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, …

Impacting Nurse Job Satisfaction And Engagement Through Shared Governance, Meghan K. Douglas

Doctor of Nursing Practice Scholarly Projects

Problem: Shared governance (SG) has been identified as an effective process to promote shared decision-making between direct care nurses and nursing leadership. However, barriers were identified at a large hospital system in the Southeastern United States (US) that postponed the full implementation of SG. This prevented nurses from having input on policies and actions that directly affected their work. Purpose: The purpose of this evidence-based project (EBP) was to determine if unit-based SG improved job satisfaction and engagement for nurses on inpatient medical-surgical units at a large hospital system in the Southeastern US. Method: Five medical-surgical units were identified to …

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" …

The Impact Of Mindfulness Meditation Exercises On Managing Stress Among New Graduate Nurses, Sharonda Marshay Jamerson

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Studies reveal, approximately 33.5 % of new graduate nurses suffer from stress and burnout, forcing the nurse to leave the workforce within the first two years of transitioning into the role of a professional nurse (Heins, 2019). The Chief Nursing Officer of a large healthcare system in South Carolina confirms new graduate nurses are suffering from stress and burnout while transitioning into the role of the professional nurse (Personal communication, March 5, 2021). Purpose: The purpose of this project is to provide new graduate nurses' mindfulness meditation exercises to help manage stress as mindfulness meditation has been proven …

The Impact Of Mindfulness Meditation On Registered Nurse Burnout, Kelli R. Scheibenhoffer

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Nurse burnout has been reported in hospitals across the nation and is prevalent around the globe. In 2019, the World Health Organization (WHO) declared nurse burnout a condition calling for recognition and treatment. Nurses working in an inpatient setting may experience higher levels of burnout than in other settings. Hospitals with nurse burnout jeopardize the number of functioning employees, patient safety, and quality of care. Introducing preventative factors such as mindfulness could shield nurses, improve patient care, and cut hospital costs. Purpose: This evidence-based project aimed to determine the effect of using meditation via the Headspace app with …

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 …

The Genome And Gene Editing System Of Sea Barleygrass Provide A Novel Platform For Cereal Domestication And Stress Tolerance Studies, Liuhui Kuang, Qiufang Shen, Liyang Chen, Lingzhen Ye, Tao Yan, Zhong-Hua Chen, Robbie Waugh, Qi Li, Lu Huang, Shengguan Cai, Liangbo Fu, Pengwei Xing, Kai Wang, Jiari Shao, Feibo Wu, Lixi Jiang, Dezhi Wu, Guoping Zhang

Publications

The tribe Triticeae provides important staple cereal crops and contains elite wild species with wide genetic diversity and high tolerance to abiotic stresses. Sea barleygrass (Hordeum marinum Huds.), a wild Triticeae species, thrives in saline marshlands and is well known for its high tolerance to salinity and waterlogging. Here, a 3.82-Gb high-quality reference genome of sea barleygrass is assembled de novo, with 3.69 Gb (96.8%) of its sequences anchored onto seven chromosomes. In total, 41 045 high-confidence (HC) genes are annotated by homology, de novo prediction, and transcriptome analysis. Phylogenetics, non-synonymous/synonymous mutation ratios (Ka/Ks), and transcriptomic and functional analyses provide …

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. …

Absence Of Association Of Tinnitus With Pre-Existing Hypertension: A Population-Based Study, Po-Hsiu Huang, Sudha Xirasagar Mbbs., Ph.D., Jin-Hua Chen, Yen-Fu Cheng, Nai-Wen Kuo, Herng-Ching Lin

Publications

OBJECTIVES: Whether tinnitus is associated with pre-existing hypertension remains uncertain. This study explored the association between tinnitus and pre-existing hypertension. METHODS: We obtained data on a retrospective cohort of 542 884 cases ≥18 years old with a first-time tinnitus diagnosis from Taiwan's National Health Insurance Research Database. We used propensity-score matching to select 542 884 matched controls and performed multiple logistic regression analyses to estimate the adjusted odds of prior hypertension among patients with tinnitus versus controls. RESULTS: Bivariate analysis showed no significant difference in the prevalence of prior hypertension between the tinnitus and no-tinnitus groups (35.58% vs 35.5%, P …

Passive Remote Monitoring And Aging In Place: A Scoping Review, Emily Read, Cora Woolsey, Lorie Donelle, Lori Weeks, Norma Chinho

Publications

Passive remote monitoring is a relatively new technology that may support older adults to age in place. However, current knowledge about the effectiveness of this technology in extending older adults' independence is lacking. Therefore, we conducted a scoping review of studies examining passive remote monitoring to systematically synthesize evidence about the technology's effectiveness as an intervention. Our initial search of Embase, CINAHL, PubMed, and Scopus databases identified 486 unique articles. Of these, 14 articles met our inclusion criteria. Results show that passive remote monitoring technologies are being used in innovative and diverse ways to support older adults aging in place …

Covid Information And Masking Behaviors In U.S. Adolescents: Findings From The Adolescent Brain Cognitive Development (Abcd) Study, Jason M. Nagata, Kyle T. Ganson, Jingyi Liu, Khushi P. Patel, Josephine C. Tai, Stuart B. Murray, Kirsten Bibbins-Domingo

Publications

Adolescents are particularly vulnerable to health misinformation and are at risk for suboptimal adherence to protective health behaviors in the COVID-19 pandemic. Guided by factors consistent with the theories of planned behavior and rumor transmission, this study sought to analyze the impact of multiple information sources, including social media, television media, internet and parental counseling, on masking behaviors in adolescents. Responses from the December 2020 COVID-19 survey, representing 4,106 U.S. adolescents ages 12-14 from the Adolescent Brain Cognitive Development Study (ABCD) were analyzed. The majority of parents (61.1%) reported counseling their children on the importance of wearing masks all the …

The Association Between Lung Cancer Stigma And Race: A Descriptive Correlational Study, Karen Kane Mcdonnell, Lisa A. Webb, Swann A. Adams Ph.D., Ms, Face, Tisha M. Felder Phd, Msw, Rachel E. Davis Ph.D.

Publications

BACKGROUND:

Stigma is a formidable burden for survivors of lung cancer that can reduce the quality of life (QOL), resulting in physical, social and psychological challenges. This study investigates associations between stigma and depression, QOL and demographic and health-related characteristics, including race.

DESIGN:

An adapted conceptual model derived from the Cataldo Lung Cancer Stigma Scale guided this descriptive correlation study assessing stigma in African American and Caucasian survivors of lung cancer. Self-reported, written surveys measuring depression, QOL, lung cancer stigma and demographics were administered. Statistical analysis was conducted to assess associations between stigma and depression, stigma and QOL and stigma …

Assessment Of Vitamin D Among Male Adolescents And Young Adults Hospitalized With Eating Disorders, Jason M. Nagata, Anna Grandis, Paola Bojorquez-Ramirez, Anthony Nguyen, Amanda E. Downey, Kyle T. Ganson, Khushi P. Patel, Vanessa I. Machen, Sara M. Buckelew, Andrea K. Garber

Publications

PURPOSE: Medical complications of eating disorders in males are understudied compared to females, as is the case of vitamin D deficiency. The aim of this study was to assess vitamin D levels among male and female adolescents and young adults hospitalized for medical complications of eating disorders. METHODS: We retrospectively reviewed electronic medical records of patients aged 9-25 years (N = 565) admitted to the University of California, San Francisco Eating Disorders Program for medical instability, between May 2012 and August 2020. Serum vitamin D (25-hydroxy) level was assessed at admission as was history of prior calcium, vitamin D, or …

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 …

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 …