Nursing Commons^™

The Impact Of Palliative Care Education On Acute Care Nurses, Heather Sadler

Doctor of Nursing Practice Projects

The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to improve acute care nurses’ knowledge of evidence-based palliative care interventions utilizing the framework from the End-of-Life Nursing Education Consortium (ELNEC) training modules. Increasing the knowledge, comfort, and competence of acute care nurses has the potential to improve end-of-life care delivery in the acute care setting. A lack of access to specialized inpatient palliative care service teams was identified in a rural county in the Southeastern United States. This county is served by a small, criticalaccess hospital. The frontline nursing staff of this facility regularly provides end-of-life …

Improving Intravenous Catheter Insertion Success In Difficult Access Patients, Heidi Berry

Doctor of Nursing Practice Projects

Around one in every nine Emergency Department (ED) patients have Difficult Intravenous Access (DIVA) and 25% of ED patients will require more than one attempt (Fields et al., 2014a). Failed insertion attempts contribute to decreased patient satisfaction, care delays, and financial losses. The freestanding ED affiliated with a multi-state, not-for-profit healthcare system in an urban community had difficulty with first-attempt Peripheral IV (PIV) insertion success in identified patients. The target population was the clinical staff of the freestanding ED which included Registered Nurses and Paramedics. The objective outcome was to enhance personal knowledge of PIV catheter insertion in difficult-access patients …

Using Unfolding Case Studies To Develop Critical Thinking In First-Semester Nursing Students, Carol Cook

Doctor of Nursing Practice Projects

There is a crisis in competency among new nurses in the United States. Prelicensure nursing education prepares them to pass the NCLEX-RN, but it does not provide the necessary foundation for sound clinical decision-making. Mistakes in the clinical setting can lead to failure to rescue, resulting in the third leading cause of death: medical error. A radical change is needed to prepare nurses with the clinical judgment skills necessary for patient care. Educators must be mindful of the academic-practice gap and adopt evidence-based improvements, including active learning with unfolding case studies. This quality improvement project involved a four-part unfolding case …

Using A Nurse Manager Prep Course To Spark Interest In Nurse Manager Succession Plan Participation, Sharon Pettiford

Doctor of Nursing Practice Projects

Hospitals strive to become Magnet-accredited facilities. Having Magnet status indicates an institution has high standards regarding nurse work environments and positive patient outcomes. The American Nurses Credentialing Center (ANCC) created the Magnet program criteria in 1994 (Dierkes et al., 2021). Obtaining Magnet accreditation is a coveted goal for hospitals. The target organization is currently not a Magnet-accredited hospital, nor does it have a nurse manager succession planning program. In preparation to achieve this accreditation, the target organization needed to implement a succession plan for nurse leaders. Institutions with successful succession planning programs pay careful attention when selecting participants for succession …

Getting The Most From M.O.S.T.: Promoting Most Education For Palliative Care Providers, Shelby Mood

Doctor of Nursing Practice Projects

Physician Orders for Life-Sustaining Treatment (POLST) forms are relatively new in medicine. These forms help patients and providers navigate some of the difficult decisions that can occur near the end of life and in palliative care. Each state has its own version of POLST forms. In the state this DNP project was implemented, this form is called Medical Orders for Scope of Treatment, or MOST form. Given the complexities of medical decisions, patients may not always understand the options covered in the MOST form or the implied tasks with each choice. To further patient understanding of the MOST form, this …

Heart Smart Holidays: Coping With Stress, Staying Active, And Healthy Cooking Strategies For Seniors In Cleveland County, Lauren Ridgeway

Doctor of Nursing Practice Projects

This Doctor of Nursing Practice Project assessed whether attending community group meetings focusing on stress, staying active, and healthy eating during the holidays, could influence cardiovascular disease awareness, mental health awareness, and quality of life of senior citizens in Cleveland County. A convenience sample of 6 participants attended the Coping with Stress and Staying Active event while 10 participants attended the Healthy Cooking Strategies event. The objectives were measured using a pretest posttest design before and after the presentations. There was strong evidence (t(9) = -13.597, p < .05) that the group seminar on managing stress and staying active during the holiday season improved the mental health awareness of participants. Data also showed a significant increase in Cardiovascular Disease Awareness from pretest to posttest (t(5) = 3.246, p < .05) after the seminar on healthy cooking strategies. The project raised community awareness to the importance of managing stress, staying active, and making small nutritional changes to positively impact the cardiovascular health of Seniors.

Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training, Carmen Mclamb

Doctor of Nursing Practice Projects

Achieving peripheral venous access in patients is one of the first steps in most treatment protocols. Delays or even failures to obtain peripheral venous access can delay lifesaving treatments, prolong hospital stays, and affect patient outcomes. Peripheral venous access can be difficult due to chronic disease processes, scarring of valves from frequent cannulation, limitation due to dialysis fistulas, or due to acute conditions such as hypovolemia and hypotension. Studies have found the use of ultrasound-guided techniques can achieve peripheral venous access quickly and prevent the need for more aggressive procedures (Skulec et al., 2020). However, there is a gap between …

Integrating A Community Mental Health Resource Tool In A Rural Emergency Department Setting, Robert Rash

Doctor of Nursing Practice Projects

Providing effective discharge education to patients who are treated in the emergency department setting remains a very important component of a patient’s visit to an emergency department. Literature confirms although there are various governmental regulatory agencies that set forth regulations and guidelines, there remains a need to continually evaluate and critique the discharge education process to best meet the evolving needs of the patients, stakeholders, and community. Universally understood standards include appropriate reading levels and usability of the discharge education being provided. Discharge education can be very simple to complex creating higher demands on nursing staff to ensure they understand …

Why Doesn't She Just Leave? Improving Identification And Response To Victims Of Intimate Partner Violence In The Emergency Room, Elizabeth Berry

Doctor of Nursing Practice Projects

The purpose of this project was to improve identification and response to victims of intimate partner violence (IPV) presenting to the emergency department. Project participants completed a pre-education questionnaire prior to the project leader providing intimate partner violence educational materials and a presentation entitled Recognizing and Responding to Victims of Intimate Partner Violence in the Emergency Room. The project participants then completed a mirrored post-education questionnaire. Evaluation of the project included a comparison of the participant's responses to the mirrored questionnaires. Project participants reported an increase in the:

• recognition of the prevalence of intimate partner violence among their patients, …

Self-Advocacy Training To Support Self-Confidence In Transition To Practice, Debora Shingleton Allder

Doctor of Nursing Practice Projects

Background: The crisis in the competency of newly licensed graduate nurses continues to grow despite the efforts of nursing academia. Transition to practice programs has improved new graduate attrition and narrowed the gap of practice readiness, but much of the responsibility to train graduate nurses falls on nurse preceptors. Many of these preceptors have minimal nursing experience and little to no training in fostering clinical judgment. Furthermore, nurse preceptors must balance providing care for their clients while also guiding novice nurses. They often do not have the time to provide the emotional support, real-time reflection, and timely feedback required to …

Enhancing Emotional Intelligence In Prelicensure Nursing Students, Aimee G. Motley

Doctor of Nursing Practice Projects

Nursing programs are intended to prepare nursing students to become competent nurses, that can make decisions to promote positive patient outcomes. However, studies suggest that as students transition into clinical practice, they are still lacking decision-making skills. Emotional Intelligence (EI) has been suggested to improve communication skills, problem-solving, and resilience. The purpose of this project was to enhance the emotional intelligence of Baccalaureate prelicensure nursing students. The PICOT statement was: Can formal EI training combined with interactive EI training, influence EI awareness, knowledge, and skills of baccalaureate nursing students as evidenced by scoring 77% or higher on an EI posttest …

How Essential Oils Help Prevent Against Healthcare Workers’ Burnout, Lauren Casey

Doctor of Nursing Practice Projects

This project set out to see if stress and anxiety (leading to burnout) could be combatted with the use of essential oils (EOs). Burnout is a common concern amongst the medical community and healthcare providers are leaving their jobs and field at unprecedented rates. While EOs have been used for patients, they are rarely used for the healthcare providers’ benefit. Because of that, this project wanted to focus on the employee for a change, which in turn would benefit the patient by having a mentally-present provider and the company by having less turnover. The project consisted of a pre-survey prior …

Combating The Sedentary Lifestyle In A Rural North Carolina Community, Kelsey Toliver Watts

Doctor of Nursing Practice Projects

A rural North Carolina community is experiencing an increase in inactivity, obesity, and comorbidities. The project leader collaborated with the local health department and recreation department to implement community walking events. The events aimed to promote physical activity while providing education to the residents as to why physical activity is important. The project leader used optional pre-walking event and post-walking event surveys to assess activity change and increased knowledge. Out of the 90 attendees, 68% completed the pre-event survey and 14% responded to the post-event survey. This created limited data available for follow-up. All participants who completed the follow-up plan …

Combating Compassion Fatigue In The Emergency Department, Pam Packard

Doctor of Nursing Practice Projects

Combating compassion fatigue in the emergency department is vital to nurses’ well-being. Compassion fatigue is the result of negative physical, emotional, and spiritual strains that often burden nurses. The weight of compassion fatigue is explored throughout this conceptualization of Combating Compassion Fatigue. Two questions were explored: Does compassion fatigue affect compassion satisfaction? If so, is compassion fatigue a precursor to suboptimal compassion satisfaction?

Increasing Future Health Care Providers’ Understanding Of The Complexity Of Endometriosis To Facilitate Early Diagnosis, Christina Alexander

Doctor of Nursing Practice Projects

The DNP project was designed to improve future healthcare providers’ knowledge on the complexity of endometriosis by providing students with a lunch and learn session on endometriosis. The intent of the project implementation was to improve students’ knowledge on endometriosis to facilitate early diagnosis for patients. Improving provider knowledge of evidence-based endometriosis guidelines is imperative to achieve early diagnosis. The educational session provided students with information regarding symptoms, impact of delayed diagnosis, discerning differential diagnoses, associating timing of symptoms, and identifying endometriosis lesions. The impact of the project implementation was measured using pre/post-survey data evaluating overall knowledge, symptoms awareness, “best …

Increasing Clergy Members Awareness, Sensitivity, And Knowledge (Ask) Of The Lgbtqia+ Community Improves Health Outcomes, Claudette Green

Doctor of Nursing Practice Projects

Introduction: Individuals who identify as belonging to the LGBTQIA+ community in the context of religion and faith often experience spiritual discrimination and are made to feel like an outcast (Cole & Harris, 2017). Often, spiritual leaders lack the training, knowledge, and skills necessary to understand and communicate in a way that offers solace and comfort to their LGBTQIA+ congregants (Yarhouse & Sadusky, 2020). Moreover, the church has been at the forefront of leading the discrimination and condemnation of LGBTQIA+ members. This discrimination has led many to leave the church and become involved in self-harming behavior, ongoing mental health struggles, …

Decreasing Nursing Burnout Post Covid-19 Pandemic Through Complementary Therapies, Linda Martiin

Doctor of Nursing Practice Projects

This quality improvement project aimed to address the problem of nursing burnout post COVID-19 pandemic through complementary therapies. Nursing burnout can be mental, emotional, or physical exhaustion which an excessive amount of prolonged stress can cause. Nursing burnout has affected nursing staff worldwide, directly impacting the care provided to patients and the patient's satisfaction. The Nursing Worklife Model was utilized as the theoretical framework for this project (Appendix A). The literature review exhibits the prevalence of nursing burnout in nursing staff. A quantitative study was utilized for this project. The Oldenburg Burnout Inventory was utilized to establish the participant's level …

Improving Handoff Communication In The Emergency Department, Amy Shepherd

Doctor of Nursing Practice Projects

Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …

Increasing Cpr Awareness In School Staff, Savanna Parker

Doctor of Nursing Practice Projects

There are a limited number of staff members in Stokes County Schools that are CPR certified. A CPR workshop was conducted to provide an opportunity to allow more staff members to become certified, to gain knowledge and gain confidence in Cardiopulmonary Resuscitation, and to reduce delays in administering aid. Participants were asked to complete the Perceived Competence Scale (PCS) before and after participation in the CPR Workshop. The PCS is a 4-item questionnaire, based on a 7-point Likert scale. Answer choices range from Not True to Very True. Each question provides a lead-in statement, allowing for the concept being studied …

Accreditation Commission For Education In Nursing (Acen): A Mixed Methods Study To Determine Accreditation Readiness At A Non-Profit Organization Located In Western North Carolina, Leslie Queen

Doctor of Education Dissertations

The accreditation process allows programs to complete the reflection process of program evaluation, where they assess and measure themselves via preset standards and suggested outcomes. The theoretical framework of Getzels and Guba (1957) was used to determine if the people within the nonprofit organization studied could successfully fulfill the predetermined expectations of the organization. This study also examined the value of program evaluation, explained the process used by schools of nursing that wish to seek national accreditation, investigated the benefits and strengths of attaining accreditation, and uncovered possible barriers that may hinder accreditation efforts. By exploring these topics, conclusions were …

Prospective Generation Z Nurses: Expectation Of The Workforce In Connotation To The Great Resignation, Amelia Borders

Undergraduate Honors Theses

The Great Resignation has left an impact on the entirety of the American workforce. Coupled with the burnout rates caused by the COVID-19 pandemic, healthcare systems have been trying to find solutions to inhibit the nurse shortage. While solutions that focus on symptoms of the problem may work for a short period of time, hospitals will continue to encounter issues with staffing nurses and will need to find a new solution (Laskowskil-Jones & Castner, 2022). A possible solution would be for hospitals to recruit and retain prospective Gen Z nurses. In a quantitative study completed at a single university in …

Doing Death Better: Practical Ways For Healthcare Professionals To Care For The Dying Patient And Their Families, Andrea Wilson

Undergraduate Honors Theses

Healthcare professionals care for patients with unique personal, cultural, religious, and medical needs, but these needs are not always met in a way that ensures the patient and their families are being treated as unique individuals. This paper first provides an overview of the physiological aspects of dying and how to educate patients and their families regarding expectations in end-of-life. The impacts of the death of a child and a parent were explored, and areas in need of more resources for these individuals were identified. The beliefs and practices of Hindu, Native American, and Islamic cultures were discussed, and lessons …

Increasing Patient Initial Visit Compliance In An Outpatient Setting, Zackery Cooper

Master of Science in Nursing Theses and Projects

Outpatient healthcare clinics make revenue based on patient visits and productivity is based on the number of visits seen per provider. When patients do not attend their scheduled appointments, practices lose the revenue from the visit, plus have the added cost of a potentially unproductive provider. The current practice in the project facility is to send reminder text messages through the electronic health record scheduling system. The system sends reminder texts 48 and 24 hours prior to the appointment date. The proposed change to the practice is to add telephone calls to patients the morning of their scheduled visit. The …

Hand Hygiene Compliance In Nursing Staff Of Long-Term Care Facilities, Lindsay Clontz

Master of Science in Nursing Theses and Projects

Elderly residents of long-term care facilities are most at risk to acquire serious infections. Because of the relationship with nursing staff members, they are most likely to get an infection from a member of the nursing team. It is imperative that nursing staff members receive proper training related to hand hygiene in order to adhere to infection prevention and control guidelines. The goal of this project is to improve hand hygiene in nursing staff to reduce the number of resident infections recorded on the monthly infection surveillance report. This project utilizes a multi-faceted approach including a pre-test, presentation, post-test, return …

Prevention Of Infection During Hemodialysis Treatment Initiation, Jessica Stroupe

Master of Science in Nursing Theses and Projects

Infection in the dialysis access of a patient can be detrimental to the health of a dialysis patient. For this reason, infection control is extremely important in the outpatient hemodialysis setting. The goal of this project is to prevent infection during dialysis treatment initiation. This goal will be achieved during a 5-week project in which staff of an outpatient hemodialysis unit will be directly observed and then educated on the importance of infection control during treatment initiation. Staff will be given education on areas that need improvement regarding infection control during treatment initiation. The staff will be able to use …

The Importance Of Skin-To-Skin Initiated In The Operating Room, Katina Miller

Master of Science in Nursing Theses and Projects

The benefits of skin-to-skin contact has been well documented for both infants and mothers. Out of all the different modes of delivery a pregnant patient can have, skin-to-skin contact is performed the least amount for mothers who delivery via cesarean section compared to mothers who have a vaginal delivery. All mothers, should they choose, should be allowed to have skin-to-skin contact with their infant in the operating room. This project was designed to increase skin-to-skin contact between a mother and their infant shortly after birth via cesarean section at least 75% of the time. Education was conducted during team huddles …

Fluid State And Diet Control In Patients With Acute Kidney Injury On Hemodialysis, Carolyn Evans-Howard

Master of Science in Nursing Theses and Projects

Prolonged hospitalization, high number of readmissions, and high mortality rates are associated with patients diagnosed with Acute Kidney Injury (AKI). The purpose of this quality improvement proposal is to address the need for more education for nurses caring for these patients. If the kidneys shut down temporarily due to acute illness or medication taken, fluid and toxins will build up in the body with no way of being released. It is proposed that if dietary and fluid restrictions are followed it may help the patient recover faster. The method proposed is to have nurses learn the necessary dietary and fluid …

Patient Satisfaction, Amber Bowman

Master of Science in Nursing Theses and Projects

This thesis project reviews how nursing care, specifically that of nursing assistance, impacts patient satisfaction. Care provided to patients during hospitalization is scored by post-discharge surveys. For this project, the HCAHP survey is specifically referred to and discussed. The survey data obtained from the HCAHP survey is available to the public for review. This data can affect the population's outlook on healthcare organizations. Research has found that care provided by nursing assistants has an impact on the satisfaction of patients. Research in the area of improving patient satisfaction is lacking in data and tools for improvement.

Proposal For A Formal Pediatric Abuse Screening Tool For The Emergency Department, Christina Bolin

Master of Science in Nursing Theses and Projects

Implementation of a quick, reliable pediatric child abuse assessment tool for use in the emergency department is of great importance. A thorough assessment of all pediatric patients presenting to the emergency department (ED), regardless of complaint, should become second nature in order to recognize the signs of child abuse. Because a tool of this nature is lacking in many ED's, the Escape Instrument is needed. This instrument is a successful, efficient screening tool that can be applied to all pediatric patients during triage in the emergency department. This tool will allow the emergency department staff to quickly identify children under …

Case Manager Discharge Planning For Safe Discharge Of Homeless Patients, Melody Jenkins

Master of Science in Nursing Theses and Projects

Acute care case managers are continually challenged with the task of identifying discharge barriers and preparing a discharge plan that facilitates successful recovery and healing. Planning a discharge for a patient that is homeless can be extremely challenging. This MSN Nursing project addresses the complex discharge barriers involved in planning a safe discharge for homeless patients. The project goal was to create a Case Management Resource Algorithm that will organize available community resources to meet the social determinants of health deficits to prevent the progression of disease processes, prevent repeat visits to the emergency room, decrease inpatient admissions, as well …