Nursing Commons^™

Advancing A Culture Of Safety Through The Creation Of A Unit-Based Safety Team, Lynda K. Carr

Theses and Graduate Projects

Hospitals are challenged to create a strong culture of safety within their organization to eliminate harm to patients. This paper describes a project to advance a culture of safety on a cardiovascular acute care unit at an urban hospital through the creation of a unit-based safety team. Based on the premise that patient safety is a local phenomenon, the rationale for the project is to aim interventions at the unit level where they will have the greatest impact. Four key steps in creating an effective unit-based safety team are highlighted: team member selection, team development, enacting interventions, and evaluating interventions …

Facilitating The Staff Nurse's Role In Creating A Culture Of Care On An Obstetrical Care Unit, Laura Struve Hanson

Theses and Graduate Projects

The art of caring is foundational to the nursing profession, but too often nurses prioritize care for others above care for themselves. Nurse self-care and peer care are integral in the creation of a unit culture of care. This project introduces a new nursing practice model based on Jean Watson's caring theory and Caritas Processes to guide staff nurses on an obstetrical unit in creating a culture of care for self and peers. The practice model relies on nurse courage, intentional collaboration, and creativity to uniquely integrate the Caritas Processes into professional practice. This progression fosters the emergence of holistic …

Introducing Integrative Medicine At The Bedside To Patients With Post-Traumatic Headache Pain, Melissa E. Allard

Theses and Graduate Projects

The use of integrative medicine is growing, and the nursing profession has a responsibility to meet the changing needs of patients. This paper describes a model of nursing for delivering integrative medicine practices at the bedside to persons suffering with post-traumatic headache pain related to traumatic brain injury (TBI) and is grounded in Katherine Kolcaba's Comfort Theory. A patient is best served when the holistic principles of integrative medicine are facilitated by a nurse who is centered and able to introduce these modalities with positive intention. The goal of the practice model is to provide the foundation for nursing to …

Creating A Healing Environment In The Intensive Care Unit, Elissa Egbers

Theses and Graduate Projects

The intensive care unit (ICU) can be a very stressful environment. Patients are critically ill and require constant monitoring. Indeed, high tech care in the ICU environment includes multiple factors that may impair the patient's ability to sleep and rest. The purpose of this paper is to describe a practice model that is conducive to patient healing in an intensive care unit in a large urban hospital. This practice model is significant to patients, families, and nursing staff and is based on Florence Nightingale's Environmental Model of Nursing and her thirteen canons. This paper describes the potential implementation of the …

Care Of Self: How Reiki Is Used By Nurses To Reduce Stress On An Acute Care Unit, Leann Olson

Theses and Graduate Projects

As the nursing shortage escalates and patient acuity levels continue to rise, nurses can expect to experience increased stress and burnout. Indeed, studies show that job dissatisfaction among nurses today is widespread. Finding ways to reduce the stress, improve job satisfaction, and retention is important not only for nurses, nursing units, and organizations, but also for patients. This paper describes a nursing practice model that was developed to reduce stress and burnout among nurses in an acute care unit of a large urban hospital. The model uses the energy therapy of Reiki and is guided by Martha Rogers' Science of …

A Bridge To One World: An Indigenous Wisdom-Based Approach To Designing A Transcultural Patient Family Advisory Council, Julie Lundberg

Theses and Graduate Projects

As health care organizations face increasing challenges to accommodate diverse patient populations amid growing concerns of persistent health disparities, there is urgent need to better understand and listen to diverse, unique patient experiences. This paper describes the design and implementation of a transcultural Patient Family Advisory Council (PFAC) as a concrete step towards ensuring that the voices of culturally diverse patients and families are effectively engaged to improve the patient experience at a large, Midwestern healthcare organization. Storytelling, ritual and dialogue provide a wisdom-based approach to the design of a Bridge to One World practice model grounded in Leininger's Culture …

Health And Wellness Coaching For Older Adults Within A Faith Community, Julie K. Philbrook

Theses and Graduate Projects

By the year 2030, an estimated 22% of the U.S. population will be older than 65, which translates to more than 70 million people. Maintaining and improving an older adult's functional status in all aspects of his or her life will be crucial for elderly persons, their communities, and society as a whole. Nurses practicing within a faith community have a unique opportunity to autonomously implement community-focused wellness programs that will honor each person's self described needs. The purpose of this project is to develop a nurse facilitated health and wellness program for older adults in a suburban Lutheran faith …

Creating Community With Homeless And Marginally Housed Women, Judy Schlaefer

Theses and Graduate Projects

The purpose of this project is to create a weekly Drop-In Center where Homeless and Marginally Housed (HMH) women receive support, respite, and respect in a safe, welcoming environment. Homeless and Marginally Housed (HMH) women have unique needs due to daily struggles with disenfranchisement which include barriers to health services, battering, poor transportation, lack of recreation and education, neglect, and institutionalized poverty. The impetus for the Drop-In Center was to offer respite from the harsh environment created by the institutionalized violence against HMH women who deserve significant emotional and social support, nutrition, and respite. The transculrural nurse will be focused …

Empowering And Retaining New Graduate Nurses Through A Structured Mentoring Program, Kelly O. Gamble

Theses and Graduate Projects

The purpose of this project is to improve the orientation experience of the new graduate nurse at a metropolitan Minnesota hospital through the development of a structured mentoring program. The transition from student nurse to professional nurse is stressful for new graduate nurses. Stress combined with increased technology and patient acuity in the acute care setting has led to many new graduate nurses leaving the profession, contributing to the anticipated nursing shortage. Literature on new graduate nurse orientation, the nursing shortage, mentoring, and generational differences were incorporated in the development of the structured mentoring program. The importance of nursing leadership …

A Call To Action After A Patient Fall, Lisa D. Bungum

Theses and Graduate Projects

Fall prevention has always been a quality and safety initiative within hospitals. The purpose of this project is to define, develop, and implement an interdisciplinary huddle following a patient fall event so patient specific modifications to the plan of care can be initiated. The huddle will occur soon after the fall event to facilitate collaboration between all the patient's healthcare providers. The number of patients who repeat falls during a single hospitalization is significant and well documented in professional literature. A patient's risk for a repeat fall will be minimized by assessing and modifying interventions to reduce risk through an …

Frequent Users Of The Emergency Department: Guiding Patients To Comprehensive And Coordinated Care, Anne L. Draeger

Theses and Graduate Projects

The purpose of this project is to implement a rural community-based collaborative care network to assist high frequency emergency department users navigate a comprehensive system to access a full range of health care services and decrease reliance on the emergency department. Patients who frequent the emergency department are less apt to receive coordinated treatment of pain and other chronic disease which leads to suboptimal care focusing on symptoms rather than disease management. Nurses who practice in the emergency department identify the pattern of frequent use and lack of care coordination but struggle to provide a connection to preventative services and …

A Conceptual Framework For Providing Healthy Meals For A Marginalized Population, Hoching Wu

Theses and Graduate Projects

The purpose of this project is to create a conceptual framework grounded in a caring relationship that provides nutritious, economic, and efficient noon meals to 200 to 400 homeless people at an inner city church kitchen. Awareness of the concerns of the church kitchen coordinator and the needs of the homeless population provided the motivation to explore comprehensive and effective solutions through a conceptual framework. The typical menus from the inner city church kitchen and the research articles both showed the meal programs were fairly nutritious but high in total calories and low in dairy products. Creating new menus for …

Developing A Conceptual (Mosaic) Transcultural Model Of Nursing Care For Use At A Pediatric Inner-City Hospital, Lani Hollenbeck

Theses and Graduate Projects

The purpose of this project is to develop a transcultural model of nursing care for use at a pediatric inner-city hospital located in the Midwestern United States. The experience and outcome for pediatric patients and their families may be negatively impacted when language and culture are different from those of the nurse. Nurses working at the hospital have expressed discomfort when providing care for patients from diverse ethnic and cultural backgrounds. They feel challenged to provide supportive nursing care without imposing their own ethnocentric viewpoints or nursing practices that may be inconsistent with desires of those from another culture. The …

The Self- Caring Tree: A Model Of Nursing Self-Care, Cynthia M. Severson

Theses and Graduate Projects

Being a nurse can be physically, emotionally, and spiritually exhausting. Nurses are exposed to sickness, sadness, trauma, suffbring, terminal illnesses, and potentially harmful contagions in their daily work. Nurses tend to care for others more than they care for themselves and can become overwhelmed, lose their resilience, and burnout. Nurses who practice daily self-care benefit by experiencing greater self-esteem, resilience, and ultimately wisdom and compassion. This project focuses on the development of a self- care model for nurses to help nurses learn how to care for themselves. The model is grounded in the work of Dr. Jean Watson and her …

Let Your Life Speak: Exploring The Lived Experience Of Graduate Nurses In An Emergency Department Setting, Mary Margaret Healy

Theses and Graduate Projects

The purpose of this research was to explore the lived experience of graduate nurses (GNs) who made the transition from academic to practice environment in the high-acuity setting of a Level 1 trauma center. These GNs entered clinical practice through a nurse residency program at Truman Medical Center (TMC) emergency department (ED) in Kansas City, Missouri. The researcher interviewed 6 GNs participating in the nurse residency program with IRB approval from the University of Missouri, Kansas City IRB. The method of inquiry was hermeneutic phenomenology. The basic research question for this study was as follows: As a participant in a …

Creating An Environment That Fosters Feedback Among Nurses, Anne M. Egan

Theses and Graduate Projects

The goal of the project is to provide a voice for the nursing staff by adding their input on potential changes to the unit and to ultimately build stronger relationships among nurses. Involving staff from the beginning, this project started with a communication needs assessment completed in one unit at a small rural hospital in the Midwest. This included session meetings and a ballot survey. A project was designed to strengthen feedback among nurses on the unit, addressing horizontal violence in the workplace, and relating to Watson's nursing care theory. The project's goal is to create an environment that fosters …

Public Health Nursing And The Community: Partnering To Improve Health By Improving The Environment, Anna Haubrich

Theses and Graduate Projects

Florence Nightingale wrote that the environment is the single most important factor to a person's health. This paper discusses the process of bringing public health nursing together with community members to implement a Healthy Homes primary prevention project that improves the environment for people living in the Rondo Neighborhood of Saint Paul. The Rondo Neighborhood has a high ratio of low-income people. People living in lower socio-economic neighborhoods have poorer health outcomes, partially because of systemic environmental conditions. The framework of this community engagement project is guided by Community Based Participatory Action Research to emphasize the value of community involvement …

New Graduate Nurse Orientation Program, Darcie L. Thies

Theses and Graduate Projects

The purpose of this project is to create a new nurse orientation program. The project provides socialization, mentorship, organizational context, and information that is crucial for a new graduate nurse to successfully integrate into the IHS healthcare team. It is critical for all new graduate nurses to be socialized and acculturated into their practice environments. This is particularly true when a nurse is hired to work in an environment that has a very specific cultural context, such as Pine Ridge Hospital, located on the Pine Ridge lndian Reservation in South Dakota. lnformation for this project was gathered through a literature …

Motivational Interviewing With Patient Education To Promote A Safe Sleep Environment For Lakota Infants, Kari Johnson

Theses and Graduate Projects

Sudden Infant Death Syndrome (SIDS) has preventable risk factors; the sleep environment of the infant is one of those risk factors. SIDS is the leading cause of infant deaths in the Aberdeen Area of Indian Health Service, accounting for more than one fourth of the infant deaths. The project proposed utilizes Madeline Leininger's Culture Care Theory combined with an education model incorporating motivational interviewing with the current patient education used by the Public Health Nursing Department at the Pine Ridge Indian Health Service Hospital promoting a safe sleep environment.

Transcultural Nursing In Community: A Doctor Of Nursing Practice Project To Advance Nursing Education In Partnership With An Indigenous Community, Deb Shuhmacher

Theses and Graduate Projects

Through a culturally responsive partnership process, a doctoral project to advance nursing education on the Pine Ridge Indian Reservation in Pine Ridge, South Dakota is presented. The collaborative partnership is explored across a dominant Western culture and an Indigenous tribal community. A lens of awareness for White dominant culture is explained in relation to building a partnership with a Lakota tribal community. Traditional Indigenous values of mutuality, reciprocity, honor, and respect are discussed as significant in building a partnership. The process of engaging Indigenous wisdom and respecting Indigenous self-determination is foundational for the partnership process. Dr Leininger's culture care theory …

Ways Of Knowing Transcultural Herbal Healing, Kristin M. Mchale

Theses and Graduate Projects

This project was born from 5 years of deeply moving transcultural learning experiences. As I walked with cultural guides from the Pine Ridge Reservation in South Dakota, energy workers of the Celtic tradition in England, traditional folk healers in Mexico, healers of the US southwest, Alaska natives, and Italian mountain people, stories unfolded which showed a universal commonality; a connection to the land and the use of herbs for health and healing. Across the globe, herbal remedies are used by people of all cultures for health and healing throughout the lifespan. Within many cultures, knowledge of herbs is a source …

Somali Cares: Listening To The Voices Of The Other, Joyce P. Miller

Theses and Graduate Projects

Care during pregnancy is an important preventative health intervention for women and their unborn baby in all cultures. Healthcare inequities exist among some ethnic minority groups and contribute to racial disparities in birth outcomes. Pregnant Somali women, newly immigrated to the United States, ffie forced to seek prenatal care within a cultural context that can be very different from their own experiences and expectations. This refugee population is expected to fit into a medical system that is not only unfamiliar to them, but at times unable to meet their needs during pregnancy. As Somali women seek access to western healthcare …

Community Health Workers: Bearers Of The Light In Health, Healing, And Care, Jean M. Gunderson

Theses and Graduate Projects

Since the 1940's with the development of the community oriented Primary care model of sydney and Emily Kark that originated in Africa and was transposed to the United States, Community Health Workers (CHWs) have been integrated in community health activities. As individuals from the community intimately connected to its people and its cultural life-ways and meaning, they provide primary services and care as advocates, liaisons, educators, cultural brokers, and navigators; bridging multifaceted hanscultural constructs within systems. Thi increasing diversity of communities, the health inequities, and the call for culturally responsive care, reinforce the significance of understanding the practice of community …

The Caring Connection: Using Leadership Metis To Facilitate Community Outreach For Hospital-Based Nurses, Susan Rein Loushin

Theses and Graduate Projects

This presentation and poster describes advanced practice as a leadership process that links nurses working in a hospital setting with people in the neighborhood who are homeless. It gives voice to the experiences of nurses volunteering within the homeless community. There is documented evidence supporting the virtues of volunteerism and the effect on the target population. However, there appears to be a gap in the literature regarding the effect outreach projects have on the personal and professional lives of nurses volunteering their time in the community.

This DNP project .created opportunities and leadership for nurses to work as citizen professionals …

Transcultural Nursing In Guatemala: A Different Yield, Katherine A. Baumgartner

Theses and Graduate Projects

Daily life in Guatemala for most indigenous Mayan persons involves struggle, risk, and hardship. This country holds sharp contrasts: amazing beauty with volcanoes and jungles, and thousands of years of the advanced Mayan civilization along side the history of Spanish colonization, oppression, the daily face of poverty. Following a thirty-six year civil war, which ended in 1996, thousands of Guatemalan refugees returned from Mexico to re-create their lives in their homeland.

It is within this context, that a health initiative was begun as an international collaboration. The purpose of this initiative was to establish a program to educate and support …

Comparison Of Registered Nurse Job Satisfaction To Patient Satisfaction And The Link To The Role Of The Nurse Manager, Deborah M. Spotts

Theses and Graduate Projects

This is an in depth qualitative research study using a compelling literature review and an in depth case study of one hospital comparing registered nurse job satisfaction scores with patient satisfaction scores. The literature review indicates that research positively correlates nurse job satisfaction to patient care satisfaction. This research study focuses on understanding the possible relationship between registered nurse job satisfaction and patient satisfaction with nursing care. The role of the nurse manager is explored in order to understand possible the impact of that role on the satisfaction scores of both groups.

Nursing Vigilance - Blocking The Road To Delirium Through A Culture Of Care, Mary Ann Kinney

Theses and Graduate Projects

Vigilance at the bedside: The most viable tool we as nurses have is vigilance in our patient care. Vigilance is a gift and a tool that must be nurtured through academia and practice. The application and results of this tool lead to identifying and circumventing hospital and surgical post-operative delirium in orthopedic patients resulting in reduction of length of hospital stay, cost and eliminating the precursor delirium leading to dementia.

Case Study Scenario And Simulation: Supplementing A Student Nurse's Missed Foundational Clinical Nursing Experience, Lori Versaguis

Theses and Graduate Projects

Optimizing clinical education for student nurses in a local associate degree nursing (ADN) program is essential to prepare them to become competent professional nurses. The focus of this project is to develop a case study scenario and related simulation for associate degree nursing students who are absent from clinical experiences in a foundational nursing class. An innovative approach to replace a missed clinical experience is an educational module utilizing a patient care scenario followed by realistic nursing evaluation and interuentions in a simulation lab. Margaret Newman's theory of health as expanding consciousness supports this case scenario and simulation project. Bloom's …