Nursing Commons^™

Exploring The Perceptions Of English-Speaking West African Born Registered Nurse Graduates From United States Entry Level Nursing Programs Regarding Academic Factors That Contribute To Retention And Success In United States Nursing Programs, Afua Ampiaw

Seton Hall University Dissertations and Theses (ETDs)

Background: The United States (U. S.) population is becoming more racially and ethnically diverse. To ensure equity in healthcare access and outcomes between majority and majority populations, there is need for minority representation in the health professions including nursing to reflect their representation in the general population. Nevertheless, ethnic minorities are underrepresented in the nursing profession. One of the many issues identified to compound this problem is the lack of retention and success of ethnic minority people in U.S. nursing programs. While the English-Speaking West African (ESWA) population in the U.S. forms about 5% of the 45 million immigrant population …

Therapeutic Gardening For Addiction Recovery, Hayley Milleson

Master's Projects and Capstones

The following study examines the potential benefits of implementing therapeutic gardening and outdoor activities as a supplemental resource for adult males with a history of substance abuse issues who have been affected by the criminal justice system and are seeking sobriety while in a residential treatment program. The goal is to investigate how therapeutic gardening can add to traditional addiction treatment methods. Through a review of current evidence-based practice, this study focuses on how alternative interventions such as therapeutic gardening and outdoor activity can improve overall mental health and well-being, promote a sense of community, improve social connections, alleviate stress …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis: Bundle Elements, Grace Jenks

Master's Projects and Capstones

Problem: Based on the findings of a pre-survey conducted, it was observed that around 6% of the Medical-Surgical nurses who participated from Hospital A possessed "expert knowledge" of the "inpatient handoff sepsis bundle checklist." The results highlight the potential for educating and boosting the confidence of nurses working in a healthcare organization located in Northern California, enabling them to provide better care for patients afflicted with sepsis.

Context: The microsystem is a Medical-surgical unit situated within Hospital A, which is one of the 21 hospitals located in Northern California. Dr. Theresa Mostasisa conducted a survey on February 15, 2023, …

Bridging The Gap: Educating Medical-Surgical Unit Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Meara J. Matthews

Master's Projects and Capstones

Problem: Sepsis is a life-threatening response to infection that remains one of the leading causes of death worldwide. Based off results obtained from a pre-education survey of nurses on a medical-surgical unit in a large hospital organization, there is an opportunity to increase knowledge and confidence level regarding sepsis and care of septic patients so that nurses are prepared to detect sepsis early and intervention can begin.

Context: The project is being conducted in a medical-surgical unit at a large hospital organization in Northern California. The data from the survey includes 17 nurses on the unit who completed the pre-education …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Jillian J. Abinader

Master's Projects and Capstones

Problem: A sepsis protocol and bundle has been implemented in an urban Emergency Department to help screen patients and treat sepsis efficiently and effectively. The benchmarks from the bundle are not being met consistently every month and are below the targeted 90%.

Context: A microsystem assessment and a gap survey sent out to nurses, helped determine that there is room to improve nurses’ knowledge and confidence about sepsis and the sepsis bundle workflow. Sepsis is one of the most expensive and burdensome conditions in U.S. hospitals. Literature supports staff education to improve sepsis bundle compliance.

Intervention: A video was created …

Therapeutic Gardening For Mental Health In Substance Use Recovery, Stephanie E. Schafer

Master's Projects and Capstones

Abstract

As the clinical nurse leader (CNL) in this project, I used the “[CNL]

Essential 1: Background for Practice from Sciences and Humanities” (Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice, 2013) and its competencies to focus on designing nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences and to synthesize evidence for practice to determine appropriate application of interventions across diverse populations. With the help of the CNL competencies and collaboration with the healthcare team, we created and implemented a therapeutic garden for residents in a substance use …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Christopher N. Guinto

Master's Projects and Capstones

Problem: Results from a voluntarily anonymous pre-survey about sepsis revealed that a majority of the seventeen nurses assessed themselves below an "expert knowledge '' level. The survey results present an opportunity to improve the nurses’ knowledge and confidence in nursing response and improve patient outcomes with sepsis.

Context: The quality improvement (QI) project was conducted on a medical-surgical unit in a large Northern California hospital.

Intervention: A QI team initiated evidenced-based practice research and created an educational sepsis handout for nurses to increase sepsis knowledge and confidence.

Measures: The self-assessment pre-survey would be compared to the responses from the post-survey. …

Implementation Of Readmission Prevention Pathway To Reduce Skilled Nursing Facility Readmission, Bina Darai

Doctor of Nursing Practice Scholarly Projects

Background: Individuals admitted to Skilled Nursing Facilities (SNFs) are at risk of preventable hospital readmissions due to complex medical issues. Evidence indicates that many residents are transferred from SNFs to the hospital at least once. The Centers for Medicare & Medicaid Services penalizes facilities with high rehospitalization rates. Implementing an evidence-based strategy could reduce 30-day readmission rates in this setting.

Local problem: This project was conducted in a 34-bed Sub-Acute Care Unit in an SNF. The unit's 30-day readmission rate was high compared to the average rate at the SNF and the national benchmark, identifying a need to reduce readmission. …

Impact Of Maternal Fetal Triage Index On Emergency Healthcare Providers, Samantha Shepard

Doctor of Nursing Practice Scholarly Project

IMPACT OF MATERNAL FETAL TRIAGE INDEX ON EMERGENCY HEALTHCARE PROVIDERS

An Abstract of the DNP Scholarly Project by

Samantha Shepard

Care of obstetrical patients in non-delivering facilities is increasing. Obstetrical service availability in rural areas has decreased by more than 50% in recent years, according to Hung et al. (2018). Healthcare providers in these areas lack confidence and competence due to lack of regular training and encounters with obstetrical patients. The Maternal Fetal Triage Index (MFTI) provides a standardized approach for triaging the obstetrical population. The purpose of this project was to determine if staff confidence and competency improves within …

Self-Managment Of Urinary Incontinence In Women, Abbey Klein

Theses & Dissertations

Urinary incontinence is experienced by approximately 60% of adult women in the United States and negatively impacts many aspects of physical and psychological health. Many women do not seek care for urinary incontinence due to social stigma. However, those who do seek care do not often receive treatment options that align with clinical guidelines. Urinary incontinence self-management has been used interchangeably in the literature with other terms, like self-care and coping, but no conceptual definition has been delineated. The overall purpose of this dissertation was to describe urinary incontinence self-management in women. To accomplish this, a concept analysis was conducted …

Referral Triage To Improve Neurology Access, Melinda Mata

Doctor of Nursing Practice Scholarly Projects

The demand for neurology consultation far outweighs the number of specialists, thus causing long wait-times for consultation. Other contributing factors to obtaining timely consultation include, quality of information sent with the referral, insurance authorization, triage process, and appointment availability. This retrospective quality improvement study explored the effects of a referral triage process on reducing appointment wait time. All referrals were sent to one fax number and a new standard referral and triage process was implemented with specific operators with defined roles and responsibilities. The initial results following intervention implementation did not show improvement in wait times. Comparing the new triage …

Situation Awareness And Cognitive Load In Nursing Students Managing A Computer-Based Virtual Reality Simulated Deteriorating Patient, Tracy Chesney

Electronic Theses and Dissertations

Background: When a patient’s baseline clinical state shifts to a worse clinical state requiring a transfer to a higher level of care within the healthcare system, it is the hallmark of a deteriorating patient situation. Up to 37% of newly licensed nurses fail to identify and manage a deteriorating patient partly due to inexperience and a lack of expertise, contributing to lower situation awareness (SA), specifically in cue perception. Long-term memory schema development leads to expertise that allows individuals to develop higher SA necessary to identify and effectively manage patient deterioration. Expert nurses access long-term memory schema in managing deteriorating …

Developing An Advocacy Campaign To Minimize Barriers To Srna Political Awareness, Alejandra Villescas

Doctor of Nursing Practice Projects

Continuous advocacy and political participation have secured better working conditions and recognition of certified registered nurse anesthetists (CRNAs), translating into better patient care. This project aimed to launch an advocacy campaign targeting student registered nurse anesthetists (SRNAs). A pre-lesson survey was designed to identify SRNAs’ political participation barriers and assess their political literacy. Additionally, a lesson was developed to help SRNAs’ understand CRNA advocacy. To evaluate the educational tool, a post-lesson survey was created. These materials were distributed via email to all SRNAs (n=320) enrolled in a CRNA program in Illinois. Only 51 students completed the pre-lesson survey, and 39 …

Remifentanil In Labor Analgesia, Courtney Silberberg

Doctor of Nursing Practice Projects

Labor has the potential to be the most excruciating and intense physical pain a woman experiences in her life. Neuraxial anesthesia, which includes epidural, spinal, or combined spinal-epidural technique, is the gold standard for pain control in laboring patients (Lee et al., 2017). Seemingly forgotten, a subset of parturients cannot experience the benefits of neuraxial anesthesia due to several absolute and relative contraindications. These women rely on other options for labor pain control. Remifentanil has emerged as a preferred opioid option for labor and delivery due to its rapid onset (peak effect in 1.1 minutes) and rapid metabolism by non-specific …

Hyperoxemia Education To Nurses To Increase The Adherence To Oxygen Weaning Goals In Inpatient Copd Patients., Katherine Ellingson

Doctor of Nursing Practice Projects

Hyperoxemia in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at risk for increased hospital stay, mechanical ventilation, and increased risk of death. Literature supports that establishing increased education to nursing staff on the risks of hypoxemia to increase adherence to oxygen weaning protocols has the potential to improve future practice. Oxygen weaning protocols are often not followed for concern of patient care. Nurses may believe to be helping patients when increasing oxygen, when they could actually be potentially harming them. Increased education on hypoxemia in COPD patients for the nursing staff will assist them to feeling …

Type 1 Diabetes In The Classroom, Ursula Herrell

Undergraduate Honors Theses

Type 1 diabetes [T1D] is an autoimmune disease that presents in a pathophysiological disorder as insulin deficiency. Managing this illness during childhood is a constant challenge of maintaining blood glucose levels within a healthy range, resulting in increased stress for children and caregivers. School attendance is one factor that may result in increased stress. Studies have highlighted the fact that teachers of students with T1D may receive little education regarding management of the disease and may be required to make accommodations which can result in confusion, miscommunication, and increased psychosocial stress. The goal of this research was to learn about …

Implementation Of An Online Suicide Prevention Training Program With Undergraduate And Graduate Students At A California State University, Cheryll May P. Villamor

Doctoral Projects

Background: One of the leading causes of death in the college age population is suicide. While colleges provide opportunities in the acquisition of knowledge and skills for future careers; those same opportunities can also bring about challenges that put students at risk for suicide such as: dealing with their mental health issues, finding and maintaining support system, financial costs, and the pressure from ensuring academic success. One of the ways to help student at risk for suicide is by early intervention by connecting them with mental health support system such as crisis counselors. Question, Persuade, and Refer (QPR) is a …

Just Culture In Undergraduate Nursing Academia, Marcie Leonard

Doctor of Nursing Practice Projects

Understanding the importance of reporting errors, near misses, and good catches by nursing students is not a standard part of the curriculum at the project site. Nursing students lack pre-requisite knowledge of how just culture does not aim to place blame on individuals but focuses on system flaws. Nursing students fear being dismissed from the nursing program if they make and/or report errors. A focus on eliminating the fear of dismissal from a nursing program for error reporting and formally educating how error reporting can help shape practice for many other nursing students and nurses will result in better data …

New Graduate Nurse Professional Development Planning, Cassandra Adkins

Doctor of Nursing Practice Projects

A 150-bed urban hospital in Chicago lacked a formal process to assist new graduate nurses (NGRN) in developing incremental goals as a part of their longitudinal plan during their first year of professional nursing practice. This left NGRNs feeling unsupported in their journey from novice to expert. With many NGRNs choosing to leave the nursing profession within the first year of practice, organizations must invest in programs to support their transition from academia to practice. This project implemented First Year Coaches and regularly scheduled touchpoints with NGRNs to increase intent to stay at the organization, feelings of support, and future …

Enhancement Of A Peer Mentorship Program For Student Registered Nurse Anesthetist, Cassie Starrett, Katrina Harlan

Doctor of Nursing Practice Projects

Nurse anesthesia programs are associated with rigorous didactic work, doctoral projects, long clinical days, and high levels of financial debt (Mesisca & Mainwaring, 2021). Doctoral students experience significantly higher levels of stress than other graduate students, necessitating resources that support emotional wellness (Griffin et al., 2017). A mentorship program for student registered nurse anesthesiologists (SRNA) may help minimize perceived stress and lessen the adverse physical and psychological effects. While mentorships foster both personal and professional success for mentees, mentors also report increased interest in professional development, productivity, and satisfaction (Flexman & Gelb, 2011). This study aimed to evaluate the effectiveness …

Utilization Review And Utilization Of Evidence-Based Guidelines, Rosetta E. Hairston

Doctoral Projects

The quality improvement project focused on determining why utilization review nurses submitted epidural steroid injection treatment requests within evidence-based guidelines to peer review. The study reviewed six months of data from June 2022 through December 2022 to develop a pre-training baseline for the number of epidural steroid injection treatment requests approved by the nurse and approved by peer review. Deming's method for quality improvement was identified as the framework for implementing changes. The UR nurses were provided four weeks of refresher training on applying evidence-based guidelines to epidural steroid injection treatment requests. Post-group training sessions reflected a 91% increase in …

Implementation Of Web-Based Patient Education In Newly Transplanted Kidney Recipients, Tabo Mwikisa-Kelly

Doctoral Projects

Kidney transplantation is the preferred treatment for patients suffering from kidney failure. It is a complex process that is intended to improve one’s quality of life by adhering to a lifelong treatment plan of immunosuppressant therapy. Therefore, it is essential for patients or their caregivers to have adequate knowledge to care for themselves following post-transplant, which can contribute to better patient outcomes. In a metropolitan Bay area hospital in Northern California, the current state of practice involves educating newly transplanted kidney recipients through face-to-face interactions with the patient and handing out a transplant booklet during their initial transplant hospital stay. …

Speak Up For Hand Hygiene And Decrease Healthcare Associated Infections, Bernadette Priya Pandya-Orozco

Doctoral Projects

Background: Hand hygiene (HH) is one of the most cost-effective and simplest ways to reduce healthcare associated infections (HAIs). Incorporating Speak Up for hand hygiene enables healthcare workers (HCW) to communicate without fear when they observe noncompliance with HH requirements.
Objective: To increase HH compliance by utilizing Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS education to encourage Speak Up for HH and lead to reduction in HAIs.
Methods: The researcher provided educational training on “Speak Up for Hand Hygiene” and performed regular audits to examine its effects on one hospital unit in a California Bay Area healthcare system. A …

Nursing Professional Development Practitioner’S Experience Of Use Of Instructional Design Industry Standards, Denise Renfro

Doctoral Projects

Instructional design (ID) is a critical skill for nursing professional development practitioners (NPDs). Instructional design seeks to solve gaps in knowledge or skill by identifying both the educational issue and the outcomes by designing how to achieve the outcomes. There are complex and advanced instructional design needs for problem solving that requires an educational foundation in instructional design and experience. The purpose of the quality-improvement project was to assess the changes in NPD practitioners’/nurse educators’ adaptation to industry standards for ID pre- and post-implementation of a standardized instructional design model. The Nurse Educator Self-Assessment in Measuring Learning survey was developed …

An Evaluation Of A Structural Competency Training For School Nurses, Rachel J. Torres

Doctoral Projects

The aim of this quality improvement project was to use structural competency as a tool to highlight the broad social, political, and economic structures that influence health and subsequent inequities and disparities. A one group, pre-and post-design quality improvement project was used to determine whether the Structural Competency Working Group curriculum influenced school nurses’ thought processes regarding the factors that influence health outcomes. The curriculum was adapted to a 1.5-hour training and delivered to a group of school nurses from a highly populated and socially, economically, and culturally diverse urban county in northern California. The results showed that after the …

The Effectiveness Of Targeted Education On Improving Nurses’ Self-Efficacy In Caring For Psychiatric Patients On Medical Surgical Units, Rachel Shirey

Doctor of Nursing Practice Scholarly Projects

Individuals with mental illness are occasionally hospitalized on medical units, specifically medical-surgical units. Nurses working on medical-surgical units may find patients with mental illness more challenging due to the complexity of care they sometimes require. Nurses’ perceived ability to provide quality care for these patients is reduced in comparison to their perceived ability to care for patients without mental illness. Consequently, low self-efficacy can result in the provision of a lower quality of care for this population. The purpose of this quality improvement project was to improve the care that patients with mental illness receive while hospitalized on medical-surgical units. …

A Nurse Led Heart Failure Education For Self-Care Symptom Monitoring And Management, Lynda Browning

Doctoral Projects

Title

Nurse-led education heart failure education for symptom monitoring and management

Abstract

Problem Statement: Over six million adults in the United States have heart failure (CDC.gov,2020). According to the Agency for Healthcare Research and Quality (AHRQ), almost 20% of heart failure patients hospitalized are readmitted under 30 days (AHRQ, 2013). The American Heart Association (AHA) (2022) recommends a visual symptom tracking tool for self-care symptom monitoring to increase patient adherence and reduce readmissions. Despite this recommendation, the AHA tool for symptom monitoring is not fully incorporated into the discharge of every heart failure patient often because of nursing management …

Ohio Forensic Nurse Examiners: Readiness To Care For Victims Of Sexual Assault With Disability, Deanna Nicole Smith

Doctor of Nursing Practice Scholarly Projects

Forensic nurse examiners (FNEs) care for crime victims in acute care settings. These nurses are specifically trained in trauma-informed care and evidence collection in cases of sexual assault, domestic violence, abuse, and human trafficking (RAINN, 2022). The scholarly project focuses on the care of victims of sexual assault living with disability, as this population is three times more likely to be victimized than any other population (NSVRC, 2022). The project literature review reveals a lack of data on preparation standards for FNEs on caring for victims with disability and providing accommodations during forensic examination. Currently, it is unknown if FNEs …

An Integrative Review: Best Practices For Educating And Engaging Care Partners Of Patients With New Ostomies, Lauren Flook Brown

Master of Science in Nursing Final Projects

PURPOSE: The purpose of this integrative review was to identify and synthesize the best practices of engagement and education for care partners of patients with new ostomies to support adaptation.

METHODS: Five-stage integrative review process: (1) problem identification, (2) systematic literature search, (3) data evaluation, (4) data analysis, and (5) presentation.

RESULTS: Four themes with sub-themes emerged to understand effective engagement and education of care partners: (1) care partner influences on patient outcomes; (2) care partner needs; (3) barriers to care partner adaptation; and (4) diverse engagement strategies. Each theme and sub-themes related to care partners could not be separated …

Determination Of Individuals’ Attitudes Toward Covid-19 Vaccines And Health Fatalism: A Cross-Sectional Study From Turkey, Emre Erkal, Bedriye Cansu Demirkiran, Şerife Köleoğlu, Sevgi Demir Çam

Makara Journal of Health Research

Background: Vaccines have positive effects on the course of epidemics. This study was conducted to determine individuals’ attitudes toward coronavirus disease-2019 (COVID-19) vaccines, their health fatalism, and factors affecting these.

Methods: This cross-sectional study included 944 participants living in Turkey, who were included in the study by snowball sampling, one of the nonprobability random sampling methods. Participant information form, attitudes toward the COVID-19 vaccine scale, and religious health fatalism scale were used to collect the study data. Independent sample t-test, one-way analysis of variance and Pearson correlation analysis were used in the data analysis.

Results: Participants had …