Nursing Commons^™

Exploring Medical-Surgical Nurse Turnover And Stratagies, Amber D. Weaver

Nursing Theses and Capstone Projects

This study explored the issue of medical-surgical unit nurse turnover and strategies to create nurse retention. The goal of this study was to provide nursing administrators with data that shows the cause of nurse turnover in this nursing specialty. The hypothesis was that there will be findings to indicate that medical-surgical nurses are at increased risk for employment turnover due to increased patient load and patient turnover. To study this concept, the Revised Casey-Fink Nurse Retention Survey was utilized. The results of the survey were revealed, and recommendations were made that may lead to nurse retention on the medical-surgical unit.

Telephone Follow-Up To Reduce The Readmission Rate In Gynecologic Oncology Surgery Patients, Karla Kenyon Fernandez

Nursing Theses and Capstone Projects

Unplanned hospital readmissions are commonly viewed as a marker of poor quality care and result in increased costs for both healthcare institutions and patients. Factors associated with readmission for gynecological oncology patients can be related to the radical surgical interventions required for the management of their disease, as well as complex comorbidity profiles, surgical complexity, cancer stage, and perioperative complications. The purpose of this study was to explore and examine the impact of nursing-led telephone follow up on the reduction of the readmission rate in gynecologic oncology abdominal surgery patients following initial discharge post-operatively. A cross-sectional research study was used …

The Effects Of Preoperative Education On Readmission Rates For Total Joint Arthroplasties, Michele Gobble

Nursing Theses and Capstone Projects

Background: Primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) are two of the most successful procedures performed in orthopedics. The demand for these procedures is estimated to grow 174% for THAs and 673% for TKAs by 2030, which will have a valued bill of almost $50 billion for Medicare. The bundled payment plan is a way to reduce costs for these procedures, where an estimated 35% of the bill is related to post-discharge care (Schaeffer et al., 2015, p. 723).

Review of the Literature: In 2015, this healthcare reform began including readmission penalties for patients readmitted within 30 …

The Structure Of Multidisciplinary Rounds And The Effects On Patient Perceptions, Frank Alagna

Nursing Theses and Capstone Projects

Daily rounds is one strategy to improve communication between caregivers and engage patients and families in care decisions. The purpose of this study was to determine if the structure of multidisciplinary rounds affected the patient's perception of care. King's Theory of Goal Attainment guided this study related to the relationship of interaction and outcomes three medical surgical units were identified as using different structures for patient rounding: tabletop rounds, nurse-led rounds, and team-based rounds. Patient perceptions were collected from the Professional Research Consultants (PRC) database, a nationally recognized patient satisfaction survey. Over a six month period, survey data was analyzed …

Preprocedure Warming To Prevent Intraoperative Hypothermia, Kathy C. Anders

Nursing Theses and Capstone Projects

Maintaining homeostasis during surgery is vital to preserving health and preventing postoperative complications. Research supports the benefits of preprocedure warming in preventing or reducing intraoperative hypothermia. Better postoperative outcomes are linked to intraop normothermia such as a reduction in the occurrence of surgical site wound infection, reduced bleeding, and faster recovery from anesthetics. However there were barriers to prewarming at the researcher’s institution such as cost, convenience, and compliance. The purpose of this research project was to study the impact of prewarming in the high risk population of surgical spine fusion patients. The researcher also hoped to examine and raise …

Lean And Six Sigma Impact On Operating Room Safety Attitudes And Efficiency, Nancy Marlene Geedey

Nursing Theses and Capstone Projects

Non-healthcare organizations have utilized Lean Six Sigma methodologies for several decades to eliminate waste, decrease expenses, and improve efficiency. This approach to problem-solving can be successfully applied to health care process improvement projects. Health care leaders and front line staff can use a prescribed set of steps to define steps in care processes and identify potential solutions. Health care leaders can use Lean Six Sigma tools such a fishbone diagram or a cause and effect matrix to identify issues. After carefully organizing the problems into groups according to priority, leaders can develop action steps toward resolution.

Timeliness Of Patient Discharges: A Comparison Of The Acute Care Discharge Process For Medical And Surgical Patients, Robert Moore

Nursing Theses and Capstone Projects

Patient flow is becoming increasingly important to the efficient operations of an acute healthcare setting. Multiple factors peaking in their influence on the number of patients seeking healthcare services are on a collision course. When the true impact is felt in healthcare the potential for record numbers of patients to seek acute medical care are high. It is imperative to streamline patient flow processes to ensure healthcare facilities have the ability to provide the care sought by patients in a timely manner. This study’s purpose was to assist in increasing the number of patients an acute care facility can provide …

Patient Comfort And Multimodal Analgesia: Effects Of Preoperative Ibuprofen, Rodney Nash

Nursing Theses and Capstone Projects

Multimodal therapy for surgical patients is explified by use of a combination of a non-steroidal anti-inflammatory and an opioid to control visceral pain by decreasing both inflammation and pain transmission. Perioperative or postoperative use of multimodal therapy has been shown to provide adequate surgical pain relief while decreasing the total dose of opioids required. This project demonstrated that preoperative use of ibuprofen for women undergoing total laparoscopic hysterectomy decreased the total dose of opioids consumed in a 24-hour period, and increased the likelihood of the patient reaching her pain goal target at discharge. This finding adds to the literature support …

Compassion Fatigue Among Emergency Department Nurses, Tracy Ann Petleski

Nursing Theses and Capstone Projects

Aim: The purpose of this capstone project was to determine the prevalence of compassion fatigue among emergency department nurses. Background: Healthcare workers especially nurses working in high acuity areas are at high risk for developing compassion fatigue, burnout, and secondary stress. A concern is nurses working in the emergency department are at risk for developing compassion fatigue and should be aware of the concept, self-care activities, and available resources to improve compassion satisfaction scores and to reduce the effects of compassion fatigue burnout, and secondary stress on nurses' working in stressful environments. Method: The project was carried out at a …

Attitudes And Practices Of Perioperative Nurses Effecting The Election Of Wearing Protection From Occupational Radiation Exposure, Jane Leonard

Nursing Theses and Capstone Projects

Health effects from exposure to radiation are unpredictable. On a daily bases, nurses working in the perioperative setting are exposed to medical x-rays (ionizing radiation) and are vulnerable to its carcinogenic effects. Regardless of the potential health consequences, the use of protective equipment remains inconsistent among perioperative nurses. Most research studies regarding nurses' occupational health risks either failed to include or separate radiation exposure from chemicals and blood borne pathogens. The purpose of this study was to examine the relationship between the attitudes and practices of perioperative nurses that influence their decisions to wear or not wear radiation protection equipment …

Preoperative Education: How Effective Teaching Impacts Knowledge With The Surgical Patient, Heidi Grossweiler

Nursing Theses and Capstone Projects

This research study involved questions identifying the perception of nursing staff related to preoperative teaching. Does initiating teaching, built through relationships and learning during the preadmission visit, have a positive effect on outcomes? The study design included a survey based on the Likert scale, evaluating nurses who conduct preadmission testing visits with patients in the outpatient surgical setting. The evaluation provided information about the correlation of information given between the nurse and the patient, which provides teaching guidelines for educating a patient preoperatively. A cover letter was given to the participant that detailed the purpose of the study and included …

Evaluating The Knowledge And Attitudes Regarding Pain Management Among Nurses In A Surgical Setting At An Acute Care Facility, Barbara Turner

Nursing Theses and Capstone Projects

It is estimated that seventy-three million patients undergo surgical procedures each year in the United States. Of these, 80% experience acute post-operative pain, and approximately 20% experience severe pain (Hutchinson, 2007). Benner's Theory from Novice to Expert was used to guide the study, "Evaluating the Knowledge and Attitudes Regarding Pain Management Among Nurses in a Surgical Setting at an Acute Care Facility". A convenience sample of twenty-one nurses in an acute care hospital in Southwestern North Carolina participated in the Knowledge and Attitudes Survey Regarding Pain. Results showed a weak correlation between knowledge and attitudes of pain management and years …

Effects Of Early Initiation Of Induced Therapeutic Hypothermia, Frank Castelblanco

Nursing Theses and Capstone Projects

Cardiac arrests are responsible for about 325,000 deaths annually in the United States (Heart Rhythm Foundation, 2010). The majority of these cardiac arrests occur outside the hospital setting, with a dismal national survival rate of 8% (American Heart Association, 2010). The Bernard (2002) and HACA (2002) studies demonstrated that by initiating therapeutic hypothermia as a treatment modality for cardiac arrests the survival rate could be as high as 49% and 55% respectively. Therapeutic hypothermia can be initiated in many different settings. The question remains, does the setting of the initiation of therapeutic hypothermia effect patient outcomes? The purpose of this …

Reorientation Of The Experienced General Medical/Surgical Nurse To A Progressive Care Medical/Surgical Nurse Utilizing Benner's Novice To Expert Theory, Barbara Radford

Nursing Theses and Capstone Projects

The decisive factor for this project was the Health Care Organization's decision to combine the medical/surgical units from two campuses into one department. This process required the Registered Nurses to reapply for their positions, merge into one unit, and transition to a different physical location. The next major process to occur will be the changing of patient acuity-levels from general medical/surgical to medical/surgical progressive care.

This project will provide a cost effective educational plan based on Benner's novice to expert theory which will ensure efficient transition for the expert medical/surgical nurse to an expert progressive care nurse. A structured orientation …