Nursing Commons^™

The Costs And Benefits Of Outsourcing Marketing, Student Recruitment And Retention Services In An Online Rn-To-Bsn Program, Jacqueline M. Wuellner

Doctor of Nursing Practice Scholarly Projects

ABSTRACT

In 2010, the Institute of Medicine advised that by 2020, 80% of working nurses should have at minimum a baccalaureate degree. Across the country, the profession will fall short of that goal. In New Mexico, the numbers of associate degree nurses and baccalaureate degree nurses are nearly equal. As the flagship university for the state, the University of New Mexico has offered a program for baccalaureate degree completion for registered nurses for over 55 years. Wishing to fulfill the IOM mandate, the University of New Mexico, College of Nursing desires to grow its RN-to-BSN program by expanding its marketing, …

Preterm Labor Assessment Toolkit Implementation, Mandi Wilkins

Doctor of Nursing Practice Scholarly Projects

ABSTRACT

PRETERM LABOR ASSESSMENT TOOLKIT IMPLEMENTATION

Mandi Mae Wilkins

Every year 10% of babies in the United States are born premature. Prematurity is the leading cause of infant mortality. Standardized preterm labor (PTL) assessment protocols reduced preterm birth rates, decreased costs, and resulted in more timely diagnoses and prevented the overtreatment of pregnant women who were not experiencing true preterm labor. At a Midwestern, Level II trauma hospital with regional neonatal intensive care unit and 700 annual deliveries, a Preterm Labor Assessment Toolkit (PLAT) was implemented and pre- and post-data garnered. The toolkit contained a provider algorithm and an order …

Oral Health Literacy In Parents And Care Providers Of Young Children, Rachel Nye

Doctor of Nursing Practice Scholarly Projects

Tooth decay ranks first as the most common chronic disease in childhood (U.S. Department of Health and Human Services [HHS], 2000). In addition to the morbidity directly related to cavities, there are a myriad of other systemic implications of this disease. The purpose of the study was to determine baseline oral health literacy levels for a sample of pediatric caregivers living in the Upper Peninsula and to determine the impact of a community based education program on these levels. The program was offered at three locations. A paired sample t-test of sixty-four complete data sets demonstrated a statistically significant increase …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

Doctor of Nursing Practice Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

Advance Care Planning: Cardiopulmonary Resuscitation Education And The Veteran Population, Rhian Elizabeth Dalgord

Doctor of Nursing Practice Scholarly Projects

Cardiopulmonary resuscitation educational tools are prevalent in the realm of advance care planning and shared decision making. However, tools developed specifically in the interest of veterans are lacking. This deficit impedes the advance care planning process. Easy-to-use advance care planning tools that meet specific population needs can result in a threefold higher rate of usage. The purpose of this DNP scholarly project was to evaluate the use of the Honoring Healthcare Choices CPR educational handout through administration of the iDECIDE CPR Decision Aid Acceptability questionnaire to veterans (N=70) residing in a veterans nursing home in the Midwest. The iDECIDE CPR …

Measuring Health Care Providers' Perceived Age Of Transition And Transfer For Youth With Special Health Care Needs, Doris V. Tinagero

Doctor of Nursing Practice Scholarly Projects

Approximately 98,000 or 19% of all children residing in New Mexico have special health care needs with almost half of these children nearing the critical transition period of moving into an adult-oriented medical model of care. A critical initial step to ensuring the medical, developmental, and psychosocial needs are addressed in the transition process includes the creation of an organizational transition policy. The aim of this study was to explore differences in the perceived age of transition and transfer for youth with special health care needs into an adult-oriented medical setting, based on providers’ location of clinical time, the population …

Sexual Orientation And Gender Identification Data Collection: Attitudes, Beliefs, And Perceived Barriers Among Inpatient Registered Nurses And Medical Providers On Progressive Care Units, Ryan J. Harris

Doctor of Nursing Practice Scholarly Projects

As the United States healthcare system continues to evolve and more Americans receive health insurance coverage, trends in diseases and care delivery to meet these trends are expected to shift. As this evolution takes place the ability to track trends to address the anticipated needs will need to develop at a faster pace. One such area is how healthcare providers engage the Lesbian, Gay, Bisexual, Transgender (LGBT) community and how these interactions can improve care, perceived healthcare quality, and address health disparities. Currently most electronic health record (EHR) programs do not have the ability to track the sexual orientation or …

Impact Of Student Nurses' Clinical On The Workload Of Rn's On A Medical-Surgical Unit Of A Critical Access Hospital, Reta Hamilton

Doctor of Nursing Practice Scholarly Projects

This pilot study explored Registered Nurses (RNs) perceptions of the impact of student nurses’ clinical on the workload of medical-surgical RNs in a Critical Access Hospital (CAH). The real-life experience of students in the clinical learning environment has been seen as a valuable part of nursing student education. With the increase in the number and size of nursing programs leading to a shortage of clinical sites, maintaining a positive relationship with clinical sites is extremely important to nursing programs. Previous research has found that nurses often have ambivalent feelings regarding nursing students on their units. Purpose: Explore RNs” perceptions of …

Improving Nurse Managers Skills In The Veterans Health Administration, Charles Silveri

Doctor of Nursing Practice Scholarly Projects

The Veterans Health Administration (VHA) provides an education module for nurse mangers that prepares them for unique duties and responsibilities. This project explores the self-reported confidence in knowledge learned of nurse managers who participated in an online management and leadership training program through measurement of pre- and post- training participation. The aim of this study is to analyze an online training program for nurse managers in regards to improvement in leadership/management skills and promote better management and patient advocacy (Kvas, Seljak & Stare, 2014; American Organization of Nurse Executives (AONE) Nurse Executive Competencies, 2005).

Nursing Knowledge And Attitudes Toward Trans* And Gender-Nonconforming Patients, Christine Humphrey

Doctor of Nursing Practice Scholarly Projects

This project aims to impact nursing knowledge and attitudes toward trans* and gender-nonconforming patients. The term transgender, synonymous with the term trans*, is utilized by individuals whose gender and designated sex at birth differ from one another, compared to cisgender persons whose gender and assigned sex are aligned (Erickson-Schroth, 2014).

The trans* population remains underserved. Nurses conscious and unconscious biases impede the advancement of knowledge and attitudes needed to promote best outcomes for trans* patients. Trans* patients have many of the same healthcare concerns as cisgender individuals. However, unique needs for this population arise from compounded issues of prejudice and …

Poster: Nursing Knowledge And Attitudes Toward Trans* And Gender-Nonconforming Patients, Christine Humphrey

Doctor of Nursing Practice Scholarly Projects

This project aims to impact nursing knowledge and attitudes toward trans* and gender-nonconforming patients. The term transgender, synonymous with the term trans*, is utilized by individuals whose gender and designated sex at birth differ from one another, compared to cisgender persons whose gender and assigned sex are aligned (Erickson-Schroth, 2014).

The trans* population remains underserved. Nurses conscious and unconscious biases impede the advancement of knowledge and attitudes needed to promote best outcomes for trans* patients. Trans* patients have many of the same healthcare concerns as cisgender individuals. However, unique needs for this population arise from compounded issues of prejudice and …

Efficacy Of Post-Discharge Interventions On Preventing Hospital Readmissions In Stroke Patients, Monica R. Vickery

Doctor of Nursing Practice Scholarly Projects

More than 795,000 people in the United States have a stroke every year. Some 610,000 of them are first or new strokes, and 185,000 of these are recurrent strokes (Centers for Disease Control and Prevention, 2016). Studies show that anywhere from 17.4% to 66% of patients discharged from a healthcare facility following an acute stroke are readmitted within 30 days (Zhong et al., 2016; Lahiri et al., 2015; Strowd et al., 2015; Bjerkreim, Thomassen, Waje-Andreassen, Selvik, & Naess, 2016; Burke, Skolarus, Adelman, Reeves, & Brown, 2014; Kilkenny, Longworth, Pollack, Levi, & Cadilhac, 2013; Lichtman, Leifheit-Limson, Jones, Wang, & Goldstein, 2012; …

Using Safety Checklists Outside Of The Operating Room, Annabelle Gerhardt

Doctor of Nursing Practice Scholarly Projects

Abstract

The use of a Time Out checklist for patient safety in non-operating room procedural areas is equally important for positive patient outcomes as in the operating room (OR). In this busy southwestern United States hospital, the procedural teams in the non-operating room areas were reported to not be fully engaged during the performance of the Time Out pre-procedural pause prior to gastroenterological (GI) procedures. This study was conducted to improve compliance with the scripted Time Out checklist and promote full engagement of the GI procedural team during the Time Out thus reducing risks of wrong site surgery. Literature has …

Using Clinical Supervision To Improve Interprofessional Collaboration, Melissa Copenhaver

Doctor of Nursing Practice Scholarly Projects

USING CLINICAL SUPERVISION TO IMPROVE

INTERPROFESSIONAL COLLABORATION

By

Melissa Copenhaver

Interprofessional collaboration (IPC) is important to the future of the healthcare system in that IPC is part of the solution for promoting better healthcare outcomes (Gilbert, Yan, & Hoffman, 2010; Reeves, Perrier, Goldman, Freeth, & Zwarenstein, 2013). Marshall (2011) notes that “interprofessional collaborative practice promotes team identity, conserves energy by a unity in direction, and invites harmony of efforts” (p. 158). The skills needed to engage in IPC are cultivated through interprofessional education (IPE) (Reeves et al., 2013). Currently, at Northern Michigan University (NMU), there are limited opportunities included in …

Retrospective Comparative Costs And Benefits Of Registered Nurses (Rns) In A Perioperative 101 Program Residency (P101); An Immersive Perioperative Specialty Residency (Psr); And Registered Nurses Hired Into General Perioperative Services From 2009-2016, Johanna K. Stiesmeyer

Doctor of Nursing Practice Scholarly Projects

This study addresses the cost to benefit ratio of a healthcare organization’s investment in specialty perioperative residency programs for newly licensed registered nurses and experienced registered nurse orienting into perioperative services. The outcomes for transition to practice residency programs is widely reported however a standardized approach to measuring and reporting cost to benefit ratios and return on investment to these programs as well as specialty residencies remains an opportunity. This study contributes to national standardization and approach by defining the costs of a perioperative residency program and determining the cost to benefit ratio using a return on investment calculator. The …

Enhancing Clinical Manager Self-Efficacy Through A Change Management Academy, Chet Hurley Doering Iii

Doctor of Nursing Practice Scholarly Projects

Healthcare systems are facing increased pressure to develop their clinical managers’ abilities and competencies leading change. Clinical managers that are equipped with these capabilities can influence greater quality and safety outcomes for patients. Literature and industry findings both strongly suggest that leaders who possess increased self-efficacy are more effective leading change. This is demonstrated at the unit and system level through improved project management, successfully executing strategic initiatives, retaining staff, and being more fiscally responsible. There are significant clinical and business advantages for healthcare systems that foster change management skills for their clinical managers When organizations do not provide support, …

Civility Matters: Overcoming Workplace Incivility Using An Interactive Education Intervention, Joy L. Stoddard

Doctor of Nursing Practice Scholarly Projects

Workplace Incivility, a global issue, particularly affects healthcare settings due to stressful work environments and a largely female workforce. Victims of WPI have up to 33% increased turnover, with many leaving their professions entirely. The cost of turnover, particularly within the first year, may be as high as 125% of the nurse's salary Researchers identified the need to implement measures to prevent and manage WPI. The Joint Commission (TJC) calls for requiring hospitals to implement code-of-conduct policies defining acceptable and unacceptable behaviors. Code-of-conduct policies assist leaders in addressing offenders of WPI. Targets of WPI typically lack the skill set and …

Assessment Of Nurse Engagement, Manuelita I. Chapman

Doctor of Nursing Practice Scholarly Projects

Organizations with high employee engagement reap the benefits of higher employee retention and improved customer satisfaction. Studies find that engaged workers are in the minority. Among healthcare workers, nurses are found to be the least engaged. The association of the registered nurse (RN) at the bedside with improved patient outcomes has been documented by many. Today, the goal of providing safe, high quality and efficient patient care and an exceptional patient experience are benchmark measures for patient care delivery. Since nurses are essential to optimal patient outcomes, it is important to understand what motivates them. Career advancement programs (CAPs) are …

New Mexico Trauma System Funding Strategy, Razvan N. Preda

Doctor of Nursing Practice Scholarly Projects

Trauma is the leading cause of death among individuals 1 to 44 years of age. Nationally, one individual dies of traumatic injuries every three minutes. In the United States, the financial impact of trauma is estimated to be approximately $671 billion annually, spent on direct trauma care and associated costs, such as loss in productive days and rehabilitation. The New Mexico trauma system registered dramatic development over the past 10 years. In 2007, the state had only three designated trauma centers, and today there are 12. However, over the same period, trauma system funding registered an equally dramatic decrease of …

Staff Nurse Perception Of Professional Role Modeling For Student Nurses In The Clinical Learning Environment, Tamara Montgomery

Doctor of Nursing Practice Scholarly Projects

Acute care settings continue to be the primary setting for undergraduate nursing education clinical experiences. Staff nurses in acute care settings are expected to provide nursing care with pre-licensure nursing students at their side (even though there are little to no incentives for staff nurses to provide mentoring leadership), which most often takes the form of professional role modeling. In addition, there is no clear evaluative expectation that motivates staff nurses to provide contextual role modeling. Without stated expectations, staff nurse perception of the significance of role modeling for pre-licensure non-precepted nursing students may be deficient.

Because fifty-six percent of …

Poster: Communication Strategies For The School Nurse Mentor: A Pilot Training Program, Amy Hotler Dnp, Rn, Lsn, Aphn-Bc

Doctor of Nursing Practice Scholarly Projects

Mentorship has widespread support among many disciplines for the impact on improved job satisfaction, decreased job turnover and decreased costs to organizations. Ongoing support through mentorship is critical to nurses transitioning to a new role and nurse mentors must be prepared for the role with relevant education tailored to their needs . Though literature describing training programs for mentors is limited, some studies have reported an increase in confidence among mentors after training. In addition, improved mentoring skills (that includes communication) is in literature.

In one large urban school district in Ohio, a school nurse, mentorship program was developed and …

Communication Strategies For The School Nurse Mentor: A Pilot Training Program, Amy Hotler Dnp, Rn, Lsn, Aphn-Bc

Doctor of Nursing Practice Scholarly Projects

Mentorship has widespread support among many disciplines for the impact on improved job satisfaction, decreased job turnover and decreased costs to organizations. Ongoing support through mentorship is critical to nurses transitioning to a new role and nurse mentors must be prepared for the role with relevant education tailored to their needs. Though literature describing training programs for mentors is limited, some studies have reported an increase in confidence among mentors after training . In addition, improved mentoring skills that includes communication is in literature.

In one large urban school district in Ohio, a school nurse, mentorship program was developed and …

Application Of The Patient Checklist Tool In Anesthesia Handoffs, Theresa Durley

Doctor of Nursing Practice Scholarly Projects

Accurate and essential communication is required during the transfer of patient care from one health care provider to another. Communication errors during the handoff process have been identified as contributing factors in sentinel events. There is a plethora of literature supporting a standardized transfer of care process as well as several accepted handoff communication tools for the various units within a healthcare institution. However, in the anesthesia domain, there is currently only one protocol specifically created for the transfer of patient care between certified registered nurse anesthetists (CRNAs). The PATIENT protocol, created by Dr. Suzanne M. Wright, CRNA, PhD (2013) …

Implementation Of The 2012 American College Of Rheumatology Guidelines For Management Of Gout In A Sample Of Midwestern Native Americans, Myrth C. Condon

Doctor of Nursing Practice Scholarly Projects

Gout is a well understood, yet poorly treated condition that is associated with many co-morbidities including hypertension, renal and cardiac disease, metabolic syndrome, central obesity and type-2 diabetes. The American Indian population is at risk for gout due an increased incidence of type-2 diabetes, chronic kidney disease, hypertension, and alcohol abuse. The purpose of this scholarly project was to implement the 2012 American College of Rheumatology (ACR) guidelines in a sample of Tribal members within mid-western portions of the United States. This scholarly project utilized a quasi-experimental research design with pretest – posttest methods to measure uric acid levels at …

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement …

Assessment Of Air Force Providers’ Adherence To Overweight And Obesity Guidelines, Dale Harrell

Doctor of Nursing Practice Scholarly Projects

Despite the existence of obesity treatment guidelines, Air Force healthcare providers may offer suboptimal weight management. The purpose of this quality improvement project is to assess adherence by healthcare practitioners with adult overweight and obesity guidelines before and after an educational session on the optimal management of the overweight or obese patient. Overweight or obese adults treated in Military Treatment Facilities (MTF) may not be properly identified and controlled, as providers may not be adhering to the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for the management of obesity.

Nursing Perception Of Psychogenic Nonepileptic Spells: Improving Patient Outcomes, Amanda J. Cramer

Doctor of Nursing Practice Scholarly Projects

Patients with psychogenic nonepileptic spells (PNES) have generally poor outcomes and many fail to engage in evidence-based treatments (Thompson et al., 2013). Negative healthcare provider perceptions have been implicated as a barrier to patient engagement in treatment recommendations for PNES (Whitehead, Kandler, & Reuber, 2013; Worsely et al., 2011). Illness perception of these patients has been evaluated from the perspective of physicians in multiple settings but perceptions by nurses are not well studied despite the close interactions that nurses have with these patients.

This project used Pender’s health promotion model to collect information about the nursing experience with patients with …

Implementation Of An Educational Session To Improve Compliance Of Reporting Medication Errors And Near Misses Among Anesthesia Providers, Kacy C. Ballard 3679424

Doctor of Nursing Practice Scholarly Projects

There is currently no emphasis being placed on the significance of reporting medication errors, including near misses, for the anesthesia department in a Midwestern hospital system. Efforts to ensure patient safety depend upon collecting data related to actual medication errors, including near misses, so that educational or process improvement opportunities can be identified and implemented. The focus of this quality improvement project was to educate anesthesia providers about the importance of properly reporting all medication errors and near misses. The pre and post survey helped to provide data to determine whether anesthesia providers believe they are more apt to report …

Advocacy: A Vital Step In Attaining Full Practice Authority For The Advanced Practice Registered Nurse, Mandi Cafasso

Doctor of Nursing Practice Scholarly Projects

Problem Statement

Recent passage of the Affordable Care Act has made the imminent concern of poor patient/provider ratios a reality. Unfortunately, despite increasing numbers of advanced practice registered nurses graduating annually, the access to healthcare issue continues. Advanced practice registered nurses (APRNs) are limited in the care they can provide as a result of Ohio law.

The Ohio Nurse Practice Act requires APRNs to work in a collaborative relationship with a physician and also requires that prescribing practices be guided by an inclusionary formulary (Nurse Practice Act, 2014). Thus, APRNs in Ohio cannot practice to their fullest scope of education …

Development Of A Personalized Education Program Based On An Assessment Of Knowledge Of Coronary Heart Disease And Risk Factors In A Filipino-American Community In New York City, Mervin David

Doctor of Nursing Practice Scholarly Projects

Abstract

Filipino-Americans (FAs) are considered the fastest growing Asian immigrant population in the United States. There are about 2.6 million Filipino-Americans living in the United States (U.S. Census, 2010). Coronary Heart Disease (CHD) is the leading cause of death among FAs in the United States (National Vital Statistics, 2009). Research studies on CHD and CHD risk factors among FAs are limited. The purpose of the study was to explore FAs’ knowledge of CHD, risk factors for CHD and to provide a personalized educational intervention in raising awareness and changing attitudes about CHD among FAs aged 35-75 in a community setting …