Nursing Commons^™

Just Sit For A Bit: A Moment Of Caring, Gabrielle M. Malouf

Master's Projects and Capstones

Background: Research shows that time spent sitting at the bedside promotes trust, which ultimately improves nurse satisfaction, patient satisfaction and patient outcomes. Patient satisfaction scores have been below benchmark for several months on an adult medical unit at an academic medical center.

Overview: The purpose of this project was to improve patient satisfaction in the areas of nursing courtesy, friendliness, and listening. Nurses were asked to sit down for at least 5 minutes per shift with each patient, engaging in a “moment of caring”. Nurse surveys were given and both pre and post implementation. These surveys assessed whether or not …

Outpatient Medication Error Improvement, Savannah M. Klinginsmith

Master's Projects and Capstones

Patient Safety Initiative -Improving Medication Administration (Outpatient Care)

SPECIFIC AIM: We aim to Improve the medication administration process and involve all staff within 6 months

In the microsystem consisting of 14 family practice and urgent care clinics, there is not a standard process based on evidence based practices for medication administration. With and estimated of 400-600 medications (immunizations included) being administered per day, without a standard of care protocol, the risk for medication errors is evident.

Objectives and changes anticipated based on implementation of the project is to engage staff in support for improving medication administration standard of care based …

The Creation And Implementation Of A Transgender Cultural Competence Nursing Education Toolkit, James Bl Donovan

Doctor of Nursing Practice (DNP) Projects

Healthcare disparities in the transgender populations have been linked to lack of healthcare provider cultural competence (IOM, 2011; Bradford et al., Harbin et al., 2012; Eliason, Dibble, & DeJoseph, 2010; Lim, Brown, & Jones, 2013). Prior research has identified that healthcare providers receive little, if any, transgender cultural competence training during their formal education. A survey of nursing educators at the University of San Francisco School (USF) of Nursing and Health Professions suggested that few educators are providing transgender content or understand the unique healthcare needs of that population. A literature review concluded that little is known about the best …

Using An Educational Module And Simulation Learning Experience To Improve Medication Safety, Barbara Lynn Durham

Doctor of Nursing Practice (DNP) Projects

The purpose of this evidence-based change in practice project was to provide nurses with an experiential learning opportunity, using simulation, to identify and report near miss events during the medication administration process related to patient-controlled analgesia (PCA) usage. Despite extensive in-service training on a Medical/Surgical (Med/Surg) floor in an acute care hospital, inconsistent, inaccurate and incomplete documentation with use of the new PCA pumps continued to be problematic. A conceptual framework of just culture was used with the quality improvement method of the Plan-Do-Study-Act (PDSA) cycle for testing change. Medication safety education was a valid andragogical strategy to decrease rates …

Transitional Care Services: A Nurse-Led Quality Improvement Project, Debra Conroy-Mccue

Doctor of Nursing Practice (DNP) Projects

With the implementation of the Patient Protection and Affordable Care Act of 2010 (PPACA) and a national requirement for health care providers and systems to deliver care that is safe, outcome driven, and cost effective, Dignity Health (DH) as part of the hospital engagement network (HEN) launched an initiative called the “No Harm” campaign to reduce all-cause avoidable hospital readmissions. The project, led by a Doctorate of Nursing Practice (DNP) student and readmission team, sought to achieve a 20% reduction in preventable readmissions by December 2014. After having achieved initial success in implementing transitional care services for patients with heart …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Using Video Simulation To Enhance Rn-Pca Communication, Boris Chang

Master's Projects and Capstones

The purpose of this project was to develop a video simulation exercise to enhance communication between Registered Nurses (RNs) and Patient Care Assistants (PCAs). From a general microsystem assessment initially performed on an urban hospital medical-surgical unit, 75% of respondents noted that the most pertinent issue to address was improving communication between RNs and PCAs. Literature review of evidence-based practices found several studies that support the use of human clinical simulation to promote teamwork and interdisciplinary communication. RNs (n = 24) and PCAs (n = 9) were then individually interviewed with surveys and responses scored based on the …

Narrowing The Qsen Competency Gap In New Graduate Registered Nurses, Marty Mayhew

Doctor of Nursing Practice (DNP) Projects

This intervention is an evidence based, change of practice, quality improvement project that evaluates achievement of the six Quality and Safety Education for Nurses (QSEN) competencies of new registered nurse graduates. No intervention with a similar focus was found in an extensive review of the literature. The participants included 16 new graduate registered nurse hires enrolled in a new graduate RN residency program at Tucson Medical Center located in southern Arizona. The Nursing Quality and Safety Self Inventory^© (NQSSI^©) was used to identify practice gaps perceived by the new RN graduates related to the six QSEN competencies. …

Collaborating With The Unit Clerk To Decrease Avoidable Interruptions During Medication Administration On A Medical Surgical Unit, Christine Dimaano

Master's Projects and Capstones

Medical errors are the third leading cause of death in the United States. Medical errors also incur significant cost ramifications due to increased hospital length of stay and fines. Medication errors, a type of medical error, are one of the most common types of inpatient errors. Nurses are most often are responsible for medication administration, but safety during medication administration should be a priority of all hospital personnel. Avoidable interruptions during medication administration contribute to medical errors. Decreasing interruptions require increased nurse assertiveness during medication administration, interdisciplinary cooperation and unit culture change. This project identified that educating the unit clerk …

Ent Educational Patient Bedside Tool, Alina M. Toma

Master's Projects and Capstones

Early educational and discharge preparations are an advantage to patients, the interdisciplinary team, and hospital. It was determined that lack in communication and coordination among staff members led to inadequate patient teaching, therefore an educational tool that is kept at the bedside may facilitate accountability and smoother transition to home.

The aim of the project is to improve the education of patients with tracheostomies and laryngectomies, and enhance staff communication and coordination by December 2014.

Analysis methods used included Failure Mode Effects Analysis (FMEA), fishbone diagram, process map, and SWOT analysis. The social learning theory is the framework chosen for …

Relocation Of Orc To Or2, Svetlana N. Schopp

Master's Projects and Capstones

The goal of this Clinical Nurse Leader (CNL) internship project was to maintain safety and quality of care of obstetric (OB) patients undergoing Cesarean Sections (C/S) after operating room for cesarean sections (ORC) is relocated from obstetric unit to the main operating room (OR). The microsystem will accomplish this through effective teamwork, clear interdisciplinary communication, collaboration, and standardization of processes involved. The institution is a not for profit rural health care facility and is a designated Critical Access Hospital; it is located in Northern California. A general obligation bond was passed in 2007 to fund seismic upgrades. Old OB unit …

Emergency Preparedness On An Inpatient Hospital Unit, Hailee Marie Barnes

Master's Projects and Capstones

This paper will discuss the implementation of an emergency preparedness quality improvement project conducted by a University of San Francisco Clinical Nurse Leader (CNL) student on an inpatient cardiac unit, Unit H, at an urban teaching hospital in Northern California, Hospital B. An assessment of the current state of emergency preparedness, a diagnosis of Unit H’s area of greatest needs, the details of planning and implementing the quality improvement as well as the final evaluation will be discussed. The nursing process will be used for the structure of this paper as it was used as the structure of this project. …

Increasing Patient Participation In The Medication Reconciliation Process, Andrea Idudhe

Master's Projects and Capstones

It is estimated, that ambulatory care settings have a 25% adverse drug events (ADEs) rate, and 39% of those event were preventable errors (Taché, Sönnichsen, and Ashcroft, 2011). Considering many adverse drug events are related to medication errors, preventing medication errors is fundamental to improving patient safety and outcomes. Medication reconciliation is the process of identifying and resolving medication discrepancies that occur, during transitions in care. Patient participation is a key component to the medication reconciliation process. With the intent to improve patient participation, a patient awareness intervention was implemented in the cardiology outpatient clinic. Data was collected using microsystem …

Preparing Nurse Educators: Designing Hps Simulations Using Cerner Aes., Rachel Ramsey, Katrina Kessler, Robert Snow

Katrina J Eby

No abstract provided.

A Descriptive Mixed-Methods Study Examining Resilience And Transitioning To Adulthood Among Emerging Adults With Disabilities, Jennifer E. Mannino

Theses & Dissertations

Transitioning to adulthood is not without challenges. The move away from family influence towards independence and self-determination is filled with uncertainty. As emerging adults (18-29) transition to adulthood they will encounter various challenges related to their new adult roles (Arnett & Tanner, 2005; Jensen & Arnett, 2012). Increased challenges and vulnerabilities in transitioning are evident among emerging adults with disabilities because they face additional challenges related to their disability over and above what all others of this developmental stage experience (Betz & Redcay, 2002; Blomquist, 2007; Faux & Nehring, 2010; King, Baldwin, Currie & Evans, 2005; Murray, 2003; National Research …

Preparing Nurse Educators: Designing Hps Simulations Using Cerner Aes., Rachel Ramsey, Katrina Kessler, Robert Snow

Rachel A. Ramsey

No abstract provided.

"I Saved The Iguana": A Mixed Methods Study Examining Responder Mental Health After Major Disasters And Humanitarian Relief Events, Suzanne Marie Boswell

Doctoral Dissertations

The purpose of this mixed methods study was twofold. The first was to use Hobfoll’s (1989) Conservation of Resources theory to predict psychological stress based on responders’ perceptions of resource adequacy. The second was to use qualitative interviewing to gain a more comprehensive understanding of the disaster/humanitarian responder experience.

The study is significant given the expanding role of nurses within disaster/humanitarian response organizations. Furthermore, psychological stress results in increased turnover of human resources in these organizations. This turnover is detrimental to humanitarian systems that already lack adequate coverage and sufficiency because funding and human/material resources grow at a slower pace …

Evaluating The Perceptions Of Quality Of Life In Informal Caregivers Caring For Hospice Patients, Rashandra Fisher Laws

Doctoral Projects

Maintaining or improving quality of life for informal caregivers is important as they endure the burden of providing care to terminally ill loved ones on a daily basis. Caregivers are at a greater risk for depression, deteriorating physical health, financial difficulties, and premature death than demographically similar non-caregivers (Demiris et al., 2010). The goal of this capstone project was to determine the effectiveness of the creativity, optimism, planning, and expert information (COPE) intervention, which address specific needs of the family and caregiver.

Twenty informal caregivers completed the Quality of Life (QoL) Index tool, which measured their perceptions of five different …

High-Stakes Evaluation: Five Years Later, Tonya Rutherford-Hemming, Suzan Kardong-Edgren, Teresa Gore, Patricia K. Ravert, Mary Anne Rizzolo

Faculty Publications

This article compares the International Nursing Association of Clinical Simulation and Learning (INACSL) memberships' thoughts and discussions about the use of simulation for high- stakes evaluation in nursing education to a similar town hall discussion, five years ago. Data on the topic of high-stakes testing were collected through a survey before the INACSL conference in June 2014. During a town hall meeting at the conference, the survey data was presented, attendees shared their thoughts and reacted to prepared comments by selected simulation leaders. Half of the town hall attendees favored high stakes testing before the survey findings and discussion. This …

Impact Of Universal Disinfectant Cap Implementation On Central Line–Associated Bloodstream Infections, Katreena Collette Merrill, Sharon Sumner, Lorraine Linford, Carrie Taylor, Christopher Macintosh

Faculty Publications

Background: Central line–associated bloodstream infections (CLABSIs) result in increased length of stay, cost, and patient morbidity and mortality. One CLABSI prevention method is disinfection of intravenous access points. The literature suggests that placing disinfectant caps over needleless connectors decreases CLABSI risk.

Methods: A quasi-experimental intervention study was conducted in a >430-bed trauma I center. In addition to an existing standard central line bundle, a new intervention consisting of a luer-lock disinfectant cap with 70% alcohol was implemented in all intravenous (IV) needleless connectors on patients with peripheral and central lines. Compliance to the disinfectant cap was monitored weekly. A generalized …

A Narrative Analysis Of The Stories Of Mothers Who Have Parented A Child Diagnosed With Hodgkin's Disease And Is Currently In Early Survivorship, Jennifer M. Darcy

Theses & Dissertations

With the growing number of survivors of childhood cancer in the United States, it has been essential for research to look more closely at the challenges these “children” and their families face later in life as they live to adulthood. While much has been written about childhood cancer survivors and their parents independently, there are unique struggles that a mother and a childhood cancer survivor face as a dyad. A diagnosis of cancer falling on one’s child is undoubtedly a life altering event. Examining the dyadic relationship over time offers a unique perspective to understanding the parenting experience with a …

The Comparison Of Volatile Organic Compound Measurement And Analysis Methods In A Ground-Based Simulated Spacecraft Cabin, Alana Shields

Von Braun Symposium Student Posters

No abstract provided.

Building The Research Enterprise In The Academic Environment:, Geraldine Polly Bednash, Jane Kirschling, Eileen T. Breslin, Robert Rosseter

Quality Advancement in Nursing Education - Avancées en formation infirmière

The preponderance of nursing research conducted in the United States occurs in schools of nursing. Accordingly, a major role for academic leaders in nursing education is the development of a resource base to support and expand the research mission of the nursing program. The intersection of research and practice is also an essential element for assuring the relevance of nursing research and advancing the application of the evidence generated by nursing scientists. The following paper presents an introduction to nursing research in the U.S. with an emphasis on the educational and operational resources needed to maintain a robust research enterprise …

Clinical Nursing Reasoning In Nursing Practice: A Cognitive Learning Model Based On A Think Aloud Methodology, Johanne Goudreau, Louise Boyer, Dimitri Létourneau

Quality Advancement in Nursing Education - Avancées en formation infirmière

Background. The current context of increasingly complex nursing care requires a high level of clinical reasoning in nursing practice. Still, teaching clinical reasoning in nursing remains a challenge for educators in the field. Although several studies have been conducted to try to understand clinical reasoning in nursing, neither its developmental stages nor the corresponding critical milestones have been uncovered. Therefore, nursing educators cannot rely on a cognitive learning model (a description of how people learn and develop a specific competency) to facilitate the learning of this crucial competency.

Objectives. This study was conducted to develop a cognitive learning model of …

Vitamin D Deficiency And Acute Lower Respiratory Infections In Children Younger Than 5 Years: Identification And Treatment, Allison Larkin, Jane H. Lassetter

Faculty Publications

Introduction: Acute lower respiratory infection (ALRI) is a leading cause of childhood mortality. Research suggests that vitamin D deficiency (VDD) puts children at risk for ALRI. The purpose of this review is to examine ALRI and VDD in children 5 years and younger. Common etiologies, diagnosis, prevention, treatment of ALRI, and recommendations for vitamin D supplementation are summarized.

Method: Databases were searched for studies investigating VDD and ALRI in children. Independent reviewers assessed the internal validity of the studies.

Results: Of 18 studies examined, VDD was found to be associated with increased risk or severity of ALRI in 13 studies; …

Tendinopathy: Setting The Record Straight, Craig Nuttall, Ryan Rasmussen

Faculty Publications

Tendinopathy is a commonly diagnosed injury. Traditionally, tendinopathy was considered to be caused by an inflammatory process. It is now known that a majority of tendinopathies are caused by tendinosis, a failed healing response resulting in a degenerated tendon. The recurrent nature of tendinopathies can present a challenge for the health care provider and be very frustrating for the patient. There are several principles that should be followed when treating tendinopathies. These principles include rest, ice, eccentric exercises, and avoidance of corticosteroid injections. Proper treatment of tendinopathies can lead to optimal healing and decrease the risk of recurrence.

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

Electronic Thesis and Dissertation Repository

Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …

Minimizing Pain During Childhood Vaccination Injections: Improving Adherence To Vaccination Schedules, Lacey M. Eden, Janelle L. B. Macintosh, Karlen E. Luthy, Renea L. Beckstrand

Faculty Publications

Pain experienced in childhood can lead to long-term and psychologically detrimental effects. Unfortunately, the most common pain experienced in childhood is caused by vaccinations and may lead to non-adherence to the recommended vaccination schedule. As a result, it is the health care provider's responsibility to take measures to reduce vaccination pain; however, there are a plethora of pain relieving interventions during immunizations and it is unclear which interventions are most cost efficient, timely, and effective. Studies have been conducted to investigate the efficacy of different pain management interventions during vaccinations. This review evaluates various pain relieving interventions and provide health …

Np Bookshelf. [Review Of The Book Compassion Fatigue And Burnout In Nursing: Enhancing Professional Quality Of Life, By V. Todaro-Franceschi], Leslie W. Miles

Faculty Publications

This book is not just for nurses who care for the dying patient but for all nurses who find themselves at some point in their career feeling burned out, dissatisfied with work life, bullied, or lacking a sense of meaning and purpose in their professional quality of life. Todaro-Franceschi identifies the causes of compassion fatigue and burnout as being multifactorial, yet having a core symptom of the nurse internalizing suffering to the point that it negatively transforms the care a nurse can give. The target audience is wide, with application to current practitioners, students, nurse educators, and anyone working in …

Exploring Perceptions Of Staff Registered Nurse Preceptors For Undergraduate, Pre-Licensure Nursing Students, Katherine C. Hall

Doctoral Dissertations

Staff nurses are increasingly called upon to accept more responsibilities and roles in addition to provider of patient care, including that of preceptor. Aside from dealing with demands of high acuity patients, working long hours with inadequate staffing, and carrying heavy workloads, nurses may view teaching and supervising students as an additional burden, time-consuming, and not part of their role. The purpose of this dissertation was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students. Emphasis was placed on exploring RN’s perceptions of the role, specifically the preparation for, support in, and understanding of what the role …