Nursing Commons^™

Dnp Final Report: Developing Competence And Improving Patient Safety With Documentation Training In The Simulated Environment, Laura Zebreski

DNP Final Reports

With the advent of electronic health records, nursing documentation has declined in quality. Poor documentation exposes patients to safety risks. Nursing documentation is subject to legal standards set by the Texas State Board of Nursing. A DNP scholarly project was designed to create a learning and safety intervention to train student nurses to provide correct documentation before entering clinical settings. The goal of this project was to prepare nursing students to provide quality documentation that fulfills the legal standard to attempt to correct the current deficiencies seen in practice and promote patient safety. For this project, the students took a …

Evidence-Based Selection Of A Fall Risk Assessment Tool: A Program Evaluation Review, Lindsey Adams

Student Scholarly Projects

Fall prevention strategies are a consistent topic of discussion for healthcare regarding patient safety, as patient falls are costly to the patient and the organization. This project uses the CDC Framework for Program Evaluation to assess the fall prevention policy of a local hospital system, with particular emphasis on the fall risk assessment tool, Hester Davis. This project also explores the risks and benefits of adopting an alternative fall risk assessment tool, predictive analytics. Predictive analytics uses electronic health record (EHR) data analysis to provide a highly individualized patient fall risk score based on a large variety of patient and …

Reducing Readmission (And Mortality) For Older Patients & Survivors Of Life-Threatening Conditions: A Study Using The Staarr Protocol, Akhenaten Amun

Symposium of Student Scholars

Readmission rates for patients admitted for heart failure, pneumonia, chronic obstructive pulmonary disorder, a myocardial infarction, a hip or knee arthroplasty, or coronary artery bypass surgery tend to have high readmission and mortality rates within 30 days of their discharge from a hospital. Starting in October 2012, the Healthcare Reimbursement Reduction Program enforced penalties on Medicare reimbursements for hospitals with readmission rates, for patients with the conditions above, were higher than averages based on facilities with similar characteristics and patient populations. Teach-back and verify (Klingbeil & Gibson, 2018), interdisciplinary teams that engage in patient care and support (Reiter-Palmon et al., …

Botulism Toxin And Its Affects On Spasticity, Paige Nicholas

Symposium of Student Scholars

Abstract

Spasticity is a symptom associated with spinal cord injury patients that is caused from an influx in excitatory and inhibitory signals controlling muscles and reflexes generating a pattern of spasms in a period of time. When not treated properly adverse effects include: contractures, respiratory arrest, pain, paralysis and decrease in efficiency of nursing and therapeutic care. Interventions including medications (i.e. baclofen, dantrolene, gabapentin), physical therapy, surgery and orthotic devices are used to decrease spasticity however show minimal effect, short duration and multiple side effects. These side effects include dizziness, weakness, confusion, headaches, nausea and constipation. Recent research has shown …

Do Automated Reposition And Alert Systems Reduce The Development Of Pressure Ulcer?, Adanech Jones

Symposium of Student Scholars

Abstract

Do Automated Reposition and Alert systems reduce the development of Pressure Ulcer?

Each year more than 2.5 million people in the USA develop pressure ulcers, which are painful skin lesions that increase the risk for serious infection in patients. In some cases, pressure ulcers, if left untreated can lead to death. In the USA, hospital acquired pressure injury costs (HAPI) has a possibility to exceed $26.8 billion. About 59% of these costs are disproportionately attributable to a small rate of Stages 3 and 4 full-thickness wounds, which occupy clinician time and resources. PUs occurs when bedridden or wheelchair bound …

Mentoring Infection Preventionists: An Infection Prevention Practice Fellowship Program, Sejal Naik

DNP Qualifying Manuscripts

Background: The COVID-19 pandemic created enormous demands on infection preventionists (IPs). It seriously taxed IPs and required hiring new IPs to support these demands. It is highly competitive to hire experienced IPs, and it can take up to two years for new IPs to demonstrate proficiency before pursuing their certification. A gap analysis revealed that current infection prevention (IP) programs did not provide formal training or mentoring.

Methods: The fellowship program will use the Association for Professionals in Infection Control and Epidemiology (APIC) competency model to train and build IP competency. The APIC accelerated training program will provide training to …

Nurse Efficiency & Ultrasound Guided Intravenous Access: Evidence Based Intervention Benchmark, Jacob D. Frost

MSN Capstone Projects

Gaining IV access is this first step into accurate, timely diagnosis and interventions of patients. Nurses are typically the first medical professional a patient sees. If the nurse can establish IV access as early as possible this will lead to faster interventions faster diagnostic results and better management for patients and ultimately better patient outcomes. Ultrasound guided IV can increase first attempt success rates leading to decreased painful IV insertions by multiple nurses. This would increase patient satisfactions scores leading to higher re-imbursement.

An Integrative Review: The Experiences Of Stress, Burnout, And Compassion Fatigue By Ambulatory Care Nurses, Rajean Adams

Master of Science in Nursing Final Projects

Abstract

Aim: One aim of this integrative review is to highlight workplace issues outpatient (ambulatory care) nurses experience, related to stress, burnout, and compassion fatigue. Another aim is to bring awareness to and discuss recently implemented tools and strategies to help alleviate these manifestations.

Background: Stressors in the outpatient setting date back to the 1970s when psychologist Herbert Freudenberger mentioned the burnout he experienced while in a Free Clinic. In modern-day, half of nurses experiencing workplace burnout, confess to feeling emotional exhaustion. Various studies discuss the challenges nurses endure in the inpatient setting, but only a few focus on ambulatory …

Remote Patient Monitoring: Decrease Rehospitalization For Spinal Cord Injury Patients, Abegail Cabunoc-Garcia

Student Scholarly Projects

Practice Problem: The lengthy distance required to access specialty care, the overall higher cost of SCI/D care, complications associated with SCI, and the potential negative impact of shortened hospital stays are all compelling reasons to use telehealth technologies to deliver specialty services for medical issues.

PICOT: The PICOT question that guided this project was in adult spinal cord injury patients with chronic disease receiving primary care at a spinal cord injury center (P), how does the implementation of a remote patient monitoring home telehealth for SCI patients recently discharged from acute-care setting (I) compared to the usual practice …

How Is Health Seeking Behavior And Patient Outcomes For Latin Immigrants Affected By Language Barriers, Socioeconomic Status And Health Literacy?, Cassandra Sanchez

Nursing | Senior Theses

Background

Language barriers cause a disconnect between patients and health care workers. What further causes a disconnect is when patients have a lower level of education in addition to having a language barrier. I will be focusing on Latin immigrant individuals in the United States for my research. Many Latin immigrant patients may not have gone to school in their native countries, so their education level is lower making it harder to understand discharge information or patient teaching. When patients are unable to have that health literacy it may lead to negative patient outcomes due to not adhering to medication …

Substance Use Among Nurses As A Result Of Covid-19, And The Impact Of Rehabilitative Programs On Nurses, Gerome Macaspac

Nursing | Senior Theses

Background: The incidence of substance use among nurses has been a persistent issue for decades. The effects associated with substance misuse depend on what is used, the amount, how often, and how they are taken. Regardless of the substance used, any nurse who enters the workplace using substances puts the lives of others at risk. Due to the widespread effects of the COVID-19 pandemic, there is a risk that the number of nurses resorting to the use of substances may have increased. Therefore, an investigation into drug use among nurses during the pandemic is particularly important.

Objective: To explore the …

How Has The Pandemic Exacerbated Nurse Burnout, And What Can Be Done To Improve Their Psychological And Emotional Well-Being?, Lisette Diaz

Nursing | Senior Theses

Background: The COVID-19 pandemic has affected millions of people, both emotionally and physically. Nurses are among the people who are most affected. The nurses' quality of life and the way they provide care has been changed by the pandemic. Nurses are so focused on providing the best possible care for their patients that they neglect to look after themselves.

Objective: The purpose of this literature review is to identify and evaluate how the COVID-19 pandemic has affected nurses and their well-being. The significance of this research was to establish how the ongoing pandemic has impacted nurses’ performance and …

Nursing Abroad: A Comparison Of Healthcare In Italy, Sweden, And The Us, Sadie Stark

The Eleanor Mann School of Nursing Undergraduate Honors Theses

No healthcare system is perfect, nor does one system work for all populations. History and culture have dictated the mindset of people for generations. It is the ever-changing mindset of patients and providers that will continue to expand and improve international healthcare by first changing daily practices. Nursing in Italy, Sweden, and the United States look very similar but also have a number of differences. Each country’s healthcare system works for its population, but efforts for international collaboration could still prove beneficial. Whether it be universal or private, centralized or localized, a patient centered focus is the driving force behind …

Evidence-Based Best Practice For Nursing Skills Competency Assessment: A Policy Development Project For Standard Work Utilizing The Donna Wright Competency Model, Iselda Gentry

Student Scholarly Projects

Practice Problem: Traditional nursing competency assessments use a process-focused approach determined by leaders. A checklist methodology for conducting nursing competencies does not empower nurses to create their own learning experiences.

PICOT: The PICOT question that guided this project was: In an acute care setting (P), how does the development of an evidence-informed policy for competency assessment utilizing the Donna Wright Competency model (I) compared to current competency assessment practices (C), improve the guidance for nurse educators in the development of standard work and communications regarding competency assessment (O)?

Evidence: Studies using the DW Competency Assessment Model have shown that this …

Assessment Of Veteran Satisfaction With Telehealth Services During The Covid-19 Pandemic, Rhonda Kay Howard

Electronic Theses and Dissertations

Abstract

With the advent of the COVID-19 public health emergency in the United States, many U.S. veterans were unable to maintain their usual office visits due to safe access concerns. Patients were strongly encouraged to maintain their healthcare needs at home by utilizing online technology resources like telehealth services with their healthcare providers. Providing excellent healthcare services for veterans during COVID-19 became a challenge for primary care providers at many veteran healthcare organizations. Since little was known about the satisfaction of veteran clients with healthcare management using virtual care during the pandemic, this formative program evaluation was designed to survey …

Lowering Utis In Sci, Jennifer Walter

Symposium of Student Scholars

Lowering UTI Rates In SCI

Addressing UTI in spinal cord injury patients is significant because the high occurrence of UTIs adversely affects both the patient and health care organizations. Studies show that neurogenic bladder is common in SCI patients which results in increased retention of urine and rates of bacteria. This calls for continuous intermittent catheterizations, increasing risk of infection and compromising health of the patient. Studies found UTIs lead to greater hospitalization lengths, costs, and waste. The purpose of this project is to lower UTI rates by identifying bacteria in urine daily, thus treating UTI sooner. Urine cultures are …

Shortening Wait-Times In The Emergency Department, Laura Clark

Symposium of Student Scholars

Many Americans visit the Emergency Department (ED) every day for a variety of reasons. Some are extreme emergencies while others could be handled by a primary care provider (PCP). However, the EDs throughout the United States and other countries throughout the world are consistently known for their extended wait-times. Evidence has shown the average ED wait-time is about 145 minutes, being significantly longer in other states. In a state of emergency, 145 minutes could mean life or death. Shortening wait-times in the ED is crucial to saving lives, efficiently utilizing staff members, and satisfying patient needs. In this project, various …

Pressure Injury Bundles Vs Routine Pressure Injury Care, Which Will Reduce More Pressure?, Kristina Bennett

Symposium of Student Scholars

Pressure injuries are one of the most major challenges confronted in hospitals today – which can compromise a patient’s well-being, extend a patient's hospital admission, and can potentially contribute to disability or mortality. The prevention of pressure injuries is significant in delivering high-quality healthcare to patients; however, the prevention plan for pressure injury applications has been suboptimal as it causes a delay in medication delivery for nurses. The forms of care that are often used by healthcare professionals to improve HAPIs (hospital-acquired pressure injuries) are pressure preventative bundles – which are a set of evidence-based practices that are implemented reliably …

How Covid-19 Changed New Nurse Orientation, Lindsey Js Sanders

MSN Capstone Projects

Universities were no longer able to do in person learning for nursing students. Nursing students were being taught vital skills like inserting an IV catheter via online simulation. The number of hours nursing students had to participate in clinical hours at the hospital was diminished due to the hospitals not allowing in nursing students. This created a huge educational deficit in nursing students. The nursing students who graduated during the COVID-19 pandemic are arguably less skilled than their predecessors before them. To fill this educational gap, additional training and orientation time must be provided to allow for fully competent new …

From The Other Side: Nurses’ Perception On The Use Of Negative Pressure Wound Therapy In Clinical Setting, Chinal Patel

Honors College Theses

Negative Pressure Wound Therapy (NPWT) is a revolutionary technology being used more frequently in clinical settings across the United States. Though there has been extensive research on the efficacy of NPWT medically and otherwise, there has been little research regarding the healthcare providers’ perception of use of “wound-vacs,” the device used for NPWT. As new techniques and/or devices are made available for use in a clinical setting, the burden to educate staff falls upon patient care providers. The administration of NPWT is wholly reliant on a nurse as they are the ones to apply the dressing, change it and document …

Subepidermal Moisture Measurement: Preventing Pressure Injury In Acute Clinical Settings, Allen Neese, Natalie Embry

Scholars Week

No abstract provided.

Non-Covid-19 Hospitalizations: Patients’ Experiences During The Covid-19 Pandemic, Julia Patrick

Patient Experience Journal

The purpose of this Qualitative Descriptive study was to describe the experience of hospitalized adults during the pandemic who did not have COVID-19. Semi-structured interviews were conducted with 20 English-speaking adults who were hospitalized on a medical or surgical floor after April 1, 2020 and were negative for COVID-19 throughout their entire hospital stay. The interview questions focused on the overall hospital experience, the nurse’s role in their experience, comfort needs, and the experience of having comfort needs met during the hospitalization. Conventional content analysis of the transcribed transcripts revealed five main themes related to the hospital experience: I don’t …

Home Health Care Cahps® Survey: Predicting Patient Experience Performance, Stephanie Ballengee, Girlyn Cachaper, Kim S. Bradley, Hessamaldin Sadatsafavi, Ralitsa S. Maduro, Merri K. Morgan, Kathie S. Zimbro

Patient Experience Journal

Our home health (HH) division has collected Home Health Care CAHPS® Survey (HHCAHPS) data since 2011. To date, HH providers have not met performance thresholds related to patient experience. This study aimed to explore HHCAHPS composite measures and specific questions to predict 1) overall rating of care provided by the agency (Care Rating) and 2) willingness to recommend home health agency to family and friends (Recommend Agency). We also explored survey comments to identify specific themes related to positive and negative patient experiences. Logistic regression (N = 7 268) revealed being treated with courtesy and respect, and providers being informed …

Mystay – Development Of Nurse-Facilitated Condition-Specific Multimedia Resources To Facilitate Patient Participation In Postoperative Care, Jo Mcdonall, Anastasia F. Hutchinson, Natalie Heynesbergh, Bernice Redley, Richard De Steiger, Damien Khaw, Mari Botti

Patient Experience Journal

Improved postoperative outcomes and the global drive toward the provision of patient-centred care underpins efforts to enhance the nature and capacity of patient participation in acute postoperative hospital care. In this paper, we describe the design, framework and processes used to develop a modular, procedure-specific, digital health intervention platform aimed at improving the patient experience and patient participation in care following surgery. The intervention, a multimedia application MyStay, uses bedside delivery of audio-visual and text-based information to engage postoperative patients to better participate in their care. MyStay modules are developed using an iterative, multi-method approach intended to balance procedure-specific best …

Mid-Simulation Debriefing: The Impact On Confidence And Clinical Judgement Of Nursing Students In A Baccalaureate Mother Baby Course, Tonya Broughton

Graduate Theses, Dissertations, and Capstones

Debriefing is a crucial aspect of healthcare simulation. This portion of the simulation experience encompasses the vast majority of student learning and reflection that takes place, and increases skills such as communication, clinical reasoning, and critical thinking. Traditionally debriefing is performed at the end of a clinical simulation experience after the simulation experience has concluded. In the maternal-newborn setting, there are often two phases of simulation. First is the care of the laboring mother and second is the delivery and care of the newborn. This study explored the effects of completing a mid-simulation debriefing in a maternal newborn simulation at …

Objective Structured Clinical Evaluation For Volume Control And Pressure Control Ventilator Modes, Brian Bailey, Anthony Newsom

Doctoral Projects

The purpose of this doctoral project was to create a tool to teach student registered nurse anesthetists (SRNAs) in The University of Sothern Mississippi’s (USM’s) anesthesia program about pressure control and volume control ventilator modes, and how to use them. To accomplish this goal an Objective Structured Clinical Examination (OSCE) was developed. The framework used for creating this OSCE was Kolb's Theory. Kolb's Theory uses a four-stage learning cycle in which the learner encounters a new experience, reflects on the observations of said new experience, conceptualizes or modifies a concept based on this experience, and then applies their idea to …

Loma Linda Nurse - Vol. 30, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | Elizabeth Bossert— Reflecting on a Journey

8 | Gloria Huerta— A Vision for Leadership

10 | Dawn Graves—First Flight

12 | The Path to Excellence

16 | Nursing Anesthesia Around the Globe

LLUSN HIGHLIGHTS

20-25 | ALUMNI NEWS

26-29 | HOMECOMING

30-33 | ACADEMICS

34-35 | FACULTY UPDATES

Inspiring Excellence In Doctoral Nursing Education Through Partnership: Incorporating An Innovative Change Model To Improve Dnp Project Outcomes, Melanie Brewer, Debbie Conner, Transition Management Partners, Llc

All Faculty and Staff Scholarship

Background/Introduction

Franklin University, a leader in educating working adults, formed an academic practice partnership with OhioHealth. Integrating the OhioHealth Change Management Model (CM) into the Doctor of Nursing Practice (DNP) program marks a deviation from a theory-based project to a more theory-to-practice model for managing organizational change. The CM provides leadership-driven DNP students with access to an innovative, real-world approach to prepare to transform organizations, systems, and healthcare through evidence-based interventions.

Purpose

The CM is a novel, goals-focused, data-driven approach used to manage people while implementing evidence-based practice, policy, or business change in an organization. The model includes Identifying executive …

Informing Healthcare Operations With Integrated Pathology, Clinical, And Epidemiology Data: Lessons From A Single Institution In Kenya During Covid-19 Waves, Allan Njau, Jemimah Kimeu, Jaimini Gohil, David Nganga

Pathology, East Africa

Pathology, clinical care teams, and public health experts often operate in silos. We hypothesized that large data sets from laboratories when integrated with other healthcare data can provide evidence that can be used to optimize planning for healthcare needs, often driven by health-seeking or delivery behavior. From the hospital information system, we extracted raw data from tests performed from 2019 to 2021, prescription drug usage, and admission patterns from pharmacy and nursing departments during the COVID-19 pandemic in Kenya (March 2020 to December 2021). Proportions and rates were calculated. Regression models were created, and a t-test for differences between …

Determining Individuals’ Attitudes Toward Cancer Screening And Their Influential Factors, Emre Erkal

Makara Journal of Health Research

Background: Cancer screenings are of great importance for the early detection of cancer. The goal of this study is to determine the attitudes of individuals toward cancer screening and the factors affecting these attitudes.

Methods: This descriptive, cross-sectional study comprised 1059 participants who were living in Turkey. The participants were recruited through the snowball sampling method between December 6 and 24, 2021. The Individual Self-Assessment Form and Attitude Scale for Cancer Screening were used to collect data. The data were analyzed by using independent samples t-test, one-way ANOVA, and Pearson’s correlation analysis.

Results: The mean score of …