Master's Projects and Capstones

Patient safety is one of the major concern of any healthcare provider during their patient’s hospital stay. This project addressed the steady trend of fall incidences compared to last fiscal years’ data of an average of 4 falls per month. This trend created urgency to envisioned a plan for solutions to prevent this circumstance from happening. This Clinical Nurse Leader led a project in creating a process in identifying all patients that are high risk to fall (HRTF) prior to their admittance or transfer to Medical Surgical/Intermediate Care Unit and throughout their hospital stay until they are discharged. In addition, …

Recovery-Oriented Care And Inpatient Psychiatric Nursing Practice, Julia M. Mclaughlin

Master's Projects and Capstones

For the past 15 years, major organizations such as the World Health Organization (WHO), Substance Abuse and Mental Health Services Administration (SAMHSA), and U.S. federal government have been committed to shifting mental health services from the medical model of care to the recovery-oriented model of care (Moller & McLoughlin, 2013). However, not all identified recovery-oriented practices have been fully implemented throughout mental health services, specifically in acute care settings. In 2015, San Mateo Medical Center’s acute psychiatric nursing staff completed McLoughlin’s (2005) Recovery Self-Assessment- Registered Nurse (RSA-RN). Data showed that 34% of nursing staff did not believe that the nurses …

Minimizing The Inappropriate Use Of Physical Restraint, Shiela Marie C. Telmo

Master's Projects and Capstones

The aim of this project is to be able to improve patient safety by minimizing the inappropriate use of physical restraints from 45% to about 20% in the acute respiratory unit which caters to patients with acute respiratory issues, such as exacerbation of chronic obstructive pulmonary disease (COPD), patients with new or old tracheostomy, needing bipap, rigorous nebulizer treatment, and other respiratory-related devices, not to mention the multiple comorbidities that oftentimes very difficult to stabilize which makes the hospital stay longer than usual. The Clinical Nurse Leader (CNL) as an educator and an outcome manager is an agent to empower …

Admission Handoff Between Emergency Department And Inpatient Units, Amanda A. Briones

Master's Projects and Capstones

When admitting a patient from the emergency department (ED) to an inpatient unit, a handoff report is conducted. There are many ways the ED nurse can go about delivering this report to the inpatient or floor nurse. Each ED nurse tends to this task in their own way, providing the information they deem important. Due to the absence of standardization, handoff reports have the ability to lack important information regarding the patient and can even lead to compromising the safety of the patient.

The purpose of this project was to gain a comprehensive understanding of the current handover process of …

Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee

Master's Projects and Capstones

Chlorhexidine gluconate (CHG) daily bathing in hospitalized patients in the intensive care setting is one of many interventions implemented by institutions to reduce and prevent central line associated bloodstream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs). These hospital-acquired infections (HAIs) plague and complicate treatments for critically ill patients in the acute care setting. CLABSIs and CAUTIs increase patient morbidity and mortality as well as place a financial burden with increased costs and hospital lengths of stay. The decrease of CHG compliance in our ICU unit can be associated with an elevated CLABSI rates. The focus of this CNL …

Quality Of Death People With Terminal Illnesses Are Turning To An Age-Old Method To End It All: Self-Starvation, Kazi E. Awal, Alyssa Pagano

Capstones

Voluntarily stopping eating and drinking (VSED) is getting more attention in the medical community. Though physician assisted dying legislation passed in two more states in 2016--there are now 7 states where it is legal--the practice, where doctors prescribe a lethal dose of sedatives so that terminally ill patients can end their own lives, is inaccessible to many. But fasting to death is a way for patients suffering from terminal illnesses or other debilitating diseases to end their lives on their own terms that is legal everywhere. As extreme as it sounds, research shows the process can be made comfortable with …

Nurse Shift Handoff Report At The Patient's Bedside: Improving Nurse-To-Nurse Communication, Francis R. Estrella

Master's Projects and Capstones

The purpose of the CNL project is to develop a standardized approach to communication during nurse shift handoffs through utilization of bedside shift reporting (BSR). Shift handoffs are integral to nursing practice; therefore, this process must be accurate, effective, and consistent in order to ensure the delivery of safe and quality care. The project focuses on the CNL curriculum element of Quality Improvement and Safety, under the role of an Outcomes Manager. Prior to BSR implementation, shift handoffs in the sub-acute unit were being conducted at the nurse’s station or by the medication carts. Nurse shift handoffs were often rushed, …

Standardization Of Body Imaging Huddle In Radiology, Margaret M. Browne Mcmanus

Master's Projects and Capstones

Mag Browne McManus

Clinical Nurse Leader Abstract

University of San Francisco

Abstract

Communication amongst healthcare providers is critical to reducing errors, and in procedural areas, the huddle can be used to standardized communication amongst the team before the beginning of interventional procedures (Goldenhar, Brady, Sutcliffe, Muething, & Anderson, 2013). Prior to the implementation of the revised huddle, a staff survey indicated none of the staff were satisfied with the current process. The objectives of the standardization of the body imaging huddle in the department of radiology were to increase staff satisfaction by 15% and reduce the time from patient arrival …

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects and Capstones

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys were …

The Effects Of A Preceptor Coaching Intervention On Use Of Clinical Judgment By New Graduate Nurses, Sue A. Schuelke

Theses & Dissertations

This work attempts to evaluate a preceptor intervention on the development of critical thinking/clinical judgment from the new graduate’s point of view as well as from the preceptor’s point of view. Manuscript 1 is a systematic review of the literature related to preceptor’s interventions and its effect on clinical judgment. Manuscript 2 describes the results of focus group interviews of preceptors and the viewpoint on clinical judgment and related concepts. Results of a pilot study: The effects of a preceptors coaching on new graduates clinical judgement, is reported in Manuscript 3. Each section includes an overview of each manuscript, a …

Debriefing In The Emergency Department, Alyssa Johnson

Master's Projects and Capstones

Emergency Department (ED) staff are repeatedly exposed to high stress situations and as a result suffer from compassion fatigue, secondary traumatic stress, symptoms of post-traumatic stress disorder, burnout and high turnover rates. Staff turnover is costly to the health system in the form of training new staff and potential poor patient outcomes due to under staffing or inexperience of staff. Based on a survey about debriefing, Level 1 Adult and Pediatric Emergency Department staff reported 81% felt there was inadequate support for critically stressful events that occur. Debriefing was identified by 75% of the staff as an option for support. …

Common Statistical Tests And Interpretation In Nursing Research, Maria E. Main, Veletta L. Ogaz

International Journal of Faith Community Nursing

Faith community nurses need a basic understanding of common statistical tests and their interpretation to aid in the appraisal of research for evidence-based practice. The purpose of this article is to review statistical concepts, define common statistical tests, and interpret the results of statistical tests. Common statistical tests that measure differences in groups are independent samples t-test, paired sample t-tests, and analysis of variance. Common statistical tests that measure relationships are Pearson product moment correlation and chi-square. Knowledge of statistical concepts and common statistical tests assist in the appraisal of nursing research for evidence-based practice.

Critiquing Quantitative Research Reports: Key Points For The Beginner, Cathy H. Abell, Dawn M. Garrett Wright

International Journal of Faith Community Nursing

Nursing research has a long history, beginning with the first nursing researcher--Florence Nightingale. As research continues to evolve, the dissemination of findings is important. Nurses must have have an understanding of how to critically read and appraise research articles in order to assess the value of the findings.