Nursing Commons^™

Implementation Of A Bowel Management Care Bundle On The Spinal Cord Injury Patient Population During Acute Recovery, Jessica Rene Baldwin

Doctor of Nursing Practice Scholarly Projects

Over 17,000 Americans suffer from spinal cord injuries (SCI) annually. Although the loss of motor function is a blatantly obvious sequela, the loss of autonomic nervous system control, and its direct effects on various body systems, is scarcely understood. The most frequently reported impairment associated with SCI-related bowel dysmotility is Neurogenic Bowel Dysfunction (NBD), affecting approximately 20-60% of the SCI population. NBD is defined as slow colonic time and is hallmarked by constipation and often impaction, leading to life-threatening complications, such as bowel obstruction, fecal impaction, autonomic dysreflexia, and even death. Identifying dysmotility within the SCI patient population and early …

Preventing Pressure Injuries In Prone Positioned Patients In The Critical Care Unit, Tyler Dashiell Huddle

Doctor of Nursing Practice Scholarly Projects

Problem statement – Pressure injuries acquired by critical care patients in the prone position negatively impact their health, increases the length of stay, increases medical costs, decrease hospital reimbursement, and result in poorer patient outcomes.

Purpose – Determine if implementing a checklist before the prone position maneuver and maintenance skincare thereafter decreases pressure injuries in prone-positioned critical care patients.

Methods – Pre-intervention data will be collected retrospectively, and post-intervention data will be gathered in a seasonally similar timeframe for critical care patients in the prone position and the incidence of pressure injuries.

Inclusion criteria – All patients in the critical …

Integration Of The Respiratory Distress Observation Scale For Patients At The End Of Life, Alexandra Mackenzie Starnes

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Dyspnea is a distressing phenomenon experienced frequently in end-of-life patients. Nurses currently rely on their own experiences and observations of other nurses to guide their assessment and treatment of dyspnea. Lack of a standardized tool may lead to inconsistencies and inadequate care.

Purpose: Determine if the implementation of the RDOS will improve the nurses’ ability and self-reported comfort levels to assess and treat respiratory distress in patients at the end of life adequately and consistently.

Methods: A pre-test and post-test design evaluated nurses’ ability and self-reported comfort levels assessing and treating respiratory distress in end-of-life patients. Nurses rated …

A Bedside Handoff Tool To Enhance Fall Safety Measures In The Emergency Department, Isha Adora Godbold

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The Emergency Department (ED) is a fast-paced environment where the risk of communication failure enhances due to the variation in patient acuity, variety of shift options, and constant interruptions (White- Trevino & Dearmon, 2018). Ineffective communication can lead to increased adverse events, medical errors, and poorer patient health outcomes (Campbell & Dontje, 2019). Additionally, medical errors, such as falls, are more likely to occur during handoff when nurses change shifts (Campbell & Dontje, 2019). The most reoccurring medical error in the ED is patient falls.

Purpose: This quality improvement project aims to introduce a structured handoff rounding

tool, …

Take A Seat To Improve Patient-Centered Communication, Emma E. El-Shami

Doctor of Nursing Practice Scholarly Projects

Problem Statement: At a hospital in Upstate South Carolina, the patient experience surveys identify nurse-patient communication on the post-operative unit needs improving. Over three months of Summer 2021, 83.5% of patients reported that their nurses listened carefully, 82.4% stated there was comfort with talking with nurses, and 80.8% of patients reported that nurses explained things in a way they could understand. Purpose: This project aims to determine if the "Commit to Sit" Initiative compared to usual practice will affect patient satisfaction scores. Methods: Nurse-patient communication components of the patient satisfaction survey were assessed before and after the "Commit to Sit" …

Impacting Rn Intent To Leave By Developing Emotional Intelligence In Frontline Nurse Leaders, Kristin W. Smith

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Registered Nurse (RN) turnover is defined as the frequency at which RNs leave the organization within a specified timeframe (Shimp, 2017). Turnover can correlate negatively to patient satisfaction and outcomes, mortality, and overall healthcare costs (Copanitsanou et al., 2017). Frontline leaders, especially those with high emotional intelligence (EI), can have a significant positive influence over RN turnover, yet there is little focus or standard approach on frontline leader EI development (Mansel & Einion, 2019).

Purpose: This DNP project aims to determine if providing professional development focused on emotional intelligence to frontline nursing leaders will impact RN intent to …

Organizational Readiness For Implementing A Postpartum Depression Screening Protocol In The Nicu, Deanna L. Suber

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Postpartum depression (PPD) is a major depressive disorder that is the most common complication following childbirth, occurring in about 16% of new mothers (Berns et al., 2021). Mothers with infants in the Neonatal Intensive Care Unit (NICU) are 40% more likely to develop PPD but are not typically screened for this complication (Berns et al., 2021; Cherry et al., 2016; Garfield et al., 2021). Implementing a PPD screening protocol in the NICU could help increase the detection of PPD in this population but would first require an evaluation of organizational readiness to ensure sustainability. Purpose: The purpose of …

Evaluating The Use And Effectiveness Of Digital Mental Health Resources For Acute Care Nurses, Ashley M. Turbyfill

Doctor of Nursing Practice Scholarly Projects

Statement: The burnout phenomenon has been exacerbated over the last almost two years due to the COVID-19 pandemic (Maunder et al., 2021). Healthcare organizations must respond by implementing evidenced-based mental health initiatives to increase staff coping skills to reduce stress and emotional exhaustion (Galanis et al., 2021). While the project organization can access large-scale aggregate data about resource usage and its overall mental well-being, they cannot assess what percentage of users are nurses and the personal impact on their mental well-being. Due to these limitations, the organization cannot gauge how the nursing staff uses and responds to offered resources. …

Hybrid-Based Cardiac Rehabilitation: Improving Enrollment, Attendance, And Completion Rates, Victoria S. Yandle

Doctor of Nursing Practice Scholarly Projects

Problem: Barriers exist to enrolling and attending a cardiac rehabilitation (CR) program for patients who have recently experienced a cardiac event. These barriers include insurance status, cost, location, availability, convenience, and transportation. Increasing accessibility to CR through the provision of a hybrid-based cardiac rehabilitation (HBCR) program provides an alternative option that may improve enrollment, attendance, and completion rates in the CR program by removing the barriers of location and transportation. Purpose: The purpose of this project was to determine if a HBCR program was feasible for improving overall enrollment, attendance, and participation rate at Prisma Health Heart Hospital (PHHH). Methods: …

Using A Clinical Reminder Tool To Impact Vitamin D Screening, Mercy Roy

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Chronic pain patients with widespread musculoskeletal pain are not adequately screened for possible vitamin D deficiency by healthcare providers. Purpose: This quality improvement project (Q.I.) aimed to improve the screening rates for vitamin D among healthcare providers by implementing a clinical reminder tool within the documentation section of the electronic medical records (EMRs) in an outpatient federally funded pain clinic located in the Southeastern region of South Carolina. Methods: A clinical reminder template was embedded within the EMR documentation to increase screening for vitamin D levels for chronic pain patients among healthcare providers. Data were collected six weeks …

Effects Of Postcode Debriefing On Nursing Burnout And Patient Survival In The Emergency Department: A Single-Center Quality Improvement Project, Margaret Anne Lee

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Emergency department (ED) nurses are routinely exposed to stressful events, including cardiac arrest codes. The American Heart Association stresses the importance of structured debriefing as a continuous quality improvement strategy for patient care. Furthermore, literature shows that debriefing after codes is associated with improved teamwork, decreased nursing burnout, and reduced staff turnover. Purpose: This quality improvement project implemented a structured postcode debriefing tool in the ED after codes to determine if it improved nurse burnout and patient survival rates. Methods: A structured postcode debriefing tool was administered after codes in the ED. All registered nurses employed in the …

Decreasing Pressure Injuries From Respiratory Devices In The Pediatric Intensive Care Unit, Samantha Nicole Elliott

Doctor of Nursing Practice Scholarly Projects

Problem: Patients developing pressure injuries while admitted to the hospital has become a nationwide problem. The national annual cost of treating pressure injuries is $11 billion dollars, with up to $70,000 dollars for stage four pressure injuries (Cooper et al., 2020).

Purpose: The purpose of this project was to implement the use of a silicone foam dressing under respiratory devices, monitored using kamishibai cards (k-cards) to decrease pressure injuries. K-cards are a rounding tool that staff can use to identify barriers that prevent the standard of care.

Intervention: A pre-study, three-month period, was compared to the implementation period in the …

Enhancing Quality Of Life For Ovarian Cancer Patients, Kelly Marie Liguori

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Ovarian cancer is associated with a delayed onset of symptoms and late diagnosis and therefore has increased morbidity and mortality (Momenimovahed et al., 2019). These patients face multiple health complications, frequent hospital admissions, and may suffer from an overall poor quality of life (Marks, 2020). Purpose: This project aimed to determine if implementing FACT-O, a patient-reported quality-of-life screening tool, led to increased pastoral care consults and patient-reported quality-of-life for ovarian cancer patients. Methods: Iowa Model of Evidence-Based Practice was used for this project. Upon admission to 3Tower at CMC Main during a 3-month period, all patients with ovarian …

Screening For Prediabetes In The Inpatient Setting, Mikayla Jordan Moore

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Many patients that utilize the hospital system do not see a primary care provider and, therefore, miss important screenings. The hospital system can provide convenient screenings, or screenings conducted whenever a patient encounters the health system regardless of their chief complaint (Obinwa et al., 2020).

Purpose: Determine whether convenient prediabetes screenings administered to admitted patients on an Intermediate Critical Care Unit (ICCU) detect prediabetes at a higher rate than no formal screenings.

Methods: Participants will be sampled from those admitted to an intermediate critical care unit at a large acute-care facility.

Inclusion Criteria: Any adult patient (>18 …

Systematic Review Of Functional Outcomes In Cancer Rehabilitation, Alix Sleight, Lynn H. Gerber, Timothy F. Marshall, Alicia Livinski, Catherine M. Alfano, Shana Harrington Pt, Ph.D., Ann Marie Flores, Aneesha Virani, Xiaorong Hu, Sandra A. Mitchell, Mitra Varedi, Melissa Eden, Samah Hayek, Beverly Reigle, Anya Kerkman, Raquel Neves, Kathleen Jablonoski, Eileen Danaher Hacker, Virginia Sun, Robin Newman, Karen Kane Mcdonnell, Allison L'Hotta, Alana Schoenhals, Nicole L. Stout

Faculty Publications

Objective

To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive function in adults with a history of cancer and describe the breadth of evidence as well as strengths and limitations across a range of functional domains.

Data Sources

PubMed, Cumulative Index to Nursing and Allied Health Plus, Scopus, Web of Science, and Embase. The time scope was January 2008 to April 2019.

Study Selection

Prospective, controlled trials including single- and multiarm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included, if studies included a primary functional outcome measure. …

Establishing A New Graduate Nurse Peer Mentoring Program, Teresa Biediger Bowers

Doctor of Nursing Practice Scholarly Projects

Problem Statement: New Graduate Nurses (NGN) report increased stress, likely due to decreased confidence and social support (Frogeli et al., 2019). The most current NGNs are disadvantaged as much of their undergraduate clinical experience has been affected by the COVID-19 pandemic (Smith et al., 2021). At the end of their residency, information gathered from former NGNs suggested they feel they need "more support" during the residency. Purpose: The purpose of this quality improvement project was to determine if the addition of a peer mentor to the already existing nurse residency program would improve nurse confidence, job satisfaction, and intent to …

A Nursing-Driven Delirium Protocol, Alexandria Gray Bridges

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Delirium is a common, often preventable, condition in hospitalized patients and is associated with increased complications, worse outcomes, increased risk of death, and increased health care costs. Purpose: The purpose of this project was to determine if, utilizing a nursing-driven, non-pharmacological intervention, based on the NICE Guidelines, can decrease the incidence of delirium. Methods: Using the Iowa Model of Evidenced Based Practice to Promote Quality Care (Iowa Model), an EBP project was implemented. Patients were identified as being at risk of delirium using The Confusion Assessment Method (CAM) and these patients received the non-pharmacologic intervention as part of …

Assessing The Readiness Of Chf Patients To Use The Medisafe App To Increase Medication Adherence, Janet Lynn Kubas

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Heart failure (HF) is a complex cardiovascular disease that affects 6.2 million Americans and is associated with high morbidity and mortality, with almost 400,000 deaths annually. Medication adherence in HF can lower the risk of death and rehospitalization. As many as 46% of heart failure patients have medication nonadherence. The 2021 Update to the 2017 American College of Cardiology Expert Consensus Decision Pathway for Optimization of Heart Failure Guidelines recommends smartphones or other mobile health (mHealth) applications (apps) for medication adherence tracking. Purpose: This evidence-based practice project aimed to assess the readiness of HF patients admitted to an …

Improving Self-Efficacy In Heart Failure Care, Tracy Bennett Mcleod

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Heart Failure contributes significantly to the morbidity and mortality of the adult population and is one of the leading causes of 30-day readmissions. The cost of heart failure is a substantial healthcare burden. Purpose: The purpose of this project was to determine if implementing the “Rise Above Heart Failure” educational program would improve heart failure knowledge, weight monitoring, and reduced re-admission rates in heart failure patients. Methods: A pre-test and post-test survey named The Dutch Heart Failure Knowledge Scale was utilized. Van der Wal, Jaarsma, Moser, and Van Veldhuisen (2005) developed this questionnaire to evaluate patients' knowledge. The …

The Use Of A Clinical Pathway To Increase Child Abuse Screenings Of Young Children With Fractures, Stephanie Li Schaller

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Nationally, infants and young children who present to emergency departments with fractures are not being screened adequately for possible physical abuse with a skeletal survey (Paine & Wood, 2018; Shelmerdine et al., 2014; Wood et al., 2019). Without universal screenings, implicit bias along racial and socioeconomic lines becomes a factor in deciding which children with fractures get screened, resulting in either under-or over-utilization of skeletal survey screenings (Kim et al., 2017; Paine & Wood, 2018). When child abuse is not diagnosed correctly, further abusive injuries or death can occur (Ravischandiran et al., 2010). Purpose: This evidence-based practice project …

Patient Activation In Individualized Coaching For Congestive Heart Failure Patients, Jessica Marie Thomas

Doctor of Nursing Practice Scholarly Projects

Adult patients diagnosed with congestive heart failure suffer from high hospitalization rates, recurrent readmissions, decreased quality of life, increased healthcare expenditures, and increased mortality. This project aimed to determine if individualized coaching plans based on patients’ activation scores impacted emergency room visits and hospital readmissions. A pretest-posttest design was used. The 13-item Patient Activation Measure® (PAM®) tool was administered before and after completing 30-day individualized coaching. Seventy-five participants were recruited from referrals to the outpatient Continuum Case Management (CCM) program. Inclusion criteria included English-speaking adult patients diagnosed with congestive heart failure 18 years of age. The intervention consisted of individualized …

Pediatric Patients In Diabetic Ketoacidosis: A Pathway To Improvement, Rebecca Russell Vincent

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Pediatric patients in diabetic ketoacidosis (DKA) frequently present to non-pediatric specific care centers initially for medical management where providers may or may not be familiar with standards and treatment guidelines particular to this specialty population. Purpose: The purpose of this project was to establish a pediatric DKA clinical pathway (CPW). Pediatric patients require precise treatments tailored to age and weight specifications. A pediatric DKA CPW identifies treatment order sets, goals, and outcomes customized to the patient’s metabolic demand. Commonalities within a predictable course of treatment for patients with a shared clinical diagnosis result in accelerated care, improved patient …

The Impact Of Nurse-Patient Engagement With Health Information Technology On Patient Portal Usage, Quyen Thuy Vo

Doctor of Nursing Practice Scholarly Projects

The patient portal, a Health Information Technology (HIT) tool, was created to promote patient engagement with available health information to improve health outcomes. Low patient portal use of available educational interventions with a HIT tool is an identified problem at a rural hospital in North Carolina. Low usage could be related to nurses’ unfamiliarity with HIT tools. This DNP project provided nursing staff with a flipped classroom learning module on utilizing available HIT tools within the hospital setting, increasing nurses’ engagement with the patient portal. A sample of Registered Nurses (RNs) from two units who were previously taught to utilize …

Bridging The Gap: Improving Hypertension In African American Women And Preventing Cardiovascular Disease, Latoshia Danielle Williams

Doctor of Nursing Practice Scholarly Projects

Problem Statement: There is a disproportionate number of African American women (AAW) diagnosed with hypertension (HTN) with modifiable health and behavior risk factors that contribute to cardiovascular disease (CVD). Purpose: The purpose of this DNP project was aimed at evaluating if a 12-week educational program using Life Simple 7 guidelines from the American Heart Association (AHA) within a primary care facility for adults diagnosed with hypertension and who are overweight would reduce blood pressure, body mass index, and increase knowledge regarding hypertension. Methods: A pretest and posttest intervention design was utilized to determine the outcomes of this study. The setting …

Adolescent Mothers And Kangaroo Mother Care: A Scoping Review, Genna K. Rivers, Robin B. Dail Phd, Rn, Faan, Robin Dawson Phd, Rn, Cpnp-Pc

Senior Theses

Kangaroo mother care (KMC), the practice in which mothers hold their infants skin-to-skin against their bare chest, can increase bonding and attachment between mothers and their infants. However, there is not much research on the benefits of KMC within the adolescent or teen mother population (13-19 years old). The purpose of this scoping review was to identify how common KMC is within the teen mother population, determine how KMC varies based on social determinants of health and race/ethnicity within the adolescent mother population, and how KMC impacts adolescent mothers’ maternal attachment and bonding with their infants. PubMed and CINAHL databases …

The Effect Of Provider-Patient Racial Concordance On Student Health Services, Sophia B. Gilliam

Senior Theses

Objective: This research aimed to evaluate the effect of provider-patient racial concordance on perceived care received by University of South Carolina students at Student Health Services.

Methods: A total of 173 students at the University of South Carolina Columbia campus who have received care from Student Health Services within the past 2 years participated in the study. Participants were questioned about their experience with Student Health Services using an adaptation of the CAHPS® Clinician & Group Survey Version 3.0. Independent samples t-tests and descriptive analyses were used for comparisons between the 25 non-white respondents and a randomly selected proportionate group …