Nursing Commons^™

Developing A Rubric To Assess Critical Thinking In A Multidisciplinary Context In Higher Education, Sadia Muzaffar Bhutta, Sahreen Chauhan, Syeda Kauser Ali, Raisa B. Gul, Shanaz Hussein Cassum, Tashmin Khamis

School of Nursing & Midwifery

Critical thinking (CT) is a generic attribute that is greatly valued across academic disciplines in higher education, and around the globe. It is also defined as one of the graduate attributes of higher education for the sample private university where this research was conducted, as it is perceived that CT helps the graduate to become ‘engaged citizens’ in the twenty-first century. Despite the well-documented importance of CT, its assessment remains a challenge. This study addresses this challenge through the systematic development and field-testing of a rubric for assessing critical thinking in a multidisciplinary context in higher education. A multidisciplinary group …

Support And Mentorship Of Diverse And Disadvantaged Nursing Students, Elle E. Hoselton

Nursing Capstones

No abstract provided.

Evaluating The Correlation Of Diabetes And Gallbladder Disease, Robbi A. Yellow

Nursing Capstones

No abstract provided.

A Practical Understanding Of Preeclampsia For A Nurse In A Third World Setting, Anna Lovin

Senior Honors Theses

Preeclampsia is a disease of pregnancy that affects approximately 3-5% of women with child. It is one of the primary causes of mortality in mothers and babies across the globe. The exact cause, pathogenesis, or disease progression is unknown. Therefore, there is no definition of which patients are at risk for developing preeclampsia and what can work as a preventative measure. In high socioeconomic settings where there is good healthcare, standard treatment is established to manage the symptoms and decrease the progression of preeclampsia to eclampsia. However, in more rural, third-world settings of developing countries, caring for patients with preeclampsia …

Anxiety Is Something To Worry About: The Effects Of A Cognitive Behavioral Therapy And Selective Serotonin Reuptake Inhibitor Intervention Protocol On Generalized Anxiety Disorder, Alesha E. Mcclanahan

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is highly prevalent in the United States with at least 12% of the population affected (Edmund & Sheppard, 2018). GAD can pose significant distress and debilitation throughout the lifespan (Bystritsky, Khalsa, Cameron, & Schiffman, 2013; Edmund & Sheppard, 2018). Barriers to treatment include adverse effects, inaccessibility, and expense. The purpose of this project was to implement an evidence-based protocol involving combination therapy with self-administered cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication in order to improve patient outcomes through more accessible, affordable, and standardized treatment of GAD. The Neuman Systems Model and Stetler …

Effects Of An Obstructive Sleep Apnea Screening Program On Providers' Adherence, Kelsie A. Tokarczyk

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) is a widely prevalent chronic disease estimated to affect 22 million Americans, with 80 percent of moderate to severe cases undiagnosed (American Sleep Apnea Association [ASAA], 2017). Unmanaged OSA has been associated with numerous detrimental health outcomes including hypertension, chronic heart failure, atrial fibrillation, stroke, and other cardiovascular conditions (ASAA, 2017). The purpose of this evidence-based practice project was to determine if the implementation of a screening protocol would affect providers’ adherence to screening for OSA. The Theory of Planned Change was used as a guide to optimize providers’ adherence to the protocol at a family …

The Effect Of Exercise On Postmenopausal Women With Osteoporosis, Mckenzie Brown

Nursing Capstones

No abstract provided.

Meditation As An Intervention To Help College Students Cope With Stress, Marissa Bottos

Evidence-Based Practice Project Reports

According to the American College Health Association (ACHA) (2017), in a survey of 31,463 students, 31.7% stated that stress negatively impacts their academic performance (lower grades, dropped course, etc.). Additionally, 45.1% of the students stated they have more than average stress levels. The purpose of this evidence-based practice (EBP) project was to determine if mindfulness meditation was effective in helping college students cope with stress. Based on current evidence, Jon Kabat-Zinn’s online application for mindfulness meditation is supported as an effective way to help college students cope with stress (Regehr et al. 2013; Yusufov et al. 2018; Cavanagh et al. …

A Multi-Component Education, Skill, And Resource Evidence-Based Practice Intervention For The Alzheimer’S Caregiver, Cheryl Garmon

DNP Final Reports

Abstract

Dementia caregiving is expensive, stressful, and consumes all facets of the caregiver’s (CGs) life. The purpose of this project is to introduce the evidence-based practice (EBP) interventions most helpful in decreasing stress and burden in those who are in-home caregivers for Alzheimer’s disease and related dementias (ADRD) individuals.

The three primary intervention domains of the EBP studies that results in a positive impact are; providing education about the terminal course of the disease, introducing communication and caregiving skills, and furnishing resource and social network information.

The methodology included a convenient and voluntary population of CGs who sought service at …

Changing Healthcare Provider And Parent Behaviors In The Pediatric Post‐Anesthesia‐Care‐Unit To Reduce Child Pain: Nurse And Parent Training In Postoperative Stress (Np‐Tips), Brooke N. Jenkins, Michelle Fortier, Robert S. Stevenson, Mai Makhlouf, Paulina Lim, Remy Converse, Zeev N. Kain

Psychology Faculty Articles and Research

Background

Children who undergo surgery experience significant pain in the post anesthesia care unit. Nurse and parent behaviors in the post anesthesia care unit directly impact child postoperative pain. Therefore, we have developed and evaluated (Phase 1) and then tested (Phase 2) the feasibility of a new intervention (Nurse and Parent Training in Postoperative Stress) to alter parent and nurse behaviors in a way consistent with reducing child postoperative pain.

Methods

In Phase 1, a multidisciplinary team of experts (physicians, nurses, and psychologists) developed an empirically‐based intervention which was then evaluated by experienced nurses (N = 8) and parents …

Patient Perception Of Telephone Follow-Up After Resection For Colorectal Cancer: Is It Time For An Alternative To The Out-Patient Clinic?, Marcus Gilmartin, Nicholas Leaver, George Hall, Helena Fawdry, Seung Lee, James Nicholson, Ramya Kalaiselvan, Raj Rajaganeshan

Patient Experience Journal

The economic reality of modern healthcare provides a timely reminder to clinicians of their duty to provide outstanding and cost-effective care. Although multiple guidelines outline investigation, management and surveillance of colorectal cancer, none advocate a particular delivery method. Nurse-led telephone follow-up in multiple specialties has demonstrated equivalent clinical outcomes and patient satisfaction when compared to traditional outpatient department follow-up. This paper aims to compare nurse-led telephone and outpatient follow-up, following surgical resection of colorectal cancer (CRC), focusing on patient perceptions. This cross-sectional study distributed adapted patient satisfaction questionnaire (PS-Q 18) to patients undergoing surveillance following CRC resection via either nurse-led …

Perioperative Antimicrobial Prophylaxis In Vascular Surgery: A Quality Assessment And Improvement Project, Brian Torres

Dissertations

Introduction: Prophylactic antimicrobial selection and administration for the prevention of surgical site infections in vascular surgery is a recommended best practice. Non-adherence to published guidelines on the selection and administration of antimicrobials has been observed and may lead to reduced efficacy of antimicrobial prophylaxis.

Methods: An observational, descriptive design was used to study clinician knowledge and behavior and included a retrospective patient record review and provider knowledge survey. A clinical education intervention targeting providers responsible for the selection and administration of antimicrobial prophylaxis was conducted. A repeat patient record review and knowledge survey was completed following the education intervention.

Results: …

Using The Interactive Theory Of Breastfeeding To Promote Breastfeeding Within The Indigenous Population, Shawn Meyer

Nursing Capstones

No abstract provided.

Contraception Utilization Among Women, Ages 18-45, Receiving Medication Assisted Therapy For Opioid Use Disorder In Middle Tennessee, Kerry J. Ternes

DNP Projects

The prevalence of unintended pregnancy among women receiving medication assisted treatment (MAT) for opioid use disorder (OUD) exceeds 80%. While much of the existing literature has focused on the consequences of substance use in pregnancy, few have focused on the prevention of unintended pregnancy. This study explored barriers and facilitating factors impacting contraception use among women, ages 18-45, receiving MAT for OUD in Middle Tennessee. A cross-sectional survey design was used to describe the women’s sociodemographic and health characteristics; report their knowledge, attitudes, and behaviors; and to assess if these variables are associated with current use of contraception. Among survey …

Responding To Opioid Use Disorder: Identifying The Therapeutic Commitment Of Maine Nurse Practitioners, Jordan S. Porter

DNP Projects

Background: Buprenorphine, an underutilized pharmacotherapy, can play a key role in closing the substantial opioid use disorder (OUD) treatment gap in the United States. Although 2016 US legislation authorized trained nurse practitioners (NPs) to obtain the Drug Enforcement Agency waiver to prescribe buprenorphine for OUD, many NPs do not have the waiver, and a large proportion of waivered NPs do not prescribe to capacity. Purpose: To identify the therapeutic commitment of Maine NPs to OUD as well as understand why Maine NPs do not adopt and utilize buprenorphine for the treatment of OUD. Review of Evidence: Commitment …

Religious Coping And Christ-Centered Recovery For Women With Substance Use Disorders, Mary Beth Bever

DNP Projects

Women have unique risk factors for the development of substance use disorder (SUD), barriers to SUD treatment, and risk factors for SUD relapse that require holistic care models and provide trauma-informed care approaches that address effective coping strategies. The use of religion and spirituality has been commonplace in many SUD programs to inspire the use of positive religious coping; however, negative religious coping may also be drawn on which poses a potential harm for women with SUD. The aim of this project was to assess for a correlation in positive and negative religious coping scores and program completion rates in …

Stress And Coping In Hospice Care, Elyse L. Collier

DNP Projects

Accommodating current hospice care needs and anticipated industry expansion requires protection and optimization of human resources serving as frontline care providers. Coping responses employed by individuals serve as important determinants of their overall personal and occupational well-being. There is limited research focusing on the coping responses of hospice professionals, specifically, how they perceive and manage their own work stress and work-related quality of life. The purpose of this study was to examine how coping responses are related to work-related quality of life among individual professionals working together on outpatient interdisciplinary hospice care teams. A cross-sectional survey-based design was utilized to …

Effects Of Adverse Childhood Experiences On Pain Interference And Anxiety In An Integrative Chronic Pain Clinic, Kerrin Doran Kunze

DNP Projects

One in four children in the United States will experience abuse or neglect before the age of 18-years-old. Adverse childhood experiences increase the risk for chronic pain disorders and maladaptive coping strategies that can intensify patients’ experience of pain and disrupt or prolong treatment. Current research encourages a biopsychosocial approach to understanding and treating chronic pain, one that acknowledges the influence of childhood trauma and works to restore health by treating pain of the body, mind, and spirit. This retrospective study examined self-reported measures in a convenience sample of 162 individuals seeking treatment for chronic pain at an integrative care …

Self-Care And Burnout Among Nurses In A Hospital Setting, Hannah Stirnaman

DNP Projects

Rates of burnout among healthcare professionals are well documented. The burnout of professional nurses is associated with a number of poor outcomes with costly consequences to both the healthcare system and public health. The American Nurses Association (ANA) has pushed for an initiative entitled Healthy Nurse Healthy Nation that encourages nurses to prioritize their health first and lists compelling statistics of nurse stress, mental health concerns, and workplace injuries. Burnout, a combination of emotional exhaustion, depersonalization, and decreased productivity, is one consequence of workplace stress and the demands placed on nurses; however, there is a lack of research on individualized …

Rn To Apn Role Transition, Bethney Hernandez

Honors Theses

Role Transition can be difficult whether the transition is planned or unplanned. The transition from student to practitioner for nurses who follow the traditional path to licensure is challenging. Practitioners who change specialties, roles or scope of practice experience some of these same challenges, as well as unique challenges. The consequences of an unsuccessful role transition include unresolved stress, reduced job satisfaction, increased risk of errors, and changing roles again, without settling into the current role. This literature review will explore these challenges from the perspective of Meleis’s Transition Theory. Successful transitions occur when the practitioner finds employment, feels pride …

Technology And The Management Of Diabetes In Older Adults - Cost Effectiveness, Shannon Pitt

Nursing Capstones

No abstract provided.

Hypothyroidism And Hypertension; Links To Consider When Providing Patient Care, Becca Trebil

Nursing Capstones

No abstract provided.

Long-Term Use Of Metformin And Vitamin B12 Deficiency, Josalyn Joy Grueneich

Nursing Capstones

No abstract provided.

My Husband Will Love Me More If I Give Birth To More Children: Rural Women’S Perceptions And Beliefs On Family Planning Services Utilization In A Low Resource Setting, Agnes Msoka, Eunice Pallangyo, Sharon Brownie, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

Introduction: Responsibility for family planning in low resource settings is almost solely delegated to women, with very low male involvement. This study investigated rural Tanzanian women’s perceptions and cultural beliefs of the barriers to family planning services utilization.

Methods: This study used a qualitative descriptive approach drawing on four group discussions with 20 purposively selected married women with two or more children. The study followed COREQ guidelines for reporting qualitative studies. Data were collected from participants at four health facilities in Bagamoyo and Kisarawe districts in Pwani, Tanzania.

Results: Participants’ occupations included housewives, small-scale farmers, and entrepreneurs. Most women were …

Identifying Structural Factors Associated With Central Line-Associated Bloodstream Infections (Clabsi) Risk In A Single-Center Pediatric Academic Hospital, Elizabeth Monsees, Paul N. Bauer, Yolanda Ballam, Brian R. Lee

Posters

Objective: compare unit structure and process-related factors against unit-specific CLABSI rate.

Conclusion: CLABSI mitigation requires more than individual competence with task-related practices; the unique work ecology of each clinical area may broadly influence CLABSI as an outcome; extending analyses to consider organizational structure can inform resource allocation and recalibrate traditional prevention strategies.

The Association Between Metabolic Syndrome And Gallstone Disease: A Case Report, Paul Rodenbiker

Nursing Capstones

No abstract provided.

Sustainability In Quality Improvement And Patient Safety Initiatives, Angelo P. Giardino, Eileen R. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The question often asked of a quality improvement initiative is whether the improvement process has been sustained within the organization. Rarely is the question answered satisfactorily. The sustainability of an improvement process is important as it justifies the investment of human and financial capital. The term 'evaporation of improvements' addresses the dilemma that between 33% to 70% of all innovations are reportedly not sustained (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015) . This evaporation of improvement captures the frustrating inability of many institutions to maintain the achieved improvement after the newness of the initial effort wears off (Buchanan, Fitzgerald, & …

Transitioning From Experienced Nurse To Resident In Blended Cohort Transition-To-Specialty Nurse Residency Programs, Rachael Frija

Doctor of Nursing Practice Scholarly Projects

Recommendations from the Institute of Medicine promote nurse residency programs for experienced nurses (EN) transitioning to new areas of specialty. A large non-profit healthcare system in the Southwest implemented three Transition-to-Specialty (TtS) residency programs using a blended cohort approach consisting of graduate nurses (GNs) and ENs. Upon review of program outcomes, ENs reported to have higher attrition rates than their GN counterparts. Given the substantial pecuniary loss related to EN turnover, understanding the ENs’ perspectives to achieve successful role transition to a new area of specialty is critical to a successful program. This qualitative descriptive study sought to describe the …

Gastrostomy Tube Complications And Management, Deborah J. Garcia

Doctor of Nursing Practice Scholarly Projects

The avoidable complications of clogging and dislodgement of gastrostomy tubes (g-tubes) place a tremendous burden on patients, caregivers, healthcare providers, and the entire medical system. These complications are associated with $130 million in healthcare utilization each year. Insufficient education of patients and personal caregivers regarding the prevention of complications of clogging and dislodgement of g-tubes is identified as a major barrier. Preintervention and postintervention education program models were established, which include a preprocedure clinic visit with education as well as scheduled follow-up phone calls. A chart review and follow-up phone call was used to evaluate the effect of providing consistent …

Quality Improvement: Developing A Hospital Program To Reduce Staff Injury Associated With The Care Of The Patient With Dementia, Kimiko Krutz

Doctor of Nursing Practice Projects

Problem Description

Hospital clinical staff injuries can occur while caring for patients with dementia. Clinician injury is a concern because it can be career-ending for the clinician and costly to the hospital ($80,000) to replace a nurse. A reliable estimate of the numbers of staff injuries by patients does not exist in the academic literature. Occupational Safety and Health Administration (OSHA) now require hospitals to provide data on clinician injuries related to patient care. This project explored the use of dementia patient-centered care education to increase clinician self-efficacy to ultimately decrease clinician injury.

Intervention

This quality improvement project provided 20 …