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Articles 331 - 360 of 401
Full-Text Articles in Nursing
Improving Survival Rates In Patients Suffering Cardiac Arrest With Specialized Resuscitation Teams: An Integrative Review, John Campbell Holcomb
Improving Survival Rates In Patients Suffering Cardiac Arrest With Specialized Resuscitation Teams: An Integrative Review, John Campbell Holcomb
Doctoral Dissertations and Projects
Over 300,000 hospitalized patients suffer a cardiac arrest requiring a Code Blue activation each year in the United States. These patients have an extremely high mortality rate. These rates are not uniform across all hospitals and facilities that employ specialize Code Blue resuscitation teams have a higher percentage of patients that survive resuscitation events. This Integrative Review shows that these teams are essential to patient survival but are prone to barriers that must be overcome to provide effective teamwork. Quality improvement projects centered around Code Blue teams can be created at the local level and have been found to be …
Identification Of Human Trafficking Victims In The Health Care Setting: An Integrative Review, Jami Leigh Castellucci
Identification Of Human Trafficking Victims In The Health Care Setting: An Integrative Review, Jami Leigh Castellucci
Doctoral Dissertations and Projects
Most victims who have escaped trafficking report that during their captivity they were taken to health care facilities. Though health care–based trafficking reporting has increased over the last few years, studies show that private practices and most hospitals within the country do not have a human trafficking protocol, policy, nor educational intervention for their frontline staff to be able to identify and refer victims for short- and long-term support. The United States health care system is poised to play a large role in the fight against human trafficking. This integrative review describes the current status of human trafficking victim identification …
Nighttime Quiet In The Intensive Care Unit: An Integrative Review, Heather Rae Smith
Nighttime Quiet In The Intensive Care Unit: An Integrative Review, Heather Rae Smith
Doctoral Dissertations and Projects
Excessive environmental noise in the ICU often negatively impacts patient sleep. The World Health Organization (WHO) and Environmental Protection Agency (EPA) have published recommendations for hospital decibel levels, but the literature indicates that noise levels in the ICU often exceed these values. Patients experience disturbed sleep and rarely enter into N3 and REM sleep. The integrative review examined both the patients’ and healthcare workers’ perception of noise in the ICU environment to identify contributors and suggested interventions to mitigate these occurrences. In addition, this study evaluated objective measurements of patient sleep to further determine how well patients were sleeping in …
Diabetes Health Literacy In The Rural Community: An Integrative Review, Shannon M. Elrod
Diabetes Health Literacy In The Rural Community: An Integrative Review, Shannon M. Elrod
Doctoral Dissertations and Projects
Health literacy is paramount for successful management of health and prevention of disease. Yet a majority of adults have low health literacy. The impact of low health literacy on chronic disease management effects health outcomes and health care costs. With six out of 10 adults in the US diagnosed with a chronic disease such as diabetes, health literacy is a serious concern. Diabetes impacts over 30.3 million Americans. Since diabetes is one of the most common chronic diseases in the country, it is imperative that health literacy be addressed as part of this population’s health management. Diabetes health literacy plays …
Ask, Advise, Assist And Follow: An Evidence Based Project To Address Unhealthy Alcohol Use In A Free Clinic Setting, Lisa K. Floyd
Ask, Advise, Assist And Follow: An Evidence Based Project To Address Unhealthy Alcohol Use In A Free Clinic Setting, Lisa K. Floyd
Doctoral Dissertations and Projects
Preventative care in free clinic settings aims to mitigate health risks for vulnerable populations. Heavy alcohol intake is a major threat to physical and mental health. Wellness care for free clinic patients must include regular screening for alcohol use in accordance with national guidelines. The purpose of this project was to implement and evaluate an evidence- based practice change to improve alcohol screening and intervention in a free clinic setting. The NIH/NIAAA screening, brief intervention, and referral for treatment (SBiRT) process was implemented. A convenience sample of de-identified patient charts was reviewed to assess alcohol screening before (n = 38 …
A Nursing Education Intervention In An Adult Inpatient Setting For Decreasing Hypoglycemia Incidence, Meredith Lynn Camilleri
A Nursing Education Intervention In An Adult Inpatient Setting For Decreasing Hypoglycemia Incidence, Meredith Lynn Camilleri
Doctoral Dissertations and Projects
Hypoglycemia can cause an array of outcomes including increased morbidity, mortality, and hospital length of stay. The literature revealed specific educational methods effective in decreasing hypoglycemia including case-based learning tutorials and unit-based lectures. Focused nursing education regarding the cause of hypoglycemia and understanding the importance of provider notification of hypoglycemia was also shown in the literature to reduce rates of hypoglycemia. The purpose of this project was to decrease inpatient hypoglycemia incidence utilizing a unit-based educational seminar as an intervention on a diabetic renal unit within a hospital. While anticipating a decreased hypoglycemia incidence after the educational seminar, an increased …
Improving Newborn Outcomes Through Implementation Of Delayed Bathing: An Integrative Review, Tennille Ideen O'Connor
Improving Newborn Outcomes Through Implementation Of Delayed Bathing: An Integrative Review, Tennille Ideen O'Connor
Doctoral Dissertations and Projects
Evidence-based practice is foundational to ensuring patient safety and quality of care. Implementing evidence-based practice is the responsibility of all care providers. The completion of an in-depth integrative review provides a project leader the opportunity to explore the benefits of delayed bathing of the newborn and impact of the practice on newborn outcomes. The goal of this integrative review is to identify the benefits of delayed bathing and ways to implement this practice in the clinical setting. This integrative review seeks to present care providers with the most recent research and guidelines as it relates to the practice of delayed …
Wellness And Coping Of Residents In A Skilled Nursing Facility, Christine M. Larson
Wellness And Coping Of Residents In A Skilled Nursing Facility, Christine M. Larson
Doctoral Dissertations and Projects
Depression is common among older adults in long-term care (LTC) facilities. As many as 50%-80% of residents will experience depressive symptoms or have a diagnosis of depression. Depression increases the risk of poor health-related outcomes in older adults. A review of the literature suggests that early intervention using movement-based techniques decreases the risk for depression and improves depressive symptoms. This scholarly project aimed to reduce the risk of depression of residents in an LTC located in a suburban area in Midwestern United States. The LTC facility and a Doctor of Nursing Practice (DNP) student implemented the Chair One Fitness program …
Decreasing Psychiatric Readmissions In A Nonprofit Behavioral Health Hospital, John Schreiber
Decreasing Psychiatric Readmissions In A Nonprofit Behavioral Health Hospital, John Schreiber
Doctoral Dissertations and Projects
This scholarly project aimed to decrease adult readmission rates of psychiatric patients in a Nonprofit Behavioral Health Hospital (NBHH). The project aims to decrease the number of readmissions to an NBHH by 25% using specific interventions that have been revealed through a literature review of evidence-based practices (EBPs). A literature review revealed focused EBP interventions that could decrease readmissions. The PICOT question for this project was, "In adult mentally ill patients who are in an NBHH, what is the effect of focused interventions compared with usual care on readmission rates in 2 months?" Reducing the number of psychiatric readmissions is …
Strength In Community: A Community-Based Health Program To Improve Weight Loss And Blood Pressure Within An African American Faith-Based Organization, Leonna Sylvitrice Ameduite
Strength In Community: A Community-Based Health Program To Improve Weight Loss And Blood Pressure Within An African American Faith-Based Organization, Leonna Sylvitrice Ameduite
Doctoral Dissertations and Projects
In general, conventional health promotion strategies have not successfully mitigated health inequality and health disparities in African American communities. Health disparities among African Americans continue to persist. Obesity and hypertension are more prevalent in African Americans and are well-known precursors to chronic illness such as cardiovascular disease, diabetes, and stroke. A wholistic solution to health disparities is complex and multifaceted. However, community-based programs such as faith-based health promotion programs can be an integral part of the solution. The purpose of this project was to provide a community faith-based weight loss program for African Americans to help guide weight loss and …
Increasing Knowledge Of Abdominal Aortic Aneurysm Screening Criteria And Introduction Of A Screening Tool To Improve Aaa Screening In A Family Practice Clinic: An Evidence-Based Practice Project, Jennifer Elizabeth Rank
Increasing Knowledge Of Abdominal Aortic Aneurysm Screening Criteria And Introduction Of A Screening Tool To Improve Aaa Screening In A Family Practice Clinic: An Evidence-Based Practice Project, Jennifer Elizabeth Rank
Doctoral Dissertations and Projects
Abdominal aortic aneurysms (AAA) are diagnosed most frequently in male patients of advanced age with a current or past smoking history. Screening for AAA by ultrasonography is effective at detecting clinically significant aneurysms and reduces AAA-associated and all-cause mortality at short-term and long-term follow-up. The criteria for screening include male gender, age 65 to 75, and a current or past smoking status. Additional criteria that may be considered include family history of AAA in a first-degree relative and/or a personal history of hypertension or atherosclerotic cardiovascular disease. Based on review of the evidence, the project leader designed an evidence-based practice …
Implementation Of An Independent, Unit Specific Lgbt Cultural Competency Training, Kristen Nicole Kaiafas
Implementation Of An Independent, Unit Specific Lgbt Cultural Competency Training, Kristen Nicole Kaiafas
Doctoral Dissertations and Projects
This paper describes the methodology of the implementation of an educational intervention in the emergency department (ED) setting seeking to improve the provision of culturally competent care for the Lesbian-Gay-Bisexual-Transgender (LGBT) population. The intent of the project was to improve the knowledge and skills, openness and support, and oppression awareness of ED nurses when providing care to the LGBT population. The scholarly project included an evidence-based, unit specific education intervention to improve these measurement outcomes. Analysis utilizing descriptive statistics demonstrated an increase in the mean knowledge and skills and openness and support following the education intervention. The results illustrated an …
Low Health Literacy Impact On Heart Failure Patients' Readmissions: An Integrative Review, Melissa S. Goodwin
Low Health Literacy Impact On Heart Failure Patients' Readmissions: An Integrative Review, Melissa S. Goodwin
Doctoral Dissertations and Projects
Heart failure is a common chronic disease that affects numerous people throughout the world. Low health literacy plays a critical role in heart failure mismanagement. The purpose of this systematic review was to summarize what is known about the impact of health literacy of heart failure patients’ readmissions. MEDLINE, CINAHL, PSYCHINFO, and PUBMED databases were searched for the years 2010-2020 and for English language articles. The findings indicated that low health literacy has a significant impact on heart failure patients’ unplanned readmissions. Interventions for low health literacy also affect outcomes for heart failure patients; for example, reduce unplanned hospital readmissions. …
Implementation Of Post Forms Upon Hospice Admission: An Evidence-Based Practice Intervention To Reduce Hospice Revocations, Joanna Grace Asselin
Implementation Of Post Forms Upon Hospice Admission: An Evidence-Based Practice Intervention To Reduce Hospice Revocations, Joanna Grace Asselin
Doctoral Dissertations and Projects
Background and Purpose: Reduction of live hospice discharges in the form of revocations is necessitated in order to maintain regulatory compliance and meet quality measures. Upon admission to hospice services, many have not considered personal desire regarding further intervention beyond Do Not Resuscitate (DNR) status. Evidence-based practice has revealed Physician Order for Scope of Treatment (POST) forms as effective in enhancing translation of patient desires related to care and interventions at end-of-life. The clinical question of this scholarly project asked if implementation of POST forms upon admission to hospice services would result in decreased revocations with related emergency department (ED) …
Evaluating The Utilization Of A Combination Therapy To Improve Self-Efficacy And Glycemic Control In Patients With Type Two Diabetes Mellitus And Low Health Literacy, Crystal Manus Masling
Evaluating The Utilization Of A Combination Therapy To Improve Self-Efficacy And Glycemic Control In Patients With Type Two Diabetes Mellitus And Low Health Literacy, Crystal Manus Masling
Doctoral Dissertations and Projects
Type 2 diabetes mellitus is a significant health issue, as it requires patients to perform daily self-management activities. One in every three Americans with Type 2 diabetes has limited or low health literacy skills. Limited or low health literacy skills can impact a patient’s overall health outcome; therefore, a critical element for disease management and patient adherence is health literacy. The purpose of this three-month scholarly project was to determine if the utilization of an educational intervention specific to one’s level of health literacy, combined with a short message service reinforcement tool, could improve glycemic control and self-efficacy in Type …
Pharmacogenomics In Primary Care: Barriers To Implementation, Joshua Michael Fleming
Pharmacogenomics In Primary Care: Barriers To Implementation, Joshua Michael Fleming
Doctoral Dissertations and Projects
As technology and research evolve it is essential that practitioners in healthcare remain aware and cognizant of the changes that are going on around them and how these advancements may aid them in providing the best care to the patients that seek care from them. The largest breakthrough in the field of genetics has been the complete sequencing of the human genome. This landmark has paved the way for innumerable insights into every part of how care is delivered and stands to change the landscape of medicine entirely. Pharmacogenomics testing exists as a subset of genetic testing, and pertains to …
Improving Central Venous Catheter Infection Rates Through The Use Of A Bundle: An Integrative Review, Janice Laverne Harris-Hall
Improving Central Venous Catheter Infection Rates Through The Use Of A Bundle: An Integrative Review, Janice Laverne Harris-Hall
Doctoral Dissertations and Projects
The role of Central Venous Catheters (CVC) is significant for the End-Stage Renal Disease (ESRD) population. The placement of the CVC for a HD (HD) patient is not only necessary, but life-sustaining. CVCs are usually placed for an emergent HD treatment, while awaiting a permanently placed arteriovenous fistula or graft (AVF/AVG), or when the permanent access becomes non-functioning. There are multiple risk factors related to having a CVC placed, the most predominant complication being catheter line-associated bloodstream infections (CLABSIs). Studies have shown that implementing a CVC prevention bundle was associated with a significant reduction in the CLABSI rates within the …
Improving Perioperative Communication Through The Use Of A Nurse Navigator: An Integrative Review, Elizabeth Irene Christman
Improving Perioperative Communication Through The Use Of A Nurse Navigator: An Integrative Review, Elizabeth Irene Christman
Doctoral Dissertations and Projects
Patient-centered communication practices are critical for ensuring that patients have optimal care experiences and clinical outcomes. Unfortunately, today’s health care environment often presents numerous barriers to consistent and clear information exchange. These barriers are magnified in dynamic and fast-paced care environments such as the perioperative setting, where numerous interactions and communication exchanges must occur. The purpose of this integrative review is to examine the value of the nurse navigator role within the perioperative setting and evaluate whether it can improve patient and family satisfaction with communication and the care experience. The review includes the identification and appraisal of relevant literature …
Using Patient Safety Principles To Prevent Patient Harm, Octavia Reed Wynn
Using Patient Safety Principles To Prevent Patient Harm, Octavia Reed Wynn
Doctoral Dissertations and Projects
While healthcare is intended to promote and restore optimal health and quality of life, it has been realized that patients often experience unintended harm while consuming healthcare services. In a project conducted in a 12-bed intensive care unit, nurses completed a pre-survey to identify a baseline understanding of patient safety principles. They then completed online educational modules designed to teach patient safety principles including patient and family centered healthcare, systems safety, and culture of safety. Following the educational intervention, a postsurvey to assess for increased understanding was administered. Forty-seven nurses completed the presurvey and education showing improved understanding of patient …
Using Screening, Brief Intervention, Referral To Treatment To Address Problematic Alcohol Use At A University Student Health Center, Tajuane H. Dockery
Using Screening, Brief Intervention, Referral To Treatment To Address Problematic Alcohol Use At A University Student Health Center, Tajuane H. Dockery
Doctoral Dissertations and Projects
Problematic drinking is a public health concern on college campuses. College students who do not have their risky drinking behaviors addressed are at greater risk for developing Alcohol Use Disorder (AUD). Despite known risks associated with drinking on college campuses, many college health centers miss an opportunity to address these behaviors because they lack a systematic process for identifying students at risk and referring them for treatment. This evidence-based project evaluated the effectiveness of using Screening, Brief Intervention, Referral to Treatment (SBIRT) to identify students with risky drinking behaviors and the impact the screening process had on facilitating a referral …
The Impact Of Intermittent Auscultation And Physiologic Labor Support Education For Nurses On Patient Satisfaction And Nurse Self-Efficacy, Heather N. Soper
The Impact Of Intermittent Auscultation And Physiologic Labor Support Education For Nurses On Patient Satisfaction And Nurse Self-Efficacy, Heather N. Soper
Doctoral Dissertations and Projects
Knowledge and implementation of intermittent fetal auscultation (IA)and labor support mechanisms in the hospital setting are becoming a lost art. Nurses are well-trained on how to utilize technology and perform medical interventions for laboring patients, but are losing the confidence and skills necessary to promote normal, physiologic births for low-risk women. In order to address these concerns, an evidence-based practice project was piloted in a hospital in Virginia. Nurses were trained on the science, clinical application, and outcomes of both intermittent auscultation and continuous electronic fetal monitoring for low-risk women; education was also focused on labor support mechanisms and the …
A Mixed-Methods Case Study Of Spiritual Formation And School Induced Stress In Student Registered Nurse Anesthetists During Hospital Residency, R. Dawn Whybrew
A Mixed-Methods Case Study Of Spiritual Formation And School Induced Stress In Student Registered Nurse Anesthetists During Hospital Residency, R. Dawn Whybrew
Doctoral Dissertations and Projects
Student registered nurse anesthetists in hospital residency undergo a rigorous schedule. For Christian nurse anesthesia students, spiritual formation may suffer due to the stressors of anesthesia residency. The purpose of this mixed-methods case study sought to understand and describe the perceived influence of participation in spiritual formation opportunities during nurse anesthesia hospital residency on students’ spiritual formation level as well as their ability to handle stressors of hospital residency. In phase one of the study, the researcher conducted a purposeful convenience sampling of 54 Junior and Senior students in a quantitative quasi-experimental design. In phase one, the participant's spiritual formation …
An Evidence-Based Intervention To Enhance Provider Awareness And Confidence In Addressing Polypharmacy, Catherine Marie Steiner
An Evidence-Based Intervention To Enhance Provider Awareness And Confidence In Addressing Polypharmacy, Catherine Marie Steiner
Doctoral Dissertations and Projects
Polypharmacy is a healthcare problem of epidemic proportions in the United States. It is frequently associated with negative health outcomes in the lives of both elderly and chronically ill persons at excessive costs to the United States healthcare system. Appropriate medication management incorporating evidence-based guidelines is essential to addressing polypharmacy. Prescribing clinicians in all disciplines have expressed a lack of confidence and perceived gaps in knowledge to address polypharmacy through deprescribing. This scholarly project aimed to determine if a polypharmacy protocol intervention, based on the most current evidence-based guidelines in prescribing and deprescribing, would improve clinician confidence in the decision …
Improving Patient Satisfaction With The Virtual Handoff Process Through The Utilization Of Educational Pamphlets In The Emergency Department, Lynda Michelle Heintz
Improving Patient Satisfaction With The Virtual Handoff Process Through The Utilization Of Educational Pamphlets In The Emergency Department, Lynda Michelle Heintz
Doctoral Dissertations and Projects
Boarding patients in the emergency room while waiting to transfer the patient to the proper unit can be harmful to clinical care and have significant financial opportunity costs. At one local hospital it was found that on average patients were being boarded in the emergency room (ED) for approximately 85 minutes waiting to be transferred. Several barriers that caused this delay were found including, delay in room cleaning, nurse staff shortage, and inability to give report to the nurse receiving the patient. In an attempt to combat this delay which may be caused by a difficulty in giving patient report, …
A Transcendental Phenomenological Study Of Student Nurses With Learning Disabilities In The Clinical Learning Environment, Lorna Jean Woodhall
A Transcendental Phenomenological Study Of Student Nurses With Learning Disabilities In The Clinical Learning Environment, Lorna Jean Woodhall
Doctoral Dissertations and Projects
The purpose of this transcendental phenomenological study was to record the lived experiences of nursing students with learning disabilities while in the clinical learning environment. Dewey’s theory of education and Knowles’ theory of adult learning were used to ground this study. Their theories provided a foundation to understand how the learning process is affected in nursing students with learning disabilities in the clinical learning environment. The study answered the following research questions: (a) What are the lived experiences of student nurses with learning disabilities in the clinical learning setting? (b) How are nursing students impacted by their learning disability during …
Increasing Asymptomatic Chlamydia Screening In The Ed, Mikyung Kim
Increasing Asymptomatic Chlamydia Screening In The Ed, Mikyung Kim
Doctoral Dissertations and Projects
The Centers for Disease Control and Prevention (CDC) recommends chlamydia screening in young women and others who are at risk based on scientific evidence related to the effectiveness of screening to prevent chlamydial infection. Female patients may visit the emergency department (ED) with symptoms such as urethritis, abdominal pain, or vaginal spotting. For men, most complaints are urinary problems, discharge from the penis, and testicular pain. However, most infected patients are never symptomatic and have no abnormal physical findings. Therefore, the question that spurred this project was, “Why aren’t asymptomatic patients screened more often?” Furthermore, “Why are the CDC screening …
The Use Of Patient Diaries In The Cvicu To Prevent Post-Intensive Care Syndrome And Improve Family Satisfaction With Care, Denise M. Goodberlet
The Use Of Patient Diaries In The Cvicu To Prevent Post-Intensive Care Syndrome And Improve Family Satisfaction With Care, Denise M. Goodberlet
Doctoral Dissertations and Projects
Patients in the ICU are at risk for adverse physiological and psychological symptoms including anxiety, depression and confusion common with post intensive care syndrome. The presence of these symptoms is correlated with poor satisfaction with care and decreased quality of life. This creates stress for patients as well as the families of these patients. This evidence-based practice (EBP) project sought to answer the clinical question: For patients and families in the cardiovascular intensive care unit (CVICU), can participating in an intensive care diary program, when compared to standard of care, decrease the symptoms and incidence of post-intensive care syndrome in …
Reducing Emergency Department Length-Of-Stay And Overcrowding Through Team Triage, Kirsten Gisela Sizemore
Reducing Emergency Department Length-Of-Stay And Overcrowding Through Team Triage, Kirsten Gisela Sizemore
Doctoral Dissertations and Projects
Emergency department (ED) overcrowding is an internationally studied phenomenon linked to adverse patient outcomes, including death. Early medical screening exams (MSE) may prevent morbidity and mortality. Yet, EDs struggle to evaluate, treat, and discharge patients within recommended and nationally monitored benchmark times. This evidence-based scholarly project explored if stationing an advanced practice provider (APP) in triage would improve door-provider-times, length-of-stay (LOS), and the left without being seen (LWBS) rate at a medical center ED in the southeastern United States. A pre- and post-intervention design compared benchmark times after a provider triaged alongside the registered nurse (RN) during times of high …
The Lived Experience Of Practical Nursing Faculty Who Have Transitioned To A Concept-Based Curriculum As Required By The North Carolina Nursing Curriculum Revision Project, Lora Poole Bartlett
The Lived Experience Of Practical Nursing Faculty Who Have Transitioned To A Concept-Based Curriculum As Required By The North Carolina Nursing Curriculum Revision Project, Lora Poole Bartlett
Doctoral Dissertations and Projects
The purpose of this hermeneutic phenomenological qualitative study was to understand the lived experience of practical nursing (PN) faculty who have transitioned from a systems-based curriculum to a concept-based curriculum (CBC) as required by the North Carolina nursing revision project. In recent years, nursing education transformation has been a topic of interest among government organizations, the healthcare system, nursing leaders and organizations, and faculty of nursing programs. However, literature specifically on how faculty perceive and transition into these new innovative methods of teaching is minimal. The participants in the study were PN faculty employed by North Carolina community colleges and …
Teachback: The Implementation Of The Teach-Back Method To Improve Patient Satisfaction With Care Transitions, Elizabeth M. Breton
Teachback: The Implementation Of The Teach-Back Method To Improve Patient Satisfaction With Care Transitions, Elizabeth M. Breton
Doctoral Dissertations and Projects
Patient education at discharge from the hospital is an essential element to continuation of care and management of chronic health issues. While many elements may contribute to patient satisfaction with discharge education, use of the teach-back method has been found to improve retention of discharge instruction, as well as increase patient confidence in chronic disease management and self-care at the time of discharge. Patient satisfaction with discharge education is a notable component of hospital reimbursement by national standards, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) results. Following education of nursing staff participating in …