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Articles 451 - 480 of 605
Full-Text Articles in Nursing
Improving Central Venous Catheter Infection Rates Through The Use Of A Bundle: An Integrative Review, Janice Laverne Harris-Hall
Improving Central Venous Catheter Infection Rates Through The Use Of A Bundle: An Integrative Review, Janice Laverne Harris-Hall
Doctoral Dissertations and Projects
The role of Central Venous Catheters (CVC) is significant for the End-Stage Renal Disease (ESRD) population. The placement of the CVC for a HD (HD) patient is not only necessary, but life-sustaining. CVCs are usually placed for an emergent HD treatment, while awaiting a permanently placed arteriovenous fistula or graft (AVF/AVG), or when the permanent access becomes non-functioning. There are multiple risk factors related to having a CVC placed, the most predominant complication being catheter line-associated bloodstream infections (CLABSIs). Studies have shown that implementing a CVC prevention bundle was associated with a significant reduction in the CLABSI rates within the …
Improving Perioperative Communication Through The Use Of A Nurse Navigator: An Integrative Review, Elizabeth Irene Christman
Improving Perioperative Communication Through The Use Of A Nurse Navigator: An Integrative Review, Elizabeth Irene Christman
Doctoral Dissertations and Projects
Patient-centered communication practices are critical for ensuring that patients have optimal care experiences and clinical outcomes. Unfortunately, today’s health care environment often presents numerous barriers to consistent and clear information exchange. These barriers are magnified in dynamic and fast-paced care environments such as the perioperative setting, where numerous interactions and communication exchanges must occur. The purpose of this integrative review is to examine the value of the nurse navigator role within the perioperative setting and evaluate whether it can improve patient and family satisfaction with communication and the care experience. The review includes the identification and appraisal of relevant literature …
Using Patient Safety Principles To Prevent Patient Harm, Octavia Reed Wynn
Using Patient Safety Principles To Prevent Patient Harm, Octavia Reed Wynn
Doctoral Dissertations and Projects
While healthcare is intended to promote and restore optimal health and quality of life, it has been realized that patients often experience unintended harm while consuming healthcare services. In a project conducted in a 12-bed intensive care unit, nurses completed a pre-survey to identify a baseline understanding of patient safety principles. They then completed online educational modules designed to teach patient safety principles including patient and family centered healthcare, systems safety, and culture of safety. Following the educational intervention, a postsurvey to assess for increased understanding was administered. Forty-seven nurses completed the presurvey and education showing improved understanding of patient …
Using Screening, Brief Intervention, Referral To Treatment To Address Problematic Alcohol Use At A University Student Health Center, Tajuane H. Dockery
Using Screening, Brief Intervention, Referral To Treatment To Address Problematic Alcohol Use At A University Student Health Center, Tajuane H. Dockery
Doctoral Dissertations and Projects
Problematic drinking is a public health concern on college campuses. College students who do not have their risky drinking behaviors addressed are at greater risk for developing Alcohol Use Disorder (AUD). Despite known risks associated with drinking on college campuses, many college health centers miss an opportunity to address these behaviors because they lack a systematic process for identifying students at risk and referring them for treatment. This evidence-based project evaluated the effectiveness of using Screening, Brief Intervention, Referral to Treatment (SBIRT) to identify students with risky drinking behaviors and the impact the screening process had on facilitating a referral …
The Impact Of Intermittent Auscultation And Physiologic Labor Support Education For Nurses On Patient Satisfaction And Nurse Self-Efficacy, Heather N. Soper
The Impact Of Intermittent Auscultation And Physiologic Labor Support Education For Nurses On Patient Satisfaction And Nurse Self-Efficacy, Heather N. Soper
Doctoral Dissertations and Projects
Knowledge and implementation of intermittent fetal auscultation (IA)and labor support mechanisms in the hospital setting are becoming a lost art. Nurses are well-trained on how to utilize technology and perform medical interventions for laboring patients, but are losing the confidence and skills necessary to promote normal, physiologic births for low-risk women. In order to address these concerns, an evidence-based practice project was piloted in a hospital in Virginia. Nurses were trained on the science, clinical application, and outcomes of both intermittent auscultation and continuous electronic fetal monitoring for low-risk women; education was also focused on labor support mechanisms and the …
A Mixed-Methods Case Study Of Spiritual Formation And School Induced Stress In Student Registered Nurse Anesthetists During Hospital Residency, R. Dawn Whybrew
A Mixed-Methods Case Study Of Spiritual Formation And School Induced Stress In Student Registered Nurse Anesthetists During Hospital Residency, R. Dawn Whybrew
Doctoral Dissertations and Projects
Student registered nurse anesthetists in hospital residency undergo a rigorous schedule. For Christian nurse anesthesia students, spiritual formation may suffer due to the stressors of anesthesia residency. The purpose of this mixed-methods case study sought to understand and describe the perceived influence of participation in spiritual formation opportunities during nurse anesthesia hospital residency on students’ spiritual formation level as well as their ability to handle stressors of hospital residency. In phase one of the study, the researcher conducted a purposeful convenience sampling of 54 Junior and Senior students in a quantitative quasi-experimental design. In phase one, the participant's spiritual formation …
An Evidence-Based Intervention To Enhance Provider Awareness And Confidence In Addressing Polypharmacy, Catherine Marie Steiner
An Evidence-Based Intervention To Enhance Provider Awareness And Confidence In Addressing Polypharmacy, Catherine Marie Steiner
Doctoral Dissertations and Projects
Polypharmacy is a healthcare problem of epidemic proportions in the United States. It is frequently associated with negative health outcomes in the lives of both elderly and chronically ill persons at excessive costs to the United States healthcare system. Appropriate medication management incorporating evidence-based guidelines is essential to addressing polypharmacy. Prescribing clinicians in all disciplines have expressed a lack of confidence and perceived gaps in knowledge to address polypharmacy through deprescribing. This scholarly project aimed to determine if a polypharmacy protocol intervention, based on the most current evidence-based guidelines in prescribing and deprescribing, would improve clinician confidence in the decision …
Shift Work: Gut Health And Metabolic Disease, Hailey Lane
Shift Work: Gut Health And Metabolic Disease, Hailey Lane
Senior Honors Theses
The number of people engaged in shift work continues to rise, and with it the research linking shift work to various diseases and conditions. Shift work changes the body’s sleeping patterns and circadian rhythms which has an effect on all parts of the body including the heart, immunity, cancer development, and inflammatory processes. Altered sleeping patterns and circadian rhythms change the composition and anatomy of the gut and microbiome, which in turn affects the development of metabolic diseases. Shift work also changes one’s eating patterns and habits. Altered eating habits similarly changes the composition and anatomy of the gut and …
Improving Patient Satisfaction With The Virtual Handoff Process Through The Utilization Of Educational Pamphlets In The Emergency Department, Lynda Michelle Heintz
Improving Patient Satisfaction With The Virtual Handoff Process Through The Utilization Of Educational Pamphlets In The Emergency Department, Lynda Michelle Heintz
Doctoral Dissertations and Projects
Boarding patients in the emergency room while waiting to transfer the patient to the proper unit can be harmful to clinical care and have significant financial opportunity costs. At one local hospital it was found that on average patients were being boarded in the emergency room (ED) for approximately 85 minutes waiting to be transferred. Several barriers that caused this delay were found including, delay in room cleaning, nurse staff shortage, and inability to give report to the nurse receiving the patient. In an attempt to combat this delay which may be caused by a difficulty in giving patient report, …
A Transcendental Phenomenological Study Of Student Nurses With Learning Disabilities In The Clinical Learning Environment, Lorna Jean Woodhall
A Transcendental Phenomenological Study Of Student Nurses With Learning Disabilities In The Clinical Learning Environment, Lorna Jean Woodhall
Doctoral Dissertations and Projects
The purpose of this transcendental phenomenological study was to record the lived experiences of nursing students with learning disabilities while in the clinical learning environment. Dewey’s theory of education and Knowles’ theory of adult learning were used to ground this study. Their theories provided a foundation to understand how the learning process is affected in nursing students with learning disabilities in the clinical learning environment. The study answered the following research questions: (a) What are the lived experiences of student nurses with learning disabilities in the clinical learning setting? (b) How are nursing students impacted by their learning disability during …
Increasing Asymptomatic Chlamydia Screening In The Ed, Mikyung Kim
Increasing Asymptomatic Chlamydia Screening In The Ed, Mikyung Kim
Doctoral Dissertations and Projects
The Centers for Disease Control and Prevention (CDC) recommends chlamydia screening in young women and others who are at risk based on scientific evidence related to the effectiveness of screening to prevent chlamydial infection. Female patients may visit the emergency department (ED) with symptoms such as urethritis, abdominal pain, or vaginal spotting. For men, most complaints are urinary problems, discharge from the penis, and testicular pain. However, most infected patients are never symptomatic and have no abnormal physical findings. Therefore, the question that spurred this project was, “Why aren’t asymptomatic patients screened more often?” Furthermore, “Why are the CDC screening …
The Use Of Patient Diaries In The Cvicu To Prevent Post-Intensive Care Syndrome And Improve Family Satisfaction With Care, Denise M. Goodberlet
The Use Of Patient Diaries In The Cvicu To Prevent Post-Intensive Care Syndrome And Improve Family Satisfaction With Care, Denise M. Goodberlet
Doctoral Dissertations and Projects
Patients in the ICU are at risk for adverse physiological and psychological symptoms including anxiety, depression and confusion common with post intensive care syndrome. The presence of these symptoms is correlated with poor satisfaction with care and decreased quality of life. This creates stress for patients as well as the families of these patients. This evidence-based practice (EBP) project sought to answer the clinical question: For patients and families in the cardiovascular intensive care unit (CVICU), can participating in an intensive care diary program, when compared to standard of care, decrease the symptoms and incidence of post-intensive care syndrome in …
Reducing Emergency Department Length-Of-Stay And Overcrowding Through Team Triage, Kirsten Gisela Sizemore
Reducing Emergency Department Length-Of-Stay And Overcrowding Through Team Triage, Kirsten Gisela Sizemore
Doctoral Dissertations and Projects
Emergency department (ED) overcrowding is an internationally studied phenomenon linked to adverse patient outcomes, including death. Early medical screening exams (MSE) may prevent morbidity and mortality. Yet, EDs struggle to evaluate, treat, and discharge patients within recommended and nationally monitored benchmark times. This evidence-based scholarly project explored if stationing an advanced practice provider (APP) in triage would improve door-provider-times, length-of-stay (LOS), and the left without being seen (LWBS) rate at a medical center ED in the southeastern United States. A pre- and post-intervention design compared benchmark times after a provider triaged alongside the registered nurse (RN) during times of high …
The Lived Experience Of Practical Nursing Faculty Who Have Transitioned To A Concept-Based Curriculum As Required By The North Carolina Nursing Curriculum Revision Project, Lora Poole Bartlett
The Lived Experience Of Practical Nursing Faculty Who Have Transitioned To A Concept-Based Curriculum As Required By The North Carolina Nursing Curriculum Revision Project, Lora Poole Bartlett
Doctoral Dissertations and Projects
The purpose of this hermeneutic phenomenological qualitative study was to understand the lived experience of practical nursing (PN) faculty who have transitioned from a systems-based curriculum to a concept-based curriculum (CBC) as required by the North Carolina nursing revision project. In recent years, nursing education transformation has been a topic of interest among government organizations, the healthcare system, nursing leaders and organizations, and faculty of nursing programs. However, literature specifically on how faculty perceive and transition into these new innovative methods of teaching is minimal. The participants in the study were PN faculty employed by North Carolina community colleges and …
Teachback: The Implementation Of The Teach-Back Method To Improve Patient Satisfaction With Care Transitions, Elizabeth M. Breton
Teachback: The Implementation Of The Teach-Back Method To Improve Patient Satisfaction With Care Transitions, Elizabeth M. Breton
Doctoral Dissertations and Projects
Patient education at discharge from the hospital is an essential element to continuation of care and management of chronic health issues. While many elements may contribute to patient satisfaction with discharge education, use of the teach-back method has been found to improve retention of discharge instruction, as well as increase patient confidence in chronic disease management and self-care at the time of discharge. Patient satisfaction with discharge education is a notable component of hospital reimbursement by national standards, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) results. Following education of nursing staff participating in …
Prenatal Yoga In Pregnancy, Ashleigh Clingenpeel
Prenatal Yoga In Pregnancy, Ashleigh Clingenpeel
Senior Honors Theses
Prenatal yoga has emerged as an advisable, beneficial, and supportive addition to birth preparation. Many studies have linked participation in prenatal yoga with both maternal and infant benefits. Physical benefits for the mother include decreased labor time, decreased labor pain, and improved comfort during pregnancy. Significant emotional and mental effects have also been correlated, such as lowered rates of depression and anxiety, increased self-efficacy in labor, and easier transitions into the postpartum period. Finally, prenatal yoga has demonstrated benefits to the neonate, with a greater number of vaginal deliveries, which are less traumatic for the infant, an increase in gestational …
Noninvasive Ventilation Protocol Development, Janise Pierce Tinsman
Noninvasive Ventilation Protocol Development, Janise Pierce Tinsman
Doctoral Dissertations and Projects
Endotracheal intubation results in many serious complications including regurgitation, vocal cord paralysis, and death. Noninvasive ventilation using bi-level positive airway pressure has been shown to provide the necessary support without intubation and is also associated with better outcomes if trialed prior to endotracheal intubation. A noninvasive ventilation protocol was applied in a rural acute care facility. Results: The average length of stay for acute respiratory failure decreased from 5.32 to 4.44 days, while intubations fell from 41.9% to zero, and mortality fell from 9.7% to zero during the pilot period. Five cases met criteria for noninvasive ventilation, and three received …
Back To The Basics With Environmental Hygiene, Shanna D. Stowe
Back To The Basics With Environmental Hygiene, Shanna D. Stowe
Doctoral Dissertations and Projects
Environmental hygiene is fundamental in preventing the transmission of pathogens that can cause health care-associated infections (HAIs). Inanimate surfaces within the patient’s environment are defined as high-touch surfaces and include areas such as bedrails, tray tables, call lights, telephones, any equipment that is attached to the patient, and the computer on wheels. HAIs develop during hospitalization and occur within 48 to 72 hours of admission or within 10 days after hospital discharge (CDC, 2014; Collins, 2008). HAIs increase the morbidity, mortality, and hospital expenditures; and critically ill patients are at greater risk for HAIs because of their compromised immune systems, …
The Benefits Of Early Referral To Palliative Care For End Stage Renal Disease (Esrd) On Dialysis, Omolola Akinmadelo
The Benefits Of Early Referral To Palliative Care For End Stage Renal Disease (Esrd) On Dialysis, Omolola Akinmadelo
Doctoral Dissertations and Projects
Palliative care provides outstanding holistic nursing for the management of undesirable symptoms and suffering related to chronic illness disease processes such as end stage renal disease. When palliative care services are initiated early in course of a chronic illness, they improve the quality of care and life and reduce stress for patients and their families. While palliative care is slowly being recognized as the most effective means of improving quality of life and care in the management of chronic illness, most health care staff and providers are not aware of the full benefits of palliative care in the management of …
Using Teamstepps® To Improve Interprofessional Collaboration In The Outpatient Psychiatric Care Setting, Amy Michele Wadsworth
Using Teamstepps® To Improve Interprofessional Collaboration In The Outpatient Psychiatric Care Setting, Amy Michele Wadsworth
Doctoral Dissertations and Projects
The AACN has identified in their QSEN competencies that collaborative teamwork and patient-centered care are two qualities that skilled nurses must exhibit to provide high-quality care. The IOM has made a call to action that healthcare professionals must exhibit patient-centered care in interdisciplinary team settings to achieve high-quality care. At a community resource program in the mid-Atlantic region, a recent qualitative job satisfaction survey revealed that employees identified issues with interprofessional collaboration and a lack of teamwork at the facility. Using the Iowa Model, this EBP project involves the use of a cohort study with a pretest-posttest design, where the …
Improving Patient Satisfaction With Quietness At Night: An Integrative Review, Victoria Rondez Squier
Improving Patient Satisfaction With Quietness At Night: An Integrative Review, Victoria Rondez Squier
Doctoral Dissertations and Projects
Despite the efforts to improve the environment of care in hospital settings by noise reducing interventions, building redesigns, and quiet hours, research maintains patients continue to report noise is problematic across all specialties in acute care settings. Patient satisfaction correlates to their perception of quality care and hospitals are economically impacted by their feedback on hospital rating surveys. Stagnant Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results across the country indicate “Quiet at Night” is in need of attention to be prioritized, as it continues to be the lowest scoring line item on hospital rating surveys since …
Significance Of Capnography In Pediatric Post Anesthesia Care, Deborah Renee Whitley
Significance Of Capnography In Pediatric Post Anesthesia Care, Deborah Renee Whitley
Doctoral Dissertations and Projects
Updated clinical guidelines and professional practice standards for pediatric post-anesthesia care call for the use of capnography until the patient is awake. The purpose of this project was to champion the implementation of capnography in the pediatric post-anesthesia care unit at the project site. Monitoring capnography in addition to pulse oximetry for all pediatric post-anesthesia patients until awake was the practice change implemented. Capnography led to an increase in the number of appropriate respiratory-related nursing care interventions provided, earlier response to changes in respiratory status, and a decrease in the pediatric post-anesthesia care unit length of stay. The implications for …
Centeringpregnancy: Perceptions Of Providers And Staff In A Private Ob Practice, Allison F. Mills
Centeringpregnancy: Perceptions Of Providers And Staff In A Private Ob Practice, Allison F. Mills
Doctoral Dissertations and Projects
Traditional prenatal care has been the stalwart of care in the United States since the 1920s; however, a new model of care is emerging: group-style prenatal care. This model of care has been well-documented within literature as having notable maternal and fetal outcomes, including increased patient satisfaction, decreased preterm birth rates, increased breastfeeding rates, and increased patient compliance, to name only a few. With such remarkable outcomes, it begs the question of why the group prenatal care model is not more widely utilized. This project aimed to determine if increasing the knowledge of healthcare providers in a private obstetrics practice …
Sepsis Education Utilizing ‘Sepsis Alert’ Checklist To Support The Adherence Of Early Management Bundle In The Emergency Department, Jean Jun
Doctoral Dissertations and Projects
Early recognition and timely management of sepsis is a priority within hospitals due to its direct impact on patients’ outcomes. It is critical for healthcare providers to be educated and aware of the signs and symptoms of sepsis. The emergency department (ED) is the forefront of the hospital where majority of patients with sepsis are assessed and either discharged or admitted into the hospital. Therefore, it is critical for ED nurses to be educated in the early signs of sepsis and follow evidence-based practice guidelines when managing these patients. The project leader implemented a sepsis education intervention aimed at clinical …
Reducing Central Line-Associated Bloodstream Infections In The Intensive Care Unit By Improving Compliance With Dressing Changes And Curos Caps Use, Jennifer Khaziga Kilel
Reducing Central Line-Associated Bloodstream Infections In The Intensive Care Unit By Improving Compliance With Dressing Changes And Curos Caps Use, Jennifer Khaziga Kilel
Doctoral Dissertations and Projects
Background: Reducing central line-associated bloodstream Infections (CLABSI) is a topic of global importance due to associated risk of sepsis, increased length of hospital stay, high healthcare cost, and increased morbidity and mortality among critically ill patients in the intensive care unit (ICU). The mortality rate of patients who acquire CLABSI 15-25% The cost of CLABSI treatment per event is greater than US $16,500. Central cine-associated Bloodstream Infections affect the organization’s national ranking in patient quality and safety as well as reimbursement from the Centers for Medicare and Medicaid (CMS). The aim of the quality improvement project was to improve the …
Mobile-Based Technology App Used To Improve Self-Care Management Of Patients With Type 2 Diabetes Mellitus, Fred Allen Smith Jr
Mobile-Based Technology App Used To Improve Self-Care Management Of Patients With Type 2 Diabetes Mellitus, Fred Allen Smith Jr
Doctoral Dissertations and Projects
Billions of dollars are spent on diabetes in healthcare each year. Patients with lower socio-economic-status tend to have poor glycemic control, higher associated diabetic complications, and higher associated mortality rates. In underserved patients with type 2 diabetes, does utilization of a Diabetes app, compared to previous self-care management and clinic education, lower the Hemoglobin A1c over a 3-month period? A 3-month scholarly project was conducted in a small rural town in Virginia with an average median income around $17,000. N=21 were selected for the scholarly project. Inclusive criteria consisted of adults aged 19-70 years with a diagnosis of type 2 …
Evaluation Of Patient Education To Facilitate Advance Directives Completion With Dialysis Patients, Xuesi Liu
Evaluation Of Patient Education To Facilitate Advance Directives Completion With Dialysis Patients, Xuesi Liu
Doctoral Dissertations and Projects
Completion of advance directives (ADs) is an important part of identifying a patient’s treatment preferences. Lack of patient understanding regarding the scope and importance of advance directives is a common barrier to AD completion. This project reports on the effectiveness of a patient education intervention in facilitating patient understanding in an outpatient dialysis facility in rural Virginia. Thirty patients were selected by convenience sampling to participate in a 10-minute verbal presentation based on a brochure entitled “Advance Care Planning: Tips from the National Institute on Aging” and completed two short questionnaires, one before and one after the education session. Patients …
Culturally Appropriate Education In Managing Hypertension In African Americans, Kristina Jones
Culturally Appropriate Education In Managing Hypertension In African Americans, Kristina Jones
Doctoral Dissertations and Projects
Abstract The historical treatment of African Americans with events such as the Tuskegee experiment and Jim Crow laws combined with distrust of the healthcare system may be affecting health outcomes in African Americans with hypertension. Cultural appropriate education by a provider of the same race is a method that can be utilized to bridge the trust gap between African Americans and providers and assist African Americans in managing their hypertension. A community based culturally appropriate educational intervention by a provider of the same race was implemented over the course of eight weeks to assist African Americans with hypertension to improve …
The Implementation Of The Teach-Back Method In Dash Diet Education To Improve Blood Pressure Control In Patients With Hypertension And Low Health Literacy, Patrice Helen Spencer
The Implementation Of The Teach-Back Method In Dash Diet Education To Improve Blood Pressure Control In Patients With Hypertension And Low Health Literacy, Patrice Helen Spencer
Doctoral Dissertations and Projects
Low health literacy is closely correlated with poorly-managed chronic disease conditions. Hypertension is a common chronic disease condition which can be better controlled through compliance with the dietary approaches to stop hypertension (DASH) diet; however, patients with low health literacy may have difficulty understanding the DASH diet without proper education. The teach-back method is an evidence-based education tool which can empower patients with low health literacy to better control the management of hypertension through adherence to the DASH diet. This is an evidence-based project which purposes to reveal the effectiveness of the teach-back method in providing DASH diet education in …
An Educational Intervention To Raise Obesity Awareness, The Importance Of Follow-Up, And The Need To Utilize Recommended Strategies And Interventions Among Advanced Care Practitioners In A Sleep Center Setting, Cindy L. Thomas
Doctoral Dissertations and Projects
Obesity is a national epidemic that affects approximately 40% of adult Americans. A lack of advanced practitioner (AP) knowledge about obesity and follow-up may contribute to the obesity epidemic. Diagnosing obesity and beginning prompt weight loss (WL) management with the aim to prevent the development or progression of chronic illnesses associated with obesity is imperative. Research has shown that WL of 5% to 10% of initial body weight can reverse or reduce the onset of chronic illnesses. The purpose of this evidence-based practice (EBP) scholarly project was to raise the awareness of weight management resources among APs caring for patients …