Nursing Commons^™

Overcoming Barriers To Uncontrolled Hypertension, Cassie Thacker

MSN Capstone Projects

Overcoming Barriers to Uncontrolled Hypertension using individualized educational interventions.

Implementing A Shared Governance Program, Mayra Elizondo

MSN Capstone Projects

Aim: To see the relationship between nursing satisfaction and patient safety outcomes through the implementation of a shared governance program.

Background: The adoption of shared governance in hospitals across the country would enable more nurses to have more resources, more autonomy in their practice, and thus higher satisfaction in their work environments which would improve patient outcomes.

Implications for future research, clinical practice and policy development: The following paper summarizes that shared governance programs increase the amount of satisfied nurses and improve patient outcomes. Further research is needed to develop effective guides for implementation of shared governance in healthcare facilities …

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Evidence-Based Individualized Discharge Educational Intervention For Coronary Artery Disease (Cad) Patients; A Benchmark Project, Sumita Thapa

MSN Capstone Projects

Coronary artery disease (CAD) is the leading cause of death worldwide, whereas, in the United States, 16,800,000 people are affected, resulting in 450,000 deaths annually. Patients’ perceptions of self-management related to treatment adherence, lifestyle modifications, and risk-factor management are significant indicators of outcomes following a cardiac event. To promote self-management in CAD patients, this benchmark project aims to determine the impact of individualized education interventions by establishing a standardized nurse-led educational intervention in the cardiac unit that emphasizes adherence to self-management and treatment regimen to improve quality of life and prevent rehospitalization due to worsening cardiac events. The evidence-based findings …

Fatigue In Rheumatoid Arthritis Benchmark Study, Devan C. Salone

MSN Capstone Projects

Fatigue is perceived as one of the dominant symptoms of Rheumatoid Arthritis (RA) along with the pain that affects activities of daily life. RA-related fatigue was also described as unpredictable in its severity, duration, frequency, and intensity (Primdahl et al., 2019). The fatigue can mean feeling overwhelmed with feeling tired, unmotivated, increased pain, lack of concentration, or not getting enough sleep to combat the feeling of being tired (Choy & Dures, 2019). According to Widemark (2014), it is estimated that 40% to nearly 90% of RA patients experience chronic fatigue. The fatigue can happen at any time with RA. It …

Are Current Pain Assessments Adequate?, Allison Caspersen

MSN Capstone Projects

“Pain is what the patient says it is” has been a big proponent to improve interventions for pain management. But how are we assessing patients’ pain? They have been asked to provide us with a number to rate their pain but what do these numbers mean to the patient? Do they rate according to pain they have experienced in the past or is it based off what they imagine the pain could be? Have we ever distinguished patient preference between unidimensional and multidimensional pain assessment? The use of unidimensional pain assessment the Numerical rating scale (NRS) has been used primarily …

Resiliency Can Be Taught: The Impact Of An Evidence-Based Training On Nurse Resilience, Margaret Maxtin

MSN Capstone Projects

A small project team implemented a resiliency training class as part of an evidence-based nursing intervention. Nurses at a tertiary care facility who work on a pediatric hematology/oncology unit participated in the 2-hour training course and learned multiple skills directed at improving resiliency. All participants surveyed responded positively to the class. Future directions for the project include long term follow-up and continued resiliency classes with varied topics to continue improving resilience and decreasing burnout.

Bridging Mental Healthcare, Kristin L. White

MSN Capstone Projects

Nurses have an important role in the care given to mental health patients presenting to the emergency department (ED). Without expectations or encouragement toward growth or continued education, the quality of care and the therapeutic ability for care are crippled, as evidenced by nurses' knowledge/competency deficits and negative attitudes. Through ongoing/continued education, the cultivation of a therapeutic culture toward patients that present to the ED for mental health complaints could result. Additionally, these improvements in care, in turn, could promote not only the closure of gaps that exist for quality mental healthcare but may also lead to an increase in …

Stroke Education Program To Reduce Readmission, Karnesha Dominguez

MSN Capstone Projects

Stroke is a major cause of long-term disability and mortality in the United States, exemplifying a complex chronic disease with high co-morbidity, associated healthcare costs, and readmission rates. Unfortunately, patients diagnosed with strokes often present to acute care settings with stroke events after they have had been previously diagnosed. Readmission rates among stroke patients are as high as 13% with most readmissions being unplanned and many avoidable (Brom et al., 2021). An estimated 6.6 million Americans aged 20 years and older have had a stroke, and each year approximately 795,000 people experience a new or recurrent stroke (Duncan et al., …

Deterring Delirium In The Intensive Care Unit, Kimberly Allen

MSN Capstone Projects

There is growing concern about the increase in cases of delirium associated with a critical care hospitalization encounter. Discovery of different types of research that can eliminate or at least minimize occurrences of delirium including early recognition, eye masks and earplug usage, and environmental changes have show promise in reducing the risk of ICU delirium.

A Need For Change: Patient Education And Diabetic Control, Meredith Sexton

MSN Capstone Projects

Type II diabetes is a difficult diagnosis for patients to receive. Patients must work through the stigma attached to the diagnosis and understand how it affects their daily lives. It is important for our patients to understand the disease, how to control their blood sugars and how to reduce the risk of preventable complications. This project is based on the following question: “In patients diagnosed with Type II diabetes, how does going to a formal support and education session at least once per week compared to not going to a formal support group affect diabetic control, as measured by patients’ …

Impact Of Nurse Residencies On A Graduate Nurse’S First Year, Melinda R. Fox

MSN Capstone Projects

The purpose of this presentation is to highlight the importance of the graduate nurses first year in their clinical role and highlight the positive impact of nurse residency programs. The target audience for this presentation includes, but is not limited to, the University of Texas at Tyler students and professors enrolled in NURS 5382: Capstone. The observers of this presentation will be able to describe the rationale behind the importance of Nurse Residency Programs, discuss the current literature recommendations, and understand the overview of the change process proposed.

Reducing 30-Day Hospital Readmissions Through Interprofessional Collaboration/Multidisciplinary Team-Based Care Approach: A Benchmark Project, Julius Solis

MSN Capstone Projects

Hospital readmissions are a costly burden that hospitals often must sustain because of current reimbursement policies. The Hospital Readmission Reduction Program (HRRP), a value-based purchasing program, was established to reduce or penalize payment to hospitals for excessive readmissions (Centers for Medicare & Medicaid Services, 2020). Lower financial payments by payors often have a negative impact on a hospital’s overall performance through the inability to purchase new and up to date equipment and materials, budget cuts, downsizing of personnel and departments, amongst all other things. Auerbach et al. (2016) estimate that approximately one-quarter or 26.9% of hospital readmissions were preventable. The …

Standardizing The Superior Preoperative Skin Antiseptic, Marissa Eckeberger

MSN Capstone Projects

Preoperative skin antisepsis is a critical component in the prevention of surgical site infections. Evidence has shown Chlorhexidine to be more effective than Povidone Iodine as well as any other agent, therefor it should be a standard of care for surgical patients. Patients expect to receive exceptional care and have good quality outcomes. Surgery is a means to resolve patient problems, not to develop new ones. Not having a standardized process in place means that patients are subject to receiving substandard care based on which surgeon they have and the surgeon’s preferences. Surgical nurses may be a part of two …

Bedside Handoff In The Emergency Department, Sheila Pochron

MSN Capstone Projects

Background

A standardized approach to bedside handoff improves nurse and patient satisfaction as well as quality outcomes.

Objectives

To compare the preference for bedside handoff in the emergency department post implementation by analyzing nursing surveys and Press Ganey data.

Design

A mixed method pilot study.

Settings

A not-for-profit community-based safety net hospital which is Magnet designated. ED is a level 3 trauma center with 60,000 visits annually.

Participants

ED nurses (n=52) and adult patients (n=86)

Methods

A pre and post implementation survey that utilized the 5-point Likert scale was given to nursing staff in the emergency department. Questions were asked …

Benchmark Study On The Impact Of Nurse Managers’ Leadership Style On Job Satisfaction And Retention Of Nurses, Khatrina Swarup

MSN Capstone Projects

Nurse managers play a crucial role in the healthcare system as they ensure that quality care is maintained and provide the necessary support for the nursing staff to perform their responsibilities well, amongst other duties. Nurses want patients to receive quality, cost-effective care, and these patients want the same. If nurses are happy with their jobs, they provide quality patient care, improving overall patient outcomes. Also, job dissatisfaction predicts how individuals perform at work and whether they intend to leave their position or not.

The current standard of practice does not specify what leadership styles nurse managers or leaders should …

Screening For Human Trafficking: Best Practice Guidelines And Recommendations For Health Care Providers, Bernadette Portillo

Student Scholarly Projects

Human trafficking (HT) is a federal and international crime and is regarded as one of the most pressing human rights issues. Adult and minor victims are trafficked by force (rape, beatings, confinement), fraud, and coercion resulting in profound physical and psychological injuries (Chisolm-Straker et al., 2019, p. 72; Department of Homeland Security, 2020; Vera Institute of Justice, 2014, p. 6). Most clinicians fail to recognize HT victims (Egyud et al., 2017; Leslie, 2018; Mason, 2018; McDow & Dols, 2020; Mostajabian et al., 2019; Patient Safety Monitor Journal, 2017; Stevens & Dinkle, 2020). This policy brief’s purpose is to provide health …

Burnout Among Intensive Care Nurses, Julia Brown

MSN Capstone Projects

At a time when the healthcare system is experiencing strain due to the current health crisis and nursing shortages, talking about, and addressing nursing mental health is of the utmost importance. Nurses who work in the pediatric intensive care unit (PICU) often face more stress due to the patient population they work with. These stresses can lead to burnout and moral distress if not addressed appropriately. Nurses should have a system in place at their workplace and tools readily available to support their mental health while on the job. Through a literature search, it is proposed that an initiation of …

Type 2 Diabetic Education Benchmark Study, Amy Lynd

MSN Capstone Projects

Evaluating the implementation of verbal and written education on diet for newly diagnosed type 2 diabetics.

Assessment Of Conduct Disorder In Primary Care: Integrative Review, Chantel M. Kilford

DNP Qualifying Manuscripts

Conduct disorder and behavioral problems in children are the 6^th most prominent childhood health disorder within the United States of America. Early recognition and interventions have shown to improve outcomes and reduce lifelong adult sequela. Evidence suggests that primary care providers are not confident or knowledgeable about identification and assessment of the disorder. The manuscript examines the prevalence, co-morbidities, trajectories, mortality risk and outcomes of conduct disorder. Health disparities and diagnostic stigma are also addressed. Additionally, the manuscript provides primary care providers with evidence-based research and recommendations for prompt identification and screening. Conduct disorder has devasting individual, social, and …

Reducing Surgical Site Infections Through Combination Skin Preparation: A Benchmark Study, Jennifer Schacherer

MSN Capstone Projects

Reducing surgical site infections allows for a tremendous reduction in healthcare costs, reduces length of hospital stay, decreases hospital readmissions, and promotes patient safety. The Centers for Disease Control and Prevention estimates that surgical site infections have a 3% mortality rate and 75% of all surgical site infection-related deaths are directly attributable to the surgical site infection (Centers for Disease Control and Prevention [CDC], 2020). With millions of surgeries being performed every year, the reduction of surgical site infections enhances patient safety and ensures the protection of the public. Currently, no standard protocol exists for skin preparation beyond the parameters …

Partnering With Hospital Providers To Facilitate Handoff For Persons With Dementia In The Acute Care Setting, Vanessa Jeune

Student Scholarly Projects

Practice Problem: Individuals with Alzheimer's disease and related dementias cannot verbalize their care needs during transitions of care (TOC) and rely on their home caregivers (HCs) for advocacy. The lack of communication between clinicians in one setting and HCs can lead to detrimental health outcomes for the length of stay.

PICOT: The PICOT question that guided this project was: With the assistance of family nurse consultants (P), how does the implementation of standardized care needs communication tool for support persons of persons with dementia (I) vs. no standardized process (C) enhance the ability for the support person to …

Change Project Using A Fall Prevention Action Program To Decrease Falls On A Behavioral Health Unit, Amy Shuptrine

Student Scholarly Projects

Practice Problem: Fall rates are increasing in the behavioral health units of the East Texas hospital. Due to the worldwide COVID-19 pandemic, the units are short-staffed, which further supports the urgent need for a targeted intervention to reduce fall risk.

PICOT: The PICOT question that guided this project was: “In adult behavioral health patients (P), what is the effect of the Edmonson Psychiatric Fall Risk Assessment Tool (I), compared with previous use of the Morse Fall Risk tool (C), on the fall rate (O), in 8 weeks (T)?”

Evidence: Falls are the most reported incidents in acute care hospitals and …

The Need For Change In Mental Health, Autumn R. Lambert

MSN Capstone Projects

In order to properly provide care for patients presenting to the emergency room with exacerbations of mental illness, appropriate education should be provided. Holistic care that has been taught to all healthcare professionals should also be practiced at all times. With the appropriate care being provided, healthcare for patients suffering with a mental illness can find healing care that is free of discrimination and bias.

An Investigation Into The Use Of An Herbal Labor Induction Tincture Containing Black Cohosh, Cramp Bark, Partridgeberry, And Motherwort On Contractile Responses Produced From Isolated Strips Of Mouse Uterine Tissues, Clayton Neuenschwander, Katrina Wu, Teresa F. Degolier

Biological Sciences Faculty Publications

Introduction: Alternative solutions in the form of herbal remedies meant to ease or expedite the process of labor have often been pursued and administered but have seldom been quantitatively tested for efficacy. Published research has shown some validation for some commonly used herbs such as blue cohosh (Caulophyllum thalictroides), red raspberry (Rubus idaeus), castor bean (Ricinus communis) and evening primrose (Oenothera biennis) on isolated mouse uterine strips. Methods: This study tested an array of herbs used by midwives in a labor induction tincture, which included black cohosh (Actaea racemosa), cramp bark (Viburnum opulus), partridgeberry (Mitchella repens), and motherwort (Leonurus cardiaca). …

Implementing Evidence-Based Treatment Of Patients With Opioid Use Disorder In An Inpatient Addiction Treatment Center, Emily Ashley

Doctor of Nursing Practice

Patients with opioid use disorder are at increased risk for overdose and death should they relapse due to reduced opioid tolerance after a period of abstinence. A retrospective chart review was performed at an inpatient drug and alcohol treatment center to identify areas in need of improvement. The global aim of this project was to promote patient adherence to treatment, as well as increase the prevention of patient overdose and death after inpatient treatment. Project objectives include improving provider management of opioid use disorder through standardizing patient education, increasing prescription of relapse prevention medication, initiating prescription of naloxone at discharge …

A Call For Liberty And Justice For All: Unraveling The Complexities In 2021, Dr. Sheila P. Davis

Journal of Health Ethics

This Preface summarizes the articles in this issue. Seven articles are presented with center on liberty and justice for all populations discussed.

Formalizing A High-Risk Obstetrical Initiative: Focus—Hypertensive Disorders, Elena Vulgamott Rodrigue

Doctor of Nursing Practice

Background: Hypertensive disorders during pregnancy have a detrimental effect on maternal and fetal outcomes, causing low birth weights, preterm births, and stillbirths. During pregnancy, hypertensive disorders affect up to 13% of all pregnancies and make up 10% of all maternal mortality in the United States (Centers for Disease Control and Prevention [CDC], 2019). Purpose: The purpose of this DNP project was to implement and standardize a high-risk obstetrical initiative for hypertensive mothers. Summary of Evidence: Data suggest that increased education and increased surveillance for high-risk obstetric patients decreases the need for obstetric services and decreases the evolution of hypertensive …

The Opioid Crisis: Evaluating Current Practices And Outcomes For Neonatal Abstinence Syndrome, Deborah A. Mendoza

Nursing | Senior Theses

Neonatal Abstinence Syndrome (NAS) in the infant are severe symptoms from opioid exposure in utero. These symptoms include: “central nervous system irritability, autonomic over-reactivity, and gastrointestinal tract dysfunction” (Ko et al., 2016). The treatment for NAS can be a combination of drug therapy and non-pharmacological interventions, but a standardized treatment is lacking. A review of this literature aims to evaluate the available interventions that lead to decreased symptom severity, reduction of length of hospital stay, and a reduction in the use of drug therapy. As a result of the literature review, the nurse researcher supports the standardization of treatment and …

Understanding Colorectal Cancer: Increasing Screening Rates Amongst Young- And Middle-Aged Adults By Enhancing Prevention Potential, Sarah Agudelo

Nursing | Senior Theses

As nurses, working towards the best health outcomes for our patients is critical to our care. A large aspect of this care includes being knowledgeable of risk factors and precautions to take to avoid conditions and illnesses. Colorectal cancer remains to be a highly preventable disease, yet it is one of the top five leading causes of cancer deaths in the nation. Preventing colorectal cancer requires the efficient use of screening and education, while also addressing barriers of inconvenience and affordability. This senior thesis delves deeper into colorectal cancer prevention by asking the research question: For young and middle-aged adults, …