Nursing Commons^™

To Implement Or Not To Implement: Safe Opioid Injection Sites As A Solution To The Opioid Crisis, Kayla Keister

Senior Honors Theses

The opioid epidemic has been a crisis in the United States for the last 30-40 years but is just now being popularized by the American public. One potential up-and-coming solution to the opioid crisis is the implementation of safe opioid injection sites, which are locations where individuals may bring drugs to inject under the supervised care of medical professionals. They are currently being used in Canada as well as several Western European countries. The question remains, however, as to whether or not the United States is ready for the implementation sites in regard to public opinion, finances, and ethics.

Development And Implementation Of Computer-Based Learning Modules On Alternative Communication For Pediatric Nurses And Nursing Students, Amanda Kaye Simmons

Theses and Dissertations (ETD)

Purpose and Rationale. To develop, implement, and assess computer-based learning modules (CBLs) on augmentative and alternative communication (AAC) with pediatric nurses and nursing students for knowledge outcomes, self-efficacy, and perceived relevance and effectiveness. Effective communication ensures all parties can understand and express themselves clearly, through any means necessary, often including AAC tools, supports, and strategies. Communication is essential in healthcare but there is limited research with pediatric nurses. Previous research with a single hospital indicated a need for nurse education on AAC. This research used focus groups and interviews to understand pediatric nurse and nursing student knowledge about AAC. The …

Improving Caregivers’ Perceived Involvement In Care Through Facilitating Communication With Hospital Providers, Heather Manolas

Student Scholarly Projects

Practice Problem: Involvement of family in care-planning for prevention of delirium in acute care settings is crucial, yet remains underutilized in those who are cognitively impaired. Despite the incidence of delirium in acute care worsening during COVID-19, many factors have led to it being placed on the back burner.

PICOT: In caregivers of cognitively impaired individuals, can implementation of an evidence-based, best practice tool that advocates for evidence-based delirium prevention strategies tailored to their loved-one and facilitates family involvement in care planning for these strategies during a healthcare experience as compared to no other intervention improve confidence in, and …

Effectiveness Of An Educational Intervention On Lgbtq Clinical Competence Among Undergraduate Nursing Students, Taylor Hall

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Persons who identify as lesbian, gay, bisexual, transgender, and queer (LGTBQ) are at increased risk for poor health outcomes. LGBTQ patients have higher incidences of poor health outcomes due to fear of mistreatment, bias, and stigmas. More education and training for healthcare professionals are needed regarding LGBTQ patients' care to change this patient population's current trend. The project implemented an educational intervention consisting of a learning module and panel discussion. The sample included 63 undergraduate nursing students at a rural central Georgia university. The project was a quantitative research design with pretest and posttest quantitative data. Written reflections from students …

The Presence Of Spirituality And Its Effect On Attitudes Towards Death, Isabel F. Cortez

Honors College Theses

ABSTRACT

Rationale Implementing spirituality practices in healthcare is not heavily emphasized yet has the potential to increase positive patient outcomes.

Hypothesis If an individual identifies with having a strong sense of spirituality, then they will have decreased negative reactions towards dying.

Methods Data was collected via distribution and processing of surveys on the Statesboro campus of Georgia Southern University. The survey included a series of questions regarding general demographics, strength of spirituality, feelings associated with death, and coping ability. The information collected was processed through SPSS in order to evaluate correlations present.

Results It was found that individuals who indicated …

Nursing Instructors’ Experiences During Covid-19, Vonda Hammons Boone

Journal of Interprofessional Practice and Collaboration

Abstract

COVID-19 came with a vengeance to the southern U.S. and had a significant impact on higher education. Both students and faculty were greatly affected. There was a rush to transform on-campus classes to online formats. Many faculty and students who lived in rural areas or where internet speeds were slow or without internet, scrambled to obtain service. This made engaging in online classes difficult and in some cases impossible. Additionally, issues arose with the use of different programs and with trying to put classrooms into an electronic format such as moving classroom lectures to Kaltura™, learning how to load …

The Challenges And Successes Of Teaching In A Pandemic - A Nursing Faculty Commentary, Katie Daigle

Journal of Interprofessional Practice and Collaboration

The purpose of this paper is to discuss alternative teaching methods, specifically those used for nursing clinical instruction during the abrupt transition to the online environment during the COVID-19 pandemic.

Belongingness In The Clinical Setting In Baccalaureate Nursing Students: A Comparative, Descriptive Study, Denise T. Leblanc

Journal of Interprofessional Practice and Collaboration

Belonging, or the need to feel wanted and connected, is vital to student learning (Levett-Jones, Lathlean, Higgins, & McMillan, 2009a). The presence or absence of a sense of belongingness within clinical placements of students enrolled in a Bachelor of Science in Nursing (BSN) program was examined. Gender, age, and level of program were examined for relationships with belongingness. A comparative, descriptive study was performed utilizing the Belongingness Scale Clinical Placement Experience (BES-CPE), a 34-item Likert scale questionnaire. The BES-CPE was disseminated via Qualtrics survey software to Level I, Level II, and Level III BSN students. There was no statistically significant …

Compliance With A Nurse-Driven Hypoglycemia Protocol: Time From Hypoglycemia Event To Euglycemia, Robin A. Chappell

Student Scholarly Projects

Practice Problem: Hypoglycemia is a known complication of diabetes mellitus and is considered one of the top three adverse drug events by the U.S. Department of Health and Human Services (2019) because it is common, clinically significant, measurable, and preventable.

PICOT: The PICOT question that guided this project was: In non-critical hospitalized adult patients on medical-surgical units with documented HGEs, how does active surveillance for strict adherence to a nurse-driven hypoglycemia protocol, compared to no surveillance, affect the time from hypoglycemia to euglycemia?

Evidence: Treatment of hypoglycemia is commonly inconsistent and prolonged; however, active surveillance and monitoring of a …

Implementation Of An Opioid Risk Assessment Tool In An Acute Pain Service, Emoshoke Owie

Graduate Research Showcase

The U.S is currently experiencing an opioid epidemic because of the number of people that died from an opioid overdose. An estimated 10 million people aged 12 or older misused opioids in 2019. Studies have shown that applying a systematic method for risk stratification for all patients considered for opioid therapy could be vital to screening patients at risk for opioid misuse to ease the opioid epidemic. Based on the assumption that the Diagnosis Intractability Reliability Efficacy (DIRE), an opioid risk assessment tool, would substantially change the providers’ prescribing decisions, it was implemented in an Acute Pain Service. Purposive sampling …

Exploring The Phenomenological Experience Of Precepting, Erica Fowler

The Eleanor Mann School of Nursing DNP Capstone Projects

Nurse practitioners and physicians are increasingly sought to volunteer as preceptors for nurse practitioner students. Preceptors serve a crucial role in student education in providing mentorship, instruction, and supervision in the clinical setting. However, preceptors are often difficult to come by, leaving a shortage of available clinicians willing to participate in preceptorships. There is a paucity of information related to exploring the experiences of precepting among clinicians who have served as preceptors. Insight into these experiences are imperative in identifying the impetuses that drive or dissuade clinicians to commit to the preceptor role. This DNP project implemented a survey designed …

A Systematic Review Of Acuity-Based Staffing In Acute Healthcare Environments, Demitria Idella Stafford

Electronic Theses and Dissertations

Nursing leadership is responsible for considering the equity of patient care assignments when providing nursing care. Nursing leadership is responsible for assuring the delivery of patient care assignments with the intent to offer nurses an unbiased, evenly distributed patient load. Effective distribution of patient care assignments ensures patients receive the safest, most efficient, and highest quality of care. The purpose of this project was to provide nursing leadership with an executive summary of a systematic review of evidence-based research on the structure and process of making patient care assignments, and it provided evidence on how those patient care assignments affect …

Dnp Final Report: Breaking The Cycle: Care Coordination Interventions And Sickle Cell Readmissions, Naphtali Edge

DNP Final Reports

Background

Approximately 100,000 people in the United States are affected by Sickle Cell Disease (SCD). Sickle Cell Disease represents the second highest readmitting diagnosis at Houston Methodist Hospital. The purpose of this study is to determine the impact of implementing care coordination interventions to reduce hospital readmissions of patients with SCD.

PICOT

In adult patients with SCD in the acute care hospital setting, how does care coordination intervention compared to no care coordination intervention affect the readmission rate for patients with SCD over a 3 – 6-month period?

Body of Evidence

Eleven studies were critical appraised and included in the …

Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen

Nursing DNP Projects

Purpose and Rationale

The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.

Synthesis of Evidence

Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …

Improving Self-Confidence Of Nursing Students Through Implementation Of A Workplace Violence Virtual Simulation, Tara Mosher

Graduate Research Showcase

Patient violence against nurses is a constant and valid local and global concern, and is an issue requiring action and advocacy on the behalf of novice nurses, as they are often more vulnerable to possible harm from workplace violence (WPV) than other health care providers A practice gap was identified within an undergraduate nursing program that no courses within the curriculum addressed the management of WPV against nurses. Current literature supports the need for awareness and strategies to prevent WPV against nurses and measures to improve nurses’ self-confidence in managing violent situations they may encounter in the workplace.

The purpose …

Working Through A Virtual Reality: Empowering Experienced Nurses Through Hybrid Orientation Programs, Latoria Massey

Master of Science in Nursing Theses and Projects

The year 2020 was not the year of the nurse that many expected. Frontline teammates were put at risk for so much more than just the usually fast-paced clinical and ethical decisions of their time. In a matter of months, the same professionals that were noted for being hard-working, diligent individuals were now fatigued, burned out, and working under some stressed and unrealistic constraints. The staffing needs in several acute care facilities changed drastically as the global crisis now known as COVID-19 continued to spread. Nationwide redeployment models were initiated, pulling many nurses into new unchartered territory. Among the stress …

Nursing Annual Report: 2021, Centracare Health

Nursing Annual Report

Message from the CNO

Message from Central Operations, SVP - St. Cloud Hospital President

St. Cloud Hospital Statistics

New Magnet Program Director, Nursing Strategic Plan FY 2021

Patient Experience

Nursing Care Delivery

Exemplary Professional Practice

Shared Governance

Working Relationships

Professional Development

Nursing Makes a Difference

Implementation And Standardization Of Evidence Based Practice For Reprocessing Of Flexible Endoscopes, Patricia Dumonceaux, Jenna Rooda, Dena Walz

Nursing Posters

To improve patient safety and quality of care by implementing a standardized process for high level disinfection (HLD) of flexible endoscopes

Increasing Access To Data Through Microsoft's Power Bi, Rumana Ahmad, Kristi Patterson

Nursing Posters

What is Power BI?

• A collection of software services, apps, and connectors that work together to turn unrelated sources of data into coherent, visually immersive, and interactive insights.

What’s in it for me?

• Users can quickly & easily explore trends for CC inpatients across common outcome measures including case counts, length of stay, mortality, & unplanned readmissions to help identify variation & opportunity for improvement. For example, compare COPD patient case counts, length of stay,and in-house mortality across CC hospitals.

No One Goes Missing: Creating An Elopement Risk Safe Plan Of Care, Jennifer Burris, Kathryn Collins, Holly Kockler, Tiffany Omann-Bidinger, Elizabeth Plante

Nursing Posters

To identify patients at risk for elopement by developing an evidence-based elopement risk screening tool and plan of care.

Admission Documentation Overhaul, Jennifer Burris, Holly Kockler, Hillary Waldum

Nursing Posters

Improve the admission documentation workflow by revamping the admission Navigator and Functional Health Assessment

High Reliability Principles In Safety, Abby Henderson, Leigh Klaverkamp

Nursing Posters

• Subject matter experts compare actual performance to expected performance.
• A standard set of questions for specific subtypes of events help establish trends.
• HRO's (High Reliability Organization) equip leaders and frontline staff to spot systemic causes of human error.

Improving Hepatitis B Vaccination Rates In Nephrology Patients With Chronic Kidney Disease: A Qi Initiative, Jill Swanson

Nursing Posters

• Hepatitis B vaccination is an important health maintenance preventative measure for patients with chronic kidney disease (CKD)
• Prior to initiating dialysis, hepatitis B vaccination administration is proven to be more effective than waiting until patients begin dialysis treatments.
• Efficacy and immune response of the hepatitis B vaccine is greater when kidney function is greater
• To better improve hepatitis B vaccine administration among the CKD stage 4 population, education measures and Epic modifiers will be implemented to achieve change
• Nursing knowledge and hepatitis B vaccine administration will improve after implementation of these measures

A New Approach To Sternal Precautions: Keep Your Move In The Tube, Kelijo Fernholz, Jayna Theis, Erik Anderson

Nursing Posters

Purpose:

• To guide patients and staff in a new approach to sternal precautions following median sternotomy

Current Practice:

• 10-pound lifting restriction for 4 weeks
• 20-pound lifting restriction until 3 months post operation
• Limited arm exercises
• Sit to stand push restrictions

Why Change:

• Literature review demonstrates great variation in sternal precautions
• Currently too restrictive; may hinder recovery and long-term mobility. Too many restrictions can create fear of movement, resulting in short term rehab discharge needs
• To create more independence for the patient, less reliant on family members for ADLs and basic needs. Patients to return to regular home and work activities …

Performance Improvement Leadership Rounding Implementation, Dena Walz

Nursing Posters

To improve patient experience scores and address patient concerns in real time.

A proactive behavior that facilitates leaders building relationships with patients and families, managing expectations, and achieving and validating consistency of key behaviors.

A member of leadership will conduct a purposeful conversation with a chosen patient three days a week regarding the care provided during their procedural appointment.

Contemporary Treatment Options For Pulmonary Embolism, Tanya Glenz, Teresa Jahn

Nursing Posters

Purpose:

Provide RNs education on the classifications of PEs and new catheter directed treatment options.

Significance:

• PE remains a common and lethal entity
• PE is the 3rd leading cause of cardiovascular death in hospitalized patients (60,000-1000,000 per year)
• 150,000-250,000 PE related hospitalizations per year
• RNs must be knowledgeable of the classifications of PEs and catheter directed therapies to promote positive patient outcomes
• Prior to catheter directed therapies, submassive PEs had a mortality rate up to 20% at 3 months and were traditionally treated with IV heparin, or oral anticoagulant therapy

Routine Post Surgical Vital Signs: Time For A Change, Kristina Kjellberg, Elizabeth Plante, Sadie Seezs

Nursing Posters

Purpose Statement:

The purpose of this evidence-based practice project is to evaluate the current routine post operative vital signs and determine if reduced frequency of vital signs is as effective in identifying deterioration after a post anesthesia care unit (PACU) discharge.

Synthesis of Evidence:

• Patient survival in the post operative time period is maximized with the recognition and management of abnormal vital signs
• Post op periods can carry great respiratory and circulatory complications, which are identified by abnormal vital signs especially heart rate and blood pressure
• Multiple sources have identified that current frequency of post operative vital signs is based …

Rapid Evaluation Teams (Ret): No Longer Just For Hospitals, Amanda Thorson

Nursing Posters

Study:

Everyone goes to the Nursing Home for End of Life - Right? Wrong Cumulatively, over a 4-year study there were 678 residents with Full Code status residing at Carris Health Care Center and 687 residents the DNR/DNI status. That is only a 10-resident different between Full Code and DNR/DNI

Plan:

• Improve long-term care staff's ability to call for, and receive, support to rapidly evaluate and address an urgent or concerning situation.
• Need for this plan is supported by increased number of OHFC substantiated events related to code status in MN and number of residents with Full Code status in …

Suspension Of Independent Double-Check For Subq Insulin Administration, Mallory Mondloch, Jennifer Watson

Nursing Posters

Study:

After a 1-month pilot of suspending the dual sign-off/independent double-check process, 160/163 random subQ insulin administrations from various units were administered correctly. This yielded a 98% success rate. No patient harm occured.

Plan:

Per Institute of Safe Medication Practices, dual sign-offs/independent double-checks are more effective for select high risk meds and not all. Since implementation of the insulin calculator, medication errors related to subQ insulin administration have reduced compared to previously when solely two licensed staff members performed a manual, independent double-check. After implementation of the validated eMAR tool - the insulin calculator - it was still required for …

A Practice Innovation To Improve Staff Vaccination Knowledge And Skills, Ijeoma Ugochukwu

Nursing Posters

Abstract:

The practice improvement project explored the best practices for equipping CentraCare Health System's (CCHS) Licensed Practical Nurses (LPNs) and Certified Medical Assistants' (CMAs) with childhood vaccination knowledge and communication skills necessary to educate hesitant patients and parents about the benefits of vaccination compliance. Innovative computer-based education (CBE) was identified and developed to empower LPNs and CMAs working in the ambulatory setting with childhood vaccination knowledge and communication skills to improve their ability to educate hesitant patients and parents about the benefits of vaccination. The CBE module was guided by the Theory of Planned Behavior in identifying vaccination knowledge and …