Nursing Commons^™

Prevention And Reduction Of Catheter-Associated Urinary Tract Infection, Lea F. Garin

Master's Projects and Capstones

Abstract

Problem: Fifteen to twenty-five percent of hospitalized patients receive indwelling urinary catheters (IUCs) during their hospital stay and are at high risk for catheter-associated urinary tract infections, according to the Centers for Disease Control and Prevention (CDC, 2015).

Context: A CAUTI Prevention program was implemented in a community hospital surgical unit to address concerns of high rates of CAUTI.

Interventions: Staff training/education, pre-CAUTI and post-CAUTI prevention survey, hand hygiene, bundle care audit, and staff competency for indwelling urinary catheter insertion were implemented to prevent and reduce CAUTI cases in the surgical unit.

Measures: The Standardized Infection Ratio …

Reducing Hospital-Acquired Clostridium Difficile, Tracy Esposo

Master's Projects and Capstones

Background: This project focused on implementation of clostridium difficile (C. diff) education sessions at Hospital A, a not-for-profit, short-term, acute care hospital serving the Greater Sacramento community. It comprises of 241 staffed beds in the medical-surgical, telemetry, and intensive care units.

Problem: My Clinical Nurse Leader project focused on preventing hospital-acquired C. diff. At Hospital A, there were 19 hospital-acquired C. diff cases for the 2022 performance year. Of the 19 clostridium difficile cases, 12 were related to C. diff testing criteria fall-outs.

Despite huddling with staff on opportunities and providing education through health stream modules, Hospital A continues to …

Implementation Of A Wellness Program For Nurse Leaders, Ericson A. Fernando

Master's Projects and Capstones

Background: The setting for this study is the implementation of a wellness program for nurse leaders at Hospital A, a healthcare organization servicing the South Sacramento area in California. Healthcare is a challenging and high-demand profession, and the COVID-19 pandemic has exacerbated an issue of burnout and unwavering job-related stress for physicians and employees. This remains true for nurse leader professionals who take on the responsibility to ensure safety and quality always remains at ideal measures for any facility.

Problem: During the past several years of the pandemic, the nurse leader role has had to endure several unknowns, placing significant …

Analyzing Reporting Of Hospital Acquired Pressure Injuries In The Acute Care Setting, Trineca R-N Godfrey, Gabriella Garcia, Ameerah Tolentino, Gisselle Chairez, Jane Kwak

Master's Projects and Capstones

This project was conducted at a level one trauma center, acute care hospital consisting of 459 beds. With more patients than wound care nurses, hospital-acquired pressure injuries (HAPIs) have become a significant problem for this hospital. A gap between reporting in the Safety and Quality Information System (SQIS) and the reporting that takes place in electronic health record (EHR) with wound care consults has been observed. A root cause analysis (RCA) was used to identify discrepancies. The accurate collection of data was identified as paramount providing information necessary to create improvements and lower the occurrence of HAPIs. The conceptual framework …

Hapi Prevention On A Medical Surgical Telemetry Covid Unit, Maria G. Gonzalez

Master's Projects and Capstones

Abstract

Problem: Hospital acquired pressure injures (HAPI) are potentially preventable but frequently occurring events in hospitalized patients. Pressure injuries can occur because of prolonged pressure and in combination with shear and friction forces. HAPI negatively impacts a patient’s quality of life. HAPI also increases the hospital’s financial burden and increases the patient’s length of stay.

Context: The 52-bed medical surgical, telemetry, COVID, unit is one of several unis within a hospital setting. The unit is challenged with the management of HAPIs. The staff are challenged with documenting and escalating the findings, and with finding a second nurse to assist with …

Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez

Master's Projects and Capstones

Abstract

Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …

Examining School Nurses' Knowledge And Confidence Related To Their Intention To Screen For And Report Child Sexual Abuse: A Descriptive Cross-Sectional Study, Suzanne Ackers

Electronic Theses and Dissertations

Background: Child sexual abuse (CSA) in a preventable national public health problem that results in adverse health consequences. Research suggests many victims are currently attending school. Screening for early detection of health issues is integral to school nurse (SN) practice but there is little evidence that screening for CSA is occurring in schools despite recommendations that it should be. Lack of confidence and knowledge related to screening for suspected CSA contribute to a SN’s missed opportunity for early intervention.

Purpose: To describe SNs knowledge and self-efficacy associated with screening for and reporting CSA in school settings.

Methods: A descriptive cross-sectional …

“One University’S Covid-19 Pandemic Mitigation Response And Anxiety Construct: A Summative Program Evaluation”, Ann Hodgin

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

The effects of the COVID-19 pandemic continue to ripple through everyday life. In December 2019, an outbreak occurred in China. Subsequently, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus that quickly spread around the globe (Nazario, 2022). As of May 31, 2023, there were 6,938,353 confirmed deaths worldwide from COVID-19 (WHO, 2023).

A needs assessment completed by the University identified that a program evaluation of the university’s COVID-19 response was warranted. Therefore, this program evaluation was conducted to assess the effectiveness of the policies and protocols implemented at a Catholic University in Southwestern Pennsylvania to …

Evidenced-Based Practice Competency Assessment For Competency-Based Orientation Protocol To Improve Competency Level Among Medical-Surgical Nurses, Maryann Ornelas

Student Scholarly Projects

Practice Problem: Within a 12-month period, high incidences of severe post-spinal surgical complications resulted in a host of concerns in this clinical site when patients either returned to the operating room for spine revision or increased the length of stay.

PICOT: The PICOT question that guided this project was: "In Medical Surgical (Med-Surg) nurses (P), how would a Competency-Based Orientation (CBO) protocol with the inclusions of four critical elements of postoperative spinal care [POSC] (I) compared to the usual postoperative practice (C) enhance competency level in Med-Surg nurses when delivering postoperative practice at an inpatient setting (O) over 10 weeks …

A Program Evaluation Of Domestic Violence Screening At A Large Urban Hospital., Taylor L'Heureux

Doctor of Nursing Practice Papers

Domestic violence has been deemed a direct invasion and violation of human rights by the World Health Organization (2021). Due to the continuous rise in cases of domestic violence, national organizations like the United States Preventative Services Task Force (USPSTF) have recommended that healthcare providers screen patients for this abuse. The purpose of this study was to reinforce the current screening procedure and protocol to ensure that each patient was screened for domestic violence before being discharged from the hospital. This study evaluated a quality improvement project formed to promote the completion of a preexisting domestic violence screening form that …

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Care Transition Assessment Redesign In The Acute Care Setting, Darla M. Johnston

Electronic Theses and Dissertations

There is a gap in case management professional practice with a lack of consistent, research-based transition evaluation (TE) tools available and used in practice. An evidence-based case management TE is necessary to develop a holistic and comprehensive discharge plan for hospitalized patients. Updating and implementing an evidence-based case management TE would positively impact the transition of care and promote improved health outcomes including a reduction in readmissions. This quality improvement project used a quantitative nonexperimental, interventional pretest-posttest design. Kirkpatrick’s multidimensional knowledge attitudes assessment (KAP) education evaluation model was used to assess (1) the influence an educational offering on evidence-based assessment …

The Transformation: Teaching Critical Thinking And Clinical Decision Making In Nursing Education, Winifred Ferguson Adams

Electronic Theses and Dissertations

Abstract

The profession of nursing has recognized in the past 20 years the need for graduate nurses to enter the profession prepared to care for complex medical patients in an ever-changing healthcare environment. It has become a major challenge for nurse educators to provide students with adequate didactic and clinical education in nursing. The overall purpose of this project was to help nurse educators accept the challenge required to make the radical transformation in education. Faculty participated in the measurement of self-efficacy pre and post-exposure to teaching strategies related to (1) critical thinking, (2) clinical judgment, and (3) clinical reasoning …

The Routine Use Of Tympanometry To Prevent Unnecessary Antibiotics In Patients With Otalgia: An Evidence-Based Practice, Quality Improvement Project, Leslie Leffler

Graduate Theses, Dissertations, and Capstones

Abstract

Background: The use of Tympanometry to diagnosis Otitis Media with Effusion (OME) in adults is not routine practice in primary care, although it is supported by evidence and clinical practice guidelines. The misdiagnosis of OME frequently leads to inappropriate antibiotic prescribing, contributing to the rise in drug resistant infections.

Purpose: This evidence-based practice, quality improvement project sought to determine if the use of tympanometry by Family Nurse Practitioners (FNPs), to assess adults visiting primary care clinics, improved the accuracy of otitis media diagnoses and decreased unnecessary antibiotic therapy. The project also evaluated whether experience using the tympanometer …

Intimate Partner Violence Screening In The Emergency Department, Rebecca Stuerman

Dissertations

Problem: Intimate partner violence [IPV] is a public health concern that affects one in three women worldwide. IPV can be addressed through identification and early intervention with minimal risk to the patient. The emergency department is an important setting for screening given the frequency with which people who experience abuse may present with IPV-related injuries and other related concerns (depression, suicidality, etc.). Successfully implementing a validated tool for screening and providing early access to resources and referrals may help to mitigate the longterm negative impacts of IPV. The need for increased staff education was a major barrier to screening for …

Self-Care, Resilience, Self-Compassion, And Burnout In Doctoral Nursing Students: An Exploratory Needs Assessment, Logan Justice

Dissertations

Abstract

Problem: In the United States, one in three nurses experience symptoms of burnout, and doctoral nursing students are additionally challenged to juggle multiple school, work, and life demands (Reith, 2018; Woo et al., 2020). The purpose of this project was to explore the current self-care practices of doctoral nursing students to understand how self-care relates to resilience and burnout.

Methods: This exploratory needs assessment utilized a convenience sample of Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students at a medium sized midwestern university. An electronic data collection survey was constructed to assess student self-care practices, …

Improving Nurses Wound Care Knowledge Utilizing An App, Monica Amador

Student Scholarly Projects

Practice Problem: Nurses needed additional wound care support, but formal training was not in the budget at this time. Nurses needed a quick reference guide to help them assess, document, and treat wounds correctly until the hospital could provide adequate training.

PICOT: The PICOT question that guided this project is; “When treating wound care patients within a hospital setting (P), how does the implementation of a wound software app. (I) as compared to pre-existing nursing knowledge (C) increase a nurse’s self-reported ability to accurately assess and treat wounds (O) during a 10-week period? (T)”

Evidence: Based on a thorough and …

Implementing An Emergency Severity Index (Esi) Triage Refresher Training To Decrease The Under-Triage Rate In The Emergency Department (Ed), Monique Wallace

Doctor of Nursing Practice Projects

Background: The Emergency Severity Index (ESI) is a triage tool used in most emergency departments in the United States (U.S.) that assesses acuity and resource allocation for emergency care patients. Registered nurses (RNs) must assign the appropriate triage category to ensure patients are seen in a proper time frame, have ideal patient outcomes, and have efficient patient throughput.

Purpose: This quality improvement project aims to decrease the under-triage rate of patients in the emergency department (ED) by implementing an Emergency Severity Index (ESI) triage refresher training.

Methods: This project used an A3 methodology. The triage specialist completed retrospective chart reviews …

Interfacility Transfer Of Pediatric Patients To A Comprehensive Children's Hospital, Kim Zaky

Student Scholarly Projects

Practice Problem: Secondary transfers to pediatric centers have increased by 25% due to the regionalization of specialty care. Low pediatric volume and the lack of access to pediatric subspecialty confounds the need for transfer requests to comprehensive children’s hospitals. Referring hospitals rely on pediatric teams to determine the level of service and mode of transportation decisions due to a lack of comfort in caring for and managing pediatric patients.

PICOT: This project was guided by the following question. In pediatric patients transferring from other healthcare facilities to a comprehensive children’s hospital (P), does the implementation of a nurse-led pediatric illness …

Establishment Of Unit-Based Council Using A Shared Governance Toolkit For Surgical Clinics, Fica Etienne

Student Scholarly Projects

Practice Problem: Shared governance (SG) is an organizational framework that empowers healthcare professionals by granting them authority over their own professional practice. The absence of a unit-based council (UBC) has been identified as hindering collaborative decision-making and problem-solving approaches.

PICOT: In four surgical clinics requiring a Unit Based Counsel (UBC) structure (P), what is the impact of implementing a Shared Governance (SG) toolkit (I) compared to not implementing an SG toolkit (C) over eight weeks? (T)

Evidence: The existing literature strongly indicates that shared governance (SG) empowers nurses to collaborate as equal partners with nursing leaders within …

Evaluation Of Nursing Diagnoses Perception Among Nursing Students, Pramilaa R

Manipal Journal of Nursing and Health Sciences

Introduction: The basic quality of nursing practice is being compassionate and this quality is the one of the significant functions of the nursing profession .Nursing process manages the sick population holistically encompassing all domains such as socio cultural, psychological, economic and spiritual. It augments critical thinking too. Nursing process is also viewed in a resolution perspective. The objectives of the present study were carried to determine nursing students’ perceptions of nursing diagnoses and associate the level of perception with selected demographic variables. Methodology: A descriptive study to evaluate the nursing students’ perception of nursing diagnoses was conducted. Permission of the …

A Study On The Correlation Between The Study Habits Of Nursing Students And Perceived Exam Anxiety, Rebecca A. Bracken

Honors College Theses

Anxiety is a concept very familiar to many university students. This especially applies to students who have decided to major in nursing. With the knowledge and experiences that accompany attending nursing school, come a series of rigorous, high-stakes exams. Nationwide, many students share a common struggle to be successful on these exams, which often leads to a sense of anxiety that becomes associated with one's experience during testing, known as test anxiety. A study across multiple baccalaureate nursing school cohorts was completed to determine a correlation between the various methods used by nursing students to prepare for an exam and …

Commencement Program 2023, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2023 Events of Commencement

5 | The Academic Procession

6 | Institutional Administration

7 | Board of Trustees

8 | Significance of Academic Regalia

9 | University History Highlights

11 | Criteria for Institutional Awards

13 | Loma Linda University Health and Loma Linda University Honorees

25 | The Program, The School Honorees, and The Speakers

• School of Medicine, 26
• School of Pharmacy, 52
• School of Dentistry, 69
• School of Public Health, 93
• San Manuel Gateway College, 108
• School of Allied Health Professions—Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication …

Never-Ending Parenting: Challenges Experienced By Caregivers Of Adults With Severe Autism, Andrea Palerino

Dissertations, Theses, and Capstone Projects

Despite the large number of children with autism spectrum disorder (ASD) who are annually aging out of the school-based systems in the United States, much of the academic literature has been focused on the concerns and challenges of preschool or school-aged children with ASD. As a result, there lacks a clear understanding of how primary caregivers of adult children with severe autism spectrum disorder (SASD) utilize various forms of capital to navigate care.

This qualitative descriptive study explored some of the challenges experienced by primary caregivers of adult children with SASD. Convenience sampling was used to conduct semi-structured interviews with …

Self Management Programs And Its Effects On Blood Pressure, Thao Vo

Master of Science in Nursing Family Nurse Practitioner

No abstract provided.

Improving Nursing Student Retention: Early Identification Of Determinants Causing Attrition In Nursing Academic Programs, Tennille Gifford

Doctor of Nursing Practice Final Manuscripts

Introduction: Student success in higher education is a vital focus for the health of a community and the improvement of an individual’s life. It is equally detrimental if a student leaves an educational program without a degree. The purpose of this project was to improve the early identification of students at risk of attrition in a nursing program by using an electronic dashboard interfaced with a self-reporting student survey to identify determinants that are statistically significant factors for student attrition. Background: The current accreditation benchmark for nursing program completion is 70% for Bachelor of Science in Nursing degrees. Concordia St. …

Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

Improving Outcomes In Persons Who Inject Drugs: A Multidisciplinary Healthcare Initiative, Carla S. Martin

Doctor of Nursing Practice (DNP) Projects

Background: Outpatient parenteral antimicrobial therapy is the standard of care for patients who require long-term antimicrobial therapy but is not considered a safe discharge option for persons who inject drugs (PWID). Many PWID leave against medical advice before completing therapy, resulting in high emergency department utilization and frequent readmissions.

Local Problem: A 646-bed academic and Level I trauma center where opioid overdoses are 6.5 times higher than the state average experiences disproportionately high PWID admissions. Prolonged hospitalization for the duration of antimicrobial therapy increases costs and reduces access for other acute care patients.

Methods: A prospective cohort of PWID discharged …

Implicit Bias In Nursing: Raising Awareness, Fostering Change, Jeanette C. Sandoval

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Extensive research evidence demonstrates that implicit bias can lead to differential treatment of patients based on race, gender, weight, age, income, language, and insurance status. Evidence-based interventions that couple implicit bias mitigation with therapeutic communication skills can contribute to the delivery of equitable care.

Local Problem: Implicit bias in healthcare occurs when unconscious behavior that is not favorable to the patient population served perpetuates unequal treatment and contributes to poor healthcare outcomes.

Methods: Knowledge of implicit bias in the nursing staff was assessed through a validated and reliable survey tool before and after participation in an online LMS …