Nursing Commons^™

Evidence Based Change To Improve Outcomes In Cardiac Patients, Amy L. Callahan

MSN Capstone Projects

According to the Centers for Disease Control and Prevention, “heart disease is the leading cause of death in the United States” (CDC, 2022). Modern healthcare has made numerous advances in changing the prevalence of heart disease and has shifted resources to promoting prevention. When a patient requires admission to an acute care facility for heart disease exacerbation, the focus is more of treating the acute process and how to manage the condition moving forward.

Although there have been a substantial number of resources that have been allocated to prevention in the primary care and outpatient setting, there is a need …

Palliative Care In The Neonatal Population, Raegan Miller

MSN Capstone Projects

In more than 90% of cases of neonate deaths, terminal comfort care was provided in a Neonatal Intensive Care Unit (NICU) (Soni et al., 2011). Palliative care teams are increasing, but not enough organizations have embraced the need for better palliative care guidelines. Nor do many organizations know when, how, or if palliative care should even be introduced. These events lead to comfort care measures being underutilized in the NICU for most newborn infants with life-limiting and life-threatening conditions. Neonatal palliative care is discussed more than in years past, but little research has been dedicated to how early palliative care …

Standards Of Care In Surgical Site Prevention Benchmark Study, Jasmine Taylor

MSN Capstone Projects

In depth synthesis of studies supporting efficacy of alcohol-based rubs in prevention of surgical site infections.

Peer Support Buddy System To Reduce Nurse Burnout Benchmark Study, Ebony Jones

MSN Capstone Projects

This paper is a Benchmark project to introduce the use of a Buddy System program as peer support for acute care nurses, in the attempt to reduce nurse burnout.

Sepsis Work-Up And Treatment Interdisciplinary Approach, Alyssa M. Hughes

MSN Capstone Projects

Sepsis affects millions of Americans annually. Oncology patients are at greater risk for infection which in turn makes them higher risk for sepsis. In order to address sepsis bundle compliance a interdisciplinary team with distinct roles can be created out of current staffing with the end goal to provide better patient outcomes. The interdisciplinary teams involved include: nursing, pharmacy, physicians, lab technicians, and patient care technicians. Mobilizing all of these people and giving an assigned role along with early notification with the goal to improve compliance to sepsis bundles to 90% a month among all patients diagnosed with sepsis.

Mitigating Fatigue In The Triage Process: A Creative Solution To Shorter Shifts, Rebecca J. Arismendi

MSN Capstone Projects

Triage is a critical assessment process performed by a registered nurse by which Emergency Rooms (ERs) sort patients who present for a medical evaluation. With ER visits increasing, pressure on staff to move patients through the department is often palpable. Whether a patient decides to walk in, or come in by ambulance, the first person to assess the patient is the triage nurse. They determine the appropriate level of care needed for the presenting complaint.

After a review of literature, it was found that fatigue is correlated with shift length in triage with the highest level of fatigue being at …

The Implementation Of A Nurse Residency Program, Jessica Conrad

MSN Capstone Projects

Implementing a nurse residency program in a hospital can be a successful plan to improve nurse retention and the quality of patient care. Nurse residency programs allow new graduate nurses to transition into professional practice and gain skills for safe and effective care. Components of the programs include preceptorship, educational seminars, shadowing days, and support from preceptors, educators, and other leadership members. The program also may provide benefits to hospitals, including improved patient outcomes, nurse job satisfaction, and decreased costs associated with reduced turnover. Successful implementation needs leadership, collaboration, and communication among all stakeholders, including the staff nurses, preceptors, educators, …

The Introduction Of A Family Advisory Council In A Neonatal Icu, Jennifer Streelman

MSN Capstone Projects

Having a baby can be a beautiful thing, but sometimes it’s not all sunshine and roses. Birth sometimes does not go smoothly, and sometimes it happens way too soon. The babies that need help at birth all end up in the neonatal ICU requiring differing levels of care. This is never what anyone plans, and therefore can cause lots of stress to new parents trying to navigate not only being new parents, but suddenly thrust into a world of medical uncertainty. Creating an environment that focuses on family centered care is vital to healthy role transition. The presence of a …

Job Satisfaction And Burnout In Nursing, Tasha M. Tovar

MSN Capstone Projects

Job satisfaction, or lack thereof, can directly lead to burnout. Nursing is known globally as a high-stress career, thus leading to an increased level of burnout. Job burnout is among the most important occupational disorders and phenomena which have received great attention in the recent century (Nabizadeh et al., 2020). Multiple studies have proven that subtle, low-cost interventions can decrease the burnout experienced by nurses, leading to reduced turnover rates and an increase in the quality of patient care. Higher quality of care leads to improvement in patient satisfaction scores and also to increased reimbursement rates (Jun et al., 2021). …

Outpatient Intravenous Antibiotics, Audrey Crews

MSN Capstone Projects

This paper discusses the use of outpatient intravenous antibiotics in comparison to inpatient intravenous antibiotics. Hospital admission rates, cost of care for patients and facilities, length of stay, patient experience, and patient outcomes are compared and evaluated with treatment to determine the efficacy of use.

Benchmark: Impact Of Weight Loss Education On Obese Patients, Tabitha A. Moorehead

MSN Capstone Projects

Objective: With an epidemic as severe as obesity, it is paramount that healthcare professionals be aware of the overarching negative effects the disease can contribute to the human body. If constructive dialogue can be achieved between patient and provider without suspicion of bias or judgment, we would potentially experience an elevated willingness of patients to follow treatment steps.

Background: According to the World Health Organization (WHO), worldwide obesity has nearly tripled since 1975. “Most of the world's population live in countries where overweight and obesity kills more people than underweight” (WHO, 2021). “More than 4 in 10 Americans are …

Dedicated Vascular Access Team Benchmark Study, Rachel Davis

MSN Capstone Projects

Hospitals see a rise in the critically ill population. These patients present with multiple comorbidities resulting in frequent emergency department trips. Unfortunately, with each visit, these patients require a vascular access device. Over time their veins will no longer be easily accessible. Patients with veins that are no longer visible, palpable, or require special techniques to obtain access are considered to be difficult intravenous access (DIVA) patients. They will likely experience multiple attempts with each admission to the hospital, resulting in physical and emotional pain, not to mention being costly. The purpose of this paper is to compare the advantages …

Constant Observation The Benchmark Study, Kalana Sanders

MSN Capstone Projects

Constant observation is defined as “an increased level of observation and supervision which continuous one-to-one monitoring techniques are utilized to assure the safety and wellbeing of an individual patient in the patient care environment. In the hospital setting constant observation has become the most used resource for mental health patients. The use of constant observation has significantly improved patient safety outcomes reducing falls and suicide rates drastically. With one study in Pennsylvania showing a vast improvement in patient safety in simply one-month times. As fall rates decreased from 53,966 falls occurring without the implementation of constant observation to only 323 …

Nurse Efficiency & Ultrasound Guided Intravenous Access: Evidence Based Intervention Benchmark, Jacob D. Frost

MSN Capstone Projects

Gaining IV access is this first step into accurate, timely diagnosis and interventions of patients. Nurses are typically the first medical professional a patient sees. If the nurse can establish IV access as early as possible this will lead to faster interventions faster diagnostic results and better management for patients and ultimately better patient outcomes. Ultrasound guided IV can increase first attempt success rates leading to decreased painful IV insertions by multiple nurses. This would increase patient satisfactions scores leading to higher re-imbursement.

Congestive Heart Failure Educational Approach Benchmark Study, Sheridan B. Westmoreland

MSN Capstone Projects

Heart failure continues to burden the American healthcare system. Disease management programs and transitional care services are used by hospitals to help patients living with congestive heart failure (CHF) transition from the hospital to home life. Twelve articles were chosen to evaluate the effectiveness of a multidisciplinary approach in reducing hospital readmission rates, cost, and death. One article was chosen to see how a nurse-led 1:1 patient educational approach was effective, and one article evaluated patients’ perception on living with CHF. This paper aims to evaluate the best educational approach on reducing hospital readmission rates, death, and cost in CHF …

Adjustable Velcro Compression Devices, Spring Reed

MSN Capstone Projects

Venous Ulcers and edema are expensive to treat and chronic conditions that are a strain on home health care companies and decrease patient quality of life. The standard treatment is expensive multilayer compression wraps that time consuming requiring three weekly visits, a strain on home health care agencies and are often not successful in resolving edema and venous ulcers. Adjustable Velcro compression devices are proven to be successful compression therapy due to low one-time cost, patient's increased comfort and the patient or patients' family self-sufficient in their application.

Implementing A Medication App For Transplant Recipients, Allison Arnold

MSN Capstone Projects

The purpose of this benchmark, evidence-based practice project is to evaluate the utility of medication adherence app for transplant recipients to reduce rejection. Studies have shown that medication apps can improve adherence, reduce transplant rejection, and be helpful to patients. The Perx Health app rewards patients for taking their medications, provides patients with reminders, and provides healthcare providers with data from patients. The Perx app will be implemented at a single, large volume, pediatric transplant center. Historical data related to rejection rates and medication level variability indexes will be compared to data collected after app implementation. In addition, patient surveys …

Meeting The Needs Of Gen Z Nurses To Improve Nurse Retention, Ronna M. Best

MSN Capstone Projects

This benchmark project explores the unique learning styles and generational characteristics of Generation Z nurses (those born between 1995 - 2012). The need exists for a change in traditional orientation and onboarding processes to meet the needs of Gen Z nurses. Gen Y and Gen Z nurses are expected to make up 50% of the workforce by 2024. Retention of these nurses is critical to a hospital organization as it is an effective strategy in dealing with the nursing shortage. Specific strategies for engaging the gen Z nurses include incorporating more digital platforms in the orientation and onboarding process, face …

Retention Drivers Post-Pandemic, Maria Charles, Christina Gonzalez

MSN Capstone Projects

The Covid pandemic influenced the world in many ways that we still witness a need for recovery. One significant concern that remains apparent is the culture change within the healthcare system. This study is directed to cover only one aspect of this culture change but remains to be a very significant topic for the nursing workforce (AHC Media, 2021). Even though we have managed to find a downward trend of Covid cases, the pandemic has devastated nursing retention to well established facilities. There is currently an exodus of nurses in high acuity departments or simply bedside nursing entirely. This causes …

Bedside Nurse Shift Length: Evidence-Based Intervention On Nursing Burnout, Natalie Suzanne Medina Bsn, Kristen Morreale Bsn, Bryanna Whitehurst Bsn

MSN Capstone Projects

With the aging baby boomer population, employee burnout, and lack of quality medical training, the United States is facing one of the most detrimental nursing shortages in history. Before the COVID-19 pandemic, the United States Health and Human Services projected the demand for nurses to be much higher than the actual number of employed registered nurses through 2030. Since 2016 the nursing population was widely composed of nurses between 25 to 34 years old. After the global pandemic hit, the number of nurses in that age group declined by 5.2 percent, and nurses aged 35 to 44 have reduced by …

Changing Hand-Off Communication In The Pacu Setting, Alisa M. Berndt

MSN Capstone Projects

Through extensive research on the importance of hand off communication in the PACU setting a correlation between patient safety and hand off report was found. Lack of a standardized hand off communication report in the PACU setting may lead to compromised patient safety and negative patient outcomes. In year 2021- 2022, the PACU there had several occurrences of miscommunication that were considered “near misses” in their incident reporting system. The objective of this capstone project is to investigate if utilizing a standardized hand off communication tool to guide healthcare professionals when transferring patient care to the next provider will mitigate …

Using Debriefs To Reduce Nursing Burnout In Nurses Caring For The Oncology Population, Courtney M. Wilkes

MSN Capstone Projects

Nurses are a critical part of healthcare and make up the largest section of healthcare professionals in the United States. According to the World Health Organization (2020), there are approximately 29 million nurses and midwives globally. The increasing need for nurses is not a new discovery. According to the American Association of College of Nurses, more registered nursing jobs will be available through 2022 than any other profession in the United States. The number of nurses leaving the workforce each year has been growing steadily from around 40,000 in 2010 to nearly 80,000 in 2020. Nursing burnout is a known …

Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux

MSN Capstone Projects

Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …

Promoting Sleep To Decrease Delirium, Stephanie Mayne

MSN Capstone Projects

Delirium is potent risk factor for complications, an increase length of stay, and mortality. Hospital acquired delirium is a prevalent and serious health condition that can occur in patients, especially the older adult population, when admitted to the hospital. It has the ability to be prevented if properly addressed and interventions are set in place to help reduce the occurrence of hospital acquired delirium. Many factors can contribute to the development of delirium, including a disruption of one’s circadian rhythm. Sleep is not always a high priority in the hospital, therefore there are little interventions and goals aimed at improving …

Regional Anesthesia In Outpatient Total Joint Arthroplasty, Laci Caesar

MSN Capstone Projects

Within the past five years, outpatient total joint arthroplasties have increased three-fold due to the change in insurance companies’ reimbursement plans. After continuous literature research collection, support for spinal anesthesia was higher than compared to general anesthesia (GA) for outpatient total joint arthroplasty procedures. Healthy patient who receives regional anesthesia showed decreased post-operative pain, increased rehabilitation, and, most of all, a decrease in facility stays (Macfarlane et al., 2009). This has allowed healthy patients who meet physician, anesthesia, and facility requirements to transition from hospitals to ambulatory surgery centers for total joint replacement procedures. With this new transition comes change …

Iris Nursing Strong Program: Benchmark Study, Sonia Bunyard, Keviesha Lacy

MSN Capstone Projects

The change project we are presenting is the IRIS-Nursing Strong program. IRIS stands for: Increasing, Reason & Relaxation, Implementation, Strategies all aimed to prevent nursing burnout. The Iris flower symbolizes hope and strength as nurses are healthcare providers who constantly provide that hope and strength to their patients. We plan to develop this program in the workplace to infuse that hope and strength back into the nurses who spend so much time taking care of others. The goal is to offer a non-judgmental environment, recognize early signs of distress in ourselves and our peers, provide …

Palliative Care In The Icu, Grace Cunningham

MSN Capstone Projects

Death and dying is an evident part of being admitted to the intensive care unit. However, too many times, the end-of-life conversations and palliative care team introduction are done when it is too late. The PICOT question is “In ICU patients (P), how does early palliative care involvement in the death and dying process (I) compared to later palliative care involvement in the death and dying process (C) affect positive patient outcomes (O) within the ICU hospital stay (T)?” The objective of this change project is to instill a sense of urgency in providing palliative consults upon admission as this …

Multi-Disciplinary Biopsychosocial Approach In Low Back Pain Benchmark Study, Liza Beth Cocanougher Short Rn, Ms

MSN Capstone Projects

Low back pain (LBP) is the third most common reason people seek care in America and is the primary reason for missed work days. Working in a pain clinic for eight years and managing research studies directed toward improving low back pain in patients was the motivation for choosing the evidence based intervention in this population. The health care professionals (HCP) in the pain clinic usually have a conversation with the patients who have acute or subacute onset of LBP about their disease and give them a written handout with exercises and ask them to perform these exercises at home. …

End-Of-Life Simulation Education, Lucas Farris

MSN Capstone Projects

In the current healthcare workforce, there exists a lack of comfort and knowledge about providing end-of-life (EOL) care that will only continue to worsen without prompt changes to the delivery of education (Jablonski et al., 2020). The lack of knowledge and comfort expressed in providing EOL care leads to a nurse’s moral and physical difficulty when a patient chooses palliative care or hospice. This is a detriment to patients and should be a consideration for schools of nursing when developing curriculum and clinical activities. By promoting changes in curriculum and the addition of an EOL simulation at the undergraduate level, …

How Covid-19 Changed New Nurse Orientation, Lindsey Js Sanders

MSN Capstone Projects

Universities were no longer able to do in person learning for nursing students. Nursing students were being taught vital skills like inserting an IV catheter via online simulation. The number of hours nursing students had to participate in clinical hours at the hospital was diminished due to the hospitals not allowing in nursing students. This created a huge educational deficit in nursing students. The nursing students who graduated during the COVID-19 pandemic are arguably less skilled than their predecessors before them. To fill this educational gap, additional training and orientation time must be provided to allow for fully competent new …