Nursing Commons^™

Implementation Of A Scripted Education On Comfort Goals To Improve Patient Perception Of Pain Control, Vicki F. Mclean

Doctoral Dissertations and Scholarly Projects

Pain management is the culmination of physician, nurse, and patient expectations. Successful pain management is impacted by the patient’s perception and expectation of the provided interventions, as well as the perception of the care provider of the patient’s pain. Pain assessment tools have been utilized for decades and still pain control is rated as inadequate. Providing scripted education to the patient on the purpose and utilization of these tools impacts the patient’s perception of pain management. This project implemented the evidence-based practice intervention of education to improve the relationship of comfort goals to pain management. Nurses’ knowledge of pain management …

Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering

Senior Honors Theses

In recent years, there has been a significant increase in pediatric onset of type II diabetes. This paper will examine elements contributing to this trend. Type II diabetes will be discussed, including related pathophysiology, manifestations, diagnosis, and complications, with differentiation between adult and pediatric onset. Possible prevention and treatment methods appropriate for pediatric patients will also be discussed, along with possible outcomes in pediatric patients that could result from this disease. Overall, this paper will provide insight on the causes of this growing trend, and ways to improve the risks imposed on pediatric patients.

The Relationship Between The Number Of Hours Taken In A Senior Practicum Course In Prelicensure Nursing Education And The Score Of Preception Of Professional Competence By The Newly Graduated Nurse, Arlene Holowaychuk

Doctoral Dissertations and Projects

This study determined whether there is a relationship between the number of direct acute care hours completed in a senior practicum course during pre-licensure nursing education and the scores of perception of Nurse Professional Competence (NPC) in newly graduated nurses between the third and sixth month of employment. A sample of new hires of newly graduated nurses within a large, nonprofit healthcare system was used. Institutional Review Board (IRB) approval was obtained from Liberty University’s IRB and the healthcare organization’s IRB prior to the survey being sent out to prospective participants and data collected. A non-experimental, correlational design was used …

Impact Of Utilizing The Nurse Practitioner Role In Trauma, And The Effect It Has On Healthcare Utilization And Patient Satisfaction, Jason Pilkerton

Doctoral Dissertations and Scholarly Projects

The addition of Nurse Practitioners (NPs) on the trauma service at night was examined to see if it has positively impacted healthcare utilization and satisfaction in trauma patients. This four-month evidence-based, quasi-experimental project took place on the Trauma Medical Surgical Unit (TMSU) at a level II trauma center in California. Retrospective analysis of medical records and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) satisfaction surveys were performed for those trauma patients located on the TMSU 60-days prior to NPs starting at night and 60-days after. The measured outcomes were LOS, readmissions within 30-days of discharge, LOS after readmission, …

An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Chart Audit And Educational Provider Feedback Intervention To Improve Appropriate Use Of Spirometry In Patients With Chronic Obstructive Pulmonary Disease, Ruth Demetros

Doctoral Dissertations and Scholarly Projects

Despite being a GOLD guideline and having documented benefits, confirming a COPD diagnosis with spirometry is not routinely done. The purpose of this project was to increase patient referrals for spirometry to confirm COPD diagnosis. A quasi-experimental design was incorporated in a primary care office. A retrospective pre-intervention chart audit and two post-chart audits, 30-days apart, compared the frequency of documented spirometry to confirm a COPD diagnosis. An educational intervention with a pre and post-survey examined provider behavior intention to order spirometry to confirm a COPD diagnosis. The pre-chart audit revealed that 27/50 (54%) of patients had spirometry documented to …

The Impact Of An Educational Intervention To Enhance Self-Management In Type 2 Diabetes Patients, Demetria Bates

Doctoral Dissertations and Scholarly Projects

Type 2 diabetes mellitus is a chronic health condition that requires patients to be engaged in their health care. Knowledge of the disease and self-management skills are key components to improving health and outcomes in diabetes patients. Due to the lack of self-management skills, diabetes patients are at risk for diabetes-related health complications. Hemoglobin A1c is a measure that demonstrates the average blood glucose level, which is an indicator of diabetes control. Medical treatments and education are continuously improving and readily for type 2 diabetes. The purpose of this project was to enhance knowledge and self-management skills among chronic care …

Evaluating Impedance Monitoring To Reduce Hospital Readmissions For Patients With Heart Failure With Reduced Ejection Fraction: An Integrative Review, Abigail Newton

Doctoral Dissertations and Scholarly Projects

Congestive Heart Failure (HF) is a chronic progressive cardiac disorder with high mortality rates and is the number one reason for hospital readmission in the United States. More than 5 million Americans live with HF with more than 900,000 new diagnoses annually. The likelihood of developing HF increases with age making it the most common primary diagnosis for patients over age 65. HF has a significant impact on quality of life, with depression being a common comorbid condition. Thoracic impedance monitoring has shown to reduce exacerbations and hospitalizations in patients with HF. This project evaluated the literature related to impedance …

Enhanced Depression Screening In The Cardiac Rehabilitation Setting An Evidence-Based Project, Heidi Winslow

Doctoral Dissertations and Scholarly Projects

Depression is common amongst patients with cardiovascular disease. This evidence-based project was designed to evaluate the impact of a practice improvement intervention for screening and referrals in cardiac patients with depression. The American Heart Association Advisory Council recommends depression screening, treatment, and support to provide adequate diagnosis, treatment, and follow-up to patients. Cardiacrehabilitation (CR) is a coordinated effort of structured treatments with physical, mental, and social components, to favorably influence cardiac healing and resume optimal functioning. The problem is current depression screening and referrals are not being documented electronically in the cardiac rehabilitation (CR) setting limiting real-time communication amongst the …

Reducing Rehospitalizations From One Skilled Nursing Facility: A Quality Improvement Project, Victoria Ann Phillips

Doctoral Dissertations and Scholarly Projects

The purpose of this quality improvement project initiated by a core project team in a large medical center was to investigate possible causes for increased hospital readmissions from one specific skilled nursing facility. The conceptual framework utilized was the Define, Measure, Analyze, Improve, Control (DMAIC) model from the Lean Six Sigma methodology. Data collection from chart audits, a staff survey, a system probe, and a process mapping project assisted to narrow the focus of the plan to improve communication among facilities by standardizing documentation and coordination of care as patients transitioned from the skilled nursing facility to the medical center’s …

To Heal, Escape: Using Theatre Arts To Promote Holistic Health In The Clinical Setting, John Filegar

Senior Honors Theses

The purpose of this thesis is to provide an argument for the implementation of theatre arts therapy in the clinical setting. The effects of traditional art therapies involving visual arts, expressive arts, and music on the holistic health of the patient in the clinical setting have been thoroughly researched and understood. However, the extent of the influence of theatre arts therapy on the holistic health of individuals in the clinical setting lacks sufficient evidence and therefore cannot be compared to the influence of traditional art therapies on the holistic health of individuals in the same setting. Following an overview on …

Influence Of Smartphone Diabetic Messaging On Hba1c, Patricia Perryman

Doctoral Dissertations and Scholarly Projects

Associated personal, financial, and societal costs of a diagnosis of Type 2 Diabetes Mellitus impacted over 22 million Americans at a cost of over $245 billion in 2012. The project provided evidence-based outcomes that demonstrated improved HbA1c levels in the intervention group and positive feedback on diabetes related text messages. Ongoing opportunities are available to expand text messaging within the physician network; the potential for replication studies; and the feasibility and effectiveness of text messaging for improving engagement in managing people with T2DM health are also findings within the study.

Teach-Back Methodology To Improve Patient Satisfaction In An Urgent Care Setting, Candi Payne

Doctoral Dissertations and Scholarly Projects

The project used teach-back methodology to provide an evidence-based approach to improve patient satisfaction scores in an urgent care clinic. The teaching plan should include evaluation of patient teaching to determine effectiveness and patient understanding per The Joint Commission (TJC) for Ambulatory Care Center standards. The project was developed to assist nurses (N=12) with an evidence-based method to improve patient understanding and provide an opportunity to ensure comprehension to increase patient satisfaction scores from a one or two to a level three at the end of 30 days following implementation of teach-back. The scores revealed an increase of patient satisfaction …

Pots: Educating School Nurses, Stephanie Sherwood

Doctoral Dissertations and Scholarly Projects

The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident …

Clustering Diabetes Appointments And Education, April Pugh

Doctoral Dissertations and Scholarly Projects

Diabetes impacts the lives of millions of Americans, and the number is growing rapidly every year. Diabetes education has been demonstrated to have a positive impact of the self-management of this chronic disease and effective in the reduction of A1C, weight, and blood pressure. Barriers to attendance at both diabetes education classes and provider appointments are varied with lack of transportation and available time cited as two of the many reasons, especially in the rural and medically underserved regions of the country. The project assessed a process improvement intervention clustering diabetes education with provider appointments to increase attendance and decrease …

Knowledge And Attitudes Of Orthopedic Nurses Regarding Pain Management, Matthew Neumann

Doctoral Dissertations and Scholarly Projects

Nurses are at the forefront in the care of patient pain management; however, many nurses do not possess the knowledge, skills, and attitudes required for best pain management outcomes. Adequate pain management education is often infrequent in academic settings and in post-graduate health care environments. That shortcoming suggests a need to improve pain management education as advocated by The Joint Commission and U.S. Department of Health and Human Services. The purpose of this study is to measure 20 nurses’ knowledge and attitudes regarding pain and pain management while working in an orthopedic setting. It was an evidence-based practice project utilizing …

Perceived Knowledge And Perceptions Of Palliative Care Among Advanced Practice Cardiac Providers, Jordan Vance

Doctoral Dissertations and Projects

Providers of healthcare have continued to focus on addressing patients’ chronic health outcomes. When understanding how to manage chronic disease, there remains many opportunities in facilitation of better management. With such a wide range of individuals who suffer with a chronic condition, better management to address this population is essential. Palliative care aids in accomplishing this task. It was seen that there was a lack of education in relation to palliative care, with perceptions that continued to be a barrier to the utilization of the service. Due to the lack in education, the strongest barrier to palliative care service utilization …

Attitudes Towards Care Of Dying Patients Among Sophomore, Junior, And Senior Pre-Licensure Nursing Students At A Christian University While Controlling For Religiosity, Diane Bridge

Doctoral Dissertations and Projects

There is a need for nurses who can effectively care for dying patients. The purpose of this study was to evaluate the attitudes of nursing students towards providing care of dying patients while controlling for religiosity. The study used a quantitative causal-comparative research design using two administered questionnaires, the Frommelt’s Attitudes Towards Care of the Dying (FATCOD B) and the Duke University Religion Index (DUREL). A convenience sample of 417 residential undergraduate nursing students were used in this study. The sample consisted of 137 sophomore, 142 junior, and 138 senior pre-licensure nursing students who attended a large Christian university located …

Educational Intervention To Improve Self-Efficacy And Self-Care In Patients With Heart Failure, Helen Parke

Doctoral Dissertations and Scholarly Projects

Heart failure is a high mortality, chronic disease that is economically and physiologically costly for patients, caregivers, and society. Heart failure teaching alone is insufficient in meeting the complex self-care needs of the heart failure patient. This project implemented evidence-based teaching methods that are skill-based and problem-solving based to educate heart failure patients in an outpatient setting. The theoretical foundation of this project was Bandura’s theory of self-efficacy and Orem’s theory of self-care. The level of self-care and self-efficacy was assessed before and after the multi-sensory teaching intervention. Self-care and self-efficacy have been studied and shown to be major components …

Study Of Nurses' Attitudes And Practices Towards Pain Evaluation In Nonverbal Patients, Rebekah Lovin

Montview Journal of Research & Scholarship

Pain, and the appropriate treatment of it, has recently come to the forefront of issues addressed with healthcare providers. Since the cornerstone of pain management is an appropriate assessment, methods of accurate pain evaluation are necessary. This need is particularly important in the population of patients who cannot express their pain. While pain assessment tools are available for use with nonverbal patients and hospitals typically mandate the use of one of these tools, actual compliance with such policy may not actually occur. Various barriers, such as education in the use of a tool, time, and the personal views of the …

Mental Health Rehabilitation In Victims Of Sex Trafficking, Kayla E. Freemire

Senior Honors Theses

Human trafficking is a global epidemic that leaves victims with short- and long-term physiological, psychological, and sociological issues. The mental health needs of trafficked persons have become a topic of research in both medical and psychiatric circles. In order to comprehensively understand the mental health consequences of trafficking, the process must be defined and related to the mental health effects on its victims. The specific mental health disorders diagnosed within this population will be discussed. Treatments used currently for this population will be reviewed, along with future treatments presently being researched and evaluated regarding their potential for use in the …

Study Of Nurses' Attitudes And Practices Towards Pain Evaluation In Nonverbal Patients, Rebekah Lovin

Senior Honors Theses

Pain, and the appropriate treatment of it, has recently come to the forefront of issues addressed with healthcare providers. Since the cornerstone of pain management is an appropriate assessment, methods of accurate pain evaluation are necessary. This need is particularly important in the population of patients who cannot express their pain. While pain assessment tools are available for use with nonverbal patients and hospitals typically mandate the use of one of these tools, actual compliance with such policy may not actually occur. Various barriers, such as education in the use of a tool, time, and the personal views of the …

Deaf Access To Healthcare, Jennifer L. Yates

Senior Honors Theses

Modern medical professionals strive to provide culturally competent care; however, Deaf[1] culture remains overlooked. Common language and experience draw deaf individuals together as a cultural group. Ignorance about Deaf culture perpetuates barriers to holistic care in the medical setting. Deaf patients receive misdiagnoses, delayed treatment, and privacy breaches. Deaf culture understandably avoids healthcare and is characterized by numerous health disparities as a result. Obstacles hindering Deaf access to healthcare are directly opposed to the intended therapeutic relationship and holistic care. Increased awareness of Deaf culture is required to improve the Deaf’s access to healthcare.

[1] The word deaf should …

The Mechanism Of Sex Trafficking And What You Can Do About It, Benjamin J. Huebner

Senior Honors Theses

Awareness for sex trafficking is on a steady incline. Many organizations and events help to raise awareness for sex trafficking and often collect money to combat the issue. However, the unfortunate reality is that the public has gained a non-functional awareness of the issue. The public knows about the problem, they know that the number affected is astronomical, and they know that it is ugly, but they know of no tangible way to work toward the solution. Nothing is wrong with donating to an organization that is working to resolve the issue, but people need to be made aware of …

From The Top Down: Assisting Critical Care Nurses In Coping With Job Stresses, Cynthia R. Bryant

Senior Honors Theses

Critical Care nurses are faced with traumatic scenarios on a daily basis at work and are expected to remain professional in the face of chaos. In the midst of caring for their patients and catering to each family’s emotional needs, their own mental health tends to get pushed aside. Nurses are expected to remain supportive to sick patients and their families while enduring psychologically disturbing images and sounds, witnessing phases of the dying process, and hearing end-of-life care decisions being made. Because these nurses are only human, their energy reserves are rapidly depleted and they are left emotionally exhausted. Nurses …

The Benefits Of Breastfeeding, Annagrace E. Anderson

Senior Honors Theses

Breast milk is the gold standard for infant nutrition. In the past, infant formula was promoted as equal or superior to breast milk. However, research has shown that breastfeeding is the superior form of infant nutrition except in rare circumstances. Breast milk provides for all of a newborn’s caloric needs and has the correct balance of nutrients to promote proper development. In addition, breast milk provides protection against illnesses, supports an infant’s immune system, and promotes life-long health for the newborn. Mothers also experience personal benefits by breastfeeding such as decreased cancer risks, bonding with their babies, and faster postpartum …

Cerebrovascular Accident Survival: Strategies Of Flight Nursing And Aeromedical Transport, Alexis Caudle

Senior Honors Theses

Cerebrovascular accidents (CVA), known as strokes, are a leading cause of death worldwide. The delivery and timing of treatment for CVAs is a critical factor in restoring health to the patient. One of the variables in recovery is the method of transport used in bringing the patient to a health care facility. Aeromedical transport remains a valuable resource to achieve full recovery in stroke patients. An ongoing debate of risk versus benefit of helicopter emergency services will be included as well as examination of variables including location, time, physiology of the flight, and the patient’s condition to be scrutinized. In …

Provider Screening For Depression In Patients Post-Myocardial Infarction, Heather Vasioutovitch

Doctoral Dissertations and Scholarly Projects

In this scholarly project, the project leader implemented a chart audit and provider feedback intervention with the aim of improving provider referrals for patients who screened positive for depression—a risk factor in the myocardial infarction (MI) population—with the Patient Health Questionnaire-9 (PHQ-9). The clinical question was developed in order to examine whether the depression-screening tool that was implemented improved provider referrals to the in-house licensed counselor or primary care physician after an educational feedback intervention, focusing on physicians, nurse practitioners (NPs) and physician assistants (PAs). The target population involved cardiology providers and adult patients who experienced a MI, including Non-ST …

The Benefits And Concerns Of Veganism In Women's Health, Elisa R. Hester

Senior Honors Theses

There are many health benefits of consuming a vegan diet. It is associated with a decreased incidence of obesity, cardiovascular disease, type two diabetes, and a variety of cancers. Despite its numerous benefits, there are several concerns for consumers of a vegan diet, including nutrient deficiency and cardiovascular risk associated with consumption of coconut oil. However, many nutrients of highest concern, such as calcium and protein, are not needed in as high amounts as is commonly believed and recommended. Moreover, it is possible for vegans to obtain adequate nutrition with proper education despite restriction of animal products. Coconut oil consumption …

Telemedicine For The American Indian/Alaska Native Population, Janine M. Good

Senior Honors Theses

When compared to other Americans’ health, a worse health status is seen among the American Indian and Alaska Native population. American Indians and Alaska Natives are faced with numerous disparities in healthcare, such as decreased access to healthcare. Additionally, healthcare data about this group are missing. Although health beliefs and traditions can differ among tribes, there are also similarities. Telemedicine is the use of technology (i.e., phone, videoconferencing) to deliver healthcare. This healthcare service may be beneficial for this population’s healthcare needs because of telemedicine’s possible advantages. Although telemedicine also has disadvantages, a knowledge of and respect for American Indian …