Nursing Commons^™

Reducing Care Companion Utilization In Medical-Surgical And Telemetry Units, Mary Jane B. Sagabaen

Master's Projects and Capstones

Abstract

Problem: The facility highly utilized sitters or care companions, negatively impacting the staffing plan, budget, and productivity. An average of 56 hours of care companions were used daily. This greatly exceeded the budget of 33 hours a day. Reassigning Patient Care Technicians (PCT) as care companions resulted in inadequate nurse support for patient care and increased cost for additional staffing needs. Despite this, the fall rate remained higher than the target.

Context: The patient population is mainly 65 years old and above, sometimes with confusion, dementia, delirium, and at high risk for falls and elopement. The culture included promptly …

Improving Triage Accuracy In The Emergency Department, Catriona E. Clohessy

Master's Projects and Capstones

Problem: Hospital Z’s emergency department was experiencing a triage inaccuracy rate that exceeded the accepted national benchmark of 10%. This quality improvement project aimed to reduce triage inaccuracy to less than 10% in the emergency department at Hospital Z, through improved education and availability of supplemental reference materials.

Context: This quality improvement project was conducted in a 40 bed emergency department at Hospital Z. This microsystem serves a diverse patient population from the surrounding community that experience a variety of conditions requiring emergency medical intervention.

Interventions: Clinical Nurse Leader nursing students partnered with unit leadership to create a new ESI …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Using Clinical Staff-Initiated Protocols In The Urgent Care Setting To Improve Throughput, Holly S. Mason

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

One of the goals and purposes of the urgent care setting is to provide quality patient care within a timely fashion. This process improvement project was designed to improve patient visit times in the urgent care setting, thus improving throughput. In this project, testing/imaging protocols were developed, agreed upon by the office healthcare providers, and utilized by clinical staff for patients who presented with complaints of 1) dysuria, 2) sore throat with an accompanying fever, 3) upper respiratory symptoms without an accompanying fever, 4) upper respiratory symptoms with an accompanying fever, and 5) an orthopedic injury known as a FOOSH …

Implementing Audiovisual Education To Improve Quality And Patient Experience For Outpatient Colorectal Cancer Screening Patients, Stephanie Armstrong

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Colorectal cancer continues to be the second most deadly cancer in the United States, with thousands of new cases being diagnosed each year. Comprehension of bowel preparation education is an important factor in ensuring patients follow purgative and diet instructions. Inadequate bowel preparations lead to longer procedure lengths, decreased cancer screening capabilities, and decrease patient satisfaction. Audiovisual education has been shown to positively impact patient comprehension and instruction adherence, when compared to the standard written education. The goal of this quality improvement project was to implement audiovisual education and identify whether it improved bowel preparation adequacy and patient satisfaction. The …

Engaging In Research: Reflections From Summer Undergraduate Research Assistants, Elyse Sumarsono, Julia Raugh

Wisdom & Compassion: The LUSON Journal

The aim of the journal was to organize the reflections of two undergraduate nursing students regarding the journey of navigating through summer research along with faculty. Through this reflective experience, research assistants were able to identify many benefits that come with participating in the research conduction process that should encourage other undergraduate students to involve themselves in future research. Research assistants were challenged to take on new and unknown tasks in a high-level research study, which ultimately enhanced skills for future academic success and professional careers as nurses.

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Teela Sade Miller-Buford

Master's Projects and Capstones

Abstract

Problem: This quality improvement project aims to enhance early sepsis management and sepsis bundle compliance among Emergency Department nurses to reduce the risk of sepsis-related deaths and hospital length of stays.

Context: A group of students studying to become Clinical Nurse Leaders (CNLs) evaluated Hospital A's Emergency Department (a clinical microsystem) located in the greater Bay Area. This microsystem provides diverse emergency care for patients with various medical conditions and diagnoses. The CNL students concentrated on patients diagnosed with sepsis for their quality improvement project.

Interventions: Although time constraints prevented the implementation of interventions, the CNL students proposed recommendations …

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Massive Transfusion And Shock Index, Kasey House

MSN Capstone Projects

Hemorrhagic shock is one of the leading causes of preventable death in military trauma patients. Literature shows that pre-hospital transfusions of blood products within the combat environment have shown to have a greater likelihood of survival. This has produced a challenge in the pre-hospital setting to have a standardized method of predicting the patient’s need for a massive transfusion. In the last few years, the development of a Massive Transfusion Protocol (MTP) has become the standard to quickly deliver blood products to actively bleeding patients. Every minute waiting to administer blood products increases mortality by 5%.

While initiating an MTP …

The Leadership Experience Of Academic Chief Nurse Administrators In The State Of Georgia During The Covid-19 Pandemic Upon Return To Campus After Full Virtual Instruction: A Qualitative Study, Susie Jonassen

Dissertations

The impact of the COVID-19 global pandemic has been rated as the highest factor of intent to leave the profession in nurses serving in a leadership role. During the pandemic, crisis leadership swept across academia partly because nursing academia was not prepared for the rapid transition to virtual instruction. The reopening of nursing programs, while pandemic restrictions were still required, caused unprecedented disruptions and stress for academic leaders. One-third of nursing faculty anticipate retirement within the next two years. With the present burnout and shortage of nursing academia leaders, there was a need to explore the lived experience of academic …

Attention-Deficit/Hyperactivity Disorder And Teachers, Samantha Ann Tierney, Samantha Ann Tierney

Honors College Theses

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common disorder, estimated to affect 5% of all children and adolescents. The current rate of diagnosis is steadily increasing. This increase in the number of students with ADHD affects educators, who have a large role in the success of students with ADHD. Despite this, many teachers are not prepared to deal with the extra challenges that come with teaching students with ADHD. Teachers may not be properly taught how to deal with children who have ADHD in their classrooms or the role they have in these children’s lives. The purpose of this study is to …

Lactation Benefits, Experiences, And Education In Bereaved Mothers: A Literature Review, Grace Davis

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Background: Parents who lose an infant through miscarriage, elective termination, or stillbirth experience perinatal bereavement (Centers for Disease Control and Prevention, 2022). A bereaved mother’s grief could be influenced by lactation as most will still experience lactation regardless of their loss. Generally, these women are solely taught to suppress their milk production, oftentimes resulting in discomfort, leakage, clogged ducts, and even mastitis (Carroll et al., 2020). To prevent adverse effects, bereaved mothers need a comprehensive list of options and education regarding lactation including donation, expression, and suppression. Bereaved mothers' lactation experiences, education, and benefits are vital areas to be …

Emergency Department Patient Navigator Post Chest Pain Diagnosis Discharge, Nancy Simoes

Seton Hall University Dissertations and Theses (ETDs)

Abstract The most common complaint seen in the Emergency Department, along with abdominal pain, is nonspecific chest pain. Often, these complaints cause prolonged lengths of stay in the ED, followed by hospital admissions and subsequent readmissions for various reasons. When thinking about these various reasons, the question for prevention of readmission comes to mind. What could we do as a department to keep patients from continuously using the Emergency Department as a primary point of care instead of outpatient facilities when necessary? Project Aim: The purpose of this quality improvement project was to initiate the need for a patient navigator …

Purposeful Rounding For Fall Reduction, Deborah Grant Rn

Master's Projects and Capstones

Objective. The quality improvement project aimed to study the effects of purposeful rounding on falls in a long-term care unit. The focus was on CNAs who provided care for 6 residents each, with a current census of 36 residents in the long-term care setting. Problem. Many of the residents are at risk for falls due to immobility, medication, and environmental hazards (Centers for Disease Control and Prevention, 2022). Context. Research has found that the key reasons residents call for staff include needing to use the bathroom, to address pain, to address positioning, and to address IV pumps and alarms (Studer …

Transformational Leadership Training For Leaders, Kristie M. Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …

Promoting Patient Mobility To Decrease Hospital Length Of Stay, Saira Kinuthia

Student Scholarly Projects

Practice Problem: Promoting patient mobility may reduce hospital-acquired complications and length of stay (LOS). Evidence-based studies have established that there is a correlation between immobility and an increased length of stay in the hospital. How can nurse-driven mobility interventions effectively increase patient mobility and reduce the risk of complications and length of hospital stay?

PICOT: The PICOT question that guided this project was: For veteran patients in the Progressive Care unit (PCU) of a medical center (P), will using the Johns Hopkins Highest Level of Mobility tool (JH-HLM) (I) compared to not using a mobility tool (C) decrease hospital length …

Nurse Leader Rounding To Provide Fall Prevention Strategies, Kerri Philipbar

Student Scholarly Projects

Practice Problem: Falls while patients are hospitalized are all too common. It was identified that the 300-bed facility in Southeast Georgia had a clinical practice gap with inpatient falls. Inpatient falls cause unnecessary pain and suffering to the patient and families. In addition to the negative effects to the patients, it creates a hardship to the organization. Increased length of stay and additional testing and treatments are charged to the hospital because of a fall.

PICOT: The PICOT question for this project is as follows: In adult patients in an acute care setting (P), does nurse leader rounding to …

The Lived Experience Of Second-Degree Nursing Students’ Anxiety Before And During Their Initial Clinical Rotation, Shelly Wheatley

Graduate Theses, Dissertations, and Capstones

Anxiety in nursing students can impact learning. Literature has shown that nursing students, especially those in second-degree nursing programs, report higher stress levels compared to other undergraduate students (Penprase & Koczara, 2009). Nursing clinicals can be jarring for students and present many stressors that can impeded learning and cause poor clinical performance. Much research has been done about traditional undergraduate students’ feelings of anxiety. There is a noted gap in research of second-degree, accelerated nursing students and their feelings about their initial clinical placement. Comparisons have often been made between traditional and nontraditional students, but the lived experiences of second-degree …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

Mentoring Minority Nursing Students, Justin Morris

Graduate Theses, Dissertations, and Capstones

Throughout the pandemic, there was a spotlight on the problems with nursing satisfaction and retention. However, minority nurses, a sub-population of nurses, were hidden in the shadows. To create change to this disparity we need to start in the academic world, as these students feel more pressure to succeed due to outside stressors (Osakwe, et al., 2022). The mentorship intervention has been long studied and has shown great promise to improve academic status, nurse retention, and nurse satisfaction. This evidence-based practice (EBP) project aimed to 1) combat the disparity in minority nursing students’ professional support needs through quality mentorship and …

The Impact Of Self-Compassion Strategies To Reduce Stress And Support The Transition To Practice For New Graduate Nurses: A Pilot Project, Charity Michelle Ballmann

Electronic Theses and Dissertations

Abstract The purpose of the study was to analyze the impact of self-compassion exercises to reduce stress and support the transition to practice for new graduate nurses. As the years pass, one thing remains a consistent topic in healthcare, and the need for nurses remains constant. The nursing staffing shortage gap seemingly widened further as the COVID-19 pandemic created additional challenges for healthcare systems, patient care, and employees. Retention of the workforce and an intentional focus on new graduate nurses' well-being have become increasingly important. New graduate nurses are a pipeline for the nursing workforce. Supporting the transition to practice …

Exploring The Unmet Care Needs Of Women With Chronic Obstructive Pulmonary Disease (Copd), Jessica Madiraca

MUSC Theses and Dissertations

The primary objective of this study was to examine the feasibility of study procedures to and explore the unmet needs and potential barriers of women with advanced COPD who may need palliative care (PC). This multi-method study was guided by the adapted Hierarchy of Needs Model and explored unmet care needs, assessed knowledge of PC services, and identified barriers that women experience when receiving or during the implementation of PC. Further exploration of PC needs by sex provided information on unmet care needs of women with advanced COPD. Participants were recruited through convenience sampling by using COPD Patient-Powered Research Network …

Effects Of Clinical Competency In Nursing Students Following The Implementation Of Student-Led Learning, Cori E. Hack, Jacob N. Hicks

Scholars Week

Research and supporting evidence represent a gap identified in didactic learning between students and faculty. This gap shows emotional factors of the nursing curriculum that may suggest negative impacts on nursing students, but also improvements that can be made to increase students’ clinical competency levels. By adhering to strict definitions of student-led learning theory and clinical competency, we were able to create concrete evidence with measurable data that can contribute to the elimination of this gap in learning. Upon inspection of past text, we identified a need for further research on this topic to bring awareness and encourage this method …

Benefits Of Bedside Report, Konner Spalding, Hannah Mattingly

Scholars Week

No abstract provided.

The Benefits Of Telehealth For Rural Communities, Cade Alberson, Taylor Alberson

Scholars Week

No abstract provided.

Prescribing Protocol For Postoperative Opioids In An Orthopedic Spine Practice, Kelly M. Manda

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The opioid epidemic is magnified by excessive post-surgery prescriptions. Over six months at an orthopedic spine practice, 50% of patients received two or more opioid refills beyond their first. This highlighted the absence of a clear prescribing policy and emphasized the need for a structured protocol and to promote patient safety.

Aim of the Project: The primary aim was to implement a prescribing protocol to lower opioid refills provided to post-surgical patients in this surgical practice. The desired result was to reduce the number of opioid refills provided to patients after surgery.

Review of the Evidence: Evidence highlighted …

Enhancing A Pressure Injury Prevention Bundle In A Skilled Nursing Facility, Lorillie Soleta

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The purpose of the project was to address the increase in pressure injuries in a skilled nursing facility, which had risen from 6% to 10% despite the implementation of a prevention bundle. The project aimed to evaluate and enhance the effectiveness of existing interventions.

Aim of the Project: The aim was to add evidence-based interventions to the existing pressure injury prevention bundle. The desired outcome was to decrease the number of acquired pressure injuries.

Review of the Evidence: Research indicated that pressure injury prevention bundles were more successful when incorporating offloading interventions. These offloading measures, including frequent turning and …

Cross-Cultural Adaptation And Psychometric Properties Of The Arabic Version Of The Academic Nurse Self-Efficacy Scale, Junel Bryan Arre Bajet, Jonas Preposi Cruz, Ejercito Mangawa Balay-Odao, Jennifer Mesde, Nahed Alquwez, Khalaf Alotaibi, Sheerween Cacanando

Makara Journal of Health Research

Background: Students’ academic self-efficacy is greatly associated with their academic performance. An effective instrument is needed to assess academic self-efficacy in the Saudi context. This study assessed the psychometric properties of the Academic Nurse Self-Efficacy Scale-Arabic version (ANSE-A) given to student nurses and the associations between the students’ demographics and overall ANSE-A scores.

Methods: Quantitative and descriptive methods were applied. The study was conducted from January to July 2022 at Shaqra University with 200 nursing students as the convenience sample. For content validity, the item-level content and scale-level content validity indices were utilized following the averaging method. We …

Factors Affecting The Healthcare Of Adults With Communication Difficulties Due To Autism Spectrum Disorder And/Or Intellectual And Developmental Disability, Kathryn L. Shady

MUSC Theses and Dissertations

Purpose: This dissertation explores the healthcare barriers and facilitators experienced by autistic adults and adults with intellectual and developmental disabilities (IDD) who have communication difficulties (CD).

Problem: Approximately 5-10% of Americans have CD, including difficulties such as stuttering, aphasia, apraxia, and other forms of language impairment(1,2). Communication difficulties are present in about 25-30% of autistic individuals and 57.9% of those with IDD, which accounts for a large and poorly studied portion of those with CD(3,4). Individuals with CD report negative healthcare experiences and decreased levels of satisfaction with healthcare providers secondary to practices such as communication solely with a …

An Implementation Of Combined Fecal/Gastric Occult Blood Testing In The Emergency Department, Desiree Long

Master's Projects and Capstones

Problem: The gastrointestinal occult blood test is a point-of-care (POC) test used to detect the presence of occult (hidden) gastrointestinal bleeding via stool or gastric contents. Existing fecal and gastric occult blood point-of-care (POC) testing requires separate and unique sampling cards and developer, respectively. Separate fecal/gastric tests are less definitive and take longer than a combined test. Fecal/gastric testing can be improved and more effective using a combined testing mechanism.

Context: This project includes the microsystem of the emergency department, which involves groups of medical professionals, such as groups of clinicians and staff working together with a shared clinical goal …