Nursing Commons^™

A Resource Nurse In The Community: An Evaluation Of Role Implementation, Michelle Bull

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: Children who live in low-income households are more likely to develop childhood obesity-related to low food security and lack of access to healthier foods (Lee & Lim, 2009; Sage, McCracken, & Sage, 2013). Health promotion efforts that focus on family interventions are successful in combating childhood obesity (Jang& Whittemore, 2015; Ordway, et al., 2018). The role of the nurse can be positioned to facilitate health promotion interventions in the community setting.

Purpose/Specific Aims: The purpose of this project was to evaluate a pilot intervention using a nurse as a resource in a local community working with families in a …

Identifying Nurses’ Perceived Barriers To Mobilizing Patients On A Medical-Surgical Unit: A Quality Improvement Project, Jil Lukin

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Researchers have found that low and moderate levels of mobility are independently associated with greater functional decline in activities of daily living (ADLs) at discharge (Zisberg et al., 2011) and that bedrest promotes declines in muscle mass and muscle strength (Coker et al., 2014; Dirks et al., 2016). The negative effects of low mobility and immobility are recognized by nurses, yet most acute care nurses do not prioritize the mobilization of their patients. Interventions to increase mobilization of hospitalized patients may be more effective if they are barrier targeted. The purpose of this quality improvement project was to identify nurses’ …

Development Of An Educational Program For Registered Nurses On Post Traumatic Stress Disorder, Stephanie Connor

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Post-traumatic stress disorder (PTSD) is highly prevalent in the United States, compared to European, Asian, and Latin American countries. Post-traumatic stress can develop through repeated occupational exposure to someone else’s trauma, hearing details of other’s trauma as well as one’s own traumatic events. Nurses are at high risk for developing secondary PTSD due to caring for patients who have suffered life-threatening illnesses or injuries. There is a complex correlation between PTSD and suicide and nurses are also at greater risk of completing suicide versus their non-nursing peers. The Betty Neuman Systems model recommends primary, secondary, and tertiary measures of prevention …

Resilience: Semi-Structured Interviews With Oncology Nurses, Erika L. Leonard

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The purpose of this project is to explore the relationship between resilience and oncology nurses through semi-structured interviews and identify key themes discussed by participants.

Use Of High-Fidelity Simulation To Improve Confidence In Military Nurses' Deployment Readiness, James F. Jeff

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

High-fidelity simulation (HFS) has been shown to be a successful means of skill sustainment and improved confidence across many professions in which human lives are a stake to include the fields of aviation and healthcare. More specifically, HFS technology has displayed efficacy with doctors, nurses, and other advanced practice providers. The flexibility of HFS makes for an ideal educational tool in both professional development and academia. Military medicine could benefit from HFS technology due to the dynamic nature which requires readiness at a moment’s notice. The benefit can be significant in the military nursing community due to the frequency of …

Nurse’S Knowledge Of Early Ambulation Of The Post Operative Patient And Complication Prevention: A Quality Improvement Project, Meghan K. Carides

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Ambulation is the single most important nursing intervention in the prevention of postoperative complications. It is also a key component in maintaining optimal patient outcomes. Current literature has revealed that when ambulation is initiated early there is a marked decrease in pain, length of hospital admission, and overall complication rates. However, even with this depth of evidence early postoperative ambulation on the two surgical units at a teaching hospital in Rhode Island, patient ambulation continues to be inconsistent. The purpose of this quality improvement project is to improve nursing knowledge regarding early ambulation after surgery for the prevention of post-operative …

Knowledge Of Electrolyte Replacement Protocols Among Medical-Surgical Registered Nurses: A Research Project, Sarah-Jane H. Santos

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Electrolyte abnormalities in hospitalized patients may result from a variety of acute and chronic medical conditions. Hospital admissions related to electrolyte imbalances in adult patients may be a direct result of acute illness such as nausea, vomiting, diarrhea, and dehydration or complications related to medications or surgical procedures. Patients with deficiencies of electrolytes such as potassium, magnesium and phosphorus are at an increased risk for life threatening complications such as seizures, delirium, cardiac dysrhythmias, respiratory muscle weakness and respiratory compromise. Nurses must possess a baseline knowledge of electrolyte disturbances and recognize potential and possible complications related to deficiencies of key …

The Impact Of Rapid Response Team Activation On Unplanned Transfers To The Icu, Erica Nelson

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Rapid Response Teams (RRTs) were addressed by the Institute for Healthcare Improvement (IHI) as a means for improving inpatient hospital morbidity and mortality. There implementation was encouraged nationwide with the goal to decrease inpatient cardiopulmonary arrests, mortality rates and unplanned admissions to the Intensive Care Unit (ICU). The purpose of this systematic review was to evaluate the impact of RRTs on unplanned transfers to the ICU. A comprehensive literature review was performed using the PubMed database focusing on RRTs and unplanned ICU transfers. The Donabedian model was used as the theory for this review in conjunction with the PRISMA framework. …

The Effects Of Using Ultrasound Guidance Versus Traditional Method For Peripheral Intravenous Placement, Jennifer Kennedy

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Roughly 230 million peripheral intravenous (PIV) catheters are placed in the United States each year (Helm et al., 2015). The establishment of a PIV access may be lifesaving in times when emergent medications or procedures are critical for survival. The literature suggests the use of ultrasound guidance (USG) may decrease the attempts, decrease the length of time to obtain PIV access and improve patient satisfaction. The primary purpose of this study was to compare the longevity of ultrasound guidance PIVs versus the traditional method within the population of patients 18 years and older. A secondary outcome was to determine the …

Symptom Triggered Therapy Versus Fixed-Dosed Scheduling For Alcohol Withdrawal: A Systematic Review, Amanda Saucedo

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Alcohol Use Disorder (AUD) is a significant health problem that is seen widely inall hospitals and in the community. Individuals who have AUD and cease to consume alcohol develop Alcohol Withdrawal Syndrome (AWS). Alcohol Withdrawal Syndrome can either be treated on an inpatient or outpatient basis. Three different pharmacological regimens for treating AWS with medications exist. The three regimens include fixeddosing, symptom-triggered, and loading dose regimens (Sachdeva et al., 2015). As Acute Care Nurse Practitioners (APRNs), AWS will be a common diagnosis treated. Advanced Practice Registered Nurses (APRNs) must be aware of the different treatment modalities and the best evidence-based …

Compassion Fatigue In Critical Care Nurses: An Educational Quality Improvement Project, Natasha Teixeira

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Compassion fatigue is estimated to affect 40% percent of the 2.9 million registered nurses in the United States. There exists a critical need to explore how nurses understand compassion fatigue, how they identify it in self and others, and what strategies they enact to lessen the eventual threats to health. With the current COVID pandemic, along with the high intensity nature of the intensive care unit (ICU), critical care nurses are vulnerable to the symptoms and side effects of compassion fatigue. This quality improvement project evaluated the impact of an educational session on compassion fatigue and self-care in relation to …

Prophylactic Percutaneous Endoscopic Gastric Tubes For Head And Neck Cancer: Are They Worth Their Weight?, Kathy D. Martin

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

It is estimated that 54,000 new cases of Head and Neck Cancer will be diagnosed in the United States in 2021 (Cancer Facts and Figures, 2021). Head and Neck cancers represent those that originate from sites which include the nasopharynx, oropharynx, oral cavity and hypo-pharynx. In advanced cases, treatment modalities are combined to include surgery, radiation and chemotherapy. Expected side effects of treatment can include mucositis, dysgeusia, dysphagia, odynophagia, nausea, vomiting and xerostomia. These toxicities can contribute to dehydration, weight loss and malnutrition. This paper examines the current state of evidence as it pertains to nutritional outcomes for Head and …

The Effect Of Green Space On The Physiologic Function Of The Adult: A Systematic Review, Brenna Franco

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Environmental greenness is often associated with improved psychological outcomes, but the use of green space as a protective factor for maintaining physiologic health is understudied. However, growing evidence exists on the benefit of greenness on physiologic health. The purpose of this systematic review was to evaluate the effect of green space on the physiologic function of the adult. Cohort studies were searched for that had all elements of inclusion criteria. Six final studies were included in this systematic review utilizing PRISMA guidelines and CASP tool for cohort studies. Data from the studies was collected and a cross study analysis was …

Does Oral Chlorhexidine Mouth Care Prior To Intubation Impact Ventilator-Associated Pneumonia? A Systematic Review, Hannah Rothhaar

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: Chlorhexidine gluconate (CHG) is a broad-spectrum antiseptic agent that has become widely used for mouth care in intubated patients. Many studies have found it to be effective in the prevention of ventilator-associated pneumonia (VAP) when used after intubation; however, there is very limited research exploring the proper time to initiate CHG.

Purpose: The purpose of this systematic review was to determine if the use of oral care with CHG prior to intubation impacts the incidence of VAP. Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was used to guide the selection process of articles and the …

Interventions To Decrease Mortality Among Patients With Acute Respiratory Distress Syndrome, Emily Cohn

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Acute respiratory distress syndrome (ARDS) is a severe complication which affects thousands of patients every year and is associated with high mortality rates and increased healthcare costs. A systematic review was conducted to determine the efficacy of various interventions used to decrease the staggering mortality rate of ARDS. The interventions studied were extracorporeal membrane oxygenation (ECMO), prone positioning, and neuromuscular blockade. Data bases searched were Google Scholar, PubMed, Cochrane library, and the CINAHL databases to find relevant research articles and a literature review conducted. A total of 21 articles were considered and screened for inclusion/exclusion criteria, ultimately yielding five articles …

Nurses’ Knowledge On Delirium Prevention And Detection In Hospitalized Adults: A Quality Improvement Project, Kayla Deery

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Delirium, recognized as a medical and psychological emergency, is a symptom of an acute medical condition. Despite the prevalence of delirium in the hospital setting, it continues to be unrecognized, resulting in poor patient outcomes, and exorbitant healthcare cost. Patients with dementia who are chronically ill, as well as patients previously diagnosed with delirium, represent a vulnerable population and require closer surveillance due to their predisposing factors. This quality improvement project goal is to increase nurses’ knowledge and understanding of delirium. This was completed through providing education to medical-surgical nurses on the causes of delirium (predisposing and precipitating factors), prevention, …

Assessing Nurses’ Knowledge Of Noise In The Intensive Care Unit: An Educational Intervention Project, Jennifer Fortes

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Noise in the intensive care unit (ICU) has been studied for over thirty years, but it continues to be a significant problem and a top complaint among patients. Staff members are now reporting detrimental health effects from excessive noise. One of the significant factors of inadequate noise control in the ICU is that nurses have insufficient awareness regarding the hospital noise issue and its negative impact on health status. The level of knowledge of clinical staff on the topic of noise is not known. A quality improvement project to explore noise in the ICU could facilitate better understanding of the …

Dexmedetomidine Use In The Pediatric Postoperative Patient With Emergence Agitation: A Systemic Review, Elizabeth Kittredge

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Emergence Agitation is a frequent complication in the pediatric postoperative population; with up to 80% incidence (Stamper, Hawks, Taicher, Bonta & Brandon, 2014). These patients will present with crying, overexcitement, thrashing, agitation and is seen within the first 30 minutes of emergence of general anesthesia (Mohkamkar, Farhoudie, Alam-Sahebpour, Mousavi, Khani & Shamomhammadi, 2014). Dexmedetomidine, a selective alpha 2 agonist, reduces norepinephrine output, initiates firing of inhibitory neurons such as the gama aminobutric acid system and reduces release of substance P and other catecholamines. These actions provide the patient with sedation, analgesia, and anesthesia (Nagelhout & Elisha, 2018). Due to the …

Comparing Sugammadex In The Adult And Geriatric Population, Jason Medeiros

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A comparison of using sugammadex for neuromuscular blockade reversal in adult and geriatric populations, examining time to recovery and adverse outcomes related to residual neuromuscular blockade.

Stress And Coping Methods Utilized By The Srna, Dawn Hughes

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The purpose of this survey was to was to determine stressors and coping methods utilized by the SRNAs enrolled in the combined RIC/SJHSNA program. A survey was sent to the students and analyzed. The findings of increased stress in the SRNA are similar to previously studies.

A Review Of Phenylephrine Versus Norepinephrine For The Treatmemnt Of Maternal Hypotension During Spinal Anesthesia For Cesarean Delivery, Megan S. Sullivan

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Maternal hypotension is a common sequala of spinal anesthesia used during cesarean delivery. The current first line vasopressor used for treatment of maternal hypotension is phenylephrine. Administration of phenylephrine can cause a physiologic decrease in cardiac output that could contribute to adverse maternal or fetal outcomes. This systematic review was conducted to investigate the use of norepinephrine as an alternative vasopressor for the treatment of maternal hypotension. A database search was conducted using electronic sources including CINAHL, MEDLINE, Google Scholar and PubMed. Inclusion and exclusion criteria were used to narrow search results and the Critical Appraisal Skills Program checklist was …

Comparing Recovery Times Of Desflurane And Sevoflurane, Gina M. Stangel

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

General anesthesia is intended to deliver proper comfort and pain relief, with a safe and rapid recovery with minimal side effects. Ideally, patients are optimized prior to undergoing anesthesia, (an asthmatic receiving an albuterol treatment to reduce the likelihood of bronchospasm, for example). Emergence from anesthesia involves the reversal of a neuromuscular blockade if used, a patient breathing spontaneously, regaining consciousness, and the ability to follow commands. Patients requiring general anesthesia can be given intravenous propofol, an inhaled anesthetic gas or a combination of both. Volatile anesthetic gases used today allow for rapid recovery from anesthesia due to their low-blood …

Comparing Pretreatment Modalities, Corey Mammen

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This manuscript investigates the negative sequelae (in particular, myalgia) of using succinylcholine for patients undergoing tracheal intubation, pretreatment strategies to minimize or eliminate these untoward effects, and compare their efficacy. Various strategies are commonplace in the clinical setting, and there are a number of research studies that discuss the efficacy of individual agents as well as compare them against others. This manuscript explains the anatomy and physiology of neuromuscular junctions, muscle contraction, and their relationship with muscle relaxants used in the clinical setting.

A Systematic Review To Examine The Effectiveness Of Antibiotic Educational Programs In Outpatient Settings At Reducing Antibiotic Prescribing?, Mathew Reynolds

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Antibiotic resistance has been identified by both the Center for Disease Control and the World Health Organization as a worldwide epidemic. Antimicrobial stewardship programs have been utilized at inpatient settings that include educational programs about antibiotic resistance. A systematic review was conducted to evaluate the effectiveness of antimicrobial resistance education in outpatient settings. The databases searched were MEDLINE, PubMed, Google Scholar and CINAHL. PRISMA checklist and flow diagram were used for identifying the randomized control trials for the systematic review. A total of five articles were identified and organized using data collection tables. The Critical Appraisal Skills Programme (CASP) checklist …

Dexamethasone In The Adult Diabetic Surgical Patient, Jessie Mcburney

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The purpose of this systematic review was to investigate the current literature and examine the impact of dexamethasone on blood glucose levels in the adult diabetic surgical patient when used in the prevention of postoperative nausea and vomiting. The findings of this systematic review concluded dexamethasone 8mg IV was associated with an increase in perioperative blood glucose levels, although the increase may not have been statistically significant.

An Iv Anesthetic Decision Tree For Cardiac Surgery, Brian Doucette

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A thorough literature review was conducted covering the topics Intravenous anesthetics, pathophysiology of structural heart disease, and decision-making in anesthesia. A systematic review of randomized controlled trials was performed guided by the PRISMA protocol. Through the lens of Information Processing Theory, the results of the systematic review were used to guide the creation of a decision tree for the selection of the appropriate intravenous anesthetic for cardiac surgery.

Improving Patient Engagement Among Homeless Veterans, Shonda L. Escobar

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This integrative review was conducted to examine research that explores the effectiveness of open-access interdisciplinary care and outreach in engaging homeless veterans in health care. The literature reviewed for this study provided substantial evidence for the benefits of open-access clinics, an interdisciplinary team, and outreach for the sustainability of engaging homeless veterans in health care. The advanced practice nurse plays a valuable role in this process as there is need for enhanced program and policy development to meet the needs of this population as well as the demand to disseminate population-specific education to the interdisciplinary team.

Improving Compliance With Best Practice Standards For Patients At Risk For Opioid Use Disorder, Casey Williams

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: Available literature suggests that provider adherence to best practice guidelines regarding the prescribing and management of opioid therapies is low. Documentation of patient screening for present or future opioid use disorder is inconsistent. Provider incorporation of evidence-based guidelines into routine patient care is essential to optimizing outcomes related to opioid use disorders.

Purpose/Specific Aims: The purpose of this scholarly project was to facilitate recognition of patients at high risk for opioid use disorders and facilitate best evidence based practices in the care of this population. Specific aims were to achieve provider compliance with: patient risk screening, PDMP review, completion …

Examining Knowledge Of Pain Management, Sunita D. S. Dutt

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Pain places a significant burden on the society and individuals through health care costs, loss of productivity, and loss of income. A widening gap exists between increasing knowledge about pain and the application of this knowledge to treat pain. The Joint Commission (TJC) provides guidelines for nursing care of patients with pain. The purpose of this paper explore the application to practice of TJC guidelines for nursing care of the patients with pain.

Knowledge, Skill, And Attitude Towards Workplace Violence Interventions Among Emergency Department Nurses, Jessica Lynn Collinson

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This study investigates the knowledge, skills, and attitudes towards workplace violence interventions among emergency department nurses.