Nursing Commons^™

Reducing Surgical Site Infections Through Combination Skin Preparation: A Benchmark Study, Jennifer Schacherer

MSN Capstone Projects

Reducing surgical site infections allows for a tremendous reduction in healthcare costs, reduces length of hospital stay, decreases hospital readmissions, and promotes patient safety. The Centers for Disease Control and Prevention estimates that surgical site infections have a 3% mortality rate and 75% of all surgical site infection-related deaths are directly attributable to the surgical site infection (Centers for Disease Control and Prevention [CDC], 2020). With millions of surgeries being performed every year, the reduction of surgical site infections enhances patient safety and ensures the protection of the public. Currently, no standard protocol exists for skin preparation beyond the parameters …

The Need For Change In Mental Health, Autumn R. Lambert

MSN Capstone Projects

In order to properly provide care for patients presenting to the emergency room with exacerbations of mental illness, appropriate education should be provided. Holistic care that has been taught to all healthcare professionals should also be practiced at all times. With the appropriate care being provided, healthcare for patients suffering with a mental illness can find healing care that is free of discrimination and bias.

Effect Of Blue Light On Sleep & Delirium In The Intensive Care Unit, Hunter Montgomery

MSN Capstone Projects

Intensive care units (ICU) across the country are plagued with a silent morbidity that increases monetary costs, patient stay, and nursing retention known as delirium. Delirium can drive up all three of these factors creating an unnecessary burden on hospital and community resources. In response to the silent crisis, a delirium prevention bundle was created to alleviate the burdens that ICU delirium can put on a hospital.

Reviewing implementation strategies showed that employees needed extensive training on recognizing the different types of delirium including hyperactive, mixed, and hypoactive delirium. It was determined that for the delirium bundle to be successful …

Medication Reconciliation In The Elderly, Tina L. Coen

MSN Capstone Projects

Medication reconciliation is a practice that is underutilized in hospitals and primary care settings, and as a result the geriatric population is experiencing frequent ER visits and hospital readmission's. The geriatric population is subject to injury due to medication errors more than any other group. Medication reconciliation is an important part of safely caring for the geriatric population and can decrease the number of inappropriate medications that are prescribed. (Moro, 2016)

Hourly Rounding To Reduce Patient Falls - A Quality Improvement Project, Shelley L. Lloyd

MSN Capstone Projects

Patient falls are devastating. They can result in injury and even death. They also result in extra costs for the patient as well as they facility. Hourly rounding is a simple process that can help reduce the number of patient falls within an acute care facility. Purposeful hourly rounding will help meet the needs of the patient as well as allow the staff member to asses the environment for safety issues. Rounding should happen every hour during the day and every two hours at night. During these rounds, staff will ask the patient about pain, bathroom needs, comfort, peacefulness of …

Music Therapy For Pain And Anxiety Management In Postoperative Orthopedic Patients, Rhapsody C. Onderko

MSN Capstone Projects

It is estimated that 50-75% of postoperative patients feel they are not receiving adequate pain relief (Schneider, 2018). Both patients and nurses feel overwhelmed when pain is not well managed. Music therapy is safe, inexpensive, and has the potential to be easily incorporated into the nursing plan of care (Hole, Hirsch, Ball, & Meads, 2015). There are statistically significant findings that music decreases pain throughout the literature (Ames et al., 2017; Aris et al., 2019; Dai et al., 2020; Gallagher et al., 2018; Hole et al., 2015; Hsu et al., 2019; Laframboise-Otto et al., 2021; Leonard, 2019; Lin et al., …

Evidence-Based Change Benchmark: Implementing Intervention Strategies Aimed At Reducing Patient Falls, Victoria Nix

MSN Capstone Projects

This paper provides an overview of an evidence-based change project that arose from the following PICOT: In patients at risk for falls [P], how does implementing fall risk prevention [I] compared to no fall risk prevention [C] affect fall rates [O] within 3 months of implementation [T]? A comprehensive review of primary sources dealing in clinical studies was found to support the case that fall prevention measures, specifically patient-specific bedside tools, have shown to be instrumental in reducing patient falls. The development and implementation of a robust Fall Prevention Program designed around the latest research was the goal; however, the …

Cardiac Rehabilitation Benchmark Study, Catherine Cottle

MSN Capstone Projects

This benchmark study attempts to evaluate the effectiveness of cardiac rehabilitation in reducing mortality and hospital readmission rates of post-myocardial infarction patients. Several peer-reviewed articles were reviewed assessing the efficacy of cardiac rehabilitation. It was discovered that cardiac rehabilitation reduced several negative effects regarding heart disease, including the reduction of mortality and hospital readmission rates.

A Narrative Review Of Closing Bundles To Prevent Surgical Site Infections, James G. Tucker

MSN Capstone Projects

Each year, surgical site infections (SSIs) ravage patients and our healthcare system. The amount of pain, suffering, and money lost each year to a mostly preventable complication places a great deal of strain on our already fragile healthcare system. In the following paragraphs, sound, quantifiable data is presented indicating the effectiveness of closing bundles. While no "one size fits all" bundle can be recommended, the evidence presented suggests that using additional evidence-based interventions in surgical patients' care drastically lowers SSI rates. The need for future research revolves around tailoring bundles to meet the needs of individual patients. No two patients …

Reducing Burnout Through Guaranteed Breaks In Nurses In The Acute Care Setting: A Benchmark Study, Stefan D. Arias

MSN Capstone Projects

This benchmark study attempts to promulgate the issue of burnout and the importance of addressing at least one way to mitigate further damage to the profession of nursing.

Evidence-Based Follow-Up Care For The Cardiac Patient: A Benchmark Project, Natalie E. Kelley

MSN Capstone Projects

Since the implementation of the Affordable Care Act (ACA) in 2012 and the Hospital Readmission Reduction Program (HRRP), hospitals and organizations have been encouraged to improve care coordination to reduce the number of avoidable readmissions (CMS, 2020). Three of the six publicly reported condition or procedure-specific 30-day risk-standardized unplanned readmission measures in the HRRP are cardiac-related: heart failure, acute myocardial infarction, and coronary artery bypass grafting (CMS, 2020). Although guidelines call for structured follow-up in patients with cardiac diagnoses after a hospital admission, just over half of admitted patients are being scheduled for follow-up (Goyal et al., 2016; Heidenreich et …

An Education Change Project To Improve Pharmacy And Nursing Collaboration, Ebra Secka

MSN Capstone Projects

Nursing and the pharmacy department play a significant role in the delivery of quality health care. The relationship between nursing and the pharmacy staff is interdependence, making it extremely important for these two departments to communicate. In the absence of effective communication, misunderstanding between nurses and pharmacists could lead to unnecessary delays in the quality of service that the patients receive. The Veterans Affairs North Texas Health Care Systems (VANTHCS) devised a Drug Policy and Procedure (DPAP) on August 14th, 2013, governing the control and utilization of drugs for both inpatients and outpatients (North Texas Health Care Systems Memorandum No. …

Use Of Probiotic In Preventing Antibiotic-Associated Diarrhea, Chanda Amatya

MSN Capstone Projects

Antibiotic-associated diarrhea (AAD) including Clostridium difficile associated diarrhea (CDAD) has been a challenging topic for the healthcare industry. AAD is caused by the disruption of normal microbial balance along with the gastrointestinal (GI) tract due to the use of an antibiotic. AAD not only increases healthcare cost burden but also increases morbidity and mortality among vulnerable populations such as the elderly. Death from CDAD for a patient over 65 years is about 90% (Mallina et al., 2018). Antibiotic use is very common among the elderly and it is the responsibility of healthcare providers to take appropriate measures in preventing complications …

Music Therapy For Treatment Of Bpsd, Heather Cunningham

MSN Capstone Projects

Alzheimer's disease can cause a decline in cognitive and physical abilities, however, behavioral and psychological issues can occur as well. With the many ways to alleviate behavioral and psychological symptoms in dementia (BPSD), music therapy shows to be an effective, low-cost, feasible, and safe option for patients. Music therapy can reduce BPSD and equips caregivers with a non-pharmalogical way to provide their loved ones with comfort.

Earplugs For Intensive Care Unit Delirium Prevention: Impact Of An Evidence-Based Intervention On Patient Outcomes, Morgan P. Click

MSN Capstone Projects

Delirium is characterized by the abrupt onset of significant confusion that may cause the patient to become agitated, aggressive, unable to focus, and sometimes hallucinate. Intensive care unit (ICU) delirium is a large area of focus for current research to help understand the causes, preventative measures, and potential treatments. This problem isn’t only faced in the hospital setting, but can affect patients long after discharge. The PICOT question guiding this benchmark project stated: In adult ICU patients (P), how does the use of earplugs (I) compared to the use of no earplugs (C) affect the patient’s future risk of ICU …

Effects Of Alternate Pain Therapies With Scheduled Pain Meds, Ebubechukwu F. Ojukwu

MSN Capstone Projects

Despite the high possibility of saving lives and improving general welfare, surgery can also lead to potential harm, including acute and long-term pain. Postoperative pain control is an essential step of the surgical care plan and is critical in improving the patient’s outcome. Pain can be treated in several ways, but in the health care system the primary method used is through medication. The aim of this project is to use literature to explore the following picot question: In post-surgical patients (P) how the implementation of alternative pain control methods (I) paired with narcotics/opioids (C) compared to only using medications …

Workplace Violence Interventions: A Benchmark Project, Madison Orwosky

MSN Capstone Projects

Workplace violence incidence rates are increasing in the medical field. The staff in the emergency department (ED) is especially prone to these workplace violence events due to patients arriving in such unpredictable states. Alarmingly, most medical staff members report experiencing some type of workplace violence, whether that is verbal, physical, or sexual violence. The former director of the Parkland ED sent out a survey to the ED staff regarding workplace violence. Out of 145 participants that completed this survey, 121 participants reported that they had personally experienced a workplace violence event. This survey data illuminates that a change is warranted …

Telemedicine In Schizophrenia, Stacy H. Williams

MSN Capstone Projects

Schizophrenia is a chronic neurological brain disorder that affects approximately 2.6 million adults in the United States alone. This condition affects twenty million people worldwide according to the World Health Organization. “Patients with schizophrenia often die at a considerably younger age than the rest of the population,” (Wallace, 2017). The treatment of this condition is complex because of the array of different symptoms and presented behaviors. Treatment consists of targeting the symptoms. This is done with medication and psychotherapeutics treatments. ‘Despite continued therapeutic advances, the life expectancy of patients with schizophrenia is reduced by approximately 10-25 years compared to that …

Aromatherapy Essential Oil Usage In Managing Chemotherapy Side Effects: A Benchmark Study, Ariana C. Smith

MSN Capstone Projects

This capstone project details the usage of essential oil aromatherapy in managing the common side effects of chemotherapy in the outpatient setting. Patients often report that these side effects to to burdensome and place significant effects on one's quality of life. Through this project, viewers will learn about four common oils, including ginger oil, lavender oil, peppermint oil, and orange oil in managing the side effects of chemotherapy.

Video Education On Fever To Empower And Educate Caregivers, Amanda April Thiel

MSN Capstone Projects

Nursing research and evidence-based practice are an essential part of the nursing profession. This paper includes discussion of the evidence to support an evidence-based benchmark project using a video to educate caregivers on how to care for a child experiencing a fever and an overview of the proposed project process. Fever has been shown to cause parental anxiety, and caregivers tend to seek medical help due to lack of education on how to care for a child with a fever (Bertille et al., 2018; Gunduz et al., 2016). The following PICOT question is the foundation of the proposed benchmark project: …

Implementation Of The Deterioration Index: A Benchmark Study, Danielle E. D'Aquisto

MSN Capstone Projects

With Intensive Care Unit (ICU) and Emergency Department (ED) beds extremely limited during this pandemic, it is time to implement an automated early warning scoring index to assist nurses in identifying clinical deterioration prior to the patient becoming clinically unstable. The goal of using this risk score is early identification of clinical deterioration, with early intervention, and thereby decreasing cardiac arrests outside of the ICU and decreasing unplanned ICU admissions. There are multiple early warning scoring tools, but they all serve one purpose, to calculate a score based upon nursing and physician assessments, lab values, and medical history that will …

Further Fall Prevention, Kristen L. Janes

MSN Capstone Projects

Falls continue to occur in the acute care setting despite our best efforts. Decreased falls, increased patient safety, decreased cost, and decreased length of stays in the acute care setting are imperative. This is a benchmark study on the concept of an education pamphlet being presented to patients and family members educating on all fall precautions and interventions that are to be expected to be in use during their stay. Study also reflects fall interventions that are in use and have shown to decrease falls.

Fall Prevention: Remote Video Monitoring, Shawna Moser

MSN Capstone Projects

Patient safety is a top priority for all healthcare organizations, but as a healthcare facility, is everything, within the means of the facility, being done to ensure patient safety? Challenges exist for all healthcare organizations when faced with patient safety, but there it is a necessity for these healthcare organizations to overcome these challenges and protect their patient population. A common challenge within the acute care setting is the prevention of falls. “Falls during hospitalization harbor both clinical and financial outcomes” (Gringauz et al., 2017, p. 1). Research on fall interventions has shown that a multifocal approach is most effective …

Post-Operative Nausea And Vomiting Risk Assessment, Lindsay Majors

MSN Capstone Projects

Patients who must undergo surgery with general anesthesia sometimes experience nausea and vomiting. This is a potential side effect of general anesthesia and is termed post-operative nausea and vomiting, or PONV. The screening process prior to surgery usually includes questions regarding previous problems with PONV; however, this only applies to patients who have had previous experiences with surgery and general anesthesia. Relying on a patients’ history of PONV alone to predict this unwanted side effect limits the providers’ ability to assess and prophylactically treat PONV. Assessing for risk of PONV using a pre-operative risk assessment tool can help to identify …

Educational Tool For Chronic Low Back Pain Interventional Procedures And Modalities, Stacy Dominy

MSN Capstone Projects

Chronic low back pain is a problem for many people. It can be debilitating and those suffering often have a difficult time finding relief. Many times, people rely on potentially dangerous and and addicting medications for pain relief. There is a great need to educate people on the dangers of this route and the potential benefits of interventional procedures and modalities for pain relief. By creating an educational tool backed by evidence-based information, patients can be empowered to make the best choices for their health.

Type 2 Diabetes - A Change For A Better Life, Hilary Greene

MSN Capstone Projects

Cardiovascular disease has been known to be the leading cause of mortality in patients with type 2 diabetes. With diabetes on the rise in the United States, it is important to assess changes in these patients to decrease the risk of developing cardiovascular disease or a major cardiovascular event such as a myocardial infarction, stroke, or death. If able to address healthy alternatives to patients to reduce the risks of major cardiovascular events such as a myocardial infarction or stroke, it could potentially save many lives. As a nurse educator, it is important to provide patients with the education they …

Effects Of Palliative Care On Nurses’ Knowledge And Attitudes, Daniel Kerr

MSN Capstone Projects

Heart failure (HF) is a chronic, progressive disease that affects 6 million Americans (Ng & Wong, 2017). During the course of the disease, patients have worsening symptoms and need increasing levels of care from both medical staff and home caregivers. Often, these caregivers are family members or friends who spend a significant amount of their free time assisting the patient, leading to significant stress and burden on the caregivers. Recent changes in recommendations from the American Heart Association (AHA) include Palliative Care (PC) consultation for patients diagnosed with advanced stage heart failure, but many physicians have not included a PC …

Treatment Of Acute Bronchitis In Active Duty Military Members Benchmark Project, Nicole Williams

MSN Capstone Projects

Antibiotic resistant infections are a growing problem in the United States and the world. The main cause of this is antibiotic prescriptions, which can not only cause antibiotic resistance but adverse events. Decreasing the amount of antibiotics prescribed for inappropriate conditions can help to decrease the rates of antibiotic resistant infections and the problems these infections can cause. One illness that is treated frequently with antibiotics, against recommendations, is acute bronchitis. Acute bronchitis is a self-limiting viral infection, characterized by cough. By decreasing the number of providers who are prescribing antibiotics for acute bronchitis, the clinic can help to prevent …

Post Operative Handoff Tool Benchmark Project, Savannah E. Vinson

MSN Capstone Projects

According to a sentinel event statement issued by The Joint Commission in 2017, inadequate hand-off communication is responsible for many adverse-events, including sentinel events in healthcare. A study released in 2016 estimated that communication failures in U.S. hospitals and medical practices were responsible at least in part for 30 percent of all malpractice claims, resulting in 1,744 deaths and $1.7 billion in malpractice costs over five years(The Joint Commission [TJC], 2017). Successful handoff communication has the potential to substantially improve patient safety when leadership displays their commitment to successful handoff, when handoff is standardized and done face-to-face between healthcare providers, …

Administrative Interventions To Increase New Graduate Nurse Retention, Adam Ruff

MSN Capstone Projects

Topic: Administrative Interventions to Increase New Graduate Nurse Retention

PICOT Question: In acute care units (P), how do employee engagement interventions from nursing administration (I) compared to no employee engagement interventions (C) affect new nurse turnover (O) within 3 months of hire (T)?

Rationale: New nurse retention and turnover is arguably the most significant factor affecting health administrators on a regular basis. This issue becomes even more pertinent as it is estimated that up to 40% of the nursing workforce is expected to retire within the next decade with new nurses becoming the best option to replace them. Administrative nursing …