Nursing Commons^™

Implementation Of Scripted Debriefings Following Neonatal Delivery Room Resuscitations., Kimberly M. Knott

Doctor of Nursing Practice Papers

Abstract

Background: The functioning of neonatal delivery teams can be affected by technical and non-technical skills of individual team members. The team in this project was challenged by varying knowledge and skill levels and did not have a standardized process for debriefing resuscitation events. The literature shows that debriefings can aid in improving knowledge, skills, teamwork, and communication of resuscitation teams.

Purpose: The purpose of this quality improvement project was to implement a scripted, post-resuscitation debriefing with the neonatal delivery team to improve non-technical skills of the resuscitation team and identify challenges to providing optimal care.

Method: Scripted, …

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …

Implementing A Standardized Nursing Communication Tool To Improve Inpatient Nursing Communication, Ashley D. Nator

Dissertations

Implementing a Standardized Nursing Communication Tool to Improve Inpatient Nursing Communication

Ashley D. Nator

B.S. Nursing, University of Missouri-St. Louis, 2018

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice with an emphasis in Family Nurse Practitioner

August 2022

Advisory Committee

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C

Chairperson

Sarah Jackson, DNP, APRN, FNP-C

Amy Terbrock, MSN, PCCN, SCRN, RN

Copyright, Ashley D. Nator, 2021

Original: 08/2021 Revised: 09/2021, 10/2021, 04/2022

Abstract

Problem: Patient handovers occur among nurses more than 4,000 times …

Improving Confidence And Job Satisfaction In Emergency Nurses Through Teamstepps., Anna Moore

Doctor of Nursing Practice Papers

Problem Statement: New-graduate nurses (NGNs) are experiencing job dissatisfaction related to low communication confidence leading to high turnover rates and avoidance behaviors.

Purpose: To improve communication confidence and job satisfaction in NGNs through a nurse-led education session on emergency department (ED) communication techniques.

Methods: One online class lasting ~60 minutes was provided to educate NGNs on standardized emergency communication techniques. A pre-test post-test design was used with evaluations occurring before the education, immediately after, and 30 days later.

Results: Descriptive statistics were used to analyze the sample makeup. The Wilcoxon signed-rank test was used to calculate significant changes in communication …

Utilization Of Staff Education To Improve The Management Of Aggression And Violence In The Rural Inpatient Psychiatric Setting, Clara Ugwuibe-Ogunseye

Doctor of Nursing Practice Projects

Background: Workplace violence (WPV) is a global concern and an occupational hazard faced by healthcare professionals worldwide. Aggression and violence can result in serious injury to the patient, healthcare professional, other patients, or visitors and cause stress to healthcare workers, and increase work absences (Picot, 2021).

Purpose: This DNP process improvement project aim was to utilize an educational training program on violence risk assessment, therapeutic communication, and verbal de-escalation techniques, to improve the confidence of mental health nursing staff in using early intervention to manage aggressive, violent patients. This education and early intervention reduced rates of aggression and violence escalation, …

Improving Healthcare Team Communication With Limited English Proficiency Families In The Nicu, Ivonne Mandell

Doctor of Nursing Practice Projects

Language barriers are common in healthcare settings, creating disparities in care between individuals with limited English proficiency and those with English proficiency. In the NICU setting, professional medical interpreters have been shown to improve parent/staff communication and increase parent satisfaction by allowing parents to ask questions and form trusting relationships with staff. Solid parent-provider communication can result in better health outcomes by increasing parental empowerment and participation in their child’s care. Despite the acknowledged advantages of using professional interpreters in healthcare settings, they are frequently under-utilized, even when readily available. The purpose of this project was to improve communication with …

Civility And Communication Interventions To Improve Patient Outcomes, Lane Denney

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Communication in health care is vital for the successful care of patients and their outcomes while they are hospitalized. Healthcare workers are responsible for communicating patient information whether it is between change of shifts or reporting to a patient’s provider. It is important that this information is communicated effectively. This review evaluates how nurses communicate in shift- report and how this affects patient outcomes and civility between nursing units and teams. Overall, bedside shift reports promoted the best patient outcomes and increased teamwork on hospital units.

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Impact Of Emotional Intelligence On Interprofessional Teamwork, Interprofessional Communication, And Interprofessional Leadership, Kathleen M. Cox

Nursing Theses and Dissertations

Objective: The purpose of this body of work was to explore relationships among emotional intelligence (EI) and interprofessional (IP) competency domains to enhance IP team dynamics and communication.

Background: Decentralization of healthcare delivery may hinder effective handoffs creating opportunity for miscommunication of vital information and subsequent medical errors. Fostering effective communication is paramount for IP teams; however, differing communication styles can promote misunderstanding and conflict. Behavioral aspects of team dynamics and communication that comprise EI may be a solution but are rarely addressed in educational and safety programs.

Methods: Included in this portfolio are three manuscripts that help elucidate …

Huddle Implementation In The Perioperative Setting, Tina Thomas

DNP Projects

Background: Communication is essential for safe and effective patient care. In the perioperative setting, information sharing is critical to care coordination. Lack of communication between caregivers can lead to medical errors. Evidence shows that huddles lead to increased communication, satisfaction, and engagement between team members resulting in better patient outcomes. Huddles are short, less than 10-minute gatherings that focus on the daily schedule, identify potential obstacles, explain unique needs, and discuss preceding day issues.

Objectives: This project aimed to evaluate the effectiveness of huddles on employee satisfaction, engagement, and communication of healthcare workers while also determining if huddles were …

An Educational Program To Enhance Knowledge And Communication For Nursing Staff Who Care For Dementia Patients, Behnaz Mohammadi

Walden Dissertations and Doctoral Studies

AbstractDementia is a progressive chronic disease that requires skilled nursing care. Staff at a skilled nursing facility were not using best practices to prevent and manage the psychological and behavioral symptoms of dementia. The purpose of this DNP project was to implement a dementia care education to address this gap in knowledge. The question for the evidence-based educational project was whether the program increased knowledge, promoted positive attitudes, and increased confidence in dementia care staff. A 5-hour workshop was presented in person, twice in two weeks. The person-centered care model served as a framework for the project. Nursing staff (N …

Optimizing Secure Patient Messaging Workflow In A Vermont Primary Care Clinic, Kimberly S. Oleary

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Optimizing Secure Patient Messaging Workflow in a Vermont Primary Care Clinic

Kim O’Leary, DNPc, RN

DNP Advisor: Margaret Aitken, DNP, AGNP, ANP-BC

Site Mentor: James Williamson, MHA, Site Supervisor, Adult Primary Care

Background: Secure patient messaging is a popular tool designed for non-urgent questions, yet patients sometimes use it to relay urgent concerns. As office workflows tend to prioritize responses to other methods of communication, this presents a potentially unsafe situation in which clinical staff may not respond to these urgent messages in a timely manner.

Purpose: To develop a methodology to improve the timeliness, effectiveness, and safety of secure …

Situation-Background-Assessment-Recommendation During Hand-Off In A Mental Health Nursing Unit, Renel Ramos

Walden Dissertations and Doctoral Studies

AbstractCommunication failures, especially inadequate hand-off communication, in U.S. hospitals has accounted for 30% of malpractice claims, resulting in 1,744 deaths over 5 years. This prompted the Joint Commission to recommend utilizing standardized communication tools to reduce the number of medical errors related to miscommunication. The Situation-Background-Assessment-Recommendation (SBAR) Communication Tool has been used to improve the effectiveness of communication among health care providers. The partner organization noted failures to communicate patient-care-related information between psychiatric mental health nurses (PMHN) during hand-off, given the absence of standardized communication. This project aimed to develop a program to educate PMHNs on the SBAR Communication Tool. …

Reduction Of Order-To-Scan Times To Increase Patient Throughput And Improve Patient Outcomes: A Quality Improvement Project, Jason Harrington

Master's Theses and Capstones

Background: Throughput is a key metric for both the emergency department and the hospital system. Diagnostic tests, such as CT scans, can lead to a large delay in patient throughput which can negatively impact patient satisfaction and patient outcomes. Finding ways to reduce delays in CT scan acquisition can positively impact patient satisfaction and patient outcomes.

Aim: The specific aim of this quality improvement project was to decrease the amount of time it takes to complete abdominal CT scans with IV contrast once ordered from 61 minutes to below 35 minutes by July 1^st, 2022

Methods: Plan was …

Improving Communication Skills Of New Graduate Nurses: Using Sbar Format, Meredith Lyanne Parker

Master of Science in Nursing Theses and Projects

New graduate nurses face many challenges as they transition to professional practice (Mongale et al., 2018). Support from transition to practice (TTP) programs can have a tremendous impact on the success of a new graduate nurse and improve retention rates (Silvestre, 2017). Research identifies a gap in new graduate knowledge of communication skills (Song & McCreary, 2020). Education on improving communication using a standard format can impact patient outcomes and improve provider confidence (Marshall et al., 2008). Research also links provider confidence and proficiency to improved outcomes (Owens & Keller, 2018). Benner’s Novice to Expert Theory provides a theoretical foundation …

Standardized Daily Family Updates To Improve Patient Satisfaction Scores On A Pulmonary Medical Progressive Care Unit, Quentin Butterfield

Doctor of Nursing Practice Projects

Communication remains one of the most challenging aspects of healthcare. COVID-19 added another layer of communication breakdown in the form of visitor restrictions that limited or removed visitation for hospital-positive patients. Guided by the principles of Jean Watson’s theory of human caring, a literature review was performed to determine best practice evidence related to improvements in communication.

A daily family update form was drafted to guide the nurses of a pulmonary medical progressive care unit in providing standardized daily family updates to improve communication through consistency of information shared. Patients identified family members they would like to receive daily updates …

Identification, Treatment, And Management Of Patients With Suicidal Ideation On The Medical-Surgical Unit For Nurses, Renea Crawford

Walden Dissertations and Doctoral Studies

Suicide and suicidal ideations are among the leading causes of death in the United States. The Joint Commission identifies inpatient suicide as a sentinel event that should never happen. Nurses working on the medical/surgical (M/S) unit in a hospital located in the midwestern region of the United States voiced their concern that they were not prepared to recognize the signs that may indicate an escalating emotional situation in patients with suicidal ideation; in addition, there were no guidelines in the hospital to use as a resource. The purpose of this project was to determine whether an evidence-based (EB) clinical practice …

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …

Nurse Manager Communication Associated With Staff Nurse Satisfaction Or Retention, Svetlana Periut

Master of Science in Nursing Final Projects

Background: Nursing communication is a significant part of a nurse's job, especially when communicating with their patients, patient's families, and the healthcare team. Communication is the center of attention of many studies, and the way nurse leaders relate massages can influence an organization’s outcomes, including nurse satisfaction and retention. This integrative review aims to analyze communication styles, behaviors, and instruments used by hospital unit nurse managers to increase staff nurse satisfaction and retention.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis were used in the literature search and review. The Johns Hopkins Evidence-Based Practice Model and Guidelines were …

Closing Communication Gaps For Unplanned Surgical Patients: One Pre-Op Checklist At A Time, Seda L. Vash

Master's Projects and Capstones

Problem: Unplanned, inpatient surgical patients were experiencing poor outcomes and dissatisfaction with their overall care. This surgical patient population also lacked communication from their healthcare teams with regard to plans of care throughout their hospital stays.

Context: This was a quality improvement project for the unplanned, inpatient surgical patient population in the Central Valley of California. Approximately 13% of this hospital’s surgical patients required post-surgical care in the inpatient units. These patients, according to unfavorable HCAHPS scores, experienced unsatisfying care and insufficient communication from their healthcare teams, including physicians and nurses.

Intervention: This project implemented an Add-On Communication Tool for …

Standardizing And Documenting Decision-To-Incision Intervals For Unscheduled Cesarean-Section Deliveries, Molly Bloom

Master's Projects and Capstones

The term decision-to-incision interval (DII) refers to the interval between when a laboring patient and their healthcare provider agree to an unscheduled surgical cesarean section (C/S) delivery and when the first incision is made in the operating room. The ideal length for this interval varies with the urgency of each case, and there is no international consensus regarding the timing. In an urban labor and delivery unit in a private hospital, examination of this interval revealed inconsistent documentation of the decision, as well as unclear guidelines on the DII for two of the three unscheduled C/S urgency levels. This quality …

Facilitating Implementation Of In-Room Whiteboards In The Skilled Nursing Environment Using The Parihs Framework, Ashley Lubbers

Dissertations

The application of research to practice is a difficult task to successfully carry out for many healthcare professionals and organizations. The Promoting Action on Research Implementation in Health Services (PARIHS) framework is a tool that acts as an implementation guide for translating research evidence to practice. This study explored the use of an adapted version of the PARIHS framework as a guide to implementing in-room whiteboards in a skilled nursing facility (SNF) on their short-term rehabilitation wing. While the utility of in-room whiteboards has been demonstrated in the acute care setting, there are few studies of their use in SNFs. …

Improving Therapeutic Communication In Mental Health Nursing: A Quality Improvement Project, Patricia A. Nill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 46 million adults in the United States (U.S.) live with a mental illness. Locally in Nevada, the psychiatrist to patient ratio is approximately 700:1, and patients are seen primarily in the inpatient setting, if seen at all, due to the wait average of 85 hours in the hospital emergency rooms for access into mental health hospitals or specialty units of a general hospital. Moreover, costs for mental health mood disorders alone are estimated at over seven million dollars annually. The Institute of Medicine (IOM) opined the need for change in healthcare to redesign practice and clinical communication with patients …

Disruptive Communication Among The Interdisciplinary Team: Gaining Insight And Providing Nurse Education, Kristen Marie Anderson

Doctor of Nursing Practice Scholarly Project

The purpose of this study is to identify what types of disruptive behavior nurses are experiencing, discuss outcomes of disruptive behavior, and educate healthcare providers and administrators of disruptive communication. Understanding the consequences of disruptive communication can help educators articulate the need for training in conflict management and therapeutic communication methods. It can also aid healthcare providers to be more conscious of their behavior in the professional setting. Seven research questions related to communication were developed and analyzed in this study. The author developed a pre-education survey that included demographics, multiple-choice questions, and open-ended questions to assess the nurses' knowledge …

Implementation Of A Nurse Leader Rounding Program In The Emergency Department, John Swanhorst

Student Scholarly Projects

Practice Problem: The identified practice problem was the low “Likelihood to Recommend” patient experience survey scores within the ED at the identified project setting.

PICOT: The PICOT question that guided this project was “In ED patients (P), how does the implementation of Nurse Leader Rounding (I) compared to the prior state of no Nurse Leader Rounding (C) affect the “Likelihood to Recommend” top box score (O) within eight weeks (T)?”

Evidence: In a review of 13 articles, the evidence consistently showed that Nurse Leader Rounding was a proven intervention for increasing patient engagement scores.

Intervention: Nurse Leader Rounding is defined …

Trauma Admission Guidelines For Elderly Isolated Orthopedic Injuries, Jessica Lauren Hamrick-Welchel

Master of Science in Nursing Theses and Projects

A rise in complications at a southeastern level one trauma center had the trauma department and performance improvement personnel looking for a cause and a solution. It was determined through data mining that the patient population that was driving certain complication cohorts above acceptable levels was the injured elderly patient admitted by the non-surgical hospitalist group. Patients admitted by this group commonly sustained a single injury, mostly hip fractures. Elderly patients are admitted by this group in efforts of successfully managing the many co-morbidities these patients typically possess with co-management by the orthopedic group to manage the injury. A meeting …

Family Texting In The Perioperative Care Setting, Crystal Chantel Vestal

Walden Dissertations and Doctoral Studies

Family members experience anxiety not knowing how their loved one is progressing during the surgical process. Communication between perioperative staff and the family can be challenging due to the operating room being in a restricted location. Communication between perioperative staff and the patient family, as reflected in scores on the Press Ganey evaluation report, was below the benchmark for a hospital located in the Western United States. This report measures how satisfied patients were with the information provided to their family during surgery. To address this gap in practice, the hospital implemented a text messaging quality improvement project from August …

Motivational Interviewing: A Strategy To Improve Health Professional's Communication, Lanita James

Walden Dissertations and Doctoral Studies

Miscommunication between patients and healthcare professionals is common in U.S. hospitals and is considered one of the chief factors in reduced patient satisfaction with care. Collaboration with the nurse researcher who reviewed the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) data for a local hospital noted that negative ratings were directly related to the miscommunication between the patient and care providers. Further identified that the nursing staff was not knowledgeable about evidenced-based strategies needed to communicate effectively with the patients. The purpose of this DNP project was to develop an education program to increase nurses' knowledge about …

Impact Of A Standardized Situation, Background, Assessment, And Recommendation Tool On Satisfaction And Communication In The Perioperative Area, Salomy Abraham

Walden Dissertations and Doctoral Studies

AbstractEffective communication among health care providers is critical to maintain patient safety during the handoff of care. Communication breakdown during handoff can lead to medical errors and sentinel events. The perioperative area is a vulnerable area that is prone to communication errors due to the involvement of providers from various disciplines and the nature of the quick patient turnovers within the perioperative area. To ensure proper communication during the handoff in the perioperative area, a unit-specific handoff tool is required. The focus of the project was to implement a standardized situation, background, assessment, and recommendation (SBAR) communication tool in the …

Developing An End-Of-Life Discussion Protocols, James Hawley

Rural Health Professions Projects

End of life (EOL) issues are far too often addressed reactively in Emergency Departments when patients can no longer express their wishes. This scenario can result in unwanted futile care, increased healthcare costs, and emotional hardships for family and healthcare workers. The purpose of this quality improvement project was to implement a provider-patient communication protocol that would shift advanced directive conversations proactively back into the local rural primary care setting.