Using Design Science Research To Create A Virtual Environment For Nursing Students, Benjamin Botha, Lizette De Wet

African Conference on Information Systems and Technology

This paper aims to provide insight into the design science research approach followed during a transdisciplinary research study between computer scientists and professional nurses. The researchers used a design science research approach to create a virtual environment where nursing students could practice managing a patient with a foreign object in the right lung. The virtual environment underwent multiple changes as it progressed through the different cycles of design science research. Within these cycles, namely the relevance, design, and rigor cycle, various iterations of each of the cycles took place. Presented in this paper the design science approach followed will be …

Implementing A Courtesy Call System To Increase Patient Satisfaction, Tessa Garcia

Master's Projects and Capstones

Abstract

Problem: An assessment of a home health microsystem found a decrease of patient satisfaction using Home Health Consumer of Healthcare Providers and Systems (HHCAHPS) survey scoring. Low HHCAHPS scores equivalate to poor quality care, which has a negative impact on patients and the organization itself.

Context: The setting for this project was a home health department microsystem in Northern, California serving a 400-patient population. The project was implemented within the quality department of the home health organization.

Interventions: Evidence shows that implementation of a courtesy call check-in improves satisfaction and patient outcomes. A courtesy call check-in was implemented to …

Determinants Of Reproductive Freedom Among Israeli Women Ages 18-50: A Mixed Methods Study, Abby Kra-Friedman

Electronic Theses and Dissertations

Introduction: Reproductive freedom is a social determinant of health (SDOH) that reduces health disparities and increases health equity. Through the National Health Insurance Plan, Israeli women can access a range of contraceptive methods. Scant data on Israeli women limits development of policies and interventions to meet international benchmarks for reproductive freedom. The purpose of this dissertation study is to synthesize current international multidisciplinary literature using the capability approach for reproductive freedom, explore determinants of reproductive freedom among Israeli women ages 18-50 using Nussbaum's capability approach, and make recommendations for nursing research, practice, and theory.

Methodology: Using Whittemore and …

Managing Congestive Heart Failure Through Standardized Symptom Assessment, Shanda M. Joy

Master's Projects and Capstones

Abstract

Problem: Transitional care programs have increased in popularity to focus on optimizing transitions of care from acute hospitalization to home based settings to reduce hospital readmissions. The transitional care model utilized at this urban, integrated health facility is mostly 100% telephonic, short term (30 days) case management. Approximately 30% of the patients referred to the program have a diagnosis of congestive heart failure.

Context: Hospital reimbursement has decreased due to high readmissions rates, especially among congestive heart failure (CHF) patients. This process improvement project was aimed at decreasing CHF related readmissions through educating patient/families on CHF watch symptoms and …

Improving Outreach With Stroke Patients After Discharge, Marsha Belen

Master's Projects and Capstones

Problem: The 90-day mRS post discharge call project aimed to improve the outreach in stroke patients treated with thrombolytics alone or in combination with mechanical endovascular reperfusion (MER) therapy. An audit of calls was completed and revealed a gap that a number of patients were not reached or did not receive a call attempt. Having a higher outreach provides useful feedback on the patient’s progress within 90-days of being discharged in relation to the effectiveness of the stroke treatment received according to the mRS.

Context: The Neuro Coordinator was responsible for making the 90-day post discharge call and worked in …

Tepezza: Improving Delays In Treatment, Rebecca D. Page

Master's Projects and Capstones

Problem: There is gap in time from when a Tepezza (teprotumumab) order is placed until the time a patient receives their first infusion.

Context: Delays in the initiation of Tepezza infusions result in worsening symptoms and a decrease in quality of life for patients diagnosed with thyroid eye disease.

Interventions: Interventions included scheduling regular meetings with involved departments, following each patient who has been prescribed Tepezza through the initiation of therapy, and improving staff and patient education.

Measures: Outcome measures include decreasing days from order placement to first infusion from an average of 61 days to 30 days or less …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

Intervention To Increase Home Preparation For Colonoscopies, Joshua Victor Stone

Master's Projects and Capstones

Abstract

Problem: Inpatient colonoscopies are costly to healthcare systems and inconvenient for eligible patients. The cost for a two-night inpatient bed is currently $4800.00 currently. The department manager led a five-month quality improvement project that was initiated in one 180-bed community medical center in Northern California to increase outpatient options, reduce the census and decrease the admission rate.

Context: Overburdened medical facilities often miss the opportunity to utilize ambulatory procedures due to competing operational priorities. In this setting, the Care Without Delay (CWD) department microsystem addresses barriers that impact operational throughput, efficiency, and unnecessary admissions.

Intervention: A …

Audit And Feedback For Blood Glucose Point Of Care Testing, Faith A. Onwuka

Student Scholarly Projects

Practice Problem: Patient identification errors in point-of-care testing (POCT) is responsible for test results being missed or transferred to the wrong patient’s chart. A hospital in Los Angeles County experienced a 50% compliance rate in patient barcode scanning prior to blood glucose POCT which affected the delivery of care.

PICOT: The PICOT question that guided this project was: Among emergency room nursing staff (P), how does the implementation of audit and feedback (I), when compared to random observations (C) improve compliance of patient identification with barcode scanning before performing blood glucose check (O) within ten weeks (T)? Evidence: …

A "Collaborative" Approach To Improving Nurse Turnover, Tiffany M. Nawabi

Master's Projects and Capstones

Problem: A cardiovascular unit is experiencing an increase in RN turnover and decreased NDNQI RN to RN interaction scores.

Context: Several recent studies demonstrate that a collaborative environment of well-being and enhanced RN communication can improve nurse retention rates (Alsufyani et al., 2021), as well as increase job satisfaction (Ylitörmänen et al., 2019).

Interventions: Nursing-led collaborative sessions were launched, consisting of the unit’s clinical nurses, the management team, and interprofessionals. The collaborative meetings provide a forum for the nurses to express their concerns, collaborate, and develop meaningful solutions.

Measures: The first measure is the Human Resource’s nursing retention report, with …

Clinical Simulation Training To Increase Medical Surgical New Graduate Registered Nurse (Ngrn) Confidence And Competence When Caring For Deteriorating Patients: A Quality Improvement Project, Tammy Schwaab

Doctor of Nursing Practice (DNP) Manuscripts

Problem: Patient harm from preventable cardiac arrest continues despite implementation of Rapid Response Teams (RRT) in the hospital setting. Medical surgical NGRNs lack adequate practice experience to prepare themselves with the competency skills necessary to manage high acuity patients in a complex healthcare environment. An awareness of a lack of readiness for practice leads to low NGRN self-confidence. Deficiencies in NGRN self-confidence and clinical competence lead to an inability to recognize and respond to patient complications with subsequent ineffective use of the RRT. Failure to Rescue (FTR) is one of the top three medical errors committed by NGRNs. Current evidence …

Establishment Of Unit Based Council Using A Shared Governance Toolkit, Viji George

Student Scholarly Projects

Practice Problem: Shared governance (SG) is an organizational structure that provides healthcare professionals control over their professional practice. Lack of a unit-based council (UBC) was noted as a problem disrupting the shared decision-making and problem-solving approach.

PICOT: In an adult acute care unit lacking a UBC structure (P), what is the effect of the implementation of a SG toolkit (I) compared to no SG toolkit (C) on the establishment of a SG UBC within a period of 10-weeks (T)?

Evidence: The literature evidence suggest that SG enables nurses to engage as a partner with nursing leaders within …

Caring For The Caregiver During Covid-19 Suspended Visitation, Melissa D. Rouse, Lorie K. Shoemaker, Priscilla Kyle, Chris Tenold, Whitney Anthony, Jordan White

Patient Experience Journal

During the 4th surge of COVID-19, August to November 2021, visitation was suspended in a hospital system in North Georgia. The Compassionate Connections Call Center (CCCC) was created to alleviate staff stress and to manage calls and communication. The goal of the initiative was to reduce interruptions to patient care caused by the increased number of calls to the clinical units by patients, families, loved ones and personal caregivers. The CCCC managed all incoming calls and communicated with the patient’s primary nurse through a coordinated process which limited interruptions. By caring for the caregiver, the aim was to improve the …

Addressing Anxiety In Hospitalized Adults Using A Music Intervention, Raina M. Rochon

Student Scholarly Projects

Practice Problem: The practice problem is anxiety related to hospitalization among adults in an acute care setting. Increased anxiety can lead to other issues while hospitalized including disruptive behaviors.

PICOT: The PICOT question that guided this project was: In hospitalized medical-surgical adults (P), how does the implementation of a music intervention as an adjunct to standard distraction techniques (I) compared to standard care (C) affect symptoms of anxiety as observed by the rate of behavior de-escalation team calls (O) within eight weeks (T)?

Evidence: There were five systematic reviews, four systematic reviews with meta-analysis with high level of …

Feasibility Of An Emergency Department Fall Screening Tool And Intervention Bundle Checklist On Nursing Fall Prevention Documentation: A Quality Improvement Project., Bailee E. Pope

Doctor of Nursing Practice Papers

Background: The World Health Organization (2018) and The Joint Commission (2015) define falling as a sudden, unplanned involuntarily advancement toward the ground, that may or may not result in injury. Fall rates are directly related to a facility’s mortality and morbidity rates, delayed patient care, additional diagnostic testing, and increased length-of-stay. Evaluating the practices of a local emergency department (ED), it was noted that ED nurses are not documenting their acknowledgment of a patient’s risk for falls, and also failed to chart interventions aimed at preventing falls. Failing to implement these practices into regular patient care can lead to negative …

Cognitive Preference And Skill Acquisition: The Relationship Between Student Nurse Anesthetists And Certified Registered Nurse Anesthetists Thinking Styles, Thomas Diller

Electronic Theses and Dissertations

Decision-making in healthcare is a complex and, at times, uncertain process. In the United States Certified Registered Nurse Anesthetists (CRNA) administer the majority of anesthesia. Nurse Anesthetists must draw on their educational background, clinical experience, and cognitive processes to make sound clinical judgments. To avoid errors understanding the relationship between cognitive preference and skill acquisition is critical. This study was designed to describe the cognitive preferences of Student Nurse Anesthetists (SRNAs) and CRNAs in the United States. The 2 cognitive preferences explored are rational (analytical) and experiential (intuitive) decision-making.

The researcher used a quantitative, cross-sectional, descriptive correlational design. The researcher …

Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason

Innovations in Health Sciences Education Journal

Due to workforce demands, new undergraduate nurses are hired directly into fast-paced units and are expected to manage complex patients with rapidly changing conditions and respond to time-sensitive situations. It is important for nurse educators to prepare undergraduate nurses for transition into clinical practice upon graduation. Simulation has been a valuable tool to provide experiential learning and promote clinical decision-making. The next iteration of improving clinical simulation as an experiential learning modality for nursing students is Immersive Virtual Reality (IVR): a realistic, immersive simulation in a 3-dimensional environment that is experienced by body movements and hand controllers. IVR can incorporate …

Multi-Method Approach To Examining Psychosocial Responses And Reactions To Covid-19 In The Us And China, Fan Li

Dissertations

Objective

The purpose is to examine health care providers’ psychosocial responses to COVID-19 in China and the US via exploring relationships among psychological responses and describing experiences of working at the epicenter during the pandemic.

Methods

In manuscript one, a cross-sectional study was conducted in nurse and physician volunteers who provided direct care to COVID-19 patients in Wuhan (volunteers) and those with no COVID-19 contact outside of Wuhan (non-volunteers). A path analysis theoretical model was developed to illustrate the relationships among psychosocial variables and was separately applied to volunteer and non-volunteer groups.

In manuscript two, a cross-sectional study was conducted …

Evaluation Of An Education Program Implementation For Adults With Stage 4 And 5 Chronic Kidney Disease, Dana Marie Carter

Dissertations

Abstract

Problem: Patients with long-term medical conditions represent a significant public health issue. Therefore, patients diagnosed with a chronic illness must have a high level of health literacy (HL) to manage their condition effectively. This Quality Improvement (QI) project evaluated the impact of an existing education-based program for stage 4 and 5 chronic kidney disease (CKD) patients and its effect on laboratory values compared before and after an NP-led education program that included vascular access, and modality choices.

Methods: A retrospective chart review was completed on 20 patients with an inclusive diagnosis of CKD stage 4 or 5 from …

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …

Effect Of A Turn Clock On Hospital-Acquired Pressure Injury Incidence, Sydney Warren

Dissertations

Problem: Hospital-Acquired Pressure Injuries (HAPIs) are the only quality metric increasing in incidence and are preventable. HAPIs are wounds to bony prominences during a hospitalization and can increase hospital costs, morbidity, and mortality. HAPIs could be prevented through interventions, including repositioning patients every 2 hours and using a turn clock method. The aim of this quality improvement (QI) pilot project was to decrease HAPI incidence.

Methods: A turn clock method was implemented on a general medicine floor at a mid-sized, suburban medical center utilizing a descriptive retrospective observational design. Data was collected for the pre-intervention timeframe from June through August …

Implementing Patient Acuity Scale On A Medical-Surgical Unit, Coreen Ladd

Dissertations

Problem: Nurses commonly report dissatisfaction with their workload levels due to inequity of shift assignments. Imbalanced workload distribution has been shown to lead to missing or delayed care. Increased nursing workload has been linked to increased fall rates, healthcare associated infections, and avoidable deaths. Research has shown that patient classification is more accurate when an instrument is used. The purpose of this quality improvement project was to implement a patient acuity tool to aid nurse-patient shift assignments on a medical-surgical unit. The project aimed to provide a standardized and objective method of measuring patient acuity.

Methods: The project took place …

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

The Effectiveness Of Continuous Video Monitoring In Reducing Inpatient Fall Rates, Yunhee Cruse

Dissertations

Abstract

Problem: Falls are one of the most frequently occurring safety events in hospitalized patients, resulting injuries that can be devastating and burdensome. Patients in neuro-telemetry unit are at greater risks for falls due to their conditions. The continuous video monitoring (CVM) program was implemented to reduce fall rates in the neuro-telemetry unit. This project was to examine the effectiveness of CVM program in reducing fall rates.

Method: A pre- and post-implementation observational evaluation was conducted. By reviewing retrospective data from January 1, 2020 to January 31, 2021 for pre-implementation period and from March 1, 2021 to October 31, …

Nursing Anxiety Self-Evaluation And Resiliency Methods, Dianne Deck

Dissertations

Abstract

Introduction: Nurses are stressed due to the demands of their job. This study aims to determine whether MICU nurses at a large Midwestern hospital would have reduced stress and anxiety after a 30-day meditation and exercise intervention.

Design and Methods: A quasi-experimental pre-post pilot study design was adopted. The convenience sample consisted of eight Medicine Intensive Care Unit (MICU) nurses in a large Midwestern urban tertiary medical center. Data collected included demographics, pre- post-Beck Anxiety Inventory Scale (BAIS), pre- and post-Single Item Stress Scale (SISS), and weekly diaries on exercise and meditation.

Results: The pre- post-SISS showed statistical significance …

Improving Recognition And Treatment Of Depression Among Women Using Phq-9 During Office Visits, Victoria Nwokocha, Heather Owens, Chris Webb

Graduate Theses, Dissertations, and Capstones

Depression can affect productivity and earnings among women, slow down the pace of active participation in social and family life, and increase health costs as well as distract attention from optimal health targets. Depression is the highest source of disability in NYC, with billions of dollars annually in related productivity losses. Although healthcare spending on depression affected patients is largely on hospital admissions, an estimated 40% of affected persons in New York do not get the adequate attention and care needed, with women most often affected by depression. This is an indication that the bedrock of preventive medicine for mental …

Predictors Of Engagement In Nursing Professional Practice: Transforming Organizational Culture In The Post-Covid Healthcare Environment, Jennifer Garnand

Dissertations

Cultivating the shared belief that individuals matter within an organization enhances the empowerment of staff and supports enthusiastic engagement in organizational efforts aimed toward a common mission, vision, and goals (McShane & Von Glinow, 2019). The nursing profession has been plagued by an unprecedented decrease in engagement and diminished job satisfaction, particularly following the prolonged tenure of the COVID-19 pandemic, leading to subsequent attrition amidst a staffing crisis. This quantitative predictive correlational study seeks to determine whether proactive and persevering characteristics, professional identity, and passion of nurses are predictors of engagement in a post-COVID healthcare environment. The research was based …

Culturally Tailored Diabetes Self-Management Educational (Dsme) Program And Its Impact On Motivation And Self-Efficacy Among Hispanic Adults With T2dm: A Pilot Study, Andrellie P. Van Wageningen

Doctoral Projects

Type 2 diabetes mellitus in the United States is an epidemic that disproportionately affects Hispanics in the state of California. Many factors have been attributed to this phenomenon because of their unique characteristics. As recent studies have pointed out, their social determinants of health, cultural influences, and genetic predisposition often lead to poor health outcomes and impaired quality of life. A targeted approach is critical in promoting increased diabetes knowledge, enabling skills to master self-care activities, and positive self-care behaviors to avert poor outcomes. The purpose of this doctoral project is to examine whether culturally tailored DSME influences an individual’s …

Providing Education To Staff Members On Implementing Follow-Up Education At Discharge To Patients With Low Heart Scores, Daniel Burton

Doctor of Nursing Practice Projects

Background: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) provides accreditation to hospitals, including “heart certification.” The facility was successful at meeting the four measures previously assigned to them. As a result, they were given four new measures. One of these standards is providing discharge education based on “heart scores.”. Only 35% of patients are receiving discharge/follow-up education at discharge from the emergency department (ED).

Purpose: The purpose of this study is to increase the number of patients receiving chest pain education and follow-up instructions in the ED as evidenced by the improvement in documentation of the interventions.

Methods: …

Covid's Impact On Nurses & Their Labor Market, Joshua Stanfill

University Honors Theses

The Covid pandemic has swept across the globe impacting many different kinds of people in many different ways. Businesses and workers experienced changes in how their respective labor markets operated with new incentives. One group of laborers that experienced quite a significant impact are nurses working through the Covid pandemic. The pandemic created new incentives for nurses that heavily impacted their labor market. Through a literature review of scientific studies examining the impacts of working through a pandemic on nurses, I discovered that this was causing psychological and emotional damage to nurses. Covid spurred on an already occurring nursing shortage …