Nursing Commons^™

Diabetes Device Knowledge And Confidence Among School Nurses: A Mixed Methods Study, Cassandra F. Moffitt

Nursing Theses and Dissertations

Problem: Type 1 diabetes is one of the most common chronic medical conditions in childhood. While manageable, these children may spend half of their day in the school setting and often need assistance from a school nurse to manage their care.

Theory: Bandura’s Social Cognitive Theory (1977) served as the theoretical framework for this study.

Research Questions: The research questions explored knowledge, confidence, and additional predictors of confidence related to diabetes devices.

Design/Methods: An explanatory sequential mixed methods design was used. The Diabetes Device Confidence Scale (DDCS) was used to measure device confidence, while Subscale 10 of the KAT-1 instrument …

“Everybody Has A Soul”: People With Dementia And Nursing Students Co-Creating Life Stories, Beth Mastel-Smith, Michelle Kimzey, Amy Ahlbrand Robinson, Melinda Hermanns

Nursing Faculty Publications and Presentations

Lack of meaning and purpose in life can increase disability, stress, mortality, and the risk of cognitive impairment. Finding meaning and purpose helps people with dementia adjust to the diagnosis and can be accomplished via expressions of identity such as life review, a formal process of systematically reviewing and reflecting on one’s lived life. Digital storytelling involves telling a story using computer technology to record and share an individual’s narrative. The purpose of this study was to understand the perceived benefits of nursing students and people with dementia (the mentors) described after digitally co-creating the mentors’ life story. Allport’s Intergroup …

Examining Well-Being And Healthy Lifestyle Interventions Among Nursing Students Worldwide: A Scoping Review, Christine S. Gipson, Belinda Deal, Michael Skinner

Nursing Faculty Publications and Presentations

Purpose: The purpose of this scoping review was to identify intervention studies related to well-being and healthy lifestyles in nursing students to identify research gaps in the literature for future research. Methods: The review followed the Joanna Briggs Institute (JBI), JBI Manual for Evidence Synthesis, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. Five databases were searched to retrieve the articles assessed by this review: APA PsycINFO, CINAHL Complete, PubMed, Scopus, and Web of Science. Inclusion criteria included articles with a sample population of nursing students; addressed the well-being, wellness, health, or healthy lifestyle(s) …

Preceptor Toolkit Effects On New Graduate Nurse Orientation Experience, Ashley Dunnier

MSN Capstone Projects

The role of the nurse preceptor is vital to the successful onboarding of new graduate nurses to the organization. By focusing on preceptor support methods in addition to the established nursing preceptor programs, organizations can improve the nurse preceptor’s confidence and competency levels. The opportunities for improvement, solution recommendation, timeline, and associated costs are provided in this summary.

Many organizations have seen an increase in new graduate nurses leaving their jobs within their first year of hire. The transition period of new graduate nurses is often a period of transition shock while they acclimate into professional practice from academia (Fink …

Improving Palliative Care Knowledge In The Acute Care Setting, Laura C. Brumett

MSN Capstone Projects

Aim: The aim of this paper is to present an education intervention for bedside nursing staff to improve their palliative care knowledge and the end-of-life care provided for terminally ill patients.

Background: When dying in the hospital, patients experience higher discomfort, lower quality of life, and prolonged family grieving. Suffering worsens when patient needs are unmet and can contribute to a traumatic death. Providing end-of-life education will increase a nurse’s knowledge of palliative care, address knowledge gaps, and promote better patient outcomes through improved clinical practice.

Design: The proposed intervention has three prongs which include: (1) virtual training using the …

Combating Dehydration In The Dementia Patient, Crystal L. Widemon

MSN Capstone Projects

Dehydration is a prevalent global health issue impacting individuals across all demographics, with the elderly—especially those suffering from dementia—being particularly vulnerable. As the elderly population grows and dementia rates increase, addressing dehydration becomes crucial to reduce hospitalizations, mitigate healthcare costs, and enhance patient well-being. This executive summary outlines a proposed intervention aimed at improving fluid intake among elderly dementia patients residing in residential care facilities.

Research indicates that dehydration significantly impacts the health and financial costs associated with dementia care. Studies have shown that dehydration exacerbates cognitive decline and behavioral symptoms in dementia patients, leading to increased dependency and healthcare …

High Nurse To Patient Ratio (Npr) Effect On Nurse Job Dissatisfaction And Burnout, Edirin Mofoye

MSN Capstone Projects

This project explores the critical importance of optimal nurse-to-patient ratios in acute care settings, emphasizing their impact on nurse burnout, job dissatisfaction, and overall patient care quality. Analysis shows the necessity for healthcare institutions to reassess and adjust staffing practices to enhance both employee well-being and patient outcomes (Lasater et al., 2021). Evidence based practice reveals that balanced nurse-to-patient ratios lead to reduced nurse burnout, increased job satisfaction, and improved patient care and satisfaction (White et al., 2019). To achieve these outcomes, I recommend implementing evidence-based staffing models tailored to different units' specific needs, conducting regular employee satisfaction surveys to …

Developmental Positioning In The Nicu, Megan Litteken

MSN Capstone Projects

For at least the past decade, one in ten infants born in the United States have delivered prematurely or before the 37^th week of gestation (March of Dimes, 2024b). As a result, there are a variety of both short- and long-term effects on the infant that include both physical and neuromotor developmental delays requiring follow-up after discharge (March of Dimes, 2024b). The extent of these delays depends on how early the infant is born and any associated congenital factors; however, the care provided in the Neonatal Intensive Care Unit (NICU) may help reduce the effects or length of these …

Women's Experience Of Cancer Treatment During Covid-19 On The Texas-Mexico Border, Kayla E. Castañeda

Nursing Theses and Dissertations

The COVID-19 pandemic exposed existing racial, ethnic, socioeconomic, geographic, and gender disparities in cancer care and highlighted the need for more research in understudied populations. No studies have elucidated the experience of women living on the Texas-Mexico border receiving cancer treatment during the pandemic. This study explored the lived experience of receiving cancer treatment during the COVID-19 pandemic in 2020 for women living on the Texas-Mexico border and identified participants' self-identified unmet needs while receiving cancer treatment during the COVID-19 pandemic on the Texas-Mexico border. Following IRB approval and informed consent, ten women living on the Texas-Mexico border who received …

Validation Of A Tool To Evaluate Nursing Students’ Electronic Health Record Competency In Simulation, Susan Mcbride, Laura Thomas, Sharon Decker, Matthew Pierce, Shelley Burson, Huaxin Song, Katie Haerling (Adamson)

Nursing Faculty Publications and Presentations

AIM

The aim of the study was to establish reliability and validity of the Competency Assessment in Simulation of Electronic Health Records (CASE) tool.

BACKGROUND

Effective teaching and learning practices, including valid and reliable assessment of students’ electronic health record (EHR) competency, contribute to safe, high-quality, efficient nursing care.

METHOD

The study used a mixed-methods design to test reliability and validity of the CASE tool. RESULTS A nationally representative sample of faculty from universities representing 27 states provided scores for videos using the CASE tool. Forty-seven participants completed the first scoring survey; 22 of the 47 participants (47%) completed the …

Social Determinants Of Health And Psychological Capital Among Youth Experiencing Homelessness, Angela J. Preston, Lynn Rew, Jason Spees

Nursing Faculty Publications and Presentations

Background: Social determinants of health affect health behaviors and outcomes. Youth experiencing homelessness suffer significant deprivation of resources such as inadequate housing, reduced education, poor health care, and decreased economic stability. Inner resources, such as psychological capital, may also be related to health behaviors and health outcomes. Objective: In this study, we sought to describe and explore associations among selected determinants of health and self-reported scores on indicators of psychological capital among youth experiencing homelessness. Methods: This cross-sectional secondary analysis was conducted with a randomized subsample of 148 youth. We calculated chi-square frequencies to describe the data, classical item analyses …

Dnp Final Report: Addressing Incivility In Nursing Education: An Evidence-Based Practice Project, Michelle L. Forgy

DNP Final Reports

Incivility in nursing education remains a pervasive issue, necessitating effective interventions to address its impact on students and faculty. This project was conducted to address a perceived problem of incivility in a nursing school in northeast Texas. Guided by the Johns Hopkins evidence-based practice model, an evidence search followed by critical appraisal was undertaken to determine the most effective intervention to combat incivility within the nursing school. Because the project included no experimental procedures and did not pose physical or emotional risks to nursing students or faculty, the organizational IRB approved the project. An evidence-based educational session incorporating cognitive rehearsal …

Dnp Final Report: Central Line Dressing Change Regimen To Decrease Central Line-Associated Bloodstream Infections, Ann Campbell

DNP Final Reports

Central line associated bloodstream infections (CLABSI) are dangerous and costly occurrences in healthcare facilities. This evidence-based project's purpose is to implement interventions to reduce CLABSIs in a healthcare facility that has higher than the national average of reported cases. The practice problem PICOT question is: In inpatients with indwelling central venous access devices at the facility, (P) how does implementation of evidence-based guidelines for central line dressing changes every seven days and as needed (I) compared to the current practice of dressing changes on Fridays (C) affect CLABSI rates over a three-month period (O). The body of evidence obtained in …

Dnp Final Report: Balancing Self-Care And Patient Care: An Intervention To Enhance Well-Being For Acute Care Nurses, Robert V. Rose Jr.

DNP Final Reports

This project delves into the profound impact of the COVID-19 pandemic on healthcare and nursing, focusing on the well-being of nurses within the context of acute care settings. Poor well-being leads to increased levels of burnout and the evidence-based practice project aimed to increase the perception of well-being.

The formulated PICOT question driving this project was: In acute care nurses (P), how does the use of Acceptance and Commitment Therapy (ACT) program (I) compared to no Acceptance and Commitment Therapy (ACT) (C) impact nurses’ perception of well-being (O). The evidence substantiates that ACT interventions effectively elevate perceptions of well-being, as …

Dnp Final Report: Effects Of Open-Access Scheduling On Patient No-Show Rates In An Outpatient Clinic, Maria Aileen A. Wilkinson Msn, Mba, Rn

DNP Final Reports

No-show rates in a South Texas outpatient clinic have been as high as 16% to 20% which increases wait times to be seen in the clinic and decreases patient access to outpatient care. This no-show rate data has continued despite multiple interventions that have been implemented in an academic health science center. Physical, socio-economic, geographic, and health/lifestyle factors affecting no show or missed appointments are crucial to determining the most appropriate interventions to alleviate this issue. No-show rates are important metrics to improve because it directly affects the organization's revenue, access to care, and appointment wait times. Research evidence regarding …

Dnp Final Report: Double Gloving As Part Of The Surgical Site Infection Prevention Bundle For Colorectal Surgeries, Dave P. Calubaquib

DNP Final Reports

Surgical site infection (SSI) is the costliest healthcare-acquired infection that encompasses around three to ten billion dollars annually. The costs do not include the societal challenges and personal losses that patients endure when they have SSI. The evidence-based project revolves around decreasing SSI among colorectal surgical patients with a PICOT question: In patients having colorectal surgery, how does an educational project regarding double gloving for reducing SSIs, compared to no educational project, improve compliance rates for double gloving? The evidence recommends that double-gloving techniques among surgical members (surgeon, surgical assistant, and scrub techs/nurses) during surgery prevent SSI. The project utilized …

Nurses' Perceptions Regarding Supportive Care In The Neonatal Intensive Care Unit, Brandi D. Garrett

Nursing Theses and Dissertations

NICU nurses are the primary supporters of NICU families and their infants, making it vital that nurses understand the impact of a NICU visit on families and how to improve the parental experience. The complex challenges begin at the NICU admission, where families are left bewildered and unprepared for the uncertainty that lies ahead. During the NICU stay, nurses support families by providing encouragement and empowerment as they navigate their new role as NICU parents. In addition, NICU nurses are advocates for supportive initiatives to help NICU families cope with challenges such as being away from their infant and better …

Electronic Health Records: Using Polarity Thinking To Explore The Relationship Between Technology And Nursing Practice, Debra Winckler

Nursing Theses and Dissertations

Building a robust information technology infrastructure has been recognized as integral in addressing national concerns about patient safety, healthcare quality, and healthcare costs. Federal efforts to promote the nationwide adoption and integration of electronic health records (EHRs) include the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which provided over $27 billion in federal incentives to healthcare organizations and providers to incorporate EHRs into healthcare practices. Medicare and Medicaid Electronic Health Record Incentive Programs, initiated in 2011, were enacted to expand EHR functionality, encourage EHR system upgrades, and establish nationwide use of certified EHR technology. Subsequently, …

Dnp Final Report: Resilience Training For Entry-Level Bachelor Of Science In Nursing Students: An Evidence-Based Practice Project, Ashley N. Goar

DNP Final Reports

Nursing students have moderate to high levels of stress due to responsibilities, high expectations, course grades, and clinical requirements. The practice problem identified for this evidence-based practice project was that undergraduate nursing students had elevated levels of stress but did not know how to manage it. Multiple interventions have been used to address the problem, including positive thinking, mindfulness, resilience training, and distraction-focused therapies. The PICOT question “Will resilience training (I) for entry-level BSN students (P) affect stress (O) in less than three months (T)?” was developed to guide the systematic search for evidence. Based on the evidence, one hour …

Dnp Final Report: Increasing Rapid Response Activations, Carlton J. Rojas Jr

DNP Final Reports

In 2008, facilities were encouraged to develop an emergency response system. A system in which nurses could activate a team of specialists directed to the bedside of a patient with a deteriorating condition. Despite this initiative, nurses and hospital staff have failed to recognize deterioration and correctly activate a rapid response. The clinical problem: Nurses are failing to recognize patient deterioration and activate a rapid response. The practice question was, what will increase rapid response activations? This DNP Project focused on increasing the identification of patient deterioration and activation of the rapid response team. A systematic review of the literature, …

Cognitive Behavioral Therapy To Prevent Nurse Burnout In Sub-Saharan Africa, Anna C. Johnson

MSN Capstone Projects

Overall, burnout prevention has been shown to foster nurse resilience, ability to cope with stressors, teamwork, and improving the personal value of “doing good” and “being good”; the effects have been shown to last between 6 months and one year. The current evidence is strong enough to recommend a change to current nursing practice via annual Cognitive Behavioral Therapy (CBT) trainings to strengthen nurse resilience.

This researcher proposes to implement a CBT-based burnout prevention program in Ghana’s capital of Accra in sub-Saharan West Africa. There is ample evidence that African nurses face many of the same burnout issues that nurses …

Educational Campaign: Using Exercise To Prevent Postpartum Depression, Ruth Platt

MSN Capstone Projects

Postpartum depression is one of the most common medical ailments surrounding childbirth. It affects up to 20% of postpartum women and has detrimental effects not only on the mother but her infant and family as well (Navas et al., 2021). Currently, the medical community takes a reactive approach to postpartum depression by screening and treating cases of postpartum depression as they occur. An evidence-based search of peer-reviewed articles found that exercise in the perinatal period had a positive effect on maternal mental health and decreased postpartum depression scores. This is especially true for women who have a history of depression …

Reducing Central Line Infections In Pediatric Critical Care Patients, Callie Lazarine

MSN Capstone Projects

The purpose of this project is to show how early identification of patients who are at high risk for developing central line infections has an impact on infection rates, and how prevention strategies directed towards that patient population could lead to positive patient outcomes and a decrease in central line-associated bloodstream infections (CLABSI). Central line infections are a major hospital-acquired condition within hospital settings. In pediatric critical care areas, central venous catheters are inevitable due to complex diagnoses, patient size, and small vessels. However, CLABSIs have a massive impact on pediatric patients increasing mortality from 4% to 37%, prolonged hospital …

A Benchmark Project On Early Mobility In The Intensive Care Unit, Millicent Odhiambo

MSN Capstone Projects

Introducing early mobility interventions in the Intensive Care Unit (ICU) is a crucial measure to improve patient outcomes and optimize care delivery in the critical care setting. The objective of this project is to tackle the difficulties caused by extended periods of immobility in the Intensive Care Unit (ICU), with the aim of diminishing complications, shortening the duration of ICU stays, and enhancing the functional recovery of patients.

Brain Matters: Cognitive-Behavioral Therapy And Antidepressants For Post-Stroke Depression, Lindsey Anne Smith

MSN Capstone Projects

Stroke is the leading cause of death and disability in the United States, and approximately one-third of these patients will develop post-stroke depression, which is associated with higher rates of morbidity and mortality (American Stroke Association, 2022). Even though post-stroke depression is prevalent, it often goes undertreated. The combination of antidepressants and cognitive-behavioral therapy has shown to be an effective method of treating post-stroke depression. There are cognitive-behavioral exercises that nurses can implement, such as group therapy, acceptance therapy, and cognitive retraining, a method of coaching the patient to replace negative thoughts with positive ones (Byun et al., 2021). With …

Best Practice: Implementation Of A Central Line Bundle To Reduce Central Line-Associated Bloodstream Infections, Alexis N. Montero

MSN Capstone Projects

Central line-associated bloodstream infections (CLABSIs) are among the most frequent health care-associated infections and are reported to be correlated with an increased number of inpatient days, higher cost, and attributable mortality rates (Devrim et al., 2016). For this reason, central line bundles (CLB) have been widely used in hospitals to aid in the decrease of CLABSIs. Through implementation of the prevention strategies included in CLBs, CLABSIs can be reduced by greater than fifty percent (Devrim et al., 2016). A decrease in CLABSIs is clinically significant with the avoidance of negative patient outcomes and a decrease in healthcare costs (Rinke et …

Clinician Education Program: Promoting The Use Of Care Bundles In Reducing The Hospital Length Of Stay And Readmission Rates Of Adult Copd Patients, Nordita R. Bascon

MSN Capstone Projects

Management of COPD patients can cost hospitals approximately $308,502 per month. This is based on a single COPD readmission encounter costing $7,500 and estimated daily expenses of $2,883 (Davis, 2023; Hegwer, 2018). This executive summary outlines a clinician education program held at a community hospital in West Texas to promote patient quality care by encouraging healthcare professionals to use evidence-based chronic obstructive pulmonary disease (COPD) care bundles. Eighteen physicians and nurse practitioners attended the program. Then, a survey was conducted to assess the impact of the proposed program. Most attendees said they would incorporate care bundles in COPD care.

Internal …

Nursing Care Of Individuals Engaging In Non-Suicidal Self-Injury: Impact Of Dialectical Behavior Therapy Skills Reinforcement, Lucas Bridgens

MSN Capstone Projects

As explained by Linehan et al. (2006b), the seriousness of borderline personality disorder can be highlighted by the manifestations of emotional dysregulation, such as impulsive and suicidal and non-suicidal self-injurious (NSSI) behaviors. As the mental health field grows, so too does the knowledge base from which practitioners derive therapeutic interventions with hopes of effectively and safely treating patients while maintaining a culture of dignity and respect. One such treatment modality that has proven to reduce NSSI and improve interpersonal functioning, specifically in patients with borderline personality disorder, is Dialectical Behavior Therapy (DBT) which is a form of cognitive-behavioral therapy developed …

Stepping Into Mindfulness: Enhancing Mental Health For Nursing Student Athletes, Amanda A. Marek

MSN Capstone Projects

This capstone project explores the impact of mindfulness practice on nursing student athletes, aiming to understand how mindfulness techniques can enhance their psychological well-being. The project investigates the intersection of mindfulness and addresses the unique challenges and stressors face by nursing student athletes. The project proposals a research study that focuses on how mindfulness can impact nursing student athletes. There is literature that shows how mindfulness can improve stress and mental disorders for nursing students and student athletes separately, but there is a lack of knowledge on how this may affect nursing students who are also student athletes. Mindfulness based …

Implementation Of Telemedicine In A Level Iii Nicu To Reduce Transfer Of Infants, Jennifer L. Welch

MSN Capstone Projects

In July 2012, a hospital located in North Texas opened its 9 bed Level II Neonatal Intensive Care Unit (NICU). Level II NICU is limited to the admission of infants with a gestational age of 32 weeks and above. There has been tremendous growth and expansion of the NICU resulting in an expansion to 13 licensed beds and gaining Level III NICU designation in 2017. Level III designation enables the care of infants that are 23 weeks or greater and have more complex medical conditions to be cared for. In the current competitive market of health care services, it is …