Nursing Commons^™

The Relationship Between Early Discharge Planning And Length Of Stay, Kandiss Hearn

MSN Capstone Projects

Discharge planning (DCP) and early discharge intervention has proven to have a direct effect on reducing hospital length of stay (LOS), reducing readmissions, reducing patient morbidity, improving patient satisfaction and possibly reducing patient healthcare cost. This proposal specifically addresses hospital length of stay but with research it was found that early DCP also has the potential to improve outcomes in several areas adjacent to both the patient aspect and business aspect of health care. The proposed question is as follows: In adult hospitalized patients (P), how does discharge planning within the first 24 hours of admission (I) compared to late …

Medication Error Prevention Strategies, Shana L. Brown

MSN Capstone Projects

The fundamental purpose of every healthcare organization is to enhance patient quality of life through the provision of superior healthcare to produce the best patient outcomes. In the pre-hospital practice setting of helicopter emergency medical service (HEMS) the desire of system leaders and medical staff is to be primarily patient-centered, focused on the safety and wellbeing of patients while at the same time managing the business finances and budget of the organization. Maintaining a healthy environment with safe patient practices is the responsibility of organization administrators, physicians, nurses, paramedics, and all healthcare providers.

One of the primary duties that healthcare …

New Graduate Nurse Satisfaction After Completion Of Nurse Residency Program, Jessica Andrews

MSN Capstone Projects

Transitioning from novice nurse to competent nurse can come with a great amount of stress, anxiety, and apprehension. Many new nurses feel inadequate and leave their first nursing job within one year for various reasons. Research has indicated that new nurse graduates who complete a nurse residency program (NRP) have a better sense of knowledge, critical thinking skills, and sense of belonging. Whereas nurses who do not complete a residency program often feel insufficient and are less prepared.

Although there are various types of general orientation programs available, it is important to educate new graduates on the advantages and significance …

Early Screening Of Postpartum Depression, Mary Ramirez

MSN Capstone Projects

Postpartum depression (PPD) is the most common pregnancy-related complication affecting over half-million mothers each year in the United States and only 50% of these women seek treatment or even receive a mental health evaluation (American College of Obstetrics and Gynecology, 2015; Horowitz & Goodman, 2004). Failure to detect or diagnose PPD can have serious consequences for both mom and baby. Nurses play a key role in discharge teaching and education, which puts them in the perfect position to ensure that adequate referrals are coordinated and to stress the importance of follow-up care to new mothers (Logsdon et al., 2018). Current …

The Clinically Aligned Pain Assessment Tool (Capa) Evidenced-Based Change Project- Benchmark Study, Mary Vitullo

MSN Capstone Projects

Pain is one of the main reasons people seek medical treatment in the United States (National Institutes of Health, 2017). Frequently, pain is inappropriately managed leading to negative patient outcomes that lead to prolonged discharge time that increases hospital costs (Trzeciak et al., 2018). This is due to improper assessment of pain which leads to challenges in pain management interventions, ultimately decreasing patient safety and satisfaction. By nature, pain reporting by patients is subjective. Various scales are utilized in the hospital setting, but these assessment scales only reflect pain intensity and are unidimensional, as opposed to pain experience and multidimensional …

Heart Failure 30-Day Readmission Frequency, Rates, And Hf Classification, Yolanda R. Brown, Twonia M. Goyer, Margaret C. Harvey

Doctor of Nursing Practice Projects

30 Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure

Background Congestive heart failure (CHF) is the leading cause of mortality, morbidity, and disability worldwide among patients. Both the incidence and the prevalence of heart failure are age dependent and are relatively common in individuals 40 years of age and older. CHF is one of the leading causes of inpatient hospitalization readmission in the United States, with readmission rates remaining above the 20% goal within 30 days. The Center for Medicare and Medicaid Services imposes a 3% reimbursement penalty for excessive readmissions including those who …

Huddle And Safety, Jaelynn Hall Bsn, Rn

MSN Capstone Projects

The purposed evidence-based practice (EBP) project focuses on a nursing intervention (team huddles) to increase safety and reduce inpatient fall rates. Negative outcomes to consider from an inpatient fall are harm and injury to the patient along with increased health care cost for the patient as well as hospital facility. Accrued cost associated with an in-patient injury resulting from a fall is not reimbursed according to the Centers for Medicare and Medicaid Services. The additional cost for hospital-acquired falls is estimated to be $6,694 (95% CI: -$1,277 to $14,665) (Agency for Healthcare Research and Quality, 2017). This was only related …

Exercise To Improve Cancer-Related Fatigue, Jennifer Watson

MSN Capstone Projects

For the average patient, medical professionals typically recommend exercise to enhance the health of their patients in multiple ways. Oncology patients, however, often have different issues that the treating physicians are more concerned about, so physical activity gets placed on the back burner. The need for exercise in oncology patients is certainly a decision that should be part of an individualized treatment plan, but it is reasonable to believe that most of these patients will benefit from participating in an exercise program. With the high demanding need to decrease chemotherapy side effects and improve lives of those undergoing it, this …

Effect Of Fluid Resuscitation In Patients With Esrd And Sepsis Or Septic Shock: An Integrative Review, Luke Eady

Master of Science in Nursing Final Projects

In patients with ESRD, clinicians are tentative to initiate fluid resuscitation given the chance of negative outcomes associated with fluid overload. Given this, many ESRD patients with sepsis are severely under-resuscitated with fluids and experience a delay in receiving antibiotics (Abou Dagher et al. 2015). There is also controversy surrounding the type of fluid that should be used with patients with ESRD. The mainstay fluid for treatment is 0.9% sodium chloride solution (normal saline). Patient studies have found that this fluid could be harmful to the kidneys and should not be administered in patients with kidney disease (Rochwerg et al. …

Genome-Wide Identification, Phylogenetic And Expression Pattern Analysis Of Gata Family Genes In Brassica Napus, Weizhuo Zhu, Yiyi Guo, Yeke Chen, Dezhi Wu, Lixi Jiang

Publications

BACKGROUND: Transcription factors GATAs are involved in plant developmental processes and respond to environmental stresses through binding DNA regulatory regions to regulate their downstream genes. However, little information on the GATA genes in Brassica napus is available. The release of the reference genome of B. napus provides a good opportunity to perform a genome-wide characterization of GATA family genes in rapeseed. RESULTS: In this study, 96 GATA genes randomly distributing on 19 chromosomes were identified in B. napus, which were classified into four subfamilies based on phylogenetic analysis and their domain structures. The amino acids of BnGATAs were obvious divergence …

Dnp Proposal: Delirium Prevention Protocol, Aaron Klein, Julia Kvam

Nursing DNP Projects

Purpose and Rationale: To implement a delirium prevention (DP) sleep protocol to at risk intensive care unit (ICU) patients to reduce delirium incidence and duration.

Synthesis of Evidence: A review of one clinical practice guideline, eight systematic reviews and meta-analysis, four randomized controlled trials, nine quasi-experimental trials, and one qualitative study provided evidence that interventions targeted to improve patients’ sleep may decrease delirium incidence and duration in adult patients in the ICU.

Usp<800> Compliance: A Hazardous Drug Safe-Handling Quality Improvement Project For Ambulatory Care Infusion Nurses, Cynthia Huff

Doctor of Nursing Practice (DNP) Projects

Problem: The U.S. Pharmacopeia (USP, 2016) Convention Chapter 800: Hazardous Drugs: Handling in Healthcare Settings took effect on December 1, 2019. According to Polovich and Olsen (2017), " The implementation of the USP <800> Standards. will represent an important step forward to protect nurses and other potentially exposed healthcare workers (HCWs): (p.1).

Context: The Doctor of Nursing Practice (DNP) project implemented a hazardous drug (HD) safe-handling personal protective equipment (PPE) toolkit in accordance to USP <800>standards and hospital policies at an ambulatory cancer infusion center to improve nurses' adherence with PPE use.

Interventions: The project consisted of (a) a safe-handling PPE …

Increasing Nurse Knowledge Using A Formal Lung Transplant Education Program, Amy M. Stoddard, Donna Lynch-Smith, Kate Carlson Wrammert, Bobby Bellflower

Doctor of Nursing Practice Projects

This quality improvement project was completed to show that a formal lung transplant education course for nurses caring for lung transplant patients increased their knowledge. An eight-hour education course was developed by experts in the field of lung transplantation. A pretest was administered before the education course. A posttest was administered to determine if knowledge was improved. A three-month follow-up test was administered to determine knowledge retention. Based on the data analysis, nurse knowledge improved after formal education. Item analysis determined what areas of educational content need to be the focus of quarterly education. The education course was adopted as …

Critical-Care Pain Observation Tool Benchmark Project, Rachel Lutz

MSN Capstone Projects

Background: Pain in the nonverbal adult patient is often misdiagnosed and undertreated. Patients who are unable to communicate pain does not indicate that pain is not present. With the majority of critical-care patients being hemodynamically unstable leaving pain untreated can have detrimental effects on already unstable hemodynamics thus affecting patient outcomes. Research has indicated that patients who have accurate pain management with appropriate analgesia and minimal sedation can help decrease ventilator days, improve patient’s mobility, and help decrease the rate of delirium and length of stay in the intensive care unit (ICU) (Bourbonnais et al., 2016).

Aim: This benchmark project …

Reducing Patient Falls By Realigning Nursing Hours Per Patient Days, Hermes Vargas

Student Scholarly Projects

Patient falls are the “second leading cause of unintentional injury death” (World Health Organization [WHO] (2018), para. 3) and increase healthcare costs by an estimated $13,806 per fall (Walsh et al., 2018). These fall-related costs translate to a potential savings of approximately $400,374 to the selected organization since the unit chosen for the practice change project experienced 29 falls in the fiscal year 2019 (C. Hernandez, personal communication, September 23, 2019).

The PICOT question that guided this project was: In a medical/surgical inpatient population in acute care (P) how does realigning the Nursing Hours per Patient Days (NHPPD) (I) compared …

A System Intervention Of Tetanus, Diphtheria, And Pertussis Vaccination For Pregnant Women In Primary Care, Tarshera Reyna

Doctor of Nursing Practice

The health care system in the United States has been described as having a deficit in care for women during pregnancy (IOM, 2019), and as a result there has been a resurgence over the last decade in diseases like pertussis, which is a severe respiratory infection that is particularly dangerous for infants less than 3 months of age (Tan & Gerbie, 2013). The primary objective of this project was to implement a Tdap vaccination program and increase the rates of Tdap vaccinations of obstetrical patients at a San Antonio clinic. The intervention included: 1) establishing standing orders for the Tdap …

Is Anybody Listening?: Factors Affecting Pain Management In Veterans Within An Acute Care Rehab Setting, Laura Oseghae

Doctor of Nursing Practice

Background: In the United States, pain is a widely discussed issue due to the opioid epidemic stemming from a history of pain mismanagement. Clinical guidelines for successful pain management techniques are readily available for providers to incorporate into the individualized patient care plan.

Purpose: The purpose of this project is to improve pain management through implementation of the VA pain management guidelines and improved interdisciplinary team communication.

Objectives: This project aims to decrease the number of patients reporting moderate to severe pain, enhance staff/provider communication, and improve the provider’s overall process for managing pain with an individualized treatment plan.

Interventions: …

Readiness For Insulin Pump Use In Pediatric Type I Diabetes: A Quality Improvement Project, Valeria Marin

Doctor of Nursing Practice

Background: Insulin pumps are essential in the management of type 1 diabetic pediatric patients because of their versatility in meeting the developmental needs of childhood and adolescence. Summary of the Evidence: There is lack of evidence for standardized pump initiation program in pediatric patients (ADA, 2019). Moreover, adverse events from insulin pump misuse, such as diabetic ketoacidosis, arise from lack of anticipatory guidance of pump management and troubleshooting (Evert et al., 2016; Grunberger et al., 2014, Wheeler et al, 2014). Project Purpose: The purpose of this quality improvement (QI) project was to reduce and prevent adverse outcomes of insulin pumps …

Oral Care Protocol For Chemotherapy And Radiation Therapy Included Oral Complications In Cancer Patients., Radhika R Pai

Manipal College of Nursing, Manipal Theses and Dissertations

No abstract provided.

Effectiveness Of A Comprehensive Educational Program For Accredited Social Health Activist (Ashas) To Identify Individuals With Bleeding Disorders In Udupi District: A Community –Based Study, Sulochana B

Manipal College of Nursing, Manipal Theses and Dissertations

No abstract provided.

Transformational Leadership - An Integrated Evidence Review, Marta L. Hudson

DNP Qualifying Manuscripts

Abstract

For chief nurse executives to survive in contemporary healthcare organizations must cultivate nurse leaders who are poised to produce nurse job satisfaction and subsequently, patient outcomes, including quality and patient safety. The article describes an integrated evidence review of the relationship between transformational leadership and nurse job satisfaction. The author identifies implications for practice and further research.

The Nicu Experience: Supporting Families & Providing Resources, Annie Zitelli

Senior Honors Projects

ANNIE ZITELLI (Nursing)

The NICU Experience: Supporting Families & Providing Resources

Sponsors: Colleen Kenny (Nursing)

This project aims to explore and understand the needs of family members who have an infant in the NICU to identify any gaps in resources and/or support hospitals provide to these families. The Neonatal Intensive Care Unit (NICU) provides optimal care for infants who are not fully developed or have serious health conditions. When an infant is brought to the NICU, parents and family members experience a flood of emotions. While families are trying to process the reality of having an infant in such a …

Implementing Purposeful Rounding As A Quality Improvement Project To Improve Patient Satisfaction In The Emergency Department, Kersten O'Brien

Master's Projects

Purpose: The purpose of this paper is to describe a quality improvement project to develop and implement a purposeful rounding protocol to improve patient satisfaction and call light rates which affect both patient and nursing staff satisfaction in the emergency department (ED). Importantly, patient satisfaction scores in the ED tend to be low but high scores are related to improved competitive advantage, reimbursement rate, patient outcomes, and nursing staff interruptions.

Methods: A literature review was conducted to determine best practices. Using the lean process and the Plan-Do-Study-Act (PDSA) model, this information was used to identify opportunities for improvement and to …

2020 Graduates Project Abstracts By Cizik School Of Nursing At Uthealth, Dnp Program

Doctor of Nursing Practice Projects 2018-2023

The Cizik School of Nursing at UTHealth proudly presents the DNP Project abstracts for the 2020 Class of DNP Graduates.

Traits Of Character That Facilitate Formation Of Exemplary Nurses In Bachelor Of Science Nursing Programs, Jean Marks

Dissertations

Constructivist grounded theory methods were applied in this study to explore traits of character that facilitate the formation of exemplary nurses in Bachelor of Science Nursing (BSN) programs. Interest in this study was prompted by a desire to examine attributes beyond academics alone that contribute to the formation of excellent nurses. The intent was to promote clarity in describing these attributes for further scholarly discussion.

Framing this study was Aristotle’s doctrine of the golden mean (Aristotle, 350 B.C.E./1934). Operational definitions consistent with this doctrine were created for the concepts of character, character traits, and exemplary nursing practice. The concept …

Childbirth And Control Behind Bars: A Descriptive Qualitative Analysis Of The Maternal Perception Of Control In Women Who Have Given Birth While Incarcerated, Lorin Raines

Dissertations

The perception of control during childbirth has been widely studied in various setting and groups. Many factors have been found to aid or impede the perception of control for birthing women. Significance of that perception of control during childbirth has also been measured in past studies. This descriptive qualitative study advances the knowledge of the perception of control during childbirth and examines a population that has thus far been excluded. Four previously incarcerated women participated in semi-structured interviews about their experience of giving birth while incarcerated and their perception of control during that time. The women were from diverse backgrounds …

Prevalence Of Workplace Violence Towards Nurses In Acute Care Adolescent Mental Health, Jennifer Yarberry

Theses and Dissertations from 2020

Workplace violence towards healthcare workers is an increasing problem within the behavioral health nursing profession. Workplace violence is a threat or an act of physical violence or other threatening disruptive behavior that occurs in the workplace (U.S. Department of Labor, 2013). The purpose of this quantitative research study was to identify the contributing factors of workplace violence in an acute care psychiatric facility and to implement a “safe environment” workplace violence prevention program for psychiatric nurses. This convenience sample (N=23) of registered nurses were recruited from an acute pediatric psychiatric setting in Arkansas, treating children ages five to seventeen. Nurses …

Preceptor Training: A Quantitative Study To Determine The Effectiveness Of A Formal Preceptor Training Program For Medical-Surgical Nurse Preceptors, Jessica L. Strickland

Theses and Dissertations from 2020

Nurse preceptors are essential to the success of new graduate registered nurses entering the workforce. Nurse preceptors serve to improve the competence and confidence of new graduate registered nurses during their transition to practice. To be an effective nurse preceptor, the nurse preceptor needs to be properly trained. A trained nurse preceptor understands the roles and responsibilities of a nurse preceptor. As they utilize their formal training, they increase their skills and capabilities. A positive experience during the transition to practice process may improve nurse retention and patient outcomes. The focus of this quantitative, descriptive research study was to determine …

Prepare-Ing South Dakota Farm And Ranch Women For Advance Care Planning, Theresa Garren-Grubbs, Marijo Letizia, Mary Minton

College of Nursing Faculty Publications

Purpose: Evaluate the impact of an advance care planning (ACP) educational session utilizing PREPARE for Your Care for South Dakota farm and ranch women and its ability to increase engagement in ACP and documentation of medical wishes in the form of an advance directive.
Sample: A convenience sample of women (n = 23) represented members of the farm and ranch community in South Dakota who were participating in the Power of Women as AgVocates Conference. Inclusion criteria for this study included being 18 years old or older, female, and conference participation. Exclusion criteria included men and those under the age …

Collaborating With Rural Practice Partners To Address The Need For Registered Nurses In Primary Care, Robin Brown, Heidi Mennenga, Alham Abuatiq, Linda Burdette, Christiana Plemmons

College of Nursing Faculty Publications

Purpose: Primary care in rural areas of the U.S. urgently need competent healthcare providers, especially registered nurses (RNs). Registered nurses are ideal team members to help meet the primary care needs in rural communities, yet RNs are underutilized in primary care settings and rarely practice to the full scope of their license in these settings. The purpose of the project was to conduct a needs assessment with rural primary care practice partners to address the need for RNs in primary care.
Sample: A needs assessment was sent to nurse leaders at 13 rural primary care facilities via an online survey …