Nursing Commons^™

The Relationship Between Perceptions Of Patient Safety Culture, Nurse Advocacy, And Nurse Sensitive Patient Outcomes, Margaret Dicuccio

Electronic Theses and Dissertations

The purpose of the study was to understand relationships between and among patient safety culture, nurse reported attitude toward patient advocacy and key patient outcomes. Nurses play an integral role in patient safety, providing care through constant interaction with the patient and clinical team. Advocating for patients is part of that role; however little research existed that explored how advocacy was related to the safety culture or specific patient outcomes.

A correlational cross-sectional design was chosen for this secondary data analysis. Correlation and regression models were applied to medical/surgical unit data from seven facilities within one hospital system. Sources of …

The Effect Of A Mindfulness Intervention On The Depression Symptoms Of Mothers In Treatment For An Opioid Use Disorder, Karen Alexander

Electronic Theses and Dissertations

BACKGROUND: Mothers in treatment for an opioid use disorder experience a high prevalence of depression which may influence their relationship with their child. In the general population, mindfulness-based parenting intervention has been seen in the literature to have a clear positive effect on maternal depression. No research has been published regarding the effect of mindfulness intervention on maternal depression of women in treatment for an opioid use disorder.

OBJECTIVES: To describe the characteristics of mothers in treatment for opioid use disorder, including depression and adverse childhood experiences, and to evaluate the characteristics associated with participation in a mindfulness intervention. Lastly, …

Comparison Of Two Methods Of Pediatric Triage Education, Catherine Recznik

Electronic Theses and Dissertations

Introduction. The majority of pediatric emergency patients are seen in mixed-age emergency departments and triaged by general emergency nurses. Educational methods for teaching pediatric triage education to general emergency nurses have not been well studied, and previous studies of the use of the Emergency Severity Index in children have been performed primarily in centers that are high volume for pediatrics. Methods. A repeated measures, randomized crossover study comparing two different methods of pediatric triage education was conducted. Participants were general emergency triage nurses recruited from a general emergency department that is classified as low volume for pediatrics. Each participant was …

Collaborative Task-Sharing To Enhance The Point-Of-Care Ultrasound (Pocus) Access Among Expectant Women In Kenya: The Role Of Midwife Sonographers, Sudhir Vinayak, Sharon Brownie

Imaging & Diagnostic Radiology, East Africa

Unrealized maternal and child health goals continue to challenge Kenya where adverse outcomes remain high and diagnostic services are limited. The acute shortage of doctors and radiographers requires alternate human resources for health (HRH) with the ability to identify risk factors in pregnancy through Point-Of-Care Ultrasound (POCUS). A specialist radiologist and ultrasonography team partnered with midwives to adopt interprofessional task sharing and capacity building. Faculty from the Radiology Department of our hospital designed and implemented the project which was carried out at three outreach health service centres. Designing and implementing a training model to skill midwife sonographers with the capacity …

Screening Amblyopic Risk Factors In A Pediatric Population Using An Automated Vision Screener, Rebecca Dawn Slominski

Evidence-Based Practice Project Reports

Amblyopia is the most common visual disorder in children and is potentially curable if detected early and treated properly in the first few years of life. Amblyopia is the leading cause of monocular vision loss in children (Bradfield, 2013). It is a developmental neuroplasticity which derives from birth causing structural and functional changes in the eye and brain. With this structural and functional disruption, visual blur occurs due to refractive amblyopia, strabismic amblyopia, cataracts (form-deprivation amblyopia), or a combination of any of these (Solebo, Cumberland, & Rahi, 2015). Refractive errors related to amblyopia can also occur. The purpose of this …

The Costs And Benefits Of Outsourcing Marketing, Student Recruitment And Retention Services In An Online Rn-To-Bsn Program, Jacqueline M. Wuellner

Doctor of Nursing Practice Scholarly Projects

ABSTRACT

In 2010, the Institute of Medicine advised that by 2020, 80% of working nurses should have at minimum a baccalaureate degree. Across the country, the profession will fall short of that goal. In New Mexico, the numbers of associate degree nurses and baccalaureate degree nurses are nearly equal. As the flagship university for the state, the University of New Mexico has offered a program for baccalaureate degree completion for registered nurses for over 55 years. Wishing to fulfill the IOM mandate, the University of New Mexico, College of Nursing desires to grow its RN-to-BSN program by expanding its marketing, …

The Effect Of Algorithm Implementation In The Family Practice Setting On The Pain And Recovery Of Acute Low Back Pain Patients, Joan Caito

Evidence-Based Practice Project Reports

Nearly $86 billion is spent annually in healthcare costs for Americans with low back pain (Lee, McAuley, Hübscher, Allen, Kamper, Moseley, 2016). Additionally, the burden on the economy due to loss in productivity incurs approximately $114 billion dollars of lost revenue annually (Lee et. al., 2016). Patients with an acute low back injury inadequately treated may become a chronic issue. Only 50% of patients who experience back pain symptoms for 12 months will return to work (Petit, Fouquet, & Roquelaure, 2015). The purpose of this project will be to implement an evidence-based algorithm to standardize acute low back pain care …

Strategies For Bridging Gaps Between Diversity, Academics, And Community/Clinical Partnerships, Joseph Morris Rn, Phd, Mary Dickow Mpa, Faan, Sharon Goldfarb Rn, Msn, Fnp

Community Engagement Theme

The academic‐practice gap has been well documented for over four decades in the literature, and current literature suggests the viewpoints of academic and practice leaders remain divergent. Closing this gap will require a dedicated and coordinated response from both academia and the clinical practice institutions. Additionally, diversity in the Nursing field is essential because it provides opportunities to administer quality care to patients. Goals: The panelists will share their unique perspectives and offer Strategies for Bridging Gaps between Diversity, Academics, and Community/Clinical Partnerships.

When Disaster Strikes: A Training Intervention To Improve Nurses' Confidence And Preparedness For The Surge, Nichole M. Weber

Evidence-Based Practice Project Reports

There has been an exponential rise in mass casualty incidents (MCI) internationally. These human induced and naturally occurring events have affected over 4.6 billion people, and are not discriminatory to region or community (World Health Organization, 2011). Governing bodies require training and education, but nurses continue to report suboptimal competence and self-reported readiness, and a need for standardized, evidence-based training remains. The purpose if this evidence-based practice project is to authenticate current research supporting implementation of competency-based education, to improve nurses’ self- perceived preparedness and confidence in their ability to respond to MCI. The project results can be utilized for …

The Use Of Regional Anesthesia With A Paravertebral Nerve Block And Its Effects On Breast Cancer Recurrence And Metastasis, Jessica M. Hall

Nursing Capstones

No abstract provided.

Adult Naloxone Administration Protocol, Samuel S. Adhikari

Doctor of Nursing Practice Projects

Abstract

A tertiary care facility in central Illinois noted an increase in inpatient opioid-related adverse events, including acute opioid withdrawal syndrome due to a higher than a necessary dose of naloxone. The patient required intubation with a prolonged intensive care unit stay. A naloxone administration protocol encouraging cautious titration of naloxone could potentially decrease, if not entirely avoid similar events. When a patient exhibits opioid overdose symptoms, airway management, hemodynamic support, and due appreciation of the elimination half-life of naloxone become vital in preventing potentially tragic outcomes. This quality improvement project was non-experimental and involved the design and introduction of …

The Efficacy Of The Teach-Back Method Of Education On Readmission Rates In Heart Failure Patients Within 30 Days Of Discharge, Catherine Lynch

Senior Honors Projects, 2010-2019

Background: The teach-back method is a method of education that is being used with heart failure patients in order to improve their quality of education and lower readmission rates. This literature review is aimed at synthesizing studies conducted to determine the efficacy of the teach-back method with this specific patient population.

Methods: Electronic searches of CINAHL and PubMed were performed through James Madison University libraries. Articles selected for inclusion were evaluated for study design, relevance, and sample size.

Results: Three studies met eligibility criteria, these studies showed statistically significant evidence that the teach-back method did reduce readmission rates in heart …

Addressing Disparities Among The Homeless Population With Type Ii Diabetes Through The Use Of Educational Programs, Allison Moses

Senior Honors Projects, 2010-2019

Background: The homeless population is exposed to many difficulties and barriers while attempting to manage Type II Diabetes Mellitus (DMII), which involves complex medication regimens and dietary and exercise modifications. The aim of this literature review is to increase awareness among healthcare professionals, to improve their understanding and ability to educate the homeless population, to help reduce health disparities and promote chronic disease management.

Methods: Access to two electronic search engines, CINAHL and PubMed, was obtained through James Madison University’s Library Database. The Ratings System for Level of Evidence was used to determine articles for inclusion based on reliability, sample …

Nature's Effect On Mental Health, Hannah Thomas

Senior Honors Projects, 2010-2019

The United States has an overwhelming number of people suffering from mental illness, especially anxiety and depression. These disorders can be debilitating in many areas of the person’s life. Not even half of those diagnosed with these conditions are treated effectively and costs are expected to rise significantly in the coming years. One population that is often overlooked that suffers from these conditions is health professionals themselves. Physicians and nurses have high rates of depression and anxiety due to the stress from their occupation. In order for more patients and providers to be treated and for the health care system …

Rapid Assessment Of Adults With Traumatic Brain Injuries, Pedro Colio

Doctor of Nursing Practice Final Manuscripts

The aim of this evidence-based project was to improve the medical screening process, enhance medical decision-making, and standardized the utilization of an adult traumatic brain injury neuroimaging guideline among advanced practice providers in a rural emergency department. Neuroimaging, specifically computed tomography (CT) scans, help to identify life-threatening intracranial injuries when clinically appropriate. The literature supports the utilization of neuroimaging guidelines, clinical exam, and provider expertise when identifying the need for a head CT scan. Although head CT scans are clinically useful, they increase healthcare costs and pose potential cancer risks from radiation exposure. Eight advanced practice providers (i.e., nurse practitioners, …

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …

Enhanced Recovery After Orthopedic Surgery In Total Hips And Knees, Christine Rigg

Doctor of Nursing Practice Projects

The prevalence of total knee and hip replacement surgery is increasing related to a combination of factors including osteoarthritis, age, and obesity (Christelis et al., 2015). The increased demand for joint replacement, current cost, and length of stay (LOS) place an increasing burden on clinical and financial resources. Enhanced recovery after surgery (ERAS) protocols have facilitated improved outcomes, such as increased patient satisfaction, decreased LOS, and associated costs (Bernard & Foss, 2014; Husted, Holm, & Jacobsen, 2008). Development and subsequent anesthesia group education were the beginning steps toward orthopedic protocol implementation in this project. This practice project had two goals: …

A Retrospective Analysis Of An Opiate Education And Naloxone Distribution Program, Ashley M. Tyler

Doctor of Nursing Practice Projects

Abstract

Trends indicate that misuse of opiates has increased nationally, frequently resulting in death. Substance use treatment clinics are now distributing naloxone (Narcan) to clients and laypeople as an antidote for opiate-related overdose. Offering Opiate Education and Naloxone Distribution (OEND) programs at treatment facilities increase the naloxone education opportunities available to those most closely affected by overdose.

Methods: The evaluation of naloxone distribution at a Midwestern substance use disorder clinic involved a retrospective analysis via chart audit of data regarding the delivery and administration of naloxone. The project focused on 48 individuals in the initial treatment phase for opiate use …

Developing An Online Wellness Curriculum For Nurse Anesthesia Students, Gina Calvanese, Jamie Rynearson

Doctor of Nursing Practice Projects

Student Registered Nurse Anesthetists (SRNAs) begin graduate school as confident critical care nurses, unaware of the impact that constant, daily stress will have on their lives. Wildgust (1986) presented the earliest known research and concluded stress negatively impacted the physiologic wellbeing of SRNAs. It has been reported that students in anesthesia programs experiencing high levels of stress and burnout are more likely to make critical errors when caring for their patients (de Oliveira, 2013). The goal of this doctoral project was to promote wellness and stress management among students enrolled in Southern Illinois University Edwardsville’s Nurse Anesthesia program by proposing …

Promoting Antibiotic Stewardship For Uti Management In Long Term Care Residents Through Standardized Clinical Practice Guidelines., Juliana M. Enoakpa

Doctor of Nursing Practice Projects

Urinary tract infections (UTIs) are the most diagnosed infections requiring antibiotics in long-term care (LTC) facilities. The rising prevalence of antimicrobial resistance (AMR) threatens treatment of infections that were once responsive to antibiotic therapy. The inappropriate use of antibiotics in this Midwestern LTC facility provided the impetus for implementing a standardized clinical practice guideline (CPG) for diagnosing UTIs among the LTC residents. A data collection tool was developed for the audit that identified the specific assessment criteria for UTI management and eligibility criteria for antibiotics. Physicians and NPs at the LTC facility were administered a questionnaire prior to implementation of …

Standardized Patient Handoff Tool, Matthew Marten

Doctor of Nursing Practice Projects

Patient handoffs are defined as the transmission of information and accountability between teams and individuals. These handoffs can be periods of increased risk for the patient and increased errors among anesthesia providers and PACU nurses (Segall et al., 2012). The Joint Commission recommends healthcare providers improve patient handoff as a national goal (Robins & Dai, 2015). The purpose of this nursing doctoral project was to determine if using a standardized patient handoff tool could improve communication and satisfaction between anesthesiologists, CRNAs, and PACU nurses. A review of the current literature supported the need for a standardized patient handoff tool for …

Interlace: Designing An Inclusionary Architecture For Alzheimer's Sufferers, Alexander Fashinasi

Bachelor of Architecture Theses - 5th Year

This thesis intends to address the increasing challenges the Alzheimer’s disease poses for our growing American population. The research begins by looking at the brain as a combination of components which make up the individual. Following this, the research compiles information on the Alzheimer’s disease and its symptoms, followed by an analysis of the built environments effects on the condition.

Through analysis of precedent cases and the combined Alzheimer’s research, I chose to propose an experimental community in which those with Alzheimer’s can live a life with greater autonomy while simultaneously slowing the progression of the disease. I place this …

Diabetes Education, Audra Trump

Doctor of Nursing Practice Projects

Background: Diabetes Self-Management Education (DSME) has been shown to improve diabetes management. However, a Midwest academic clinic does not offer formal diabetes education. The health department offers formal diabetes education classes twice a year. However, the classes are not flexible, long, and offered infrequently. Objective: The purpose of this project is to improve access to and standardize DSME for patients newly diagnosed with type II diabetes. Methods: The project design includes a one group pre-test/post-test convenience sample of adult patients who are newly diagnosed with type II diabetes in an academic outpatient setting. Results: At the time of diagnosis, the …

Local Anesthetic Systemic Toxicity Management: An Assessment Of Simulation-Based Staff Education, Kevin L. Kanallakan

Doctor of Nursing Practice Projects

When local anesthetics are administered at toxic doses or when certain local anesthetics are directly injected into the patient’s circulation, excessive plasma concentrations of the drug will produce a systemic cascade of events known as local anesthetic systemic toxicity (LAST). LAST is a rare, potentially life-threatening complication, which affects both the central nervous and cardiovascular systems. Anesthesia providers and perioperative healthcare professionals must remain current on best practice LAST management in order to reduce morbidity and mortality.

This quality improvement project utilized high fidelity simulation paired with LAST education to improve stakeholder knowledge and management of a LAST scenario. With …

Assessment Of The Validity Of Patient-Stated Allergies: De-Labeling And Education, Tawny Thomas, Angelina Leitschuh

Doctor of Nursing Practice Projects

The initial direction of the project was to develop and implement a research-based protocol to de-label hospitalized patients with a patient-stated penicillin allergy who were not truly allergic (Phase I). The project was abruptly halted due to the lack of data to justify the need, lack of sufficient communication among stakeholders, questions regarding financial cost of implementation, and strong concerns regarding educational needs of nursing staff. After developing the initial protocol, the project team was redirected to provide evidence-based allergy assessment education to the nursing staff to foster reliable and accurate patient interviews and documentation of the results (Phase II). …

Effect Of Nurse-Developed Dyspnea Improvement Education On Home Health Patients, Teresa Gough, Nevin Ozyurt

Doctor of Nursing Practice Projects

In home health patients, dyspnea is one of the quality indicators on the Medicare Outcome and Assessment Information Set (OASIS). Any home health agency that is seeking Medicare certification is required to meet Medicare Conditions of Participation, including compliance with OASIS data collection and transmission of data (Centers for Medicare and Medicaid Services, 2012). At a hospital affiliated home health agency in the Midwest, between November 2015 and October 2016, 82.85% of patients admitted for services received Medicare coverage (Memorial Home Services, 2016). Due to the high Medicare population seen by this home health agency, it is important to show …

Effects Of Transitional Care Management On Hospital Readmissions, Samantha Dunkirk

Doctor of Nursing Practice Projects

Primary care providers are challenged to identify strategies to decrease hospital readmissions. Transitional care management (TCM) services can improve communication and allow primary care providers (PCP) an opportunity to meet with patients just after discharge to assess needs and prevent readmissions. A TCM protocol was evaluated at a large Midwestern clinic to determine if communication improved and readmissions decreased. The protocol consisted of notifying the PCP upon admission and discharge to the hospital, communicating with the patient or family within 48 hours of discharge, and facilitating a follow up visit with the primary care provider within 14 days of hospital …

Diabetic Foot Screening Tool: Utility In A Busy Primary Care Setting, Crystal A. Cusanelli

Doctor of Nursing Practice Projects

Abstract

Problem: Providers in a Midwest rural clinic identified that foot care is often overlooked due to the complexity of diabetic patients and limited time available during office visits.

Purpose: This project examined the utility of an evidence-based, diabetic foot screening tool, provider satisfaction with the tool, and provider perceptions regarding foot care in a busy primary care practice.

Methodology: Providers were instructed on using the screening tool. The tool was utilized on all diabetic patients during office visits over a two-month period. Anonymous surveys were distributed and a focus group was conducted to gather post-implementation outcomes.

Results: Two providers …

Fascia Iliaca Compartment Block Protocol For Hip Fracture, M. Ray Nordyke

Doctor of Nursing Practice Projects

Fascia iliaca compartment block (FICB) is a volume based block used to treat pain associated with hip fractures. An anesthesia group at a central Illinois hospital expressed interest in the creation of an evidenced-based protocol for FICB. After an extensive literature search an evidence-based protocol was designed. The initial implementation of the protocol was a presentation of an informational PowerPoint which discussed the aspects of the protocol presented to the anesthesia staff and the registered nursing staff who assist the anesthesia providers. The protocol was then evaluated with a Likert scale survey completed by the staff. The results from the …

Sphenopalatine Ganglion Block For Post-Dural Puncture Headache Treatment, Wesley Gallagher

Doctor of Nursing Practice Projects

Post-dural puncture headache (PDPH) is defined as an orthostatic, fronto-occipital headache. The incidence of PDPH from neuraxial anesthesia techniques averages 1%. There are several treatments for PDPHs. The gold standard is the epidural blood patch (EBP). The EBP can be costly, requires experience, and is associated with rare, but serious complications. These factors present significant barriers to treating PDPHs. The sphenopalatine ganglion (SPG) block consists of using local anesthetics to block the parasympathetic signals, which flow through the SPG. Current theories suggest that increased parasympathetic outflow is the trigger for many forms of headaches, including PDPHs. Various literature associated with …