Nursing Commons^™

Bedside Reporting, Morgan Sanford

Master of Science in Nursing Theses and Projects

Bedside reporting can directly correlate with preventing errors in the healthcare setting. The three main errors that occur are falls, medication errors, and sentinel events. These errors have a vast number of different outcomes, even resulting in death in some cases. Despite The Joint Commission directly stating that bedside reporting is best practice, this is not always what is conducted in many hospital organizations. Literature has suggested the problem that exists with implementation is the longevity of the implementation from staff. Identifying a feasible and conducive way to implement bedside reporting that is both favorable for the patient and staff …

Reducing The Number Of Patients Leaving Before Evaluation From The Emergency Department, Myranda Dills

Master of Science in Nursing Theses and Projects

Boarding patients in the emergency department (ED) can lead to several adverse events and errors that can prolong the patient’s hospitalization and delay discharges from the inpatient floors. These excessively long hospital stays decrease the number of bed available to patients being admitted from the ED, creating a bottleneck effect of patients backflowing in the ED. When this occurs, there are less available beds and resources for new ED patients, creating long wait times, and eventually an increase in the number of patients leaving before provider evaluation. This MSN project serves to create a new job role in the ED …

Promoting Alternative And Evidence-Supported Birthing Options In Healthcare Facilities, Ashley Johnson Ross

Master of Science in Nursing Theses and Projects

The project examined the standard birthing process for low-risk, natural labor, and births at healthcare facilities. All deliveries should not be treated the same with the supine-lithotomy birthing position or over-medicalized, obstetric practices, as evidence-based research advises against such practices. The goal of the project intended to deviate from standard birthing practices and implement alternative, evidence-supported birthing options at healthcare facilities. The goal of promoting alternative, evidence-supported birthing options in healthcare facilities by maternity staff, would come after thoroughly educating maternity staff and providers with intel and benefits affiliated with alternative birthing options. Evidence reveals alternative birthing options, such as …

Smoking Cessation: A Nurse-Led Approach To Address Gaps In Patient Care, Katie L. Durham

Master of Science in Nursing Theses and Projects

Currently, the rate of smoking in the US is 13.7%. While this value represents the lowest rate of smoking in documented US history, cigarette smoking remains the leading cause of preventable death, disease, and morbidity. Healthy People 2030 has set a goal to reduce the rate of smoking to 5%. Though many patients report wanting to quit smoking, nearly half report they did not receive advice from a healthcare professional to do so. Many recommended smoking cessation tools and resources remain underutilized by both clinicians and patients. To help mitigate this issue, this project sought to develop a nurse-led smoking …

Reducing The Use Of Physical Restraints Of The Elderly In The Acute Care Setting, Rachael Malone

Master of Science in Nursing Theses and Projects

The aim of this MSN project is to identify and improve the gaps in education regarding physical restraint use in the acute care setting on the elderly patient population. When admitted into hospitals, elderly patients are at much greater risk for being placed in physical restraints due to little education regarding alternative measures to physical restraints and inappropriate assessments. The purpose of this project is to implement education about the detrimental factors and consequences patients may suffer once placed in physical restraints and improve the use of alternative measures to physical restraints. This project will be evaluated by acute care …

Promoting Organ Donation Among Adults, Susan Hammitt

Master of Science in Nursing Theses and Projects

Organ donation is an important component of the American healthcare system however, the issue of low organ donation rates among the average American population is an ever-growing problem. In the United States, more than 135,000 people are waiting for an organ transplant, and as of 2019, only 39,000 donors have consented to donation. The purpose of this project is to develop an evidence-based approach to promote organ donorship among adults. The goal is to promote organ donation through hospital-based educational intervention to give patients, their families, and hospital staff the information to help promote consent for donation.

Medication Reconciliation: Protecting The Geriatric Population, Charles Jennings

Master of Science in Nursing Theses and Projects

This project was designed to address the issue of medication errors that occur during the transition from an acute care setting to an assisted living setting. Geriatric adults are often supported by a complement of medical specialists and subspecialists. As a result, reconciling medications following a hospital discharge can be challenging. To further complicate the problem, oftentimes, the primary care provider is not highly engaged with the specialists and subspecialists. The World Health Organization (WHO) has prioritized this issue through the introduction of the Medication Without Harm initiative. This initiative is focused on reducing adverse drug reactions (ADRs) and adverse …

Improving Communication Skills Of New Graduate Nurses: Using Sbar Format, Meredith Lyanne Parker

Master of Science in Nursing Theses and Projects

New graduate nurses face many challenges as they transition to professional practice (Mongale et al., 2018). Support from transition to practice (TTP) programs can have a tremendous impact on the success of a new graduate nurse and improve retention rates (Silvestre, 2017). Research identifies a gap in new graduate knowledge of communication skills (Song & McCreary, 2020). Education on improving communication using a standard format can impact patient outcomes and improve provider confidence (Marshall et al., 2008). Research also links provider confidence and proficiency to improved outcomes (Owens & Keller, 2018). Benner’s Novice to Expert Theory provides a theoretical foundation …

Implementing Rapid Response And Medical Emergency Simulation Training For Medical-Surgical Nurses, Brandon Burnett

Master of Science in Nursing Theses and Projects

This project is based on the problem of nursing competence and confidence within medical emergency and rapid response scenarios. This problem affects all patients, but specifically the medical-surgical patient population of which rapid assessment and intervention can lead to a change in patient mortality. The goal of the project is to use simulation, a common tool in undergraduate nursing education, to improve nursing competence and confidence after participation. The nurses will be cycled through three simulated scenarios, followed by a debriefing, and then moved to the next simulation. The nurses’ performance will be evaluated using evaluator checklists for each of …

A Day In The Life Of A Hospital Bedside Nurse: A Different Look At Nurse Stressors, Angela R. Higdon

Master of Science in Nursing Theses and Projects

This project is intended to be an example of the affects on the nursing work environment after years of technological advancement, healthcare reform, and process improvement. The bedside nurse work environment is riddled with a multitude of interruptions, intricate processes, and complicated documentation to prove quality care and compliance to regulatory agencies and for tracking purposes. These demands are significant as nurses are continuously reprioritizing work to meet the needs of the patient while also meeting the organizational and regulatory demands. The demands on nurses often lead to delays in patient care and sometimes omission of certain less acute patient …

Combating The Challenge Of Maintaining Active-Duty Military Medical Force Readiness, Thomas Jones

Master of Science in Nursing Theses and Projects

The United States of America’s military involvement in conflict is at one of its lowest points in over 2 decades. This presents a challenge for members of the military medical force to maintain the medical readiness skills they are expected to be proficient at in a moment’s notice to care for casualties in the nation’s next crisis or conflict. In addition to other pre-established methods, this project seeks to provide a unit-level training opportunity for Air Force active-duty medical members such as those in the United States Indo-Pacific region to practice certain medical readiness skills while continuing their steady-state daily …

Reducing Observation Unit Length Of Stay Hours: A Quality Improvement Project, Rena D. Cantrell

Master of Science in Nursing Theses and Projects

An acute care observation unit provides care for patients admitted via Emergency Center (EC) or direct admission from a healthcare provider’s office who do not yet require inpatient status. The goal length of stay (LOS) for these patients should be less than or equal to 24-48 hours. This project is being developed for a 22-bed observation unit in the Southeastern United States to decrease current LOS hours. Currently, the goal LOS for this unit is 24 hours, not to exceed 48 hours, and for patients admitted with a chest pain diagnosis, no longer than 19 hours. A plan to expand …

Perceived Effects Of Covid-19 On K-5 Educators And Learners, Fairbee Mintz

Master of Science in Nursing Theses and Projects

The COVID-19 pandemic disrupted traditional teaching methods at all academic levels bringing about unprecedented changes in the way education was delivered. In-person learning was halted all over the world as educators scrambled to transition to virtual education. The purpose of this Master of Science in Nursing research was to examine the perceived effects of systematic learning changes caused by the COVID-19 pandemic on primary and secondary educators and students as reported by educators. This research will then be applied to implications for future nursing educators and students. Nine K-5 educators were interviewed via Zoom in the spring of 2021 and …

Reduce Nurse Burnout During Covid-19: Implementation Of The Stop Method, Heather Smallwood

Master of Science in Nursing Theses and Projects

Historically, inpatient nurses experience significant levels of stress and exhaustion which can lead to burnout. Currently, nurses are at the frontlines of the COVID-19 pandemic. The workloads have increased, physical and mental burdens have increased, and fear of contracting the virus is an added stressor. There is an immediate need for mental health support and interventions to improve the well-being of nurses. The purpose of the project is to evaluate the benefits of a mindfulness-based intervention, such as the STOP technique to reduce stress and burnout among nurses. An inpatient COVID-19 unit at a large hospital will have 60 nurses …

The Struggle To Alleviate Nurse Burnout, Shawn Harmon

Master of Science in Nursing Theses and Projects

This project assumes the purpose of defining, reviewing, and performing a three-part activity to alleviate some fraction of a detrimental disorder that has plagued the nursing profession for years identified as nurse burnout. This debilitating stress induced by burnout can lead to decreased job satisfaction. If burnout is left unchecked, it may result in nurses leaving the profession altogether. The meaningful results, if realized, will be presented to the administrative leaders to implement changes as they see fit. The goals are to see positive results translate into interventions by the hospital that will, over time, increase job satisfaction for every …

"Healthy Skills 4 Life" Program: A Pilot Study And Program Evaluation, Wendy Hines

Doctor of Nursing Practice Projects

This project piloted and evaluated “The Healthy Skills 4 Life” (HS4L) program within a middle school population. HS4L is an innovative holistic health curriculum focusing on four key areas of healthy behavior: nutrition, physical activity, stress management, and sleep hygiene. A middle school physical education teacher was supplied with the HS4L instructional materials and support needed to independently implement the program. The HS4L program allowed the students to self-assess wellness behaviors and create an action plan for improvement focusing on healthy lifestyle concepts. The implementation was evaluated utilizing the "Healthy Skills 4 Life" Feedback survey. The total average …

The Use Of A Code Lavender Space To Promote Self-Care, Em Toe

Doctor of Nursing Practice Projects

The nursing shortage has been an ongoing issue across the nation. The workforce has lost valuable employees, especially in rural areas, due to staff shortages and lack of self-care. Implementing therapeutic interventions such as a Code Lavender Room aims to implement self-care during working hours to increase nursing retention in the long term. The goal of this quality improvement project was to provide a safe place for employees to go to relax and reset during working hours. A survey was used to analyze the Code Lavender Room's effectiveness in self-care and how likely the staff are to continue to use …

Addressing Compassion Fatigue In Critical Care Nurses, Melissa Bowen

Doctor of Nursing Practice Projects

Compassion fatigue causes a ripple effect that impacts caregivers, patient outcomes, and the reliability of healthcare organizations. Jarrad et al. (2018) suggests the physical, emotional, spiritual, social, and organizational consequences of compassion fatigue are so extensive that they threaten the integrity of the nurse. Addressing compassion fatigue in critical care nurses is an indispensable part of maintaining the integrity and trust of the healthcare profession. It is imperative to care for the caregivers to warrant a solid foundation for optimal patient outcomes and engagement. Self-education and awareness, nursing leadership involvement, and self-care are integral to ensuring that compassion fatigue does …

Obstructive Sleep Apnea Education To The Rural Community, Brandi Harris

Doctor of Nursing Practice Projects

This project was executed to provide obstructive sleep apnea education to the men and women of the rural community. Many residents of rural communities remain undereducated and unaware of diseases and disorders in which they are subjected to or have increased risks for. Obstructive sleep apnea affects approximately twenty-two billion Americans. Of those affected, nearly eighty percent remain undiagnosed and untreated (Nagappa et al., 2015). Victims of the sleep disorder fail to acknowledge signs and symptoms of obstructive sleep apnea, many oblivious to the etiology, risk factors, symptoms, and pathophysiology of the disorder. Presenting education to residents of the rural …

Increasing Knowledge And Comfort Levels Of Icu Nurses In Goals Of Care Discussions Through Palliative Care Education, Stephanie Harrison

Doctor of Nursing Practice Projects

Critical care nurses are tasked with treating patients during the most complex times, typically beginning with aggressive treatment measures and in many cases, transitioning to end-of-life care. According to the literature review, critical care nurses report they frequently provide care that they feel is futile and palliative care resources are underutilized in the intensive care unit. They also report limited education/training and comfort in understanding their role in goals of care conversations and end-of-life care despite their vital role in providing direct patient care. The goal of this project was to implement an education program using the IMPACT-ICU toolkit to …

Game-Based Learning Effects On Nclex-Rn Perception Of Preparedness And Pass Rates, Alexis Utley

Doctor of Nursing Practice Projects

Background: The National Council Licensure Examination for Registered Nurses (NCLEX-RN) has been used to measure the quality of a nursing program’s effectiveness in preparing nursing students to pass the exam since 1988. The combined average pass rate percentage for the Hunt School of Nursing (HSON) nursing programs for the year 2021 was 88%.

Method: Information on feelings of preparedness and time to test after graduation was collected via survey prior to the game-based learning (GBL) activity. This same information was collected post GBL and compared to the pre-survey results. NCLEX-RN pass rate data was collected 1 month after graduation.

Results: …

Using A Deterioration Index Score To Improve Patient Outcomes, Amanda Doub

Doctor of Nursing Practice Projects

Quick recognition and response to clinical deterioration have a significant impact on patient mortality and outcomes. Nurses’ confidence in their ability to recognize signs and symptoms of deterioration and activate rapid response teams (RRT) is vital in preventing code blues and transfers to a higher level of care. The objective of this project was to determine the effect of an educational intervention on nurse acknowledgment of the deterioration index score and nurse confidence in intervening to improve patient outcomes by alerting the Rapid Response Team (RRT) within two months for adult patients on a medical-surgical unit. Findings from the project …

The Impact Of Mindful Breathing On Stress Of Employees Working From Home, Lindsey Goldberg

Doctor of Nursing Practice Projects

This DNP project was designed to decrease stress among employees working from home (WFH) by educating them on mindful breathing practices. Through the implementation of a mindful breathing activity, the intended project outcome was to improve stress levels of employees working from their homes. Mindful breathing is an evidence-based strategy that has demonstrated decreased stress levels. Mindful breathing was implemented among two companies employing an estimate of 170 WFH employees to improve health and well-being with potential long-term positive impact on sustainability of organizations in the post-COVID, work from home environment. The participants were invited to perform 8-minutes of daily …

Faith-Based Approach: Reaching The Rural Population To Increase Diabetes Awareness, Regina Ledford

Doctor of Nursing Practice Projects

With diabetes at an epidemic level in the United States, more awareness needs to be brought surrounding prediabetes and diabetes prevention. This DNP Project consists of implementing a faith-based educational informational event at a local rural church to increase diabetes awareness. Findings within this DNP project suggest that the rural population can increase knowledge of diabetes awareness through faith-based education. With a sample size of 21 participants, positive statistical significance was found on analysis of pre-test and post-test Likert style questions regarding diabetes prevention, risk factors, and diabetic resources.

Improving Self-Care Awareness Among Undergraduate Nursing Students, D'Anna Helms

Doctor of Nursing Practice Projects

The purpose of this DNP project was to improve self-care (SC) awareness among undergraduate nursing students by educating on the use of constructive SC activities. Twenty-two senior level nursing students attended an educational seminar, completed the Mindful Self-Care Scale – Clinical (MSCS-C) pre- and post-survey, and reflective journaling. A paired-samples t test was calculated to compare the mean pretest score to the mean posttest score. The mean on the pretest was 77.68 (sd= 9.33), and the mean on the posttest was 75.27 (sd= 31.59). A significant increase from pretest to posttest was found (t (21) = .307, p < .05). Thematical analysis revealed enhanced awareness and incorporation of constructive SC activities. Educational interventions which seek to improve SC awareness will generate practical and sustainable acts of SC, thus improving students’ overall success and further empowering students in their transition from graduate to licensed nurses.

Enhancing The Accuracy And Effectiveness Of The National Institute Of Health Stroke Scale In A Rural Emergency Departmennt, Emily Nicole Addington

Doctor of Nursing Practice Projects

A rural facility in the foothills of North Carolina found a need for process improvement regarding the emergency department and completion of the NIHSS. The DNP student and the Stroke Coordinator along with the Quality Improvement Coordinator agreed with the need for education of staff concerning accurate assessment and documentation of the NIHSS. The DNP project implemented additional training for the emergency department nurses and paramedics in the form of face-to-face classes with a PowerPoint. A pre-and post-survey was conducted to gauge the comfort level of staff with the NIHSS and stroke processes of the rural emergency department. The Stroke …

Superwoman Schema: Fighting Back With Holistic Therapy, Chavonne Good

Doctor of Nursing Practice Projects

For decades, Black women have upheld the stereotype of being consistently strong, capable, tenacious, and unwavering throughout life’s many challenges. Unfortunately, while being resolute in their desire to succeed against all odds, many Black women have unknowingly embraced the characteristics of a phenomenon known as Superwoman Schema. Superwoman Schema consists of five characteristics that are not inherently negative. However, when Black women consistently embody these traits which include the determination to succeed and to be strong, and an obligation to help others; they may neglect their own self-care needs. Subsequently, while neglecting themselves, focusing on others, and continuously trying to …

Enhancing Knowledge And Confidence In A Retail Clinic Setting Of Practitioners In Treating Primary And Secondary Hypertension, Ravon Mckoy

Doctor of Nursing Practice Projects

Many adult and adolescent patients in primary care settings are diagnosed with primary hypertension, however the workup often does not include an evaluation of secondary causes. The purpose of this Doctor of Nursing Practice (DNP) project was to improve the diagnosis and treatment of hypertension for patients seeking health care in a retail clinic setting. The PICOT question was, what is the effect of an educational offering on hypertension standards of care in enhancing knowledge and confidence for providers working in a retail health clinic setting? The sampling frame was 40 Nurse Practitioners and Physician Assistants employed at CVS Minute …

Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley

Doctor of Nursing Practice Projects

The purpose of this program was to educate providers regarding palliative care for heart failure patients. Palliative care is underutilized in conjunction with usual heart failure management despite proven benefits of decreased symptom burden, reduced hospitalizations, and improved overall quality of life. Provider education has the ability to improve provider knowledge of palliative care for heart failure patients. A brief education session was given to hospital providers in an acute care setting to evaluate the benefits of provider education on palliative care utilization for heart failure patients. Findings included improved provider confidence in referring heart failure patients to palliative care. …

Thinking Inside The Food Pantry Box, Elizabeth Shoaf

Doctor of Nursing Practice Projects

Background: Prior research has indicated a varying relationship between food security and obesity risk. Food insecurity is a known complication of men and women’s underlying health issues, such as hypertension and diabetes, because of altered food choices.

Objective: Provide healthier food options to the food insecure within the facility’s food distribution boxes, as available, for the two most common health issues (diabetes and high blood pressure).

Methods: Clients at a local food pantry were interviewed individually to learn more about food insecurity and complicating health issues, such as obesity, diabetes, and high blood pressure (hypertension) while simultaneously offering alternative food …