Nursing Commons^™

Nurse Champions For Medication Reconciliation: Making A Difference, Stacey Waters

Doctor of Nursing Practice Projects

Background: Medication reconciliation creates a significant safety risk when patients transition from one care environment to another. This is especially true for older adults who may have multiple medications, poor health literacy, or multiple providers. During care transitions, collecting accurate information about previous medication regimens can be a challenge. If providers are unskilled at eliciting the needed information, discrepancies can result, leading to medication errors, poorer outcomes, or patient harm. These discrepancies, if unresolved, can follow the patient throughout hospitalization and back into the outpatient setting, leaving patients unable to manage their care at home safely.

Purpose: The objective …

Can We Talk? Bridging The Communication Gap Between Nurses And Providers, Jolie Wildinger

Doctor of Nursing Practice Projects

Background: Effective communication is the key to successful relationships and improving patient care. Effective and efficient communication is also essential in producing a healthy self-confidence and knowledge base, which is needed by nurses and physicians who are providing daily care to patients.

Purpose: The purpose of this performance improvement project is to increase the communication competence and self-awareness of staff nurses during intraprofessional interactions with the healthcare providers.

Methods: A quasi-experimental quality improvement process that included a pre and post-survey alongside an educational program to arm nurses with information and communication techniques needed to help build relationships to foster effective …

A Multifocused Intervention To Reducing Antibiotic Prescribing In Uncomplicated Upper Respiratory Infections In The Urgent Care Setting, Chelsea Popp

Doctor of Nursing Practice Projects

Background: Upper respiratory infections (URIs) comprise a large amount of Urgent Care visits. Though certain patients with URIs may require antibiotic intervention, the majority of patients are considered uncomplicated. Inappropriate prescribing of antibiotics has a direct association to antibiotic resistant bacteria and increased patient mortality (Harris, et al., 2016). Antibiotics are prescribed for more than half of URI’s presenting to Urgent Care clinics.

Purpose: The purpose of this quality improvement project is to determine if proper education on current evidence-based practice guidelines for both the patient and provider will result in a reduction in the number of antibiotics prescribed for …

Improving Hypoglycemia Protocol Compliance Through Nursing Education, Concepta Onyatta

Doctor of Nursing Practice Projects

Nurses hold a vital role in glucose management in order to ensure safety and quality outcome for hospitalized patients.

Background: Assessing serum and point of care glucose results and bringing abnormal results to the attention of the healthcare team can help maintain optimal management. Despite challenges to hypoglycemic protocol compliance, informed nurses can advocate effectively for their patients. Understanding insulin action and the effective use of evidence-based guidelines/protocols can help nurses promote optimal patient outcomes. Common barriers to glucose control and education of current best practices in the acute care setting were reviewed.

Purpose: To improve hypoglycemic protocol compliance …

Protecting The Integument: Changing Nursing Practice To Prevent Pressure Injuries, Latonya Lawery

Doctor of Nursing Practice Projects

The purpose of this project is to assess and improve nurses’ knowledge of pressure injuries and pressure injury preventions using evidence-based guidelines and a southeastern United States hospital’s skin integrity policy. My population of focus is direct care professional nurses caring for adults and geriatric patients in the acute care setting.

Design and Methods: The DNP student’s project is a quality improvement project using a Quasi-experimental design, which includes using a pre-test (Appendix A) and post-test (Appendex B). FADE (Appendix C) is the quality improvement method chosen for this project. FADE (Appendix C) is an acronym representing focus, analyze, develop, …

Improving School Attendance Rates Utilizing A School-Based Clinic, Tameka Minter Hines

Doctor of Nursing Practice Projects

Student attendance and good health are two essential concepts that correlate with procuring students' academic success. Students can gain knowledge with the ability to be present in the class setting. Any disruption in the student's ability to attend class can have long-lasting negative consequences. Chronic health conditions are the primary obstacles in student attendance. Chronic health conditions such as asthma, sickle cell, childhood cancers, type 2 diabetes, and mental health issues or defects are significant barriers to school attendance. School administrators, parents, and community health partners are task with developing viable options for managing student healthcare along with access to …

The Evolution Of Nursing Leadership: Novice To Expert, Yolanda Chandler

Doctor of Nursing Practice Projects

The nurse leader is critical in staff development, contentment, retention, patient safety, quality of care, and achievement of organizational goals. Nurse leaders in a managerial role must lead, oversee, delegate, guide, and support staff nurses. They are expected to demonstrate clinical competence, make decisions, communicate effectively, be visible and approachable, and empower others. Some skills learned as a charge nurse can help the new manager adapt to the role, but many healthcare organizations offer a novice nurse manager a limited orientation.

Purpose: Effective nursing leadership requires nurse managers to have clinical experience, think critically, motivate others, communicate and delegate constructively, …

The Effect Of A Provider Education Program On Antibiotic Overuse In Acute Sinusitis, Shawna Berg

Doctor of Nursing Practice Projects

Background: Acute sinusitis is a typical patient diagnosis encountered in the outpatient setting. Inappropriate antibiotic prescribing is a well-documented concern. The overprescribing of antibiotics is associated with increased antibiotic resistance, cost, and adverse side effects. Despite the research, improper prescribing of antibiotics continues to be problematic.

Purpose: A provider education program was implemented at three separate urgent care centers for healthcare providers concerning antibiotic stewardship. The objective was to evaluate the effectiveness of a provider education program to examine changes in the immediate antibiotic prescribing habits.

Design Method: A pretest-posttest quasi-experimental design with provider educational intervention was implemented concerning antibiotic …

Improving The Accuracy Of Temporal Artery Thermometry In Pediatric Direct Care Providers: A Performance Improvement Project, Kimberly L. Bell

Doctor of Nursing Practice Projects

Purpose: The purpose of the project was to improve the accuracy of temporal artery thermometry (TAT) measurements compared to axillary, rectal, and oral thermometry readings on a Pulmonary Pediatric Care Unit.

Design and Methods: A pre-educational and post-educational competency tests and skill performance test of obtaining accurate TAT results with an Exergen 5000 Temporal Scanner were implemented after the pediatric nursing staff participated in a 60-minute educational program. Of the 32 participants, most were RNs (84%) followed by certified nursing assistants (9%) and LPNs. Most participants worked the 12-hour day shift 7a-7p (59%), followed by the 7a-3p shift (38%) and …

Purposeful Hourly Rounding And Reduction Of Patient Falls, Iesha S. Bell

Doctor of Nursing Practice Projects

Falls are a pervasive and persistent problem in all healthcare settings, with adverse clinical, social, and economic outcomes for patients, staff, and institutions involved. The systematic process of purposeful rounding is an intentional act conducted with a clear purpose for the patient's benefit. Prevention of inpatient falls remains a challenge for nurses. Despite fall prevention efforts by nurses, the rate of patient falls in the acute care setting is a major safety concern. A Doctor of Nursing Practice project was crafted and implemented to educate nursing staff on purposeful hourly rounding and apply the 4 P's (pain, positioning, possessions, and …

Improving Patient Follow-Up For Laboratory Testing Using Telephone Calls As An Intervention: A Quality Improvement Project, Jill Gray

Doctor of Nursing Practice Projects

Background: Today, in the United States, 74,273 individuals are actively waiting for an organ transplant. Of those, approximately 8,000 need a liver transplant. With the increased need for an organ transplant, the use of increased risk donors is on the rise. In these patients, it is imperative to monitor for the transmission of HCV, HBV, and HIV.

Purpose: Increase compliance for monitoring transplant recipients who receive organs from increased risk donors for HCV, HBV, and HIV.

Design method: In order to measure the outcomes of this project, the following instruments were used: parametric testing and paired t-test. Parametric …

Hereditary Cancer Syndrome Recognition And Testing For The Primary Care Nurse Practitioner: Beyond Brca, Hanford Shuman, Deborah Himes

Student Works

Hereditary cancer syndromes, resulting from mutations of tumor-suppressor genes, can significantly increase risk for breast cancer. While Hereditary Breast and Ovarian Cancer Syndrome caused by BRCA1/2 mutations is well known, less well-known hereditary cancer syndromes also exist. This clinical practice feature focuses on three other syndromes including, Li-Fraumeni, Cowden, and Peutz-Jeghers. This article will help prepare nurse practitioners to recognize key features of these syndromes and understand testing criteria. Additionally, this article discusses barriers to diagnosing hereditary cancer syndromes and the role of primary care nurse practitioners in ordering genetic tests and making genetic referrals for optimal patient care.

Experiences Of Mothers Of Preterm Neonates Following Discharge From Neonatal Intensive Care Unit (Nicu) - A Qualitative Content Analysis, Monica Rita Hendricks Ms, Brian S. Carter, Suman Rao P N Dr

Manipal Journal of Nursing and Health Sciences

Preterm birth brings with it stress that requires separation from their parents, acute care, prolonged hospitalization, rigorous medical interventions with more technological contact. A preterm neonate in the neonatal intensive care unit, not only places the parents in emotional turmoil, but it also makes them experience physical, social, financial and spiritual stress. This study retrospectively explored the experiences of parents of Neonatal Intensive Care Unit (NICU) graduates (neonates who are discharged from NICU) in dealing with preterm neonates and identified their coping mechanisms. Methodology: Data was collected through a telephonic interview from six mothers of preterm infants discharged from the …

Assessment Of Cognitive-Behavioral Symptoms And Functional Status Among Stroke Survivors, Chandel M, Shashi, Yashomati, Hemalata

Manipal Journal of Nursing and Health Sciences

Background: Stroke is one of the complex causes of death and disability. Stroke survivors often experience cognitivebehavioral and functional changes. Aim: The present study aims to assess the cognitive-behavioral symptoms and functional status among stroke survivors. Methods: A descriptive study was done in Neurology and Neurosurgery Out Patient Department of a tertiary care hospital in India. Consecutive 55 adult stroke survivors who were conscious and accompanied by the caregivers were included in the study. Standardized tools such as mini-mental status examination (MMSE), Neuropsychiatric Inventory Questionnaire (NIP-Q), and Barthel index were used to assess the cognitive, behavioral symptom, and functional status …

Improving Skin Tears Healing Time Is Demonstrated By The Staff Rn Who Performs Early Initiation Treatment Of The Skin Tear Protocol, Sharon Brazile

Doctor of Nursing Practice Projects

Skin tears create numerous challenges for managing skin integrity for our aging population. Skin tears result from trauma, such as a patient bumping into a doorknob or rubbing against the wheelchair; they also occur because the epidermis and dermis lose elasticity and rub against each other, causing a shearing process that separates the outer skin layers from their protective under layers. Skin tears not only look terrible but can be painful and lead to infection if treatment is not initiated early by the nurse.

Purpose: The Chief Nursing Officer chose to focus on skin tear treatment at a southeast urban …

Increasing Long-Term Care Employee Influenza Compliance Through An Educational Approach, Shyandrea H. Brazil

Doctor of Nursing Practice Projects

Influenza (flu) is a highly contagious respiratory illness caused by several influenza viruses (Centers for Disease Control, 2019). The CDC estimates that there have been approximately 42.9 million flu incidents, 20.1 million flu medical visits, 647,000 flu related hospitalizations and 61,200 deaths from October 1, 2018 through May 4, 2019. Individuals who contract this illness may have symptoms varying from mild to severe. This project focused on the elderly population because these individuals fall into the high-risk category. Individuals 65 and older are more likely to experience flu-related complications, which could ultimately lead to hospitalizations and in some cases, death. …

Understanding The Requisite Content For Interprofessional Education On Sentinel Injuries, A Qualitative Study, Elizabeth A. Cleek

Dissertations (1934 -)

Child maltreatment is a public health concern in the United States. The consequences of child maltreatment pose both immediate and lifelong health threats to victimized children. Given the health consequences of child maltreatment, health care providers (HCPs) are legally required to report any reasonable suspicion of child maltreatment to child protective services (CPS). Sentinel injuries (SIs) are some of the earliest and most readily identifiable red flags of child maltreatment. SIs are any unexpected bruising or intra-oral injuries in non-mobile infants. SIs are highly correlated with child maltreatment and may be the only sign of child maltreatment in an otherwise …

Research Provides Evidence For Health Policy In Lao Pdr, Ian Bromage, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Sengchanh Kounnavong, Vanphanom Sychareun, Léonie Venroij

Publications

No abstract provided.

Mean Arterial Pressure In Acute Ischemic Stroke Study, Mary Angela Grove

Theses and Dissertations (ETD)

Background. There is little, if any, evidence available on the validation of blood pressure (BP) measurements obtained in the acute care setting. Despite this, acute stroke practitioners trust and rely on non-invasive blood pressure (NIBP) devices to guide acute ischemic stroke (AIS) patients’ treatment. Although systolic blood pressure (SBP) has been found to be the most unreliable measurement displayed on NIBP devices, treatment decisions for AIS are based on them. Today, 25 years after the FDA’s approval of alteplase, practitioners continue to use BP parameters of 185/110 and 180/105 to guide the initiation of alteplase bolus and infusion, although the …

Midwifing The Perinatal Microbiome, Lisa Hanson, Emily Malloy, Leona Vandevusse

College of Nursing Faculty Research and Publications

No abstract provided.

Development And Psychometric Analysis Of The Patient Preferences For Engagement Tool, Teresa Jerofke-Owen, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

Background

Assessing patients’ preferences for engaging in healthcare is needed to inform the planning and delivery of individualized healthcare. Unfortunately, patients are often not engaged in their care to the extent that they would like, leading to patient feelings of disempowerment and frustration.

Objectives

The purpose of this study was to (a) develop and (b) psychometrically test the Patient Preferences for Engagement Tool (PPET), a clinical assessment tool that can be used by nursing staff to identify patient preferences for engagement in healthcare. The usability of the PPET was also examined for both nurses and patients participating in the study. …

Spatial Analysis Of Factors Associated With Hiv Infection In Malawi: Indicators For Effective Prevention, Jerry John Nutor, Henry Ofori Duah, Pascal Agbadi, Precious Adade Duodu, Kaboni W. Gondwe

College of Nursing Faculty Research and Publications

Background

The objective of this study was to model the predictors of HIV prevalence in Malawi through a complex sample logistic regression and spatial mapping approach using the national Demographic and Health Survey datasets.

Methods

We conducted a secondary data analysis using the 2015–2016 Malawi Demographic and Health Survey and AIDS Indicator Survey. The analysis was performed in three stages while incorporating population survey sampling weights to: i) interpolate HIV data, ii) identify the spatial clusters with the high prevalence of HIV infection, and iii) perform a multivariate complex sample logistic regression.

Results

In all, 14,779 participants were included in …

Laboratory Analysis Techniques For The Perinatal Microbiome: Implications For Studies Of Probiotic Interventions, Emily Malloy, Ashley Kates, Lauren Watson, Leona Vandevusse, Nasia Safdar, Lisa Hanson

College of Nursing Faculty Research and Publications

The microbiome is composed of many organisms and is impacted by an intricate exchange between genetics and environmental factors. The perinatal microbiome influences both the developing fetus and the pregnant person. The purpose of this article is to describe the tests that are currently available for laboratory analysis of the perinatal microbiome in relationship to probiotic interventions. This article focuses on the bacterial component of the microbiome. Although adverse outcomes associated with the perinatal microbiome have been studied, a comprehensive understanding of the physiologic perinatal microbiome is still emerging. Early efforts to influence the perinatal microbiome through probiotics are currently …

Wellness And Coping Of Residents In A Skilled Nursing Facility, Christine M. Larson

Doctoral Dissertations and Projects

Depression is common among older adults in long-term care (LTC) facilities. As many as 50%-80% of residents will experience depressive symptoms or have a diagnosis of depression. Depression increases the risk of poor health-related outcomes in older adults. A review of the literature suggests that early intervention using movement-based techniques decreases the risk for depression and improves depressive symptoms. This scholarly project aimed to reduce the risk of depression of residents in an LTC located in a suburban area in Midwestern United States. The LTC facility and a Doctor of Nursing Practice (DNP) student implemented the Chair One Fitness program …

Decreasing Psychiatric Readmissions In A Nonprofit Behavioral Health Hospital, John Schreiber

Doctoral Dissertations and Projects

This scholarly project aimed to decrease adult readmission rates of psychiatric patients in a Nonprofit Behavioral Health Hospital (NBHH). The project aims to decrease the number of readmissions to an NBHH by 25% using specific interventions that have been revealed through a literature review of evidence-based practices (EBPs). A literature review revealed focused EBP interventions that could decrease readmissions. The PICOT question for this project was, "In adult mentally ill patients who are in an NBHH, what is the effect of focused interventions compared with usual care on readmission rates in 2 months?" Reducing the number of psychiatric readmissions is …

Increasing Knowledge Of Abdominal Aortic Aneurysm Screening Criteria And Introduction Of A Screening Tool To Improve Aaa Screening In A Family Practice Clinic: An Evidence-Based Practice Project, Jennifer Elizabeth Rank

Doctoral Dissertations and Projects

Abdominal aortic aneurysms (AAA) are diagnosed most frequently in male patients of advanced age with a current or past smoking history. Screening for AAA by ultrasonography is effective at detecting clinically significant aneurysms and reduces AAA-associated and all-cause mortality at short-term and long-term follow-up. The criteria for screening include male gender, age 65 to 75, and a current or past smoking status. Additional criteria that may be considered include family history of AAA in a first-degree relative and/or a personal history of hypertension or atherosclerotic cardiovascular disease. Based on review of the evidence, the project leader designed an evidence-based practice …

Low Health Literacy Impact On Heart Failure Patients' Readmissions: An Integrative Review, Melissa S. Goodwin

Doctoral Dissertations and Projects

Heart failure is a common chronic disease that affects numerous people throughout the world. Low health literacy plays a critical role in heart failure mismanagement. The purpose of this systematic review was to summarize what is known about the impact of health literacy of heart failure patients’ readmissions. MEDLINE, CINAHL, PSYCHINFO, and PUBMED databases were searched for the years 2010-2020 and for English language articles. The findings indicated that low health literacy has a significant impact on heart failure patients’ unplanned readmissions. Interventions for low health literacy also affect outcomes for heart failure patients; for example, reduce unplanned hospital readmissions. …

Strength In Community: A Community-Based Health Program To Improve Weight Loss And Blood Pressure Within An African American Faith-Based Organization, Leonna Sylvitrice Ameduite

Doctoral Dissertations and Projects

In general, conventional health promotion strategies have not successfully mitigated health inequality and health disparities in African American communities. Health disparities among African Americans continue to persist. Obesity and hypertension are more prevalent in African Americans and are well-known precursors to chronic illness such as cardiovascular disease, diabetes, and stroke. A wholistic solution to health disparities is complex and multifaceted. However, community-based programs such as faith-based health promotion programs can be an integral part of the solution. The purpose of this project was to provide a community faith-based weight loss program for African Americans to help guide weight loss and …

Implementation Of An Independent, Unit Specific Lgbt Cultural Competency Training, Kristen Nicole Kaiafas

Doctoral Dissertations and Projects

This paper describes the methodology of the implementation of an educational intervention in the emergency department (ED) setting seeking to improve the provision of culturally competent care for the Lesbian-Gay-Bisexual-Transgender (LGBT) population. The intent of the project was to improve the knowledge and skills, openness and support, and oppression awareness of ED nurses when providing care to the LGBT population. The scholarly project included an evidence-based, unit specific education intervention to improve these measurement outcomes. Analysis utilizing descriptive statistics demonstrated an increase in the mean knowledge and skills and openness and support following the education intervention. The results illustrated an …

Implementation Of Post Forms Upon Hospice Admission: An Evidence-Based Practice Intervention To Reduce Hospice Revocations, Joanna Grace Asselin

Doctoral Dissertations and Projects

Background and Purpose: Reduction of live hospice discharges in the form of revocations is necessitated in order to maintain regulatory compliance and meet quality measures. Upon admission to hospice services, many have not considered personal desire regarding further intervention beyond Do Not Resuscitate (DNR) status. Evidence-based practice has revealed Physician Order for Scope of Treatment (POST) forms as effective in enhancing translation of patient desires related to care and interventions at end-of-life. The clinical question of this scholarly project asked if implementation of POST forms upon admission to hospice services would result in decreased revocations with related emergency department (ED) …