Nursing Commons^™

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In Adult Oncology Patients Through Improved Compliance With Oral Hygiene Protocols, Rickey Maung

Master's Projects and Capstones

Objective: Oncology patients undergoing chemotherapy are at increased risk of mucosal barrier injuries and aspiration pneumonia, with current aspiration pneumonia rates exceeding target levels. Enhanced oral hygiene protocols and improved compliance have been shown to reduce these complications in this vulnerable population.

Context: The microsystem under review comprises six oncology units within Hospital A, a major medical center in California. Aspiration pneumonia, frequently linked to mucosal barrier injuries, poses a significant threat to patient safety and increases treatment costs and complications in oncology care. Recognizing the critical need to address this issue, an aspiration pneumonia task force has prioritized efforts …

Implementing Donna Wright’S Competency Model For Enhancing Nursing Professional Development In Pediatric Perioperative Units, Justin C. Chu

Master's Projects and Capstones

Background Hundreds of thousands of deaths occur in hospitals annually due to preventable adverse events. As literature shows nurse competency is positively associated with improved patient outcomes, it is the mission of any healthcare organization to continually improve staff competency. Bay Area Children’s Hospital X is looking to adopt the Donna Wright Competency Model (DWCM) to change the way they approach this process, transitioning from traditional methods of manager-selected competencies to a collaborative, shared governance approach. Objectives Utilizing the DWCM, the project goal is to enhance competencies among 90 nurses in pediatric perioperative units. The ultimate goal is to create …

Improving Documentation Compliance And Patient Mobility Using The Bedside Mobility Assessment Tool, Hayley M. Bernard

Master's Projects and Capstones

Objective: Patient immobility during hospitalization contributes to avoidable complications including increased length of stay, pressure injuries, thromboembolic events, reduced functional capacity, and increased rates of discharge to rehabilitation facilities. The Bedside Mobility Assessment Tool (BMAT) was developed to empower Registered Nurses to safely assess and mobilize patients without a physical therapy evaluation. Aim: This quality improvement projects aims to enhance nurse compliance with BMAT documentation by 10% in three medical-surgical units of a 244-bed Northern California Hospital. Preliminary findings indicate an average daily patient census of 23.7 of which only 31.3% are assessed using the BMAT. Methods: Across a six-week …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Implementing The Brief Confusion Assessment Method (Bcam) Delirium Screening Tool In An Emergency Department, Carolina Van Dalen

Master's Projects and Capstones

Problem: Persons with delirium have an elevated risk of falls. Thus, falls and delirium are inextricably linked. Both should be routinely screened for older adults.

Context: A 40-bed Emergency Department (ED) in the East San Francisco Bay area of Northern California and the first site among all acute care hospitals in the organization to implement the Brief Confusion Assessment Method (bCAM) delirium scoring tool within the Electronic Health Record (EHR).

Interventions: An EHR toolkit for delirium screening using bCAM was developed, tested, and implemented in the ED.

Measures: The outcome measure was the percentage of patients with a reported fall …

Baby-Friendly Hospital Initiative: Becoming Baby-Friendly Designated, Krystal Angelique Mora

Master's Projects and Capstones

Section I: Abstract

Problem Despite efforts to increase breastfeeding rates, the influence of formula companies has contributed to the decrease in rates, affecting the health outcomes of infants. In response, the Baby-Friendly Hospital Initiative (BFHI) introduced standardized education for nursing staff to support infant growth and development. Context Hospital A Birth Center is a 33-bed culturally diverse unit that provides care to mothers in Northern California, delivering approximately 7,400 babies each year and helping patients transition into motherhood. Aim The quality improvement project aims to enhance the retention of BFHI-aligned education provided during hospitalization by 26.2%, raising retention rates among …

Optimizing Fall Prevention: A Quality Improvement Initiative To Enhance Documentation And Intervention Accuracy Using The Hester Davis Scale In Medical-Surgical Units, Kiana Conn, Brooklin Hunter-Johnson, Jashan Kahlon, Adrian Paz

Master's Projects and Capstones

Falls among hospitalized patients remain a critical safety concern, particularly in medical-surgical units caring for geriatric and oncology patients. This quality improvement project aimed to evaluate and address gaps in adherence to fall prevention protocols by utilizing the Hester Davis Scale (HDS) in two medical-surgical units at a large metropolitan hospital in Southern California. The project focused on auditing current practices to identify inconsistencies in documentation and intervention implementation, emphasizing areas such as bed alarm activation, fall risk signage placement, and armband use. Weekly audits were conducted from October 3 to October 29, 2024, to establish baseline data and inform …

Impact Of Supply Organizational Culture Within A Surgical Unit, Irene T. Peng

Master's Projects and Capstones

Objective: This quality improvement project aims to propose an intervention that helps anesthesia technicians improve communication efforts, reduce delays in care, and reduce medical waste. Aim: At least 80% of the anesthesia technicians are educated on properly stocking the pediatric anesthesia medical lockers utilizing the standardized checklist and handoff report tool to reduce waste and increase timely patient care after three months of implementation. Methods: Assessment surveys were used to identify the surgical unit’s current issues and Hospital A’s staff's opinions of pediatric medical anesthesia C-lockers. Resources such as the GANTT Chart, Fishbone Analysis, Budget Analysis, SWOT Analysis, and PDSA …

Impact Of Training For Nursing Staff In The Prevention Of Hapis, Onyinye E. Ohia, Colleen A. Anthony

Master's Projects

Abstract

Background: The incidence of Hospital acquired pressure injuries (HAPIs) have remained a problem in healthcare despite concerted efforts by hospitals and other governmental agencies to eliminate the problem via policy and emphasis on safety. There is support in literature for the training of healthcare professionals as an important tool in the prevention and management of HAPIs. Despite the existence of studies that link training of nurses to a reduction in rates of HAPIs, evidence in support of that is still piecemeal; with poorly defined outcomes.

Aims and objectives: The aim of this integrative review is to identify …

Effectiveness Of Mental Health Interventions For Adults With Cancer In The Us: An Integrative Review, Danielle Lee, Chelsea Ferguson

Master's Projects

The purpose of this review was to synthesize existing literature on the effects of mental health interventions for adult cancer patients following their initial diagnosis and to consolidate findings related to interventions addressing mental health conditions in this population. With the growing number of adults diagnosed with cancer, further research and the development of tailored mental health interventions are crucial to improving health outcomes.

A systematic search was conducted using PubMed, CINAHL, Medline Complete, and Health Source Nursing databases between January 2024 and February 2024. To ensure rigor, Toronto and Remington’s (2020) integrative review process was applied. The Johns Hopkins …

Prescription For Change: Tackling Inappropriate Antibiotic Use In Urgent Care Settings, Lachundra Mosley

Doctoral Projects

A pressing global health issue that significantly contributes to antibiotic resistance is the inappropriate antibiotic prescribing for Upper Respiratory Infections (URI’s) in urgent care settings (World Health Organization [WHO], 2022). The purpose of this doctoral project was to reduce inappropriate antibiotic prescriptions for URI at an urgent care in D’Iberville, Mississippi through the implementation of an educational pamphlet.

A pre-post intervention project was conducted, collecting data on antibiotic prescribing practices via retrospective chart reviews before and after the educational intervention. Data was collected using a researcher developed screening tool based on Evidence based guidelines to distinguish viral vs bacterial infections. …

Emergency Room Nurses' Perceptions Of Medication Errors In The Emergency Department, Yasmeen Mustafa

Undergraduate Honors Theses

Medication errors (MEs) remain a pervasive issue in United States emergency departments, where emergency room (ER) nurses play a central role in the medication process. The medication process involves transcribing, prescribing, dispensing, administering, and monitoring. Proper adherence to the process ensures that the right medication is given to the right patient in the correct dose, route, and time. It also allows consideration of potential interactions and side effects, with the goal of achieving safe and efficacious therapeutic outcomes. Given the potential life-altering consequences of MEs, it is imperative to harness the unique insights and experiences of ER nurses who are …

Comparison Of Two Learning Methodologies: Virtual Reality And Osce Simulation, Connor Blackwell, Tabor Mcgee

Doctoral Projects

Anesthesia education has evolved immensely over the past twenty years, and with the new virtual reality (VR) simulations created by SIMVANA, the exponential growth can continue. The anesthesia program at The University of Southern Mississippi (USM) currently utilizes an educational platform known as the Objective Structured Clinical Examination (OSCE) for their students’ clinical curriculum. With the development of technology and education models, the purpose of the doctoral project is to determine if VR simulation can produce more effective learning than the OSCE modules. To determine the effectiveness, pharmacologic lessons for intraoperative hypotension were administered through both platforms and then tested …

Implementation Of A Transition-Of-Care Model For Adult Ischemic Stroke Survivors, Megan Akacsos

Electronic Theses and Dissertations

The lasting physical and cognitive deficits associated with the complexities of newly acquired

disabilities resulting from an acute ischemic stroke (AIS) may lead to hospital readmissions. The

participating healthcare facility on the U.S. West Coast reported a hospital readmission rate for

AIS survivors of 24.29% within 30 days of discharge. This doctoral nursing project aimed to

determine if implementing the Comprehensive Post-Acute Stroke Services (COMPASS) model

would reduce 30-day readmission rates compared to no standardized transition-of-care model in

adult AIS survivors over 30 days. Implementing the COMPASS model in this patient population

was expected to better educate and support stroke …

Effectiveness Of Interventions To Address Nursing Students' Mental Health: An Integrative Review, Aimee Dickson, Shelby Carter

Master's Projects

Background:

The rigors of the nursing school curriculum are associated with higher levels of stress, anxiety, and depression, resulting in unhealthy habits and ineffective coping strategies that lead to initial difficulties in the academic environment and burnout as professional nurses advance into their careers. This phenomenon further burdens the already taxed workforce, leading to ongoing turnover and compromising care. This integrative review aims to look at what coping strategies have proven most successful in fostering nursing students' well-being, leading to lifelong practices that promote strength while addressing the rigors of academia and, later, the workforce.

Methods:

The literature review search …

Evaluating An Evidence-Based Quality Improvement Initiative For Food Insecurity Screening And Referral In Adults With Diabetes Initiating Continuous Glucose Monitor Therapy, Coni Dennis

Graduate Theses, Dissertations, and Capstones

Diabetes affects 37 million people annually in the United States, with direct medical costs exceeding $237 billion per year (American Diabetes Association, 2018; Xu et al., 2018). Complications account for up to 64% of diabetes-related expenses, emphasizing the importance of glycemic stability in preventing costly and debilitating outcomes (Dieleman et al., 2016). Diet and nutrition, essential for glycemic control, are often undermined by food insecurity—defined as inconsistent access to adequate, nutritious food—affecting 16% of adults with diabetes (Casagrande et al., 2022; Kirby et al., 2021). Food insecurity is linked to higher HbA1c levels, increased complications, and hospitalizations (Thomas et al., …

The Use Of Gamification In Tutoring Sessions, Megan L. Lee

Honors Capstones

Many students entering the college world have grown up around technology and use it in their everyday lives. While students are showing an increased use and understanding of technology, traditional tutoring methods do not incorporate these skills. Tutoring can be a useful adjunct to the classroom setting regarding student success but can be lacking in student engagement when designed in lecture-based formats to mimic the classroom setting. Therefore, this study aims to evaluate the impact of gamification, especially the use of Kahoot, in tutoring sessions on student engagement. A qualitative research study was conducted with sixteen first semester nursing students …

Disruptive Clinician Behavior: A Qualitative Descriptive Study Of Non-Native English-Speaking Nurses, Seyoung Baik

Dissertations

Background: Disruptive clinician behaviors among healthcare staff are an increasing concern, negatively affecting patient safety. In 2015, 16% of nurses in the U.S. were foreign-born (Shaffer et al., 2022), and 25% of New York and California nurses were immigrants (Shaffer et al., 2021). Nurses' migration to the U.S. has been exploding. Non-native English-speaking nurses experience complications, problems, and discord in their workplace with coworkers.

Aim: The purpose of this qualitative descriptive study was to explore and understand non-native English-speaking nurses’ experiences with disruptive clinician behaviors in the U.S.

Specific aims were to 1) create a comprehensive description of the experiences …

Identifying The Risk Of Violence In The Inpatient Setting, Megan Julian

Student Scholarly Projects

Practice Problem: Workplace violence directly contributes to the development of psychological conditions in nurses and reduces nurses’ level of job satisfaction as well as organizational commitment (ANA, 2018). Additionally, the occurrence of workplace violence events impacts patient and organizational outcomes.

PICOT: The PICOT question that guided this project was, in acute-care medical-surgical nurses (P), does the use of a structured risk of violence screening tool (I), compared to current practice (C), improve the nurses’ perceived ability to identify patients who are at risk for becoming violent (O) over eight weeks (T)? Evidence: Evidence that was reviewed supported the implementation of …

Examining Mentoring As A Catalyst For Nurse Work Engagement And Professional Development, Cherryl A Rainey

Dissertations

Abstract

Research literature has identified mentoring as a strategic intervention for employee professional development. The Business and Psychology disciplines have used mentoring widely for employee development, but it has not been used extensively in nursing.

Nursing has unique challenges and is constantly changing with a need to meet some of those needs by advancing the development of nurses to serve as leaders and fill positions due to nurse shortages and high turnover rates. Mentoring has also been identified as a vehicle to promote work engagement.

The purpose of this study was to examine mentoring as a catalyst for nurses’ professional …

Their Stories, Our Testimony: A Narrative Inquiry Into The Remote Teaching Experiences Of Community College Clinical Nurse Educators During The Covid-19 Pandemic, Catherine E. Fenner

Doctor of Education Program Dissertations

This narrative inquiry explored the lived experiences of clinical nurse educators who taught at community colleges during the COVID-19 global pandemic, contributing to the growing body of literature about what nurses endured during the pandemic. The pandemic and the ensuing havoc it caused occurred when the profession faced significant staffing shortages. In the early months of 2020, when the virus was spreading rapidly, many states issued stay-at-home orders requiring nursing programs to pivot to remote learning platforms. Teaching hands-on skills, communication techniques, and time management strategies through virtual and remote pedagogy was a time of confusion for nurse educators, who …

The Association Of Individual Characteristics, Treatment Type, Treatment Satisfaction, Symptoms Of Pain And Fatigue With Health-Related Quality Of Life Among Adults With Gaucher Disease Type 1, Shauna L. Mangum

Nursing ETDs

People with rare disease have lower health-related quality of life (HRQoL) than the general population. Gaucher disease type 1 (GD1) is a rare, autosomal recessive, lysosomal storage disorder that affects multiple bodily systems. HRQoL improved with enzyme replacement and/or substrate reduction therapies, however, little is known about specific variables associated with HRQoL in GD1. This study explored associations between individual characteristics (gender, race, ethnicity, age, and genotype), treatment variables (treatment type, length of time on treatment, and treatment satisfaction) and symptoms of fatigue and pain with HRQoL among 97 adults with GD1. No significant associations were found among individual characteristics …

Clinical Learning Obstacles Of Nursing Students At The University Of Mosul: A Qualitative Study, Karam Yaseen Fathi, Younes K. Attia, Atheer Abd Ahmed, Ahmed K. Mohamed Taher

BioMed Visions Journal

Background: Clinical learning is a crucial component of nursing education, as it provides students with the opportunity to apply their theoretical knowledge in real-life healthcare settings. However, nursing students often face obstacles during their clinical experiences that can hinder their learning and professional development. The study aim to explore the obstacles that nursing students confront during clinical training.

Materials and Methods: A qualitative phenomenological study design was used to reach the study's aim. The study was conducted in Mosul city and included 20 nursing students who were selected purposefully. A semi-structured interview with open-ended questions was used to collect …

Mental Fatigue And Self-Care In Informal Oncology Caregivers: A Descriptive Mixed Methods Study, Megan Wayne

MUSC Theses and Dissertations

Purpose:

This dissertation study aimed to enhance understanding of informal caregiver wellbeing by exploring the presence of mental fatigue, the relationships among mental fatigue, self-care, and informal oncology caregiver quality of life (QOL), and determining whether differences exist in self-care engagement and QOL between caregivers who report high and low levels mental fatigue.

Problem:

Healthcare is becoming increasingly reliant on informal caregivers for the management and care of individuals with serious illnesses such as cancer. Previous research has shown that informal caregivers routinely experience many negative effects as a result of providing care including decreased mental health and …

Impact Of Participation In Cardiac Rehabilitation Post Myocardial-Infarction: An Integrative Review, Zoie Maynard, Mallory Stinson

Master's Projects

As one of the most common causes of hospitalization, the prevalence of myocardial infarction is indisputable Since this condition is so ubiquitous, a treatment protocol is initiated with methods to help patients modify their lifestyle, treat their underlying disease process, educate them to prevent reoccurrence, and improve their healthcare outcomes. This protocol relies heavily on the use of cardiac rehabilitation. Despite the implementation of this treatment protocol, the concern for recurrence and rehospitalization remains. The goal of this integrative review is to determine how participation in cardiac rehabilitation post-myocardial infarction impacts healthcare outcomes including rates of rehospitalization and depression. The …

Implementing Bedside Shift Report In The Home Health Care Pediatric Setting, Ruth Elena Ramos-Ardila

Electronic Theses and Dissertations

Developing and maintaining good communication is central in nursing because the goal is to achieve the best outcomes for the patient. In the past, written handover reports have been the standard way nurses communicate with each other, especially in the hospital and in home-based practice. Despite this rationale, this approach has considerable weaknesses: its high risk of mistakes and misunderstanding could negatively influence patient outcomes. In light of these concerns, this project examines the role of bedside shift reports in pediatric home care and the patient readmission rate. This project employed a quantitative, cross-sectional research approach involving 32 pediatric home …

Minding The Details: The Importance Of Assessment Accuracy And Consistency In Managing Nursing-Sensitive Indicator Interventions, Elizabeth Card, Noah Zanville

HCA Healthcare Journal of Medicine

Evidence-based practice holds the potential to streamline health care, reduce costs, and improve patient outcomes. A good share of the data collected to create the evidence comes from electronic health records and other digital sources. Nurse-sensitive indicators, such as patient falls, pressure injuries, and hospital-acquired infections, are examples of data used to reflect the quality of nursing care. Other data may come from routine assessments nurses perform. It is crucial that nurses use valid and reliable instruments to create this data and that the use of the instruments is consistent across nurses in units, different shifts, and even different facilities. …

Measures Of Success: Making The Case For Advanced Practice-Sensitive Quality Indicators, Ruth Kleinpell, April Kapu, Cynthia Borum

HCA Healthcare Journal of Medicine

Advanced practice registered nurses (APRNs) are key health care providers in a variety of settings. Often APRNs are grouped in a collective category, along with physician assistants, and referred to collectively as advanced practice providers. As APRNs assume an increasing role in patient care management in hospital, outpatient, and community settings, such as clinics and rural practices, measuring the impact of their care on patient outcomes and quality of care becomes a necessary component of performance evaluation. APRN-sensitive outcome indicators are an important way to identify the impact of the role. While a number of studies have been conducted that …

Development Of A Facility-Level Second Victim Syndrome Peer-Mentor Program: Program Design And Future Directions, Jacqueline Trammell, Noah Zanville, Caryn Alper

HCA Healthcare Journal of Medicine

Background

Despite efforts to prevent errors, studies show that iatrogenic, or health care-related, errors continue to occur. Understandably, these errors, which can range in severity from near-misses to serious harm, can be devastating for the health care professionals involved, creating a potential second set of victims, in addition to the patient(s) that were harmed directly. Studies show that individuals struggling with second-victim syndrome (SVS) can be at increased risk for depression, burnout, and poor work performance. However, programs designed to develop peer mentors to support individuals struggling with SVS are poorly described.

Methods

Following a review of the literature, our …

Nursing And Supply Chain As Critical Partners In Enterprise-Level Efforts To Prevent Hemodialysis Associated Central Line-Associated Blood Stream Infections: A Case Study, Dana L. Blayney, Julia Moody, James Pittman, Noah Zanville, Missy Pennington, Sarah A. Fraker, E. Jackie Blanchard

HCA Healthcare Journal of Medicine

Background

Preventing central line-associated bloodstream infections (CLABSIs) remains a critical national focus for health care facilities. This notion is particularly true for patients undergoing hemodialysis (HD), where the associated mortality rates for HD-CLABSI range from 12% to 25%. Studies show that the use of central venous catheter (CVC) end caps coated with antiseptic agents, such as chlorhexidine gluconate (CHG) on HD-CVCs, can reduce the incidence of CLABSIs. However, issues ranging from difficulty finding and maintaining an adequate (and fully standardized) supply of CHG-impregnated HD end caps and ensuring consistent practice by clinicians can prevent the use of this valuable tool. …