Nursing Commons^™

Testing Measurement Invariance With Ordinal Missing Data: A Comparison Of Estimators And Missing Data Techniques, Po-Yi Chen, Wei Wu, Mauricio Garnier-Villarreal, Benjamin Arthur Kite, Fan Jia

College of Nursing Faculty Research and Publications

Ordinal missing data are common in measurement equivalence/invariance (ME/I) testing studies. However, there is a lack of guidance on the appropriate method to deal with ordinal missing data in ME/I testing. Five methods may be used to deal with ordinal missing data in ME/I testing, including the continuous full information maximum likelihood estimation method (FIML), continuous robust FIML (rFIML), FIML with probit links (pFIML), FIML with logit links (lFIML), and mean and variance adjusted weight least squared estimation method combined with pairwise deletion (WLSMV_PD). The current study evaluates the relative performance of these methods in producing valid chi-square difference tests …

An Investigation Of The Relationships Between And Among Disaster Preparedness Knowledge, Perceived Use Of Intuition, And Triage Decision Making Of Emergency Department Registered Nurses In Acute Care Hospitals Using Benner’S Novice To Expert Theory, Brian Charles Schneider

Seton Hall University Dissertations and Theses (ETDs)

Background: Disasters are man-made or natural events that challenge resources and support in an environment lacking rules and regulations. Nurses represent the largest resource in healthcare and are among the first to encounter victims of disaster, thus having knowledge of disaster preparedness is essential to disaster response. However, there is a lack of empirical evidence concerning the relationships between everyday elements of nursing practice such as intuition and triage decision-making and disaster preparedness knowledge.

Purpose: The purpose of this study is to examine the relationships between and among disaster preparedness knowledge, perceived use of intuition, and triage decision-making in emergency …

The Fall Free Zone, Brendalyn Malimban

Master's Projects and Capstones

The fall prevention project is designed to decrease fall rates in the medical-surgical units by promoting accuracy in identifying fall risk patients and engaging patients in participating with their own safety. The project will follow Kotter’s change model to address the urgent need for reducing fall rates (Webster & Webster, 2018). A falls taskforce committee is already in place pursuing the goal mentioned. Engaging the staff members and leaders will be accomplished through reeducation of policies and procedures, admission process and the accurate use of the SCHMID Assessment Tool. These will take place during staff meetings, huddles and roving learning …

Are Students’ Being Distracted Drivers, Jill Buchholz, Ronda Christman

Adventist Human-Subject Researchers Association

The life of a nursing student can be very fast paced. Trying to keep up with friends and family while studying can be a challenge. Learn how frequently students are driving distracted, are on social media, and have personal devotions.

Perilous Times Call For Emergency Preparedness, Sonia K. Wrate, Ronda Christman

Adventist Human-Subject Researchers Association

As disasters become more frequent it is important that people are ready to respond. University students along with community volunteers learn with and from each other during a disaster simulation. Learn how participant’s perceptions of spirituality and civic engagement has changed following a disaster simulation.

New Graduate Nurses’ Perceptions And Applications Of Participating In A Multipatient Simulation, Christine A. Moniyung, Ronda Christman

Adventist Human-Subject Researchers Association

Students can benefit from simulation in-that sometimes during clinicals they don't get to provide care where they are solely responsible for the patient. Students need to learn to prioritize and provide care for their patients. Learn students’ perceptions and their practical application of their simulated learning experience.

What You Need To Know About Bar-Code Medication Administration, Marie E. Mcbee Dnp, Msn, Martha Kuhlmann Dnp, Msn, Rn, Fnp, Pmhcns-Bc, Aprn, Pam Patterson Dnp, Msn, Ne-Bc

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Medication errors are the most common type of preventable error. Bar-code medication administration (BCMA) technology was designed to reduce medication administration errors. Poor system design, implementation and workarounds remain a cause of errors. This paper reviews the literature on BCMA, identifies a gap in the findings and identifies three evidence based practices that could be used to improve system implementation and reduce error. The literature review identified that Bar-code medication administration and system workarounds are well documented and affect patient safety. Based on the critical analysis of 10 studies, we identified gaps in the standardization of BCMA planning, implementation, and …

Improving Nurse-Physician Collaboration: Building An Infrastructure Of Support, Marshall Blue

Doctor of Nursing Practice (DNP) Projects

Abstract

Healthcare organizations have come to realize the 21st century brings many challenges. First and foremost is the challenge of improving patient satisfaction with their health care and their associated experience accessing this complex system. Other challenges are incorporating the patient perceptions of delivering high quality, safe, equitable care to the surrounding community while demonstrating cohesive teamwork. Healthcare professionals and organizations must find an effective and efficient pathway to provide excellent care to the patient within an extremely competitive market. Current research demonstrates a patient perceives they are receiving exceptional care when interdisciplinary conversations are noticed between the nurse and …

Healthy Aging In The Community Initiative, Didem Kadriye Unver

Master's Projects and Capstones

In 2016 the Sequoia Health Care partnering with Peninsula Family Services developed a non-profit and free program called 70 Strong. It is a personal resource guide for the 60 and above client base for activities and services from Redwood City to Foster City to encourage independence amongst the older population. It includes a wide array of categories, such as fitness and social activities, volunteer opportunities, transportation, enrichment, and support groups. This is not an acute healthcare provider; however, it is a primary prevention effort by Sequoia Healthcare District to increase wellness among the older population in the county. The purpose …

Advance Care Planning Interventions For Racially And Ethnically Diverse Populations: A Literature Review, Haley Kirkpatrick

DNP Qualifying Manuscripts

Background and purpose: Diverse populations are less likely to engage in end-of-life-care-planning. This literature review examined research on end-of-life planning interventions for diverse patient populations.

Methods: This systematic search included Academic Search Complete, Cochrane, CINAHL, and PubMed databases. Results were limited to peer-reviewed articles published in English between 2015 to 2019.

Conclusions: Each intervention was effective at increasing advance care planning (ACP) engagement. Community-based programs are costlier. PREPARE used less resources. If diverse populations are specifically targeted, ACP engagement increases.

Implications for practice: Healthcare institutions and practitioners should employ targeted interventions for ACP engagement of diverse groups.

Keywords: end-of-life-care planning, …

Labor Management Protocol For Parturients On Buprenorphine, Erik Sanders

Doctor of Nursing Practice Projects

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Opioid dependence during pregnancy may lead to negative outcomes for both the parturient and the fetus. Opioid dependent parturients are often prescribed buprenorphine, a form of medication- assisted therapy. The use of buprenorphine within the parturient population is a relatively new practice and anesthesia providers are encountering difficulties in managing this population during the peripartum period. Literature has demonstrated anesthesia providers may best serve this population by utilizing a multimodal approach when providing analgesia (Jones et al., 2008; Meyer et al., 2010; Reddy et al., 2017). A combination of oral, intravenous and neuraxial modalities, in conjunction with the daily …

Operative Times In Adolescent Idiopathic Scoliosis Surgery. What Do They Mean?, Joanne Abby Marasigan

Research Days

No abstract provided.

Peripheral Intravenous Infiltrates: Engaging Staff To Increase Reporting, Emily Weber, Kimberly Castrillon, Joyce Ramsey-Coleman

Journal of Nursing & Interprofessional Leadership in Quality & Safety

A large free standing children’s academic hospital aimed to improve patient safety and outcomes by decreasing the overall severity of peripheral intravenous infiltration and extravasations (PIVIEs). A care bundle was developed by creating a PIVIE measurement tool within the electronic medical record (EMR) and integrating the tool into standardized daily practice for nurses. The care bundle included creating a team of clinical leaders consisting of empowered bedside nurses acting as mobilized resources embedded into each unit. The initiative resulted in a large scale increase in reported PIVIEs system-wide within 1 month of education dissemination to bedside RN staff. The QI …

The Effects Of A Mobile Fitness Application On Weight Management And Physical Acticity Amongst University Students, Erica Deenihan

Evidence-Based Practice Project Reports

The prevalence of obesity, and obesity related diseases throughout America, specifically in regard to the college student population has steadily climbed over the course of the last forty years, due largely in part to the increase in sedentary lifestyle behaviors, amongst other factors (Swanson, 2016). Physical activity has been widely recognized as a valid means of combatting obesity and weight gain while promoting health related quality of life (Swanson, 2016). Therefore, implementing strategies aimed at increasing physical fitness in attempt to control weight management is imperative to promoting improved health outcomes. The purpose of this evidence-based project was to examine …

The Effect Of Home Blood Pressure Monitoring And Self-Titration On Achieving Blood Pressure Targets, Katina A. Varner

Evidence-Based Practice Project Reports

One-third of U.S. adults over the age of 20 are hypertensive, with an estimated cost of $47.5 billion in direct medical expenses and increased individual CVD risk (CDC, 2018). Routine office visits afford primary care providers a means of managing hypertension; however, time constraints limit the ability to accurately assess and track BP in most patients (Jung, 2015). The purpose of this project was to determine if implementation of HBPM and an algorithm for selftitration of antihypertensive medications increased the number of participants at guideline recommended BP goal over a 90-day period. The Health Promotion Model provided the theoretical framework …

Clinical Practice Guideline Adherence: Primary Prevention Of Cardiovascular Disease In At-Risk Adults, Sharnita L. Rice

Evidence-Based Practice Project Reports

The American College of Cardiology (ACC) and the American Heart Association (AHA) (2013; 2016), as well as the American Diabetes Association (ADA) joined forces to create clinical practice guidelines (CPGs) recommendations for healthcare providers (HCPs) to follow with the aim of preventing cardiovascular disease (CVD). Cardiovascular disease is the leading cause of morbidity and mortality in the United States. The Centers for Disease Control (2017a) estimates CVD costs 325 billion dollars annually. Although CVD has an astronomical cost associated with it, CPG adherence continues to be an issue among HCPs and improvement is warranted. The purpose of this EBP project …

The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava

Evidence-Based Practice Project Reports

The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient outcomes, …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

Rural Hospital Nursing Skill Mix And Work Environment Associated With Frequency Of Adverse Events., Jessica G. Smith, Colin M. Plover, Moira C. Mcchesney, Eileen T. Lake

College of Population Health Faculty Papers

Introduction: Though rural hospitals serve about one fifth of the United States (U.S.), few studies have investigated relationships among nursing resources and rural hospital adverse events.

Objectives: The purpose was to determine relationships among nursing skill mix (proportion of Registered Nurses (RNs) to all nursing staff), the work environment and adverse events (medication errors, patient falls with injury, pressure ulcers, and urinary tract infections) in rural hospitals.

Methods: Using a cross-sectional design, nurse survey data from a large study examining nurse organizational factors, patient safety, and quality from four U.S. states were linked to the 2006 American Hospital Association data. …

Felty Syndrome, Dorothea Frederick, Dnp, Fnp-C

College of Nursing Posters

Take home point: It is important to remember that the diagnosis of FS may be masked in patients who present with infection, since active bacterial infection raises the WBC count to normal or slightly elevated – the neutropenia reappears shortly after successful treatment (Kay, 2017).

A Literature Review On Improving Nurse-Patient Communication Manuscript, Irene Gabbedon

DNP Qualifying Manuscripts

Effective communication happens when the sender of the message sends it, and it is conveyed and understood by the receiver (Gilbert & Hayes, 2009). Medical errors are the third leading cause of death in the United States alone (McMains, 2016). The Joint Commission (TJC) (2019) implemented National Patient Safety Goals (NPSG) in 2002, and improving communication among caregivers has been a goal that has been frequently revised. Due to ineffective communication, life-threatening errors are created among healthcare workers. Nurses play an important role in the communication channel and barriers can be created when there is a lack of health literacy. …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Women’S Experiences With Epilepsy Treatment In Southern India: A Focused Ethnography, Jane R. Von Gaudecker 3172782758, Ann Gill Taylor, Janice M. Buelow, Sailas Benjamin, Claire B. Draucker

The Qualitative Report

Women with epilepsy in rural southern India often do not receive anti-epilepsy drugs (AEDs) or take these drugs regularly, but little is known about how they experience the epilepsy treatment they do receive. The purpose of this study was to provide an in-depth description of the treatment experiences of women in this region who had been diagnosed with epilepsy but who do not consistently take AEDs. Focused ethnography was conducted using participant observation and in-depth interviews with six women with epilepsy, eight of their family members, and two traditional healers. The women’s treatment experiences are best described as living at …

The Implementation Of A Behavioral Intervention Program In Obese Elderly Patients, Zandra Brown

Doctor of Nursing Practice Projects

Abstract

The prevalence of obesity is increasing in American and patients are living longer. Research suggests that behavioral lifestyle interventions help optimize elderly patient’s health and improve their quality of life. A successful behavioral weight loss program had been in place in one clinic within a large healthcare organization. The need at another metropolitan Midwest location seemed even greater due to having a patient population consisting of elderly, demographics, obesity trends, and high rates of obesity linked morbidities such a diabetes, hypertension, and heart disease. Thirteen elderly obese patients with ages ranging from 65-75 years old were enrolled in an …

Using An Electronic Health Record Alert System To Screen And Manage Patients With Diabetes Mellitus Type 2 In A Rural Primary Care Setting, Simon Katumu

Doctor of Nursing Practice Projects

Diabetes Mellitus type 2 is the 7th leading cause of death and affects nearly 10% of the US population. Early detection of this condition leads to the initiation of treatment and lowers the risk for complications and better outcomes. Frequent testing of hemoglobin A1Cs in those already diagnosed also leads to better management, glycemic control and improves health outcomes. This project utilized a feature in the electronic health record system of a rural primary care clinic to remind providers to screen at-risk patients and retest those who were either due or overdue for hemoglobin A1C testing. Hemoglobin A1C readings were …

The Efficacy Of An Educational Intervention To Improve Low Influenza Vaccination Rates Among Federal Health Care Workers, Cynthia Berfect-Shelby

Electronic Theses and Dissertations

Influenza is a preventable communicable illness that has a significant impact on people of all ages. In 2018 it was estimated that 80,000 people died of influenza-related illnesses. Infants and elderly people are among the most vulnerable populations. The Centers for Disease Control and Prevention and Healthy People 2020 recommend that health care facilities have a 90% vaccination rate. Despite the recommendations and a mandatory directive, many facilities within the Veterans Health Administration struggle to reach influenza vaccination rates above 60%. Pender’s health promotion model was used as the theoretical framework to explore the reasons why health care workers refuse …

Improving Nurse Anesthetist Intraoperative Handoff Process By Developing And Implementing An Evidence-Based, Facility-Specific Cognitive Aid, Jason Silva, Myron Arnaud

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Miscommunication or non-transfer of pertinent patient information during intraoperative handoffs between anesthesia providers creates patient safety risks. An evidence-based facility-specific cognitive aid was developed and introduced to nurse anesthetists in an anesthesiology department of a large academic hospital with the aim of improving the intraoperative patient handoff process. The program used a handoff cognitive aid that addressed five pertinent patient information points. A secondary measure was evaluation of provider satisfaction. Twenty-four nurse anesthetists utilized the handoff cognitive aid during handoffs in the course of a 4-week pilot program. Eighty-eight nurse anesthetist handoffs were observed (23 with and 65 without the …

Exploring Individual Experiences Obtaining Medication-Assisted Treatment For Opioid Use Disorder In Rural New Mexico, Krista L. Scorsone

Nursing ETDs

In the United States, more than 2.5 million people struggle with opioid use disorder. Compared to people living in urban areas, rural residents are twice as likely to overdose from opioid misuse. Reasons for this increase include excessive opioid prescribing and illegal diversion of opioids. This holds true in the rural counties of northern New Mexico, where drug overdose deaths are among the highest in the nation. Although medication-assisted treatment (MAT) with buprenorphine, methadone, or naltrexone is globally accepted as the most effective treatment, it is still accessed half as often rurally. The reasons for this imbalance are unknown, and …

Implementation Of An Advance Care Planning Protocol To Increase Advance Directive Completion Rates, Christine Engle

Evidence-Based Practice Project Reports

Advanced directives (AD) allow an individual to retain autonomy in end-of-life decisions and can prevent unnecessary costs and treatments associated with aggressive life-prolonging measures. As of 2017, only an estimated 36.7% of the United States adult population had a form of advance directive documented (Yadav et al., 2017). The purpose of this evidence-based project was to determine if implementation of an advanced care planning (ACP) protocol would increase ACP discussions, AD completion, and result in a modification in stage of change or behavior. The Transtheoretical Model (TTM) and Stetler Model of evidence-based practice were used as the framework to guide …

Nurses' Attitudes And Understanding Of The Suicidal Patient, Cheryl Lemmon

Doctor of Nursing Practice Scholarly Project

Motivation / Problem statement: While not all suicides are predictable, there are reasonable guidelines for identifying those individuals at risk and reducing risk for high-risk individuals. There is, however, an apparent gap in best practice as there is a continual climb in suicide statistics. The aim of this project is to survey emergency department nurses to discover their attitudes and understanding of suicide. The purpose is to better understand the phenomenon, and guide education initiatives, as nurse professionals are in a key position of prevention when working with these patients.

Methods / Procedure / Approach: A non-probability, purposive and voluntary …