Nursing Commons^™

Enhancing Teamwork And Collaboration In Nursing Students, Sharon Walker

Doctor of Nursing Practice Projects

Effective teamwork and collaboration are vital components in the healthcare team’s ability to deliver safe, patient-centered care. New graduate nurses play a crucial role in the healthcare team; however, research reveals that many students' express anxieties when communicating with other healthcare personnel. The purpose of this project was to enhance students’ knowledge and understanding of the importance of effective teamwork and collaboration, ultimately influencing the delivery of high-quality and safe patient care. In an effort to promote better patient outcomes and limit failures, the integration of TeamSTEPPS^® training and simulation into nursing curricula offers students an opportunity to build …

Enhancing Learning And Self-Efficacy With Virtual Simulation, Lawone J. Lane

Doctor of Nursing Practice Projects

Background Evidence is lacking for support in the use of virtual simulation as a viable alternative for experiential learning and enhancing satisfaction, self-efficacy, and learning.

Problem Virtual simulation activities can provide opportunities for nursing students outside of clinical sites. In prelicensure nursing education, how does the development of a virtual simulation compare to traditional nursing education and does virtual simulation enhance student satisfaction, self-efficacy, and learning?

Approach A non-experimental descriptive design was used to examine attitudes of prelicensure nursing students related to perceived satisfaction, self-efficacy, and learning following a virtual simulation in place of a clinical site experience.

Outcomes Nursing …

Making Training Memorable: Assessing The Impact Of Animated Video On Learner Satisfaction, Engagement And Knowledge Retention, Leigh Highsmith

Doctor of Nursing Practice Projects

Media rich video provides attributes such as animation, narration, and music that can be incorporated into learning modules which have high potential to promote learning. This project evaluated the impact of transitioning a learning module from static PowerPoint slides to animated (media rich) video on employee satisfaction, engagement, and knowledge retention. Learner satisfaction and engagement was measured using a validated survey instrument designed to evaluate the effectiveness, appeal, and efficiency of the animated video about Hospice and Palliative Care. Knowledge retention was measured by comparing post-test scores between the initial and subsequent second post-test. A retrospective design was used to …

Addressing Hidden Barriers To Follow Up Healthcare: A Community Referral Pilot Project, Amber Williams

Doctor of Nursing Practice Projects

Objective: The project was aimed to reduce the number of participants lost to primary care follow-up following a mobile health unit screening event.

Design: A pilot study program screening tool implementation was utilized to address the hidden barriers of the Social Determinants of Health (SDoH) during a Winter 2021 event.

Sample: A group of 12 participants were screened during a mobile health unit event. Eight of the participants opted to be a part of the pilot study.

Measurements: A comparison ratio of Primary Care follow up was compared from the Winter of 2020 with Winter of 2021, where the screening …

Aerosol Spacers With Asthma Inhalers: Best Practice For School Health Nurses, Casey Page

Doctor of Nursing Practice Projects

Healthcare providers do not have adequate knowledge regarding the use of aerosol spacers and asthma inhalers. Inappropriate use of asthma inhalers may lead to poor medication distribution in the lungs and poor asthma control. The utilization of aerosol spacers with asthma inhalers is shown to increase medication distribution to the lungs. Asthma is the number one chronic condition seen by school health nurses. An online learning module was created for school health nurses to reiterate the best practice use of aerosol spacers with asthma inhalers. After completion of the online learning module, school health nurses answered nine questions on an …

Hand Hygiene For Health Promotion, Phyllis Knight-Brown

Doctor of Nursing Practice Projects

For many years public health organizations, such as The World Health Organization (WHO) and The Centers for Disease Control and Prevention (CDC), have stressed the need for proper hand hygiene. Proper hand hygiene requires a prescribed process to rid the hands of potentially infecting organisms by using soap and water (handwashing) or hand sanitizer (sanitizing). These processes need to be performed at critical times to promote infection prevention. Many studies have shown that hand hygiene is a learned behavior that becomes habitual over time, and behavior change mechanisms in addition to education are needed to affect a long-term change in …

Implementing A Hospital-Acquired Pressure Ulcer Intervention In The Icu, Audrey Gross

Doctor of Nursing Practice Projects

Background: Hospitals had been confronting greater incentives to prevent Hospital-Acquired Pressure Ulcers (HAPUs). HAPU rates had increased in the Intensive Care Unit (ICU) at an academic hospital over the past six months, especially regarding device related HAPUs.

Objectives: The primary purpose of this project’s implementation was to decrease the number of HAPUs in the ICU by 50% within a three-month timeframe. Secondary objectives were to achieve scores of 100% in terms of compliance with the Registered Nurse (RN) education module, post-test scores, and documentation.

Methods: This was a Quality Improvement (QI) project involving adult patients in the ICU of an …

Improving Emergency Department Quality Of Care, Carmen Smith

Doctor of Nursing Practice Projects

Emergency department (ED) crowding can cause an extended length of stay (LOS) and high rates of patients who leave without being seen (LWBS). This quality improvement ED project sought to reduce LOS and LWBS by implementing a triage (PIT) team. The design included an outcomes evaluation with available data and a staff pre and posttest. Length of stay and LWBS rates were compared before and after implementation. Results indicated a reduction in the average LOS and LWBS rates for the 30 days of project implementation compared to the 30 days before the project initiation. The overall goal of the PIT …

Student Registered Nurse Anesthetist Perspective On The Impact Of A Clinical Mentoring Program, Sheila M. Mccarley

Doctor of Nursing Practice Projects

There is a competitive push for recruiting and retaining the Student Registered Nurse Anesthetist (SRNA) graduate. Retention efforts begin with their first clinical experience. Mentoring in the clinical setting is a critical factor in influencing the student nurse anesthetist's retention to practice. The purpose of this project was to assess whether mentoring in the local setting noted similar findings. The method involved a survey of student nurse anesthetists queried about perspectives on a clinical-based mentorship program. Certified Registered Nurse Anesthetist (CRNA) faculty members vetted the survey instrument before implementation. The project focused on students presently enrolled in their first-year clinical …

Implementation Of An Evidence-Based Copd Screening Tool In Primary Care, Randi Davis

Doctor of Nursing Practice Projects

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic illnesses encountered in primary health care, with more than 16 million identified cases and many more undiagnosed. The condition is frequently not diagnosed until later stages due to its insidious onset. Once diagnosed, the disease is often inadequately treated. The purpose of this quality improvement project was to implement an evidence-based practice tool. The project team selected the COPD Assessment Tool [CAT], which ensured Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The device provided screening for individuals "at-risk" or with a known diagnosis of COPD. The …

Depressive Disorders And Substance Abuse Screening In Pediatric Primary Care Using Phq-A And Crafft Screening Tools, Lemuel M. Gitari

Doctor of Nursing Practice Projects

No abstract provided.

Grounds For A New Normal: Integration Of Telenephrology In Rural Communities, Carolyn J. Mattson

Doctor of Nursing Practice Projects

Patients with kidney disease represent a group of people who are known to have comorbidities, high costs of care, decreased quality of life, and invasive interventions. In rural communities of Western Washington State, many nephrology patients experience factors evidenced to impede access to quality and timely management of their disease, compounding the risk for poor outcomes. Telenephrology is a novel modality of service delivery with the potential to make care more efficient, cost-effective, flexible, and accessible. The author created this project to develop a telenephrology program plan and evaluation for rural settings in Western Washington, informed by relevant epidemiology, pathophysiology, …

Reducing Weight Bias: Creating An Anti-Weight Stigma Educational Simulation For Nurse Practitioner Students, Andrea A. Eickelmann

Doctor of Nursing Practice Projects

Background: Large-bodied people make up the majority of the American population, but healthcare providers are rarely taught specific techniques and strategies for management of their care and medical spaces are designed with furniture and equipment that does not accommodate large bodies. This alienation has resulted in a measurable detriment to the population’s mortality and morbidity, such increased mortality of 60% from experiencing weight stigma and over 50% high combined cancer death rates as compared to the rates of those with normal BMIs (Sutinet al., 2015; Calle et al., 2003).

Objective: This project will examine the evidence about weight stigma, efficacy …

Examination Of Nurses’ Perceptions, Beliefs, And Conceptions Related To Rapid Bedside Implementation Of Prone Therapy During The Covid-19 Pandemic, Alyssa Poghen, Emily La Riviere

Doctor of Nursing Practice Projects

The COVID-19 pandemic of the SARS-CoV-2 virus created significant challenges for healthcare agencies and front-line healthcare workers. The SARS-CoV-2 virus has demonstrated a unique propensity to induce severe lung injury in the form of acute respiratory distress syndrome (ARDS). High rates of COVID-19 illness in the initial months of the pandemic in the United States led to a rapid influx of patients admitted to critical care units (CCUs) for ARDS. Prone positioning therapy (PPT) has shown substantial promise in treating refractory hypoxemia in people with severe ARDS but historically received poor acceptance as a first-line therapy. With the onset of …

Catching Up With Hpv Immunization: An Educational Video For College Students, Behrooz R. Soleimani

Doctor of Nursing Practice Projects

HPV is the most common sexually transmitted infection in the US, and it can lead to minor health problems such as genital warts and serious problems like cancer in men and women. HPV vaccination can effectively prevent HPV-related cancers and is recommended by ACIP to individuals aged 9-26. HPV vaccine uptake is low among adolescents and young adults in the US. College students have a window of opportunity to catch up with their HPV immunizations, and are often uninformed about HPV, the HPV vaccine, their eligibility to receive the HPV vaccine, and where they can obtain the HPV vaccine. An …

Implementation Of A Proactive Rapid Response Team Nurse Rounding Protocol To Address Afferent Limb Failure In A Mature Rapid Response System, Sarah Welch

Doctor of Nursing Practice Projects

Background: Rapid response system afferent limb failure (ALF) is associated with increased hospital mortality rates, unplanned transfer to the ICU, and increased hospital length of stay. Factors contributing to ALF are complex, including individual, team, organizational, and systemic barriers. The aims of this study were to evaluate the impact of implementation of a proactive rapid response team nurse (RRT RN) rounding protocol on the frequency of ALF preceding adverse events, patient disposition following RRT activation, and discharge disposition of patients experiencing adverse events during their hospital stay at a 281 bed community hospital.

Methods: This was a two part quantitative, …

Pain Neuroscience Education As An Intervention For Chronic Pain, Corissa A. Sutton

Doctor of Nursing Practice Projects

Purpose: The purpose of this project was to evaluate the ability of Pain Neuroscience Education (PNE) to increase knowledge of pain as a biopsychosocial process and influence more health-promoting interpretations of pain among low-income adults as a preventative health education approach.

Background: PNE is a promising treatment approach for addressing chronic pain. However more data is needed to understand how to most effectively utilize this intervention.

Design: A program evaluation was conducted using a pre- and post- test design to elicit quantitative and qualitative data. Nine Seattle Housing Authority (SHA) buildings were invited to participate in two online pain neuroscience …

Context Matters: Evaluating The Influence Of Patient Demographics And In-Patient Care Parameters On Breastfeeding Outcomes Associated With The Baby Friendly Hospital Initiative, Sarah Vivian Martin

Doctor of Nursing Practice Projects

Objective: Evaluate the effectiveness of the global Baby Friendly Hospital Initiative (BFHI) as an intervention to improve breastfeeding outcomes and to explore factors that are most supportive and predictive of exclusive breastfeeding.

Design: Program evaluation of the BFHI using a retrospective pre and post implementation electronic health record chart review.

Setting: A tertiary level hospital in WA. BFHI designation was achieved in November 2017.

Participants: Patients with a low-risk pregnancy, who gave birth (vaginal or cesarean) to a healthy term infant in Quarter one of 2015 (N=145) and Quarter four of 2018 (N=131).Patient and infant must have been discharged home …

Building Resilience: Piloting A Mindful Self-Compassion And Stress-Management Program For Youth, John A. Hinrichs

Doctor of Nursing Practice Projects

Anxiety disorders, representing the most prevalent classification of mental health disorders across the world, pose a significant public health problem associated with burdensome costs (Baxter, Vos, Scott, Ferrari, & Whiteford, 2014; Greenberg et al., 1999). Although understanding about the etiology and effective treatments for anxiety disorders has grown, general preventative measures are not well-understood or implemented but are needed to reduce the disability and morbidity associated with this debilitating class of disorders. Research has identified perfectionism and self-criticism as risk factors for the development of anxiety disorders and mindful self-compassion (MSC) as a promising intervention to alleviate anxiety disorders (Dunkley, …

Screening For Adverse Childhood Experiences And Other Determinants Of Health In School Based Health Centers: A Program Evaluation, Olivia A. Domini

Doctor of Nursing Practice Projects

Introduction: Adverse Childhood Experiences (ACEs), such as abuse, neglect, and various household stressors, are common, connected, and contribute to multiple adverse health and wellbeing outcomes throughout life. Consequently, there has been a push to screen for adversity and toxic stress in primary care to facilitate prevention and early intervention. The purpose of this project was to evaluate and optimize the use of the Broad Level Integrated Screener (BLIS) in Neighborcare Health (NCH) School Based Health Centers (SBHCs) in Seattle, WA.

Methods: An online survey including nineteen Likert-scale questions and five open-ended free response questions was administered to all middle school …

Barriers To Effective Implementation Of Contingency Management In Outpatient Treatment Of Methamphetamine, Emma A. Nauman

Doctor of Nursing Practice Projects

The objective of this project is to: 1) identify current understanding, attitudes, and beliefs of clinicians at a midsized urban outpatient substance use treatment clinic regarding contingency management (CM) treatment modality; 2) examine how this data contributes to barriers to implementation of contingency management for methamphetamine treatment; and 3) make recommendations to improve implementation strategies. A ten-question survey was developed based on Social Ecological Theory (U.S. Department of Health and Human Services, 2005), and was administered to 31 clinicians. A key informant interview was conducted using theoretical sampling (LoBiondo-Wood & Haber, 2018) of emergent themes. Three major barriers emerged from …

Aiding Screening, Diagnosis, And Management Of Prediabetes Among High-Risk Medicare Patients In A Primary Care Setting, Manaye Utaile

Doctor of Nursing Practice Projects

Purpose: Encourage prediabetes screening, testing, and referral to a CDC-recognized Diabetes Prevention Program (DPP) as a first-line treatment.

Background: The prevalence of diabetes and prediabetes incidence is highest among Medicare-eligible Washingtonian patients, with 19% and 16%, respectively. DPP results in a 71% reduction of diabetes incidence in 65 years and older. However, only 3% of healthcare sites screen, test, and refer to DPP.

Design: Quality assessment with a descriptive quantitative evaluation method was conducted using Retrospective Chart Review for patients who visited Franciscan primary clinics from 08/31/2019 to 08/31/2020. A total of 1250 Medicare patients were extracted from a convenient …

Human Trafficking Education Module For Healthcare Providers: Reviewed And Informed By Survivors Of Sex Trafficking, Katlyn Sargent Sheets

Doctor of Nursing Practice Projects

Human trafficking (HT) is an epidemic within the United States, resulting in what could be deemed a public health crisis. HT remains concealed due to the criminal, secretive nature of the enterprise, in addition to inconsistent definitions, historically perpetuated biases, and stigmas, in addition to an overall lack of education, knowledge, and awareness. Data around HT are also minimal due to these same barriers. The majority of HT victims report accessing the emergency department and hospital during their time of trafficking, placing healthcare professionals in a unique position to recognize and assist victims. Studies indicate that few healthcare professionals have …

A Provider Toolbox On Cardiovascular Disease Prevention In Women Of Color In The Primary Care Setting, Ellerey C. Nelson

Doctor of Nursing Practice Projects

Purpose: The purpose of this practice improvement project was to increase cardiovascular disease (CVD) knowledge in women of color (WOC) in the primary care setting through enhanced provider to patient education through implementation of a provider toolbox.

Background: CVD is the number one cause of death in women in the United States. However, WOC have a higher incidence of CVD than White women. Additionally, WOC have been found to have a decreased knowledge and awareness of CVD, demonstrated by numerous national studies. Therefore, the primary investigator (PI) identified a need to increase CVD knowledge and awareness in WOC in order …

Implementing Eating Disorder Screening And Early Intervention In A Primary Care Clinic, Brandon Dukovic

Doctor of Nursing Practice Projects

Eating disorders have a high mortality rate, increasing prevalence rate, and often go unrecognized and untreated. Primary care providers are uniquely positioned to intervene early in the development of these disorders yet screening for eating disorders in primary care is limited. This project looked to improve provider confidence and improve screening for eating disorders by introducing a provider education course focused on eating disorder screening, management, and resources, as well as implementing the SCOFF questionnaire into the annual health questionnaire completed by students utilizing a university health clinic. Pre-and post-intervention survey data showed an increase in provider self-reported confidence in …

Simulation Use In Pre-Licensure Nursing Programs: Assuring Excellence In New Nurse Competence And Confidence, Suzan Griffis Knowles

Doctor of Nursing Practice Projects

Purpose: This program evaluation project aims were to review the current state of simulation experiences in pre-licensure undergraduate nursing programs in Washington State and determine policy recommendations related to the future use of simulation experiences in clinical nursing education. The evaluation compared student outcomes of NCLEX pass rates associated with clinical simulation versus traditional clinical nursing experiences. Programs were evaluated for compliance with INACSL Simulation Standards of Best Practice.

Conceptual Framework: The NLN/Jeffries Theory provided the framework for an analysis of program evaluation data regarding using the INASCL Simulation Standards of Best Practice.

Design/Method: The study design was a descriptive …

Impact Of A Novel Application In Electrocardiogram Interpretation Confidence And Performance In Nurse Practitioner Students, Hailey Bobin Cole

Doctor of Nursing Practice Projects

For the last hundred years and to this day, one of the most important diagnostic tools in medicine has been the electrocardiogram (EKG or ECG). The decision to pursue a life-saving intervention, or not, may be heavily based on the interpretation of the results of a diagnostic test. With the weight of impacts to outcomes, one would think there would be ample, if not excessive, time and effort given to teaching practitioners how to interpret an ECG. Unfortunately, with each graduating class of physicians, nurse practitioners, and physician assistants, all of whom have within their scope of practice to interpret …

Evaluating The Impact Of Federal Mental Health Policy: An Analysis Of How Federal Deinstitutionalization Impacted Persons With Severe Mental Illness, Jillian K. Douglas

Doctor of Nursing Practice Projects

This policy evaluation project evaluated how federal mental health policy changes impact individuals diagnosed with severe mental illness through analyzing how institutionalization and deinstitutionalization policies impact persons with severe mental illness (SMI). In order to determine how federal policy changes impact outcomes for people diagnosed with SMI, psychiatric hospitalization rates per 100,000 from 1850 to 2015 are compared to the life expectancy, incarceration rates per 100,000, and percentage of unhoused population with SMIs in the United States (U.S.) during the same years. Research compiled for this paper found that decreasing the numbers of psychiatric beds correlates within creased rates of …

Gap Analysis, Development, And Evaluation Of An Advanced Practice Clinician Mentorship Program, Boyon Yun

Doctor of Nursing Practice Projects

Purpose: The purpose of this five-step quality improvement project is to identify and address gaps between the current and desired state of an advanced practice clinician (APC) onboarding process. Specific aims: (1) determine organization-specific needs of APCs, (2) develop a mentorship program for newly hired APCs, and (3) conduct a program evaluation (process and outcomes).

Background: Although the APC workforce is rapidly growing, health care organizations struggle with high APC turnover. Effective mentorship has been shown to help APCs, who are either new to practice or new to an organization (Pop, 2017).

Design: A needs assessment survey was distributed to …

Long-Acting Reversible Contraception Education For Street-Involved Youth: Impact On Knowledge, Attitudes, And Behaviors, Lizzie Simon

Doctor of Nursing Practice Projects

Despite evidence that long-acting reversible contraception (LARC) is safe, appropriate, and highly efficacious for people under age 25, this younger population is under-represented among LARC users in the US. At the Orion Clinic in Seattle, Kaiser Permanente offers primary care to street-involved young people between the ages of 12 and 24. Since opening in 2016, young patients at the Orion Clinichave initiated LARC at low rates, which reflects national trends. The aims of this project are to understand the reasons for this population’s underuse of highly effective contraceptive methods; to increase participants’ knowledge and positive attitudes toward LARC; and to …