Nursing Commons^™

Impact Of Self-Care Techniques On Nurse Burnout, Macie Mayrell

MSN Capstone Projects

Nurse burnout is a serious, widespread problem in the healthcare arena. Registered nurses need to understand the importance of self-care to prevent or alleviate nurse burnout. An Evidence-Based Practice Benchmark Study implements a relaxation room on a nursing unit to encourage and promote self-care among acute care nurses.

Impact Of Resiliency Training On Combating Burnout, Kimberly Labinsky

MSN Capstone Projects

Occupational burnout has long since been a problem but has only recently been acknowledged as the spark behind the fire that has led to our critical nursing shortage. Considering the emotional aftermath of the pandemic and the hardships that a strained economy will bring, we must learn how to extinguish these flames rather than adding fuel to this complex problem. Burnout is causing a vicious cycle within the healthcare workforce that will lead to detrimental effects on quality patient care. We must learn how to break the cycle.

The cycle starts with experienced nurses leaving unprecedented numbers and units primarily …

Adolescents With Depression Capstone Benchmark Project, Myeshia Salter

MSN Capstone Projects

This change project promotes the inclusion of adolescent involvement within the informed consenting process for recommended treatment plans for symptoms of depression. This project proposal will include the adolescent throughout the development of the treatment plan to promote compliance. The incorporation of this plan will encourage autonomy in the adolescent and aid with developing a plan that the adolescent agrees with. The current process does not include the adolescents' desires or opinions, which results in poor efficacy of the treatment plan, thus exacerbating the symptoms of depression.

Polypharmacy Teaching In The Acute Setting, Brandy Marie Duncan

MSN Capstone Projects

Within stable economic societies, polypharmacy has become a phenomenon that can be more harmful, although medications prescribed are with good intentions. Education is integral to nursing responsibilities; it is an intervention tool to help patients affected by polypharmacy. The interest in polypharmacy stems from witnessing the lack of patient education within the acute setting, and the lack poses a greater risk for adverse drug events (ADEs). The healthcare industry’s responsibility is to help alleviate the adverse effects that polypharmacy causes, such as falls, adverse drug reactions, hospitalizations, mortality, and cognitive mental (Fried, 2014).

A new performance improvement project (PI) will …

Preoperative Education For Cardiac Surgical Patients Benchmark Study, Jackson W. Payne

MSN Capstone Projects

Heart surgery is a term that scares a lot of people and rightfully so, as the heart is one of, if not the, most vital organ in the human body. So naturally, one can imagine the amount of fear and anxiety that patients feel when they are told they need heart surgery. This fear and anxiety is not unwarranted, either. Heart surgery, in most cases, is a major and highly complex operation with a lot of potential complications and negatives. Despite this, the majority of the time the benefits do outweigh the risks and patients elect to go forward with …

Medical Cannabis: Alternative To Opioids For The Treatment Of Chronic Pain, Brenda F. Seaton

MSN Capstone Projects

There is a growing body of evidence to suggest that cannabinoids (CBD) are beneficial for a range of clinical conditions, including chronic pain, sleep disorders, osteoarthritis inflammation, anxiety, depression, and enhanced quality of life. For patients with chronic pain and arthritis inflammation, traditionally pain-relieving medications, including opioids, have been prescribed for pain relief but with increased risks of addiction and adverse effects with poor outcomes. Medical cannabis use is an emerging treatment alternative to prescription opioids and as an adjunctive to diminish the use of opioids addiction. This project objectively reviews the works of literature on the challenges of proposing …

Central Line Associated Blood Stream Infection (Clabsi) Prevention Through Designated-Nurse Peripherally Inserted Central Catheter (Picc) Line Dressing Change, Belinder Atabongafac

MSN Capstone Projects

The goal of this review is to show ways in which a nurse can have influence in the patient’s life by caring for their PICC line. The rate of hospital-acquired infections is related to the care that patients get while admitted in the hospital. All hospital acquired infections can and should be prevented. This is also true for central line associated blood stream infections (CLABSI). The care provided to a patient with a PICC line, including how their line is taken care of, decides if the line gets infected, and if the patients get an infection. When patients get a …

Asthma Education With Asthma Action Plan, Lois K. Sanders

MSN Capstone Projects

MSN capstone project in which pediatric asthma patients were given audio visits for the purpose of formulating asthma action plans.

Alternating Pressure Overlay Systems, Maris Rathgeb

MSN Capstone Projects

Although preventable, pressure injuries are an overwhelming problem in the healthcare system and can lead to poor quality of life, increased length of hospitalization, and unsatisfactory patient outcomes. Many cardiac surgeries take anywhere from six to twelve hours, and patients are completely immobilized for the entire length of time. Alternating pressure overlays placed on the operating room table provide tissue offloading with inflating and deflating nodes, leading to micro-movements on high pressure bony prominences. The intervention PICO question to be answered in this paper is: In intraoperative patients (P), how does the use of an alternating pressure surface (I) compared …

Benchmark Project Cryotherapy To Prevent Chemo Induced Peripheral Neuropathy, Stephanie Davis

MSN Capstone Projects

As a nurse working in chemotherapy infusion, I have a direct role in symptom management. For patients receiving Taxanes, the most common adverse effect reported by patients is peripheral neuropathy. According to one meta-analysis, Taxane-induced peripheral neuropathy (TIPN) has very high incidence ranging from 11 to 87% and severely impairs patients’ quality of life (Jia et al., 2021). Patients may experience pain, weakness, loss of sensation, decrease in ability to perform ADLs, increased falls among many other impairments as a result. We understand the importance of performance status in oncology patients. This can lead to dose reductions or held treatments …

Safe Patient Handling And Mobility Olympics, Johnny R. Cortez

MSN Capstone Projects

The focus of this study is the implementation of a Safe Patient Handling and Mobility (SPHM) program titled SPHM Olympics. The study reviews the necessary components and background necessary to implement the project as well as evaluation tools to monitor the impact of the program on the safety of culture at Houston Methodist West (HMW). The program originated from the SPHM committee’s need to improve the utilization of SPHM equipment and techniques by clinical staff throughout the hospital as evidenced by the substantial number of clinical staff suffering from musculoskeletal disorders and HMW clinical staff’s current views that SPHM techniques …

Appointment Reminder System Benchmark Study, Anthony Rawlinson

MSN Capstone Projects

The average appointment “no-show” rate is 23% across 105 studies (Dantas et al., 2018). These “no-shows” cost an estimated 150 billion dollars a year to the American healthcare industry (Ruiz-Hernandez et al., 2020). Previous estimates place the cost of one no-show event at a primary office in the range of $125 to $274 (Aysola et al., 2020). These missed appointments not only cause a loss in office revenue, but also harm the patients missing the appointment (Marbouh et al., 2020). Some of the repercussions patients suffer from are longer wait times for appointments, higher Emergency Room (ER) admission rates, and …

Health Literacy In Acute Care Benchmark Study, Micah Duke

MSN Capstone Projects

Poor health literacy levels directly correlate to poor patient discharge adherence and to an increase in repeat emergency department visits and healthcare costs. In addition, poor health literacy levels are directly correlated to a decrease in patient health outcomes. Studies clearly demonstrate that determining patient health literacy levels can be used to develop appropriate discharge instructions and education that will improve patient adherence and health outcomes, thus reducing emergency department readmissions and healthcare costs.

The purpose of this benchmark project is to implement procedures for consistently obtaining patient health literacy levels, along with language preferences, using the HLS-SF12 and to …

Supporting Nurse Residency Programs By Determining Nurse Residency Value, Byron Carlisle

MSN Capstone Projects

There is a strong influence on retention of the new graduate nurse during the first year of a nurse residency program. A positive correlation between nurse residency programs and return on investment were found. The retention of the new graduate nurse is influenced on precepting and mentoring of the new graduate nurse. Standardizing the reporting of interventions should be the focus on future studies as there are many interventions in regards to precepting and mentoring that influence retention.

Resuscitation Of Hypovolemic Trauma Patients: Controlled /Hypotensive Resuscitation Vs. Conventional Resuscitation, Pamala D. Mcgowan

MSN Capstone Projects

The manner in which clinicians have used to resuscitate hemorrhagic trauma patients has been a continuous repetitive cycle over time. The cycle has gone from “run the fluids wide open in the patient” to “less is more in the patient”. As more evidence-based practice (EBP) emerges, reasons for ‘less is more’ become acutely evident. Large fluid volume resuscitation is highly suspicious for the exacerbation of the lethal triad of trauma: hypothermia, acidosis, and coagulopathy, thereby increasing bleeding and mortality (Cotton et al., 2006). The increased risk of bleeding also worsens the complications associated with trauma resuscitation. This all creates a …

Central Line Maintenance Team, Lauren Spears

MSN Capstone Projects

Background: CLASBI infections increase morbidity and mortality rates in intensive care units. Studies have shown that line teams can reduce CLASBI rates by 65% (Cuccaro et al., 2020).

Objective: This narrative review aims to determine if initiation of central line maintenance teams will help reduce CLASBI rates in the ICU.

Summary Databases including CINAHL, PubMed, and Cochrane were searched for randomized control trials (RCT), systemic, qualitative and case control studies to find research study evidence to determine if a dedicated central line maintenance team, specifically for insertion and dressing changes, will help reduce CLASBI rates in the ICU setting. The …

Using Simulation To Develop Clinical Judgment In New-To-Practice Emergency Department Nurses: An Evidence-Based Benchmark Project, Moreno Divine Comiskey

MSN Capstone Projects

In the past 6 months, the Emergency Department at the George Washington University Hospital has onboarded over twice as many new-to-practice nurses as experienced emergency nurses. Studies suggest that these new-to-practice nurses often are deficient in clinical judgment, and our observations at our hospital support these findings. Researchers have found that onboarding programs that include simulation have success in improving clinical judgment, and advocate for its use. Simulation gives another angle to the onboarding program in addition to preceptorship and classroom learning, and allows participants to bridge the gap between theory and practice safely and without fear of harming a …

The Use Of Standardized Patients To Improve Communication Skills: A Benchmark Study, Baylee A. Azbell

MSN Capstone Projects

Effective communication is an important skill set for all nurses to withhold. In the medical field, poor communication skills have been associated with negative patient outcomes, increase in patient dissatisfaction and complaints, faulty treatment adherence, inadequate patient education, malpractice claims and poor patient and healthcare team relationships (Lin et al., 2013). Communication is a learned skill and needs to be taught from the very beginning of nursing school. Nursing schools need to be proactive and prepare their nursing students in promoting clear communication skills to ensure patient safety and satisfaction in care. This issue led to the benchmark project that …

Change Of Policy Regarding Evidence Based Practice Interventions In Postpartum Hemorrhages And Promotion Of Standardization Of Care, Danielle Fulton

MSN Capstone Projects

Postpartum Hemorrhages are occurring at a devastating rate and require intervention, as postpartum women can die from hemorrhages. This project aims to establish interventions that should be a set policy, to help decrease the rate in which postpartum hemorrhages occur and the morbidity rate.

Technology Methods In The Bariatric Postoperative Follow-Up Phase Benchmark Study, Haley Rogers

MSN Capstone Projects

Diet and exercise seem to be the safer option for weight loss, but many individuals struggle to achieve maximum weight loss with these methods. Bariatric surgery has become a growing trend to help combat the obesity epidemic that society is now facing. A large increase in sleeve gastrectomy has been utilized and in 2013, there was a documented 468, 609 cases of bariatric surgery performed worldwide (Sherf Dagan et al., 2017). Bariatric surgery has been shown to provide the greatest level of weight loss when compared to traditional methods that include diet and exercise (Khan, 2016). Weight regain has been …

To Use Or Not To Use Oxygen For Mi Benchmark Study, Alexia Celaya

MSN Capstone Projects

It is a common practice for emergency personnel to administer oxygen for a patient diagnosed with a myocardial infarction. It is a well-known practice to place the patient on supplemental oxygen even if they are not hypoxic. The use of supplemental oxygen has been a cornerstone in the treatment of myocardial infarction. The rationale behind the administration of oxygen therapy is to increase oxygen delivery to the myocardium, therefore limiting the infarct size and future complications (Hofmann et al., 2017). The use of supplemental oxygen on normoxic patients has been challenged due to the possibility of causing further injury to …

Music For The Relief Of Preoperative Anxiety, Tyler G. Roberts

MSN Capstone Projects

Anxiety is a phenomenon commonly experienced by patients awaiting surgery (Jlala et al., 2010). Anxiety has been linked to negative impacts “on the induction of anesthesia, wound healing, risk of infection, and postoperative recovery” (Stern, 2013). The alleviation of preoperative anxiety is a positive and desired outcome for perioperative patients. An interview with a patient at University Medical Center yielded some insight into the need for the implementation of additional anxiety alleviating intervention. In the interview, the patient reported feeling distress from being able to hear everything that was happening outside of the patient’s preoperative room and feeling a large …

Cardiopulmonary Resuscitation Using High-Fidelity Simulators, Rebecca Walker

MSN Capstone Projects

Simulation and high-fidelity simulators (HFS) have become an important part of nursing education and its implementation into the curricula. It has become important in enhancing their knowledge and the development of competent nurses by reinforcement of skills that have been previously learned. HFS also increases students' confidence and reinforces their skills and knowledge while introducing cardiopulmonary resuscitation (CPR). The literature suggests that overall the students have greater retention of CPR skills if HFS is used instead of classical CPR training with low-fidelity simulators (LFS). However, some studies suggest that using HFS does not lead to retention of CPR skills or …

The Impact Of Cognitive Rehabilitation Therapy On Alzheimer's Disease, Kelsey Hall

MSN Capstone Projects

The number of people suffering from Alzheimer’s disease (AD) rises daily. This is a devastating disease for the patients, significant others, and families to have to experience. “Epidemiological data confirm what retirees have observed: about 30-50% of those living to their mid-80’s will have suffered a marked loss of cognitive ability, a harbinger of advanced AD, or will have suffered advanced AD. Further, the tragedy of AD affecting loved partners takes an enormous toll on their healthier partners” (Reid et al., 2017).

The current treatment regimen for Alzheimer’s disease includes medication therapy. Evidence has shown that there are only small …

Naps: A New Approach To Decrease Patient Adverse Outcomes, Ayesha Lakhani

MSN Capstone Projects

Hospitals have been short staffed, especially during the pandemic. Due to this many staff members have been overworked causing them to become stressed, exhausted, and not alert which is resulting in adverse patient outcomes (Aiken et al., 2004). One of the solutions suggested so far is nap. Nap is a low-cost solution which can help reduce the adverse outcomes of working and help promote positive patient outcomes. This benchmark study is a guide to institute naps and will provide a detailed step-by-step instruction to anyone to ensure a successful implementation of the project.

Aiken, L. H., Hwang, W., Dines, D. …

Prioritizing Sleep In The Cardiac-Surgical Patient, Ashley North

MSN Capstone Projects

Purpose: This project aimed to improve cardiac-surgical patients’ perception of sleep using earplugs and eye masks to reduce noise and light disturbances.

Implications: Sleep is imperative in the post-operative period, and many patients suffer from a lack of sleep. Earplugs and eye masks are a simple, cost-effective tool that can reduce incidences of delirium, reduce post-operative pain, and improve quality of sleep.

Methods: The Richards-Campbell Sleep Questionnaire (RCSQ) was used to survey patients’ perception of sleep pre-intervention. Information sheets were given to the patients about the eye masks and earplugs available in the room and the benefits that could from …

The Use Of Mobility And Medication On Patient’S Perception Of Pain In Hospitalized Patients With Chronic Back Pain Benchmark Study, Katherine E. Zaske Merenda Mrs., Katherine Merenda

MSN Capstone Projects

According to Boss & Huether, twenty-nine percent of Americans have been diagnosed with chronic low back pain (CLBP). This pain can affect every part of their lives leading to lost wages and decreased quality of life. CLBP is an issue experienced by many hospitalized patients. These patients may not be able to mitigate their pain as they normally would due to safety protocols in hospital settings. Exercise or mobility has been shown to decrease a person’s perception of pain. The importance of exercise and mobility in a hospital setting to help decrease a patient’s perception of pain needs further research. …

A Whole-Food Plant Based Diet And Its Effects On Cardiovascular Disease, Meredith A. Childress

MSN Capstone Projects

The purpose of this paper and benchmark study is to present evidenced-based data regarding the impact diet choices have on heart disease and how adherence to a whole food plant based (WFPB) diet compared to a Western diet affects cardiac disease. The PICOT question being asked for this change project is as follows: In adults with history of cardiac disease (P), how does adherence to a whole-food plant-based (WFPB) diet (I) compared to the Western diet (C) impact outcomes associated with coronary artery disease (CAD) (O) over three months (T)? A search of evidenced-based literature was conducted to determine the …

Diabetes Prevention Program, Ashley L. Stine

MSN Capstone Projects

The prevalence of diabetes in Texas has increased 40 percent over the last decade and will continue to rise as of 2019. New onset diabetes, chronic, and children with diabetes has significant rise in hospitalization rates. COVID and its restraints of limiting physical activity, restrictions of gyms and sedentary lifestyles. Chronic diabetics who were frequent flyer hospitalizations rates increase due to poor social support, mental health and stressors increased during COVID also. This diabetes prevention program that consists of 16wks for new and current diabetics would decrease complications of diabetes such as DKA, retinopathy, nerve pain, chronic pain, AMS, amputations, …

Healthcare Associated Infections: A Benchmark Study, Neal Ziedan

MSN Capstone Projects

When it comes to hospital-acquired infections, whether the hospital has implemented best-practice infection control measures, whether it has introduced best practice infection control measures, or whether it will be held vicariously liable for negligent or intentional failures by staff to follow the infection control measures in place, is the determining factor. If a hospital and its administrators fail to develop or implement best practice infection control methods, resulting in patient harm, they may be held directly liable. Patients may be held vicariously liable if hospital employees fail to comply with infection control measures implemented by the hospital during the course …