Nursing Commons^™

Obgyn Surgical Prep Standardized Process Presentation, Cortney Hartman Mba-Hm, Cst, Crcst, Cis

Posters & Presentations

OBGYN Surgical Prep Presentation.

To lower the occurrences of SSIs and standardize the process of surgical preparation across Parkview Health System, the following changes were adopted on August 15, 2019.

This is version 2.0

• Infection Prevention Bundle
• Vaginal Prep Instructions
• Abdominal Prep Instructions
• Chlorohexidine-alcohol (Chloraprep)

A Quality Improvement Project To Enact Evidence-Based Guidelines To Improve Documentation Of Hemoglobin A1c For Inpatient Diabetes Populations, Karyn C. Kinney

Master's Projects

The purpose of this paper is to describe a quality improvement project aimed to improve the documentation of hemoglobin A1c in the discharge instructions for patients with a diagnosis of diabetes prior to a transition from the acute care setting. Clinical practice guidelines from the American Diabetes Association and patient education recommendations from The Joint Commission are the impetus for this process improvement. The Plan-Do-Study-Act (PDSA) model was utilized to identify, design, and implement the process change in collaboration with an interprofessional team. The documentation rate of hemoglobin A1c was measured on two medical-surgical inpatient hospital units both pre- and …

Developing An Evidence-Based Discharge Process For Patients On A Cardiac/Renal Acuity-Adaptable Inpatient Unit, Tami Gallagher

Master's Projects

Introduction: Readmissions continue to negatively impact patient outcomes and create a significant financial burden. Regardless of efforts to reduce readmission rates, the cost of readmission continues to increase.

Clinical Problem: All-cause, 30-day readmission rates on a cardiac/renal acuity-adaptable inpatient nursing unit ranged from 11% to 33% from July to December 2018 for patients diagnosed with COPD, AMI, HF, and sepsis. The readmission rate for the organization was 16.2% in September 2018 with a target goal of 14.8%.

Project Aim: To use quality improvement tools and an interdisciplinary team to implement the teach-back method during discharge education and a discharge preparedness …

An Educational Intervention On Daily Chlorhexidine Gluconate Bathing And Central Venous Catheter Infection Rates In The Pediatric Population: A Quality Improvement Initiative., Jennifer Cothern

Doctor of Nursing Practice Papers

The use of Central Venous Catheters (CVCs) in the healthcare setting is essential to patient survivability. While convenient, the utilization of such devices places patients at risk for Central Line- Associated Bloodstream Infections (CLABSI). The US spends nearly $2 billion dollars annually treating CLABSIs. The utilization of CLABSI bundles has shown to be effective in infection prevention. Daily bathing with Chlorhexidine Gluconate (CHG) is recommended by the Centers for Disease Control and Prevention (CDC) and is often included in CLABSI bundles. In an attempt to reduce the incidence of CLABSIs at a metropolitan pediatric hospital in the Southern US, a …

A Flavor Perception Game Designed To Introduce Basic Chemical Sensation Of Taste Modalities To Undergraduate Nursing And Exercise Sciences Students, Angela L. Mahaffey

Nursing: School of Nursing Faculty Publications and Other Works

The Flavor Perception Game was designed with the goals of developing an interactive and hands-on activity, providing a platform to review chemical senses of the five tastes, promoting student investment in the course material, and providing a basis for discussion on chemical senses of the five tastes. Knowledge of taste sensation is useful for nursing and exercise sciences students, as human physiology is integral to both baccalaureate curricula. The game is inexpensive, easy to incorporate into a 50-minute lecture period, and free of chocolate allergens. Student participants (N=34) tasted three candies and completed a voluntary anonymous poll regarding their detection …

Knowledge And Practices Among Nurses Regarding Patients’ Care Following Cardiac Catheterization At A Tertiary Care Hospital In Karachi, Pakistan, Adnan Yaqoob, Rubina Barolia, Ahmed Noor, Afshan Nazar

School of Nursing & Midwifery

Aims: The purpose of this study was to assess the knowledge and practices among nurses regarding patient care, following cardiac catheterization, at a tertiary care hospital in Karachi, Pakistan.
Background: Cardiovascular diseases (CVDs) are the major cause of morbidity and mortality, globally. Nurses are the largest body of health care professionals who attempt to reduce the burden of cardiovascular diseases. Design: This study employed a descriptive analytical cross-sectional study design to answer the research questions.
Methodology: The data were collected from 70 participants using two instruments. Knowledge was assessed through a 50-multiple-choice questions-based questionnaire, whereas, to assess the practices, an …

Older Adult Hospital Readmission Outcomes Of Transitional Care Model Compared With Home Based Primary Care Practice, Kellie L. Kahveci

Nursing Dissertations - Archive

Background: Thirty-day hospital readmission is a significant quality of care and economic problem for adults aged 65 years and older in the United States. The diagnoses most commonly problematic include heart failure (HF), pneumonia (PNE), and chronic obstructive pulmonary disease (COPD). Review of Literature: Multiple factors have been found to influence thirty-day hospital readmissions. Patient specific contributing factors include: depression, cognitive function, level of functional mobility, socioeconomic forces, and race. Exogenous factors include: patient education, pharmacologic agents, and health care providers quality of care. Interventions most effective in decreasing thirty-day hospital readmission include utilization of a team approach and a …

Predictors Of Perceived Faculty Support In Pre-Licensure Registered Nursing Students, Megan Marshall Mariveles

Nursing Dissertations - Archive

There is an increased demand for nurses in the United States contributing to a nursing shortage that is compounded by decreased student retention in pre-licensure registered nursing (PLRN) programs. Faculty support is a form of social support for nursing students resulting from interactions between teacher and student that involve the development of trust and a therapeutic, working relationship. Increased faculty support helps to mediate stressors. Students who perceive higher levels of faculty support are more likely to be successful academically and choose to remain enrolled in nursing programs. There were no studies found in which researchers examined factors that contribute …

Pathophysiology Of Osteoporosis, Sarah Orr

Nursing Student Class Projects (Formerly MSN)

Out of all the potential disease that may impact bones, osteoporosis is the most common. Over time it compromises the strength and integrity of the bone. As the bone becomes more compromised fragility fractures will result. A significant portion of the growing elderly population will be impacted by the disease current research indicates this is a growing drain on healthcare resources with a significant impact on morbidity and mortality for those who suffer fractures related to compromised bone integrity from osteoporosis. The disease is a world wide problem that will affect all countries and populations. While medications exist to help …

Takotsubo Syndrome, Lindsay Kerr

Nursing Student Class Projects (Formerly MSN)

Takotsubo Syndrome is a disorder that has many names and is widely misunderstood. The symptoms mimic Acute coronary syndrome, but the treatment differs. Symptoms include chest pain, shortness of breath, and/or syncope. Takotsubo Syndrome can happen to anyone, but there are those who are most at risk. They include: anyone with acute psychological or physical distress, females, elderly, postmenopausal, postoperative, those with neurological or psychiatric disorders and individuals with disorders like pheochromocytoma, chemotherapy, and malignancy. Diagnosis includes evaluating the history of the patient so see if they have risk factors, serum cardiac enzymes, EKG, echocardiogram, and heart cath. Treatment includes …

Ethics At Work: What Nurses Really Do On The Job, Kathryn Schroeter

College of Nursing Faculty Research and Publications

No abstract provided.

Comparisons Of Preoperative Blood Pressures In Surgical Patients, Brian Stacy, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Surgical patients expect anesthesia providers to provide high quality care. Blood pressure variability must be mitigated by establishing the patient’s blood pressure baseline and sustaining it through surgery. A consensus has not been established on which blood pressure measurement should be used as the patient’s baseline. Blood pressures before surgery in multiple care settings have been shown to vary. This may result in differences in drug and fluid administration, depending on the blood pressure considered baseline by the anesthesia provider. The purpose of this observational evidence-based practice project was to compare mean blood pressures leading up to surgery among …

Intraoperative Hypotension In Non-Cardiac Surgery Patients At Providence Sacred Heart Medical Center, Genna Ledrew, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Intraoperative Hypotension (IOH) during non-cardiac surgery is a common side effect of anesthesia that is associated with acute kidney injury (AKI), myocardial injury (MI), mortality, and other adverse outcomes1,3,4. These risks increase as the duration and severity of IOH exposure increase3,4. Blood pressure is a modifiable risk factor of mortality and organ damage that can be readily treated by the anesthesia provider2 . Limiting IOH can improve patient outcomes and produce monetary savings5 . The objective of this project is to report the incidence of IOH at a large tertiary teaching hospital, and extrapolate the risks of mortality and …

Introduction Of Auricular Acupuncture, Monica Lyons

Doctoral Projects

The overall purpose of this quality improvement project was to assess if there was an interest to add auricular acupuncture to a substance abuse program. The two guiding questions of the Doctor of Nursing Project were (a) how can auricular acupuncture be helpful when treating patients with substance abuse in a selected organization? (b) what information is needed for both staff and patients to make an informed decision regarding auricular acupuncture? The Promoting Action on Research Implementation in Health Services (PARiHS) framework was used as the theory framework for implementation of evidence-based research into an organization. The facilitator in the …

Audience-Specific Online Gatekeeper Training For Nursing Faculty: A Response To Increased Student Suicide Risk, Kristiana Holmes

Nursing Capstones

This DNP project was an effort to address the rising trend of suicide on college campuses. The aim of the project was to increase the number of faculty gatekeepers through implementation of an online audience-specific gatekeeper training program. Participants included 24 graduate and undergraduate nursing faculty at two private liberal arts colleges. An online audience-specific training program was implemented to improve faculty preparedness, likelihood of engagement, and self-efficacy in order to assist students in distress. The program trained participants as gatekeepers utilizing Question, Persuade, Refer (QPR) strategies and incorporated audience-specific information related to suicide risk in nursing students. Participants completed …

Audience-Specific Online Gatekeeper Training For Nursing Faculty: A Response To Increased Student Suicide Risk, Julie Honey

Nursing Capstones

This DNP project was an effort to address the rising trend of suicide on college campuses. The aim of the project was to increase the number of faculty gatekeepers through implementation of an online audience-specific gatekeeper training program. Participants included 24 graduate and undergraduate nursing faculty at two private liberal arts colleges. An online audience-specific training program was implemented to improve faculty preparedness, likelihood of engagement, and self-efficacy in order to assist students in distress. The program trained participants as gatekeepers utilizing Question, Persuade, Refer (QPR) strategies and incorporated audience-specific information related to suicide risk in nursing students. Participants completed …

Implementation Of A Smart Tool In The Electronic Health Record To Improve Interdisciplinary Discharge Communication And Hospital Readmission Rates, Katelin Umland

Nursing Capstones

In the department of Inpatient Psychiatry at a large mid-western academic medical center, interdisciplinary discharge communication between registered nurses, social workers, advanced practice providers, and physicians has presented as a problem. Patients are frequently discharged from the hospital without being seen by all necessary disciplines and concomitantly discharged without needed supplies, medications, resources, or follow-up appointments in place. This current discharge method negatively affects patient care, causes workflow disruption for all disciplines, and is known to be a contributing factor in increased hospital readmission rates. The purpose of this Doctor of Nursing Practice (DNP) project was to improve interdisciplinary communication …

A Strategy For Increasing Syphilis Screening In High-Risk Men And Women, Zillah Mulubisha

Nursing Capstones

Background: Syphilis cases among both men and women in Minnesota have been increasing over the past ten years. Currently, there are recommended screening practices for early detection and treatment of syphilis, however they are required only in pregnancy to prevent the devastating consequences of congenital syphilis. This DNP project was designed to evaluate the effectiveness of an educational program and screening reminders to promote increased syphilis screening practices among, ARNP primary health care providers in two community clinics for high risk men and women.

Objective: The purpose of this DNP project was to increase syphilis screening-rates of high-risk …

Sugammadex Versus Neostigmine: Operating Room Time And Cost, Annie Benscheidt, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background The choice of neuromuscular blockade reversal agents impacts cost and operating room time. Currently, the two medications used to reverse neuromuscular blockade are Neostigmine and Sugammadex. These medications differ in both cost and pharmacologic profiles which effect the time and predictability of reversal (Carron, Zarantonello, Tellaroli, & Ori, 2016). Evaluating cost and time differences in reversal using Sugammadex and Neostigmine helps anesthesia providers select the appropriate medication. This evidence based practice project examined the difference in case length and operating room and reversal agent costs in cases using Sugammadex and Neostigmine at Providence Sacred Heart Medical Center.

Methods • …

Differential Placing Of Flexion Creases Contributes To Sex Differences In The Second-To-Fourth Digit Ratio (2d:4d), Sanjay Kumar, Martin Voracek, Maharaj Singh

College of Nursing Faculty Research and Publications

The present research examined whether differential placing of the basal flexion creases contributes to the occurrence of sex differences in digit ratio (2D:4D) derived from palmar digit lengths. The ratio of palmar-to-dorsal digit length, a measure of the placing of the basal flexion crease in the finger, was derived for the digits 2 and 4 of the right hand in two independent samples (Study I: N = 100; Study II: N = 200), in accordance with discovery-replication sample approach. The results show that men have lower palmar-to-dorsal digit ratios than women, and this effect is significantly stronger for digit 2 …

The Benefits And Burdens Of Pediatric Palliative Care And End-Of-Life Research: A Systematic Review, Meaghann S. Weaver, Kim Mooney-Doyle, Katherine Patterson Kelly, Kathleen Montgomery, Amy Rose Newman, Christine A. Fortney, Cynthia J. Bell, Jessica L. Spruit, Melissa Kurtz Uveges, Lori Wiener, Cynthia M. Schmidt, Vannessa N. Madrigal, Pamela S. Hinds

College of Nursing Faculty Research and Publications

Objective: The aim of this study is to report the benefits and burdens of palliative research participation on children, siblings, parents, clinicians, and researchers.

Background: Pediatric palliative care requires research to mature the science and improve interventions. A tension exists between the desire to enhance palliative and end-of-life care for children and their families and the need to protect these potentially vulnerable populations from untoward burdens.

Methods: Systematic review followed PRISMA guidelines with prepared protocol registered as PROSPERO #CRD42018087304. MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and The Cochrane Library were searched (2000–2017). English-language studies depicting the benefits or burdens of palliative …

Use Of The Spiritual Development Framework In Conducting Spirituality And Health Research With Adolescents, Dora L. Clayton-Jones, Kristin Haglund, Jame Schaefer, Harold C. Koenig, Safiya George Dalmida

College of Nursing Faculty Research and Publications

Spirituality is considered a universal phenomenon, but research addressing the spiritual needs of adolescents in the context of health and illness is limited. The aim of this article is to provide a description of how the spiritual development framework (SDF) was used in conducting research with adolescents. An exemplar of a qualitative descriptive study is provided to demonstrate applicability of the SDF. The SDF was used as a guiding theoretical framework in conducting research with adolescents living with sickle cell disease. The SDF is culturally applicable and methodologically appropriate. Additional research applying the SDF is warranted.

Regulation Of Simulation Use In United States Prelicensure Nursing Programs, Cynthia Sherraden Bradley, Brandon Kyle Johnson, Kristina Dreifuerst, Patti White, Susan Kata Conde, Colleen H. Meakim, Kim Curry-Lourenco, Reba Moyer Childress

College of Nursing Faculty Research and Publications

Background

Simulation usage has proliferated throughout nursing education. Although nursing programs have sought integration of simulation to substitute traditional clinical learning hours, the variability of regulations between states raises questions about consistency of learner outcomes.

Methods

The Boards of Nursing (BONs) of the United States and the District of Columbia were queried by internet, phone, and email to discover regulations and guidelines for the use of simulation in nursing education.

Results

More than half of the BONs reported regulations for simulation use, but they varied greatly. Some had regulations defining a percentage of traditional clinical hours that could be replaced …

The Bundled Hospital Elder Life Program—Help And Help In Home Care—And Its Association With Clinical Outcomes Among Older Adults Discharged To Home Healthcare, Michelle Simpson, Jonny Macias Tejada, Amy Driscoll, Maharaj Singh, Matthew Klein, Michael Malone

College of Nursing Faculty Research and Publications

OBJECTIVES To describe the Bundled Hospital Elder Life Program (HELP and HELP in Home Care), an adaptation of HELP, and examine the association of 30-day all-cause unplanned hospital readmission risk among older adults discharged to home care with and without Bundled HELP. DESIGN Matched case-control study. SETTING Two medical-surgical units within two midwestern rural hospitals and patient homes (home health). PARTICIPANTS Hospitalized patients, aged 65 years and older, discharged to home healthcare with and without Bundled HELP exposure between January 1, 2015, and September 30, 2017. Each case (Bundled HELP, n = 148) was matched to a control (non-Bundled HELP, …

Transfusion Ratios Following Activation Of A Massive Transfusion Protocol: An Evidence Based Practice Project, Cody Woodbury, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Accidental injury is one of the leading causes of death in the United States and worldwide. Severe hemorrhage from injury is the leading cause of preventable death. Effective management of hemorrhaging trauma patients has been evolving since the early 1900’s. Recent studies have demonstrated the benefits of using a balanced resuscitation technique, revolving around the goal of recreating whole blood. The purpose of this project was to identify what ratios of blood products are being transfused at Providence Sacred Heart Medical Center (PSHMC) and Providence Holy Family Hospital (PHFH).

Methods A literature review was performed identifying seven high quality …

Contemporary Nursing In Rural Appalachia: A Hermeneutic Study, Evelyn Brewer

Electronic Theses and Dissertations

Nurses make up a significant source of direct care for individuals, families, and communities. The problematic distribution of nurses and the potential to lose practicing nurses emphasizes the importance of retention and support of nursing professionals, especially in rural locations. One of the best ways to discover what is important to nurses is to ask and listen to the replies.

The focus for this dissertation is the lived experience of registered nurses in a six-county area in three adjoining states in rural South Central Appalachia. The purpose of this study is to interpret and understand the lived experience of contemporary …

Sociodemographic Factors Associated With Mothers’ Experiences Of Psychosocial Care And Communication By Midwives During Childbirth In Nairobi, Kenya, Jane Kabo, Eleanor Holroyd, Grace Edwards, Ahmed Sarki

School of Nursing & Midwifery, East Africa

Purpose: To clarify sociodemographic and socioeconomic factors associated with mothers’ experiences of psychosocial care and communication by midwives during childbirth in Nairobi, Kenya.

Design: A descriptive cross-sectional study conducted in a government national referral hospital. Respondents were 109 systematically sampled mothers who delivered in the study hospital. Mothers’ experiences of intrapartum care were assessed using three subscales from the Experience of Psychosocial Care and Communication during Childbirth Questionnaire (effective communication; emotional support; and respect, care and dignity). Simple and multivariable logistic regression analyses were used to assess associations between sociodemographic factors, socioeconomic factors and mothers’ experiences of intrapartum care.

Findings: …

Case-Based Insights: Arab Muslim Mothers’ Experiences Of Managing A Child Newly Diagnosed With Type 1 Diabetes Mellitus, Rachel Cathrine Rossiter, Jennifer Louise Cooper, Suhad Issa Marjei, Sharon Brownie

School of Nursing & Midwifery, East Africa

Mothers frequently fulfill the role of primary caregiver for children diagnosed with type 1 diabetes mellitus (T1DM). A T1DM diagnosis has a significant impact on the child and the wider family unit. The objective is to develop understanding of mothers’ experiences caring for children diagnosed with T1DM in the cultural context of the Middle East to facilitate enhanced health service provision and support. This study used a qualitative design. Data were collected in individual semistructured interviews. Participants were mothers of Arabic descent and Muslim belief who had a child diagnosed with T1DM within the last 12 months. All mothers were …

Culturally Appropriate Education In Managing Hypertension In African Americans, Kristina Jones

Doctoral Dissertations and Projects

Abstract The historical treatment of African Americans with events such as the Tuskegee experiment and Jim Crow laws combined with distrust of the healthcare system may be affecting health outcomes in African Americans with hypertension. Cultural appropriate education by a provider of the same race is a method that can be utilized to bridge the trust gap between African Americans and providers and assist African Americans in managing their hypertension. A community based culturally appropriate educational intervention by a provider of the same race was implemented over the course of eight weeks to assist African Americans with hypertension to improve …

Mobile-Based Technology App Used To Improve Self-Care Management Of Patients With Type 2 Diabetes Mellitus, Fred Allen Smith Jr

Doctoral Dissertations and Projects

Billions of dollars are spent on diabetes in healthcare each year. Patients with lower socio-economic-status tend to have poor glycemic control, higher associated diabetic complications, and higher associated mortality rates. In underserved patients with type 2 diabetes, does utilization of a Diabetes app, compared to previous self-care management and clinic education, lower the Hemoglobin A1c over a 3-month period? A 3-month scholarly project was conducted in a small rural town in Virginia with an average median income around $17,000. N=21 were selected for the scholarly project. Inclusive criteria consisted of adults aged 19-70 years with a diagnosis of type 2 …