Nursing Commons^™

Transitioning Care From Hospital To Home, Increasing Awareness Of Take-Home Pressure Injury Prevention Kits, Erika A. Yazdanbakhsh Mrs

Master's Projects and Capstones

With proper implementation of evidence-based interventions, most pressure injuries (PI) can be prevented. While prevention is considered standard of care while inpatient, there is a need to transition this care from hospital to home. This CNL project aimed to increased awareness of take home PI prevention kits made available to staff nurses at on medical surgical hospital unit with 15 staff nurses. An author-blinded, internal chart review and a comprehensive review of evidence-based literature were studied to provide background data and support for implementation using the staff huddle. Direct observation and staff interaction was incorporated with Lewin’s change theory to …

Reducing The Incidence Of Hospital-Acquired Pressure Ulcers By Enhancing The Role Of Unit-Based Skin Champions, Anne V. Loewenthal

Master's Projects and Capstones

Reducing the Incidence of Hospital-Acquired Pressure Ulcers by Enhancing the Role of Unit-Based Skin Champions

Abstract

Hospital Acquired Pressure Ulcer continues to be an alarming issue in today’s healthcare systems. Often preventable, it is a significant nursing role and a frequently used benchmark for quality care. Studies have shown that hospital-acquired pressure ulcer (HAPU) complications have been associated with “up to 60,000 deaths each year in the United States” (AHRQ, 2014). A major health problem, it presents grave consequences on the patient’s well-being, significant treatment and recovery delays, increase length of inpatient stays, and have become a “never” event from …

Improving Patients' Pain Management Through Proper Documentation, Virzen Merina

Master's Projects and Capstones

The aim of this project was to improve pain documentation on the Surgical Unit as a means to enhance caregiver communication on finding the best methods to manage patients’ pain. Effectively managing patients’ pain leads to better patient outcomes, increased patient and nurse satisfaction, and decreased length of hospitalization. The setting is a not-for-profit hospital in Southern California. The microsystem selected is the 32-bed capacity Surgical Unit that mainly admits pre- and post-surgical patients, but also accommodates non-surgical, telemetry, and trauma cases.

To improve pain assessment documentation, collaboration was sought with the multidisciplinary team (IT department, clinical nurse specialists, and …

Preventing And Reducing Clabsi With Daily 2% Chg Wipes, Karen Ha

Master's Projects and Capstones

This project aims to decrease central line associated bloodstream infections in pediatric patients my microsystem hospital. The process begins re-enforcing daily CHG (2% Chlorhexidine Gluconate) wipes to 100% compliance rates on our patients with central lines tailored to their age and body weights. The process ends with reducing the CLABSI rates of our unit and the entire hospital to 0. By working on the process we expect personal and organizational commitment to transform the culture of safety through integration of standardized communication, issue escalation, non punitive response to errors, rounding by all leaders, and culture of continuous improvement. It is …

The Use Of Personalized Whiteboards In The Inpatient Acute Care Setting And Their Effect On Patient And Nurses Perception Of Communication, Cheryl Karn

Master's Projects and Capstones

A microsystem assessment of two inpatient medical-surgical wards in a medical facility determined a majority of nurses reported dissatisfaction with the amount and type of communication with the interdisciplinary team. This, along with a review of Press-Ganey scores from the inpatient wards, revealed patients reported decreased satisfaction when asked if “nurses kept me informed”, compared to previous quarterly reports as well as other VA facilities. Multiple studies have shown the benefit of personalized whiteboards (PWs) at the patient bedside in improving not only communication but also safety and patient outcomes. A PW was developed by the Clinical Nurse Leader …

Promoting Patient Safety By Implementing Bedside Shift Report, Maroof A. Olanigan

Master's Projects and Capstones

ABSTRACT

Patient safety is a very broad and general term used to ensure that all aspects of patient care, from medical and nursing services to social and spiritual, are provided with the best interest of the patient. The aim statement for the project is improving patient safety by ensuring the implementation of bedside shift report by 80% of nurses by August 2016. Kurt Lewin’s change theory is going to be used to effect the change.

There were in-services given to nurses on the floor and the project was also discussed in staff meetings. Flyers were posted around the units to …

Breast Cancer Specimen Collection, Handling & Adherence To Asco/Cap Guidelines, Vicki F. Rocconi

Master's Projects and Capstones

Breast Cancer Specimen Collection, Handling & Adherence to ASCO/CAP Guidelines

Background

Specimens removed from their blood supply begin to degrade immediately. Specimens are placed in formalin to halt the process of degradation. Under or over-exposure of specimens to formalin can result in false positive or false negative test results for estrogen receptors, progesterone receptors & Her-2/neu receptors.

Goals & Objectives

Improve the process of breast cancer specimen collection & handling and insure that the process is consistent with ASCO/CAP Guidelines (College of American Pathologists, 2013). The objectives included: Documentation of the time the specimen was removed from the blood supply. …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

Competency Guide For Intrathecal Pump Nurses, Christine Tevlin

Seton Hall University DNP Final Projects

There is a strong need for healthcare providers to improve the quality of care, which benefits not only patients but the whole population. Due to the increasing cost of health insurance, society is forced to bear the cost of poor care for patients. The Institute of Medicine (IOM) stunned the nation in 1999 with, “To Err is Human: Building a Safer Health System” which reported that between 44,000 and 98,000 people die each year from preventable medical errors (IOM, 1999). Since then there has been a move in the direction of accountability and quality care for patients. This change has …

The Experience Of Adult Children Cargiving For Aging Parents, Kimberly Conway

Seton Hall University Dissertations and Theses (ETDs)

Background: An estimated 35 million Americans are age 65 or older, and this population is expected to double within 25 years. When the normal progression of life for an aging person is interrupted, adult children are often suddenly faced with assuming care of their parent(s). Currently adult child caregivers of aging parents, work up to 100 hours per month at caregiving. Problem Statement: A limited body of empirical studies exists on the caregiving of aging parents exclusively by their adult children. Despite the amount of time dedicated to parental caregiving little is known about the experience of this exclusive caregiver …

Preventing Hapus In High-Risk Cardiac Cath Patients Using Foam Dressing Protocol, Charles Jasper

Master's Projects and Capstones

The purpose of this project is to implement an evidence-based change in practice resulting safer procedures as evidenced by zero hospital acquired pressure ulcers (HAPUs). It is relevant to nursing as it provides an ethical perspective regarding patient safety and contributes to our present understanding of HAPU prevention. In spite of having already decreased the total number of HAPUs by 50% in 2015, the cardiac catheterization lab (CCL) was implicated in 30% of those reported. My objective is to improve patient safety by reducing the number of HAPUs acquired in the CCL to 0% by three months using a prophylactic …

Developing Therapeutic Communication Skills: Integration Of Standardized Client Simulation In An Associate Degree Nursing Program, Kristine Weber, Timothy Farrell

UNLV Theses, Dissertations, Professional Papers, and Capstones

By the year 2020, it is projected that there will be a shortage of 300,000 to one million registered nurses in the United States (Juraschek, Zhang, Ranganathan & Lin, 2012). Therapeutic communication skills are a fundamental and integral part of any registered nurse’s practice. Despite the importance of therapeutic communication, evidence suggests that the lack of skill development in nursing programs is having an adverse effect on the NCLEX-RN pass rate of graduating registered nurses. Identifying and addressing shortfalls in effective communication offers an opportunity to improve this pass rate. Learning to effectively communicate in a simulated situation will provide …

Telephone Follow-Up For Heart Failure Patients Discharged To Skilled Nursing Facilities, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Reducing hospital readmissions has become a national priority for health care institutions. Telephone follow-up, a cost-effective intervention, has been used with varying degrees of success in reducing 30-day readmissions for heart failure (HF) patients. However, little is known about interventions directed toward HF patients discharged to skilled nursing facilities (SNFs). The purpose of this project was to test the effect of telephone follow-up with SNF staff by an advanced practice nurse (APN) on 30-day readmission rates. A one-time call to SNF staff was made by the APN to review key components of HF management. Readmission rates for the intervention …

Sentinel Event Management Model: A Performance Improvement Project, Kelly M. Johnson

Graduate Theses, Dissertations, and Capstones

The purpose of this performance improvement project was to implement a standard sentinel event management model in an acute care hospital that is part of a healthcare system based on best practices and principles of high reliability organizations. The project used define, measure, analyze, improve and control (DMAIC) methodology and Lewin’s Theory of Planned Change. High rates of medical harm and preventable deaths have been demonstrated around the world. It is estimated that one in four American families will be affected by preventable harm in healthcare involving further medical care, disability or even death. Despite international awareness and substantial efforts …

Impact Of Nurse-Led Telephone Follow-Up On Heart Failure Readmissions, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Heart failure readmissions are a common and costly issue. Poor transitions of care as patients move from one setting to another are thought to be a major contributor to this growing problem. For those patients discharged to skilled nursing facilities (SNFs), poor transitions can be especially problematic. Telephone follow-up by nurses is a cost effective intervention commonly used to improve communication and coordination of care, thought little is known about interventions directed at patients discharged to SNFs. The purpose of this review is to evaluate the evidence regarding nurse led telephone follow-up in the transition of care process and …

Effects Of Alcohol On Blood Pressure In Women With Hypertension, Anna Wistrom-Thesing

Nursing Capstones

No abstract provided.

Low Back Pain In Student Nurses: Literature Review And Prospective Cohort Study, Nancy Menzel, Du Feng, Jessica Doolen

Nursing Faculty Research

There is consensus that registered nurses worldwide have a high prevalence of work-related musculoskeletal disorders, particularly of the back. Patient handling activities such as lifting present the highest risk of injury, activities that begin in nursing school. A literature review identified 21 studies of back pain in nursing students, indicating a wide range of prevalence rates. A prospective cohort study of nursing students in a United States baccalaureate program followed 119 students who completed the Nordic Musculoskeletal Questionnaire upon beginning the 16 month upper division major and then a year later. There was no statistically significant change in low back …

Exercise In The Treatment Of Depression And/Or Depressive Symptoms, Mariah Fevig

Nursing Capstones

No abstract provided.

Effects Of A Sleep Hygiene Text-Message Intervention On Sleep In College Students, Christine S. Gipson

Nursing Theses and Dissertations

Young adulthood is a time of transition with multiple stressors that may affect healthy lifestyle habits such as sleep. Prolonged sleep disturbances can have harmful health effects along with increased risk for development of chronic diseases. The purpose of this study was to test the effectiveness of a text-message intervention on sleep among young adult college students. Using Bandura’s Social Cognitive Theory (SCT), it was hypothesized that a sleep hygiene text-message intervention would increase sleep hygiene knowledge, increase sleep hygiene, improve self-efficacy for sleep hygiene, and improve sleep quality among young adult college students. A randomized control trial (RCT) with …

Nurse Faculty Job Satisfaction: Development And Evaluation Of The Nurse Educator Satisfaction Index, Annette J. Jackson

Doctorate of Nursing Science Dissertations

ABSTRACT

NURSE FACULTY JOB SATISFACTION: DEVELOPMENT AND EVALUATION

OF THE

NURSE EDUCATOR SATISFACTION INDEX

The nursing faculty shortage in American is predicted to worsen in the near future. This faculty shortage negatively impacts nursing practice by limiting the numbers of students admitted to nursing programs, and hindering efforts to build a nursing workforce sufficient in number to care for an aging patient population. Guided by Hagedorn’s Framework of Faculty Job Satisfaction, this descriptive, correlational study sought to validate a researcher-developed instrument to measure job satisfaction in a sample of Georgia nurse educators. A web-based survey was distributed to full-time nursing …

Effect Of Using Culturally Sensitive Education In Increasing Mammogram Use And Breast Cancer Awareness: African Female Immigrants, Gertrude Mumba-Kaunda

Evidence-Based Practice Project Reports

Despite the advances in medical technology, breast cancer is the most common cancer among women and is the second leading cause of death in African-American and Caucasian women in the United States. Mammography has shown to be one of the best methods to reduce late detection of breast cancer. The American Cancer Society recommends monthly self-breast examination (SBE), clinical breast examinations every 3 years, and yearly mammography starting at the age of 40. Despite the recommendations, there is still significant disparity among different racial groups, when it comes to death rates, which can be attributed to low screening rates. The …

Effect Of An Educational Intervention For Prevention Of Std In Minority Women, Umparrys L. Witherspoon

Evidence-Based Practice Project Reports

Historically, African Americans and Hispanics in the United States have been disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), as compared with non-Hispanic whites. Females continue to outnumber males with these diagnoses. Women are generally at greater risk of acquiring HIV and other STDs than men because the female genital tract is more prone to injury and infection resulting from high-risk heterosexual contact (Crepaz et al., 2009). The purpose of the evidence based project was to implement and evaluate an educational intervention for the prevention of HIV and STDs. The Health Belief Model (HBM) was …

Investigating The Use Of Chloroquine As Antineoplastic Therapy, Catherine E. Herron, Alexandra E. Mason

Senior Honors Projects, 2010-2019

Chloroquine (CQ) is an oral lysosomotropic agent routinely used as an anti-malarial drug (Espina & Liotta, 2013). In recent years, it has been discovered that CQ also possesses anticancer effects, potentially due to the drug’s inhibition of autophagy (Kimura, Takabatake, Takahashi, & Isaka, 2012). Autophagy is a normal cellular pathway that allows for the degradation of cytoplasmic contents. In cancer cells autophagy can also serve as a pro-survival pathway under stressful metabolic conditions, ultimately promoting the survival of malignant cells (Sui et al., 2013). Therefore, in recent years CQ has been speculated as a potential antineoplastic therapy. When administered in …

Adolescent Grief: The Nurse's Role In Promoting Healthy Coping Mechanisms And Preventing Future Hospitalizations, Erica C. Reighard

Senior Honors Projects, 2010-2019

Age and developmental stage directly influence the grieving individual's ability to understand and process death. Adolescents are especially vulnerable to developing negative coping skills such as substance abuse, self-destructive behaviors, and eating disorders. After a loss occurs, nurses can use their role as a caregiver who is neither a parent nor a peer to provide adolescents with an opportunity to express their grief. Nurses can educate grieving adolescents on the differences between positive and negative coping skills and can therefore reduce the number of future hospitalizations related to ineffective coping mechanisms.

The Effect Of Simulations On Nursing Students’ Ethical Reasoning Confidence In Disasters: A Pilot Study, Sara E. Greco

Senior Honors Projects, 2010-2019

This study measured the effect of a disaster nursing simulation and debriefing session on senior BSN students’ perceived ethical reasoning confidence and their belief in the importance of ethical reasoning. Using a quasi-experimental design, this study compared participants’ responses before and after the interventional activities using the Survey of Ethical Reasoning. Post-test results demonstrated an increase in students’ perceived ethical reasoning confidence, perceived importance of ethical reasoning, and utilization of James Madison University’s Eight Key Questions Ethical Reasoning Framework.

An Adult Pcv13 Vaccination Protocol In The Retail Healthcare Setting, Christine P. Duong

Doctor of Nursing Practice Final Manuscripts

Purpose – To establish an adult Pneumococcal (PCV13) vaccination protocol within a chain of retail healthcare clinics.

Background - Invasive Pneumococcal disease results in significant morbidity and mortality in patients ≥65 and those with immunocompromised status. Despite CDC recommendations, national PCV13 vaccination rates remain low in these populations. No adult PCV13 vaccination protocol existed in the project retail healthcare clinics.

Project Plan Process – An evidence-based PCV13 vaccination protocol based on the CDC guidelines using the Provus Discrepancy Evaluation Model as a framework was implemented. NPs were educated on indications for PCV13 vaccinations and a questionnaire to identify those patients …

Rural Nebraska Women's Explanatory Models Of Postpartum Depressive Symptomatology, Elizabeth Mollard

Theses & Dissertations

The purpose of this study was to construct the explanatory models of postpartum depressive symptomatology (PPDS) from the perspective of rural Nebraska women and to compare these models with the medical model of PPDS. A sample of 20 rural Nebraska women were interviewed in a one-on-one qualitative descriptive telephone interview using questions based on Kleinman’s (1980) explanatory model of illness. This study used feminist pragmatism as a guiding philosophical paradigm. Qualitative data were analyzed using content analysis, and results were compared and contrasted with the medical model of PPDS, which included the onset, symptoms, and duration listed in the DSM-5 …

Care Transitions: A Mixed Methods Study Using A Complexity Science Lens, Carol Geary

Theses & Dissertations

Research studies on care transitions from hospital to nursing home are few and heterogeneous, offering an inadequate characterization to support practice. The purpose of this study was to characterize multiple care transitions among hospitalized older adults with advanced chronic disease who were discharged to a nursing home. This prospective, mixed methods study used multiple case studies with an embedded quantitative strand and multiple sources of information.

Four cases included an index patient (an older hospitalized adult with advanced chronic illness), his or her informal caregiver, if available, and healthcare providers involved in the index patient’s care. Two hospitals and two …

Factors And Outcomes Associated With Potentially Inappropriate Medication Use In Rural Community-Dwelling Older Adults, Marcia Y. Shade

Theses & Dissertations

Potentially inappropriate medications (PIMs) use in older adults is a significant public health concern. The use of PIMs to avoid may lead to negative outcomes such as adverse drug events. Prior conceptual analysis of PIMs use and observation of health-related factors in rural adults led to the design of this dissertation study. A sample was recruited from a population of rural community-dwelling older adults to examine the following specific aims: 1) Describe the use of PIMs to avoid, 2) Explore individual demographic characteristics (age, gender, income, education, and rural home location), health experience (comorbidity, number of medications and health providers), …

Physical Activity Levels And Related Factors In Midwestern Rural Hispanic Or Latino Adults, Alison K. Clevette

Theses & Dissertations

The purpose of this dissertation was to examine physical activity levels and specific intrapersonal, interpersonal and community physical environment factors that influence physical activity in Midwestern rural Hispanic or Latino adults. Instruments used in the study included: Self-Efficacy for Exercise Behaviors Survey, Social Support for Exercise Survey, Short Acculturation Scale for Hispanics (SASH), and Neighborhood Environment Walkability Scale (NEWS). Physical activity was measured by 7-Day Physical Activity Recall and ActiGraph^® accelerometer data. In the study of 54 participants, it was found that there was a very low level of physical activity. For example, 97% of the time was spent …