Nursing Commons^™

Caring For Agitated Patients Using Nurse Managed Protocol, Valeria S. Mease Bsn, Rn, Jessica N. Pisano Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Pressure Ulcers And Nutrition, Sara J. Behle Bsn, Rn, Lea Silfies Bsn, Rn, Shanna J. Truscott Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Psychometric Properties Of Obstructive Sleep Apnea Screening Measures In Patients Referred To A Sleep Clinic, Jennifer N. Miller

Theses & Dissertations

Background: Obstructive Sleep Apnea (OSA) contributes to all-cause and cardiac mortality. There are no current guidelines for OSA screening in outpatient settings. An American Academy of Sleep Medicine task force is focusing on improving detection and categorization of OSA symptoms and severity to promote screening, assessment, and diagnosis of the disorder. The purpose of this study was to identify the psychometric properties of three self-report OSA screening measures (Berlin, Epworth Sleepiness Scale (ESS), STOP Bang) and an objective portable sleep monitor (PSM) compared to apnea-hypopnea index (AHI) levels (≥5, ≥ 15, and ≥ 30) from polysomnogram (PSG).

Methods: …

Exploring The Relationship Between And Among Registered Nurses' Spiritual Well-Being, Spiritual Care Perspectives, And Their Provision Of Spiritual Care In Acute Care Settings, Barbara J. Kitchener

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Despite acknowledgment that spiritual care is an essential aspect of holistic nursing care, nurses often feel ill-prepared for, uncomfortable with, and uncertain about providing spiritual care. Studies have indicated that nurses who have a strong sense of their own spiritual well-being and/or a positive perspective [attitude, value, belief] about spiritual care are more inclined to provide spiritual care to their patients. However there is a scarcity of such studies among acute care nurses. This descriptive correlational study aimed to explore relationships between and among acute care nurses’ spiritual well-being (SWB), spiritual care perspectives (SCP), and their provision of spiritual …

The Relationships Between Health Literacy, Self-Efficacy And Readiness For Change To Health Promotion Behaviors In Urban Black Women, Millie Hepburn

Seton Hall University Dissertations and Theses (ETDs)

Problem: Black women have been shown to experience higher rates of morbidity and mortality as a result of stroke, cardiovascular disease, hypertension, diabetes and overweight or obesity than women of other races/ethnicities. The ability to avert certain health problems, such as cardiovascular disease, hypertension, diabetes, stroke and overweight or obesity is known to be directly related to active engagement in health promotion behaviors, yet Black women are consistently less likely to engage in these behaviors than are white women. Improved understanding of the various factors that impact individual health promotion behaviors to reduce risk, such as health literacy, self-efficacy and …

Tuning "The System": An Evaluation Or Restorative Practices In San Lorenzo School District, Amber White

Master's Projects and Capstones

In 2013, The Director of Student Support Services for the San Lorenzo Unified School District (SLZUSD) implemented a Restorative Practices program in an effort to improve relationships on campus and decrease suspension and expulsion rates in SLZUSD. The Directors push for RP was fueled by the passing of Assembly Bill 1729 (AB-1729), when the California Education Code changed to allow for alternative disciplinary actions. States nationwide have passed bills similar to AB-1729 and allowed schools to use alternative punitive practices. Despite good natured intentions there were many faculty members who did not respond with enthusiasm and there has since been …

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

Reducing The Time It Takes To Execute A Legal Hold On Patients Currently On A Voluntary Status And To Transport Them To A Locked Inpatient Psychiatric Facility, Ariel Cris B. Manipula

Master's Projects and Capstones

The purpose of this presentation is to improve the communication between departments involved in the “step-up” process. An improved level of communication is measured with the amount of time it takes to get patient from outpatient lobby to inpatient unit bed. This process begins when a patient is placed on a legal hold because they are a danger to themselves, danger to others or gravely disabled. The problem is that the current process takes up to an hour and varies heavily on whether or not the unit charge nurse and the admissions and records agent are properly trained and knowledgeable …

Improving Unit Dynamics: Incorporating Lead Nurse Program On A Medical-Surgical Unit, Kara Mace

Master's Projects and Capstones

Clinical nursing leadership is now recognized as a key professional competency that will assure quality patient care and efficient work processes. The medical-surgical unit (MSU) at VA Mather has had high turnover rates and low staff satisfaction surveys for the past two years, which has led to a decline in staff morale. Lead nurses are in key positions to develop their unit staff, promote leadership development, and they are encouraged to act as role models in their practice. Change is difficult; therefore, the application of essential leadership skills is a necessary accompaniment to a change strategy in order to produce …

Decreasing Wait Times For New Referrals To An Outpatient Specialty Clinic, Marlene A. Evans

Master's Projects and Capstones

Abstract

New patients to an Outpatient Allergy Clinic are waiting for 60 days or more for an appointment which is of concern because of severe allergic reactions, such as anaphylaxis, from which they could suffer.

The aim of this project was to reduce the wait time by 25 percent or 15 days for all newly referred patients to the Children’s Outpatient Allergy clinic by August 1, 2016. The clinic is affiliated with a Children’s hospital, services adults and children, and sees approximately 750 patients monthly. Many patients have been on service for years.

Implementation

The implementation included a ‘buy in’ …

Issues In Patient Information Transmission: Standardizing Home Health Admission, Philippa Thomas

Master's Projects and Capstones

When 84 patients, current and former, complained about lack of information during the intake process within five months period, a uniform "Patient Screening Tool" (Appendix L) was developed to improve the admissions process to this home health agency. Intake staff is responsible for receiving accurate information from the referral sources, confirming qualifications to receive services, and initiating education about services to the patient. While the population served has a wide range in age, diagnoses, discharge settings and cultures, the majority are over 65, frail, homebound and are returning home after hospital, SNF or rehabilitation settings.

Data were collected through evidence …

Development Of A Breastfeeding Class Specifically For Working Moms, Maryleah S. Needels

Master's Projects and Capstones

Successfully breastfeeding mothers who are planning to return to work and remain exclusively breastfeeding their infants have a knowledge deficit as to the federal law protecting their rights along with the basic skills for pumping, storing, and bottle-feeding of breast milk. There is a significant drop in breastfeeding rates at both the 3 and 6-month marker, which coincides with maternal return to employment. After attending the Working Moms Breastfeeding Class, 100% of mothers reported an increase in knowledge surrounding the law and the CDC’s basic skills for handling pumped breast milk based on a pre/post questionnaire. Bandura’s theory of self-efficacy …

Implementing Change To Decrease The Emergency Department Visits For Pediatric Clients Referred To Mental Health Services, Diane Sandoval

Master's Projects and Capstones

The purpose of this clinical nurse leader (CNL) internship project is to implement an improvement intervention to decrease emergency department visits or psychiatric emergency services visit rates for pediatric clients receiving mental health services through the ambulatory clinic. The goal is to increase client safety by preventing harm to themselves or others and improving quality of care provided through timely nursing telephone triage. The project is taking place in a county run pediatric ambulatory clinic. We will participate in a shared leadership team to make recommendations for improvement at the microsystem level. Team members include the charge nurse, clinic manager, …

Intranasal Naloxone Adminstration Education, Natalie O. Levchenko

Master's Projects and Capstones

The Clinical Nurse Leader project focused on the provision of education on intranasal naloxone administration to healthcare providers in Lake County in order to educate patients, their families, peers, and members of their social network. Fatal opioid overdose rates from prescribed or illicit opioids are four times greater in Lake County than California. The setting is Lake County, California, with a population of 65, 000, a radius of 1,300 square miles, and an annual per capita income of $21,000, with 24.3 % living in poverty. The CNL project focused on the Clinical Nurse Leader elements: Systems Analyst/Risk Anticipator, Outcomes Manager, …

Improving Compliance In The Use Of Catheter Kit Supplied Hand Sanitizer Prior To The Insertion Of An Indwelling Urinary Catheter, Antonette B. Prado

Master's Projects and Capstones

Abstract

More than half of the staff nurses (65% through direct observation and 60% through interview) in the operating room (OR) department do not perform hand hygiene prior to insertion of an indwelling urinary catheter. This performance improvement project aims to educate all OR staff nurses on the practice of hand hygiene prior to the insertion of an indwelling urinary catheter by using the hand sanitizer included in the sterile catheter insertion kit. Two forms of interventions were provided in order to promote this process change. The first one being an education session with a power point presentation and the …

Liver Transplant Education And Training For Medical Surgical Icu Nurses, Matthew Redila

Master's Projects and Capstones

This project focuses on the CNL curriculum element of Nursing Leadership and explores the need for appropriate education and training for liver transplant as a new patient population for Medical Surgical ICU nurses. The transplant experience for these nurses currently include critically ill Bone Marrow Transplant, as well as stable heart and lunch transplant. The methods used to implement the project were to develop an education curriculum, a clinical orientation program, and a process to ensure proper communication occurs between all parties prior to clinical orientation. The competency-based orientation document, which is still being drafted, is used to determine clinical …

Strategies To Prevent Hospital Transfers In The Snf Environment, Vinai P. Decena

Master's Projects and Capstones

This project focuses on the CNL curriculum element of Care Environment Management. The purpose of this project is to reduce hospital readmissions in geriatric patients who are currently having any changes of medical condition within the SNF microsystem. In this project, the CNL functions as the team manager and care coordinator. The CNL facilitated, and utilized patients’ outcome data to make changes in care processes to reduce acute hospital transfers in the skilled nursing facility. The CNL lead the interdisciplinary team and was resource or point of contact for this project. The CNL educated nurses to utilize (Interventions to Reduce …

Implementation Of Violence Risk Assessment Tool On In-Patient Psychiatric Unit, Manuel Alvano

Master's Projects and Capstones

Violence towards healthcare workers in acute care settings, particularly mental health units is increasing nationwide, causing safety and financial concerns for health care organizations. Efforts were made to decrease assaults directed towards healthcare staff on a twenty five bed adult mental health unit in a large academic university hospital. The aim of the project was to decrease assaults by twenty-five percent in six months after implementation of a Violence Risk Assessment (VRA) tool. The ultimate goal was to maintain assault rates below NDNQI. Assaults on the unit for the fourth quarter of 2015 were 2.92, NDNQI 2.05. Assaults with injury …

Standardized Blood Transfusion Documentation, Kelly A. Hill

Master's Projects and Capstones

The aim of this project was to improve nurse satisfaction through the use of a standardized blood administration documentation template. The goal was to reduce the time that nurses spend charting by offering a structured documentation template and to ensure that the procedure is correctly recorded in the patient’s electronic record. The leadership theme that supported this project is Information Manager, as the clinical nurse leader (CNL) uses information systems and technology at the point of care to improve health care outcomes. The selected microsystem is a medical/surgical/telemetry unit, which has 38 beds with 38 registered nurses (RNs). When surveyed, …

A New Paradigm: Group Medical Appointments For Individuals With Diabetes Using Insulin Pumps, Kathleen Brown, Cynthia Payonk

Patient Care Services / Nursing

No abstract provided.

Diabetic Kidney Disease, Karen R. Hughes Dr

Nursing Student Class Projects (Formerly MSN)

A poster project on Diabetic Kidney Disease (DKD) formerly known as diabetic nephropathy which is the most common cause of end-stage renal disease (ESRD) and death in patient with diabetes.

Advanced Practice Nursing In Latin America And The Caribbean: Regulation, Education And Practice, Keri Elizabeth Zug, Silvia Helena De Bortoli Cassiani, Joyce Pulcini, Alessandra Bassalobre Garcia, Francisca Aguirre-Boza, Jeongyoung Park

Nursing Faculty Publications

OBJECTIVE: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives.

METHOD: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in …

Case Study Of Persons With Cancer Participating In A Community-Based Exercise Program: An Exploration Of Meaning And Change, Barbara K. Haas, Melinda Hermanns, Christina Melin-Johansson

Nursing Faculty Publications and Presentations

Increasingly, research supports the importance of incorporating exercise into the cancer care paradigm. While quantitative studies have substantiated the significant effects of exercise on physical functioning, the individual’s perspective of participating in an exercise program has rarely been considered. The purpose of this study was to explain the impact of a community based exercise program on the lives of persons with cancer and their caregivers. Based on Bandura’s Social Cognitive Theory, a single explanatory case study with multiple embedded units of analyses was conducted. Interviews were conducted with 10 individuals representing participants with cancer, their caregivers, and health care providers. …

Case Study Of Persons With Cancer Participating In A Community-Based Exercise Program: An Exploration Of Meaning And Change, Barbara K. Haas, Melinda Hermanns, Christina Melin-Johansson

The Qualitative Report

Increasingly, research supports the importance of incorporating exercise into the cancer care paradigm. While quantitative studies have substantiated the significant effects of exercise on physical functioning, the individual’s perspective of participating in an exercise program has rarely been considered. The purpose of this study was to explain the impact of a community based exercise program on the lives of persons with cancer and their caregivers. Based on Bandura’s Social Cognitive Theory, a single explanatory case study with multiple embedded units of analyses was conducted. Interviews were conducted with 10 individuals representing participants with cancer, their caregivers, and health care providers. …

Improving Veteran Access To Heart Failure Specialty Care: A Change Model Project, Mark Bird Whelchel

Dissertations

Background: Many Veterans Health Administration (VHA) facilities have cardiac services, but not all VHA centers offer heart failure care. Viable alternative models exist to traditional outpatient treatment by physicians, such as Tele-medicine consultations, the use of nurse practitioner run clinics, and the use of models such as Specialty Care Access Network-Extension for Community (SCAN-ECHO) and site specific contracted physician services models. These have the potential to improve Veteran access to care. Objective: The purpose of this change project was to conduct a needs assessment survey, in joint effort with the Hershey Medical Center Heart and Vascular Institute, to identify barriers …

Implementing A Pain Toolkit To Improve Pain Management, Kathleen R. Atkins Dnp, Mary J. Dyck Phd, Nancy L. Novotny Phd, Karen S. Delong Msn

Theses and Dissertations

Abstract

OBJECTIVES: The purpose of this study was to evaluate the effect of a pain toolkit to improve pain management.

BACKGROUND: The World Health Organization and Joint Commission state effective pain management is a basic human right.

METHODS: Patients’ ratings of pain management on a 25-bed orthopedic/neurology unit three months before and after implementation of a toolkit were compared. The toolkit included bedside report, care board, purposeful hourly rounding, pain algorithm, pain status indicator, and complex pain interventions. The data are comprised of patient responses to the following Hospital Consumer Assessment of Healthcare Providers and Systems survey questions: pain control …

Ischemic Strokes, Jada Adams

Nursing Student Class Projects (Formerly MSN)

Stroke or cerebrovascular accident (CVA) is the third leading cause of death in the United States (Mvundura, McGruder, Khoury, Valdez, & Yoon, 2011). Ischemic strokes make up about 86% of the strokes that occur, (Patel, & White, 2011) hemorrhagic and cryptogenic strokes make up for the other 15%. The topic that is covered in this poster is ischemic stroke. The biggest way to alter the amount of strokes that happen are to prevent them. More and more risk factors are being found that contribute to strokes. Once the inflammatory and immune response begins once triggered by hypoxia it cannot be …

Pseudocholinesterase Deficiency: Implications In Anesthesia, Amanda Esselstein

Nursing Student Class Projects (Formerly MSN)

Pseudocholinesterase is an enzyme produced in the liver that metabolizes neuromuscular blocking agents, particularly succinylcholine. A deficiency in pseudocholinesterase is typically caused by either a homozygous or heterozygous abnormal genetic variant of the enzyme which leads to a prolonged neuromuscular block and therefore muscle paralysis. It is vital for anesthesia providers to know the mechanism of action and duration of succinylcholine, as well as appropriate assessment and treatment if a pseucholinesterase deficiency is suspected. There is no treatment for a pseudocholinesterase deficiency of a genetic origin, however supportive care, particularly ventilator support, must be provided until the medication has been …

Essential Hypertension In Adults, Elizabeth Oti

Nursing Student Class Projects (Formerly MSN)

The author chose to write about hypertension because she takes care of patients and family members with hypertension on a frequent basis, and is likely to face the challenge of managing patients with hypertension (HTN) in her future role as a nurse practitioner due to the high prevalence of HTN among men and women.

Effects Of Pediatric Emergence Delirium Education On Analgesic Administration By Pacu Nurses, Melinda C. Nwanganga

Evidence-Based Practice Project Reports

Emergence delirium (ED) is a behavioral disturbance as a result of general anesthesia that commonly occurs in pediatric patients. Adverse effects of ED lead to a complicated recovery from anesthesia due to the risk of self-inflicted injury of patients, the disturbance of surgical incisions, the development of postoperative maladaptive behaviors, and the increased use of sedatives and analgesics resulting in prolonged recovery time and delayed discharge from the post-anesthesia care unit (PACU). Due to the multiple ramifications of ED, appropriate care is needed to promote a safe recovery from anesthesia and an optimum perioperative experience for these patients. As PACU …