Nursing Commons^™

Improving Scip-4 Glucose Measures, Melissa Fradette

Nursing Posters

A performance improvement project was initiated to increase the Surgical Care Improvement Project (SCIP) glucose measure compliance. Order sets were modified to standardize glucose monitoring frequency and initiate insulin infusions. A previous practice of double documentation (manual and glucose meter interface documentation) were abstracted as 2 separate results. When glucose interfacting became an option, the practice of manual entries did not stop. The use of manually documented results for decisions failue to prompt interface confirmation; non-validated results do not interface. The plan: implement order set changes; eliminate manual documentation; and rely on interfaced measures to make clinical decisions.

Medical-Surgical Certification - You Can Do It!, Mallory Mondloch

Nursing Posters

Nursing certification is an official recognition of a nurse's knowledge and expertise within an area of specialty practice. Nurses value certification as it contributes to personal accomplishment and satisfaction. Certification is valued not only by the individual nurse, but also by patients. It has been correlated with increased patient satisfaction scores and improved quality of care. Some of these positive patient outcomes include decreased fall rates and decreased mortality and failure respond rates. Evidence has shown that certification enhances staff nurses empowerment, subsequently decreasing turnover and increasing retention. Enhanced feelings of personal accomplishment, personal satisfaction, and validation of specialized knowledge, …

Giving Time Back: Implementing A Electronic Nursing Protocol For Skin Care, Amy Gorecki, Sue Omann, Kim Schuster

Nursing Posters

Purpose Statement: To improve the accessibility of evidence based skin care interventions for the clinical nurse without the need of a CWOCN consult.

Implementing A Tiered Pain Protocol In The Total Knee Arthroplasty Patient, Heidi Meyer, Kelen Sohre, Tamara Welle

Nursing Posters

Objective: Address the culture of pain management with physicians and nurses utilizing a tiered pain protocol in conjunction with non-pharmacological approaches to achieve improvement in pain satisfaction to a tolerable level.

Patient Education Barriers, May Schomer, Hannah Newhouse

Nursing Posters

Introduction: Our survey answers corresponded closely to the research data found. The typical barriers included time, subject knowledge, patient education needs assessment, setting for teaching and nursing teaching skills.

Pneumonia: Ongoing Efforts To Improve Outcomes, Centracare Health

Nursing Posters

Background: Original improvement efforts emphasized correct antibiotic, early mobilization, adequate hydration, and early and ongoing oxygen weaning. Ongoing efforts include: early mobilization, obtaining room air sats on admission, early and ongoing oxygen weaning, and patient education.

Reducing Readmissions For Newborns With Hyperbilirubinemia, Kristi Patterson

Nursing Posters

Purpose Statement: The purpose of this project is to reduce 30 day readmissions rates by 20% for normal newborns with hyperbilirubinemia on their index admission by utilizing the AAP clinical practice guideline including: utilizing the AAP nomogram based on age in hours, screening prior to discharge, and implementing the recommended interventions at discharge.

Treating Early Sepsis Outside Of The Icu Using A Bundle Of Interventions, Jennifer Burris

Nursing Posters

To decrease cost and length of stay for sepsis patients by standardizing treatment in the progressive care units (PCUs).

Sustaining Pressure Ulcer Prevention: Implementing A Skin Champion Model, Jennifer Burris

Nursing Posters

Purpose Question: Will an evidence-based skin champion model in the ICU improve nursing knowledge and perceptions about pressure ulcer prevention and reduce hospital acquired pressure ulcers?

Using Core Competencies To Help Staff Remain Proficient, Mary Leyk

Nursing Posters

Problem: Implement a competency program that engages staff compared to usual computer-based training modules. Objective: Design a multi-modal competency program for bedside nursing staff.

Shifting The Paradigm Of Classroom Nursing Orientation, Mary Leyk

Nursing Posters

Purpose Statement: The purpose of the Evidence-Based Practice Nursing Orientation Project is to find evidence to support a change in teaching strategy for newly hired RNs (both New Grads as well as experienced nurses), from the current process in order to improve outcomes of clinical competence, independence and nurse confidence, and retention.

What The Heck Is Value-Based Purchasing??, Centracare Health

Nursing Posters

Medicare has changed the way hospitals get paid. The new payment program is called Value-Based Payments (VBP). VBP is made up of two parts: incentives & penalities.

Utilizing A Protocol To Reduce Post-Operative Urinary Retention In Total Joint Arthroplasty, Gina Anderson-Malum, Naomi Schneider

Nursing Posters

Foley catheters have not routinely been used for our total joint patients for many years, leading staff to bladder scan and straight catheterize patients postoperatively. Bladder scanning and catheterization were identified as an inconsistent practice. Patients were commonly straight catheterized when nurses determind bladder scan volume and time of last void; yet the amounts for both and decision to catheterize were inconsistent. Also, the clinical evaluation and treatment was inconsistent among physicians. Variations in practice included rationale for a urology consult, use of medications for urinary retention, and documentation. Baseline urinary retention condition codes ranged from 8-18%, which led our …

Assessing The Cultural In Culturally Sensitive Printed Patient-Education Materials For Chinese Americans With Type 2 Diabetes, Evelyn Y. Ho, H Tran, Catherine A. Chesla

Communication Studies

Type 2 diabetes affects Chinese Americans at an alarming rate. To address this health disparity, research in the area of cultural sensitivity and health literacy provide useful guidelines for creating culturally appropriate health education. In this article, we use discourse analysis to examine a group of locally-available, Chinese and English language diabetes print documents from a surface and deep structure level of culture. First, we compared these documents to research findings about printed health information to determine if and how these documents apply current best practices for health literacy and culturally appropriate health communication. Second, we examined how diabetes as …

Mobile Nurse Practitioner: A Pilot Program To Address Service Gaps Experienced By Homeless Individuals, Joan Alviar Fraino

Nursing and Health Professions Student Research and Publications

An estimated 2.3 to 3.5 million individuals are homeless in the United States, many of whom have chronic medical and mental illnesses. Underserved individuals who are homeless experience gaps in services, resulting in poor health care outcomes and readmission to the hospital setting, often presenting in crisis through the emergency department. The financial state of hospitals is negatively impacted by the burden of patients returning to the hospital due to unresolved issues. The current article presents the role of a psychiatric-mental health nurse practitioner as part of a pilot program, Opportunity Village Mobile Health, that provides a comprehensive approach to …

Nursing Annual Report Fy14-Fy15, Children's Mercy Hospital

Nursing Annual Reports

Annual report for nursing services for Fiscal Years 14 and 15 (July 2013-June 2015) at Children's Mercy Kansas City.

Cognitive-Behavioral Therapy, Robert H. Rice

Nursing Faculty/Staff Publications

Cognitive-behavioral therapy (CBT) is the merging of behavioral and cognitive therapies that mostly focuses on working with the client in the present. Although there are many approaches to CBT, there tend to be some common features. For example, CBT is generally a directive approach to psychotherapy that helps clients to challenge their problematic thoughts and to change the behaviors associated with those thoughts. In addition, most approaches to CBT are structured and time limited and include some type of homework where the client can practice the cognitive and behavioral strategies learned in the therapeutic setting. This entry focuses mostly on …

Narrative Therapy, Robert H. Rice

Nursing Faculty/Staff Publications

Narrative therapy (NT) is a strengths-based approach to psychotherapy that uses collaboration between the client or family and the therapist to help clients see themselves as empowered and capable of living the way they want. In the face of crisis or trauma, NT helps clients achieve a “This too will pass” attitude, while positioning the therapist as an appreciative ally in the process. NT is useful with individuals and is used extensively with families due to its ability to separate clients from problems and unite families against problematic patterns. NT also lends itself well to joining with families because it …

Nursing Students' Perceived Value Of The Pre-Briefing Phase Of Simulation, Jill Renae Chamberlain

Student Theses, Dissertations and Capstones

As technology has grown, many healthcare professions’ programs, including nursing, have incorporated simulation into their curricula. Overwhelmingly, research has highlighted the last phase of simulation, debriefing, as the most important component influencing learning outcomes, with limited focus on prebriefing. The purpose of this study was to describe the influence the prebriefing phase during simulation has on undergraduate nursing students’ perceptions of overall simulation effectiveness, learning, and self-confidence. Situated learning theory was selected to guide the research design due to its unique view that learning is a social process that is enhanced within the authentic environment. The quasi-experimental design study compared …

Telehealth Tool, Heidi A. Mennenga, Laurie Johansen, Becka Foerster, Lori Hendrickx

College of Nursing Faculty Publications

This tool examines current knowledge regarding telehealth.

Rural Characteristics Tool, Heidi A. Mennenga, Laurie Johansen, Becka Foerster, Lori Hendrickx

College of Nursing Faculty Publications

This tool examines current knowledge and confidence in teaching rural characteristics.

Symptom Perceptions And Self-Care Behaviors In Patients Who Self-Manage Heart Failure, Katherine M. Reeder, Patrick M. Ercole, Gina M. Peek, Carol E. Smith

College of Nursing Faculty Publications

Background: Patients with heart failure (HF) are at heightened risk for acute exacerbation requiring hospitalization. Although timely reporting of symptoms can expedite outpatient treatment and avoid the need for hospitalization, few patients recognize and respond to symptoms until acutely ill.

Objective: The purpose of this study was to explore patients’ perceptions of symptoms and self-care behaviors for symptom relief, leading up to a HF hospitalization.

Methods: To examine prehospitalization symptom scenarios, semistructured interviews were conducted with 60 patients hospitalized for acute decompensated HF.

Results: Thirty-seven patients (61.7%) said that they had a sense that “something just wasn’t quite right” before …

Student Perceptions Of Quality And Safety Competencies, Heidi A. Mennenga, Lois Tschetter, Lily Sanjaya

College of Nursing Faculty Publications

No abstract provided.

Il-4 Inhibits Il-1Β-Induced Depressive-Like Behavior And Central Neurotransmitter Alterations, Hyun-Jung Park, Hyun-Soo Shim, Kyungeh An, Angela Starkweather, Kyung Soo Kim, Insop Shim

School of Nursing Publications

It has been known that activation of the central innate immune system or exposure to stress can disrupt balance of anti-/proinflammatory cytokines. The aim of the present study was to investigate the role of pro- and anti-inflammatory cytokines in the modulation of depressive-like behaviors, the hormonal and neurotransmitter systems in rats. We investigated whether centrally administered IL-1β is associated with activation of CNS inflammatory pathways and behavioral changes and whether treatment with IL-4 could modulate IL-1β-induced depressive-like behaviors and central neurotransmitter systems. Infusion of IL-4 significantly decreased IL-1β-induced anhedonic responses and increased social exploration and …

Randomized Sham Controlled Trial Of Cranial Microcurrent Stimulation For Symptoms Of Depression, Anxiety, Pain, Fatigue And Sleep Disturbances In Women Receiving Chemotherapy For Early-Stage Breast Cancer, Debra Lyon, Debra Kelley, Jeanne M. Walter, Harry Bear, Leroy R. Thacker, R.K. Elswick

School of Nursing Publications

Purpose

Women with breast cancer may experience symptoms of depression, anxiety, pain, fatigue and sleep disturbances during chemotherapy. However, there are few modalities that address multiple, commonly occurring symptoms that may occur in individuals receiving cancer treatment. Cranial electrical stimulation (CES) is a treatment that is FDA cleared for depression, anxiety and insomnia. CES is applied via electrodes placed on the ear that deliver pulsed, low amplitude electrical current to the head.

Methods

This phase III randomized, sham-controlled study aimed to examine the effects of cranial microcurrent stimulation on symptoms of depression, anxiety, pain, fatigue, and sleep disturbances in women …

Virginia Commonwealth University Volunteer Doula Program Training Manual, Kathleen M. Bell, Susan L. Linder

School of Nursing Publications

A birth doula is a specially trained birth assistant who provides emotional, psychological and physical support and care to a pregnant and/or laboring woman. In providing this care, the doula helps the laboring woman and her support person achieve their most optimal birth experience. This is typically an unmedicated birth; however, doulas may attend any birth and be of profound assistance and comfort.

This curriculum was written specifically for nursing students who are being trained as lay doulas. Unique in its approach and delivery, the curriculum is written with the nursing student in mind; particularly a student who has already …

Inhalation Anesthesia Vs. Total Intravenous Anesthesia For Ambulatory Dental Surgery In Children, Kristin D. Neal

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to compare inhalation anesthesia with sevoflurane versus Total Intra Venous Anesthesia (TIVA) with propofol infusion as it relates to the quality of recovery including postoperative pain, Post Operative Nausea and Vomiting (PONV), and Post Anesthesia Care Unit (PACU) Length Of Stay (LOS) in pediatric patients undergoing ambulatory dental surgery. Introduction: Pediatric dental procedures are increasingly performed in an outpatient setting under general anesthesia due to inadequate cooperation, circumstantial anxiety, and other behavioral and health issues. Commonly used inhalation anesthetics, such as sevoflurane, can induce hyperalgesia in children. While sevoflurane increases the risk PONV, …

Cultural Norms Of Clinical Simulation In Undergraduate Nursing Education, Susan G. Mcniesh

Faculty Publications

Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a …

A Mixed Method Study Of The Impact And Outcomes Of Graduates Of The Csu Northern California Consortium Doctor Of Nursing Practice Program Class Of 2014, Lori Rodriguez

Faculty Publications

In 2010, in response to a demand for advanced practice nurses to meet the burgeoning needs of the state's population, the California legislature passed AB 867 which called for a pilot project to institute the Doctor of Nursing Practice program in the California State University campus system (Nava & Arambula, 2010). Two programs, one based in Southern California and the other in Northern California, opened in fall of 2012. In Northern California, Fresno State was chosen as the base campus with San Jose State University as the partner campus for the CSU Northern California Consortium of the Doctor of Nursing …

The Effect Of In Situ Simulation On Teamwork Attitudes In Nursing Students, Janice Kaye Fuson

Nursing Theses and Capstone Projects

Nursing students are not adequately trained in teamwork principles. Positive teamwork has been identified by governmental and accrediting bodies of healthcare to be an essential element in patient safety. TeamSTEPPS© is a program developed by the Department of Defense adapted to healthcare as a cost effective method to change the culture of healthcare organizations. A capstone project that implemented in situ simulation using a TeamSTEPPS© tool was conducted in a rural North Carolina nursing program. Eighteen students participated in the simulation and completed a pre and post TeamSTEPPS© Teamwork Attitude Questionnaire. Mean scores were noted to be considerably lower post …