Implementing A Hospital-Acquired Pressure Ulcer Intervention In The Icu, Audrey Gross

Doctor of Nursing Practice Projects

Background: Hospitals had been confronting greater incentives to prevent Hospital-Acquired Pressure Ulcers (HAPUs). HAPU rates had increased in the Intensive Care Unit (ICU) at an academic hospital over the past six months, especially regarding device related HAPUs.

Objectives: The primary purpose of this project’s implementation was to decrease the number of HAPUs in the ICU by 50% within a three-month timeframe. Secondary objectives were to achieve scores of 100% in terms of compliance with the Registered Nurse (RN) education module, post-test scores, and documentation.

Methods: This was a Quality Improvement (QI) project involving adult patients in the ICU of an …

Pineal Gland Abnormalities And The Relationship Of Melatonin To The Development And Symptom Severity Of Schizophrenia: An Integrative Review Of The Literature, Kathryn Margretta

Honors Undergraduate Theses

The purpose of this thesis is to critique the literature focusing on the role of pineal gland volume and function and the development of schizophrenia by asking the question, "What is the relationship between pineal gland physiologic function and development and symptom severity of schizophrenia? It is crucial that health care providers continue advocate for better understanding of schizophrenia in order to develop a more appropriate treatment and relive the suffering of those with schizophrenia. A review of published literature focusing on the pineal glands association with schizophrenia was performed using several databases including: ScienceDirect, PubMED, Google Scholar, Cumulated Index …

Cognitive Rehearsal, Self-Efficacy, And Workplace Incivility Among Baccalaureate Nursing Students, Alina Diaz-Cruz

Electronic Theses and Dissertations, 2020-2023

Workplace incivility is a widespread problem in the clinical work environment that affects present and future generations of nurses. The purpose of this study was to determine if a cognitive rehearsal intervention (i.e., TeamSTEPPS® DESC script) would increase senior nursing students' self-efficacy, decrease workplace incivility experienced in the clinical work environment, and if nursing students' pre-intervention self-efficacy level would be indirectly associated with post-intervention workplace incivility. A quasi-experimental, one-group pretest-posttest study was used to measure the effect of a cognitive rehearsal intervention on nursing students' self-efficacy levels and workplace incivility experienced in their clinical rotation at an acute care center. …

Educating Nursing Students Through The Pandemic: The Essentials Of Collaboration, Audrey M. Beauvais, Meredith Kazer, Lisa M. Rebeschi, Rosemarie Baker, Jeanette H. Lupinacci

St. Vincent’s College Faculty publications

Introduction: Throughout the COVID-19 pandemic, meeting regulatory educational requirements and graduating students competent for nursing practice was essential. Competent graduates were needed to support a strong nursing workforce in Connecticut during this chaotic time in health care. This paper describes the powerful impact of statewide collaboration toward meeting this goal.

Methods: The Connecticut League for Nursing Council of Deans and Directors (Council) organized six work groups to address the practice issues brought about by COVID-19 to continue educating nursing students and ensure a robust nursing workforce for the state. Volunteers from the Council offered to lead the groups and members …

Improving Emergency Department Quality Of Care, Carmen Smith

Doctor of Nursing Practice Projects

Emergency department (ED) crowding can cause an extended length of stay (LOS) and high rates of patients who leave without being seen (LWBS). This quality improvement ED project sought to reduce LOS and LWBS by implementing a triage (PIT) team. The design included an outcomes evaluation with available data and a staff pre and posttest. Length of stay and LWBS rates were compared before and after implementation. Results indicated a reduction in the average LOS and LWBS rates for the 30 days of project implementation compared to the 30 days before the project initiation. The overall goal of the PIT …

Student Registered Nurse Anesthetist Perspective On The Impact Of A Clinical Mentoring Program, Sheila M. Mccarley

Doctor of Nursing Practice Projects

There is a competitive push for recruiting and retaining the Student Registered Nurse Anesthetist (SRNA) graduate. Retention efforts begin with their first clinical experience. Mentoring in the clinical setting is a critical factor in influencing the student nurse anesthetist's retention to practice. The purpose of this project was to assess whether mentoring in the local setting noted similar findings. The method involved a survey of student nurse anesthetists queried about perspectives on a clinical-based mentorship program. Certified Registered Nurse Anesthetist (CRNA) faculty members vetted the survey instrument before implementation. The project focused on students presently enrolled in their first-year clinical …

Implementation Of An Evidence-Based Copd Screening Tool In Primary Care, Randi Davis

Doctor of Nursing Practice Projects

Chronic obstructive pulmonary disease (COPD) is one of the most common chronic illnesses encountered in primary health care, with more than 16 million identified cases and many more undiagnosed. The condition is frequently not diagnosed until later stages due to its insidious onset. Once diagnosed, the disease is often inadequately treated. The purpose of this quality improvement project was to implement an evidence-based practice tool. The project team selected the COPD Assessment Tool [CAT], which ensured Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The device provided screening for individuals "at-risk" or with a known diagnosis of COPD. The …

Use Of A Simplified Protocol For The Prevention Of Postoperative Nausea And Vomiting In Adult Ambulatory Surgical Patients, Roger Horne

DNP Scholarly Projects

Postoperative nausea and vomiting (PONV) remains a common complication affecting surgical patients after receiving anesthesia. Prevention of PONV is important in an ambulatory surgical setting where patient access to rescue treatment is limited after discharge. A quality improvement (QI) project introduced a simplified PONV prevention strategy to decrease the incidence of PONV at a Veterans Health Administration ambulatory surgery center. A retrospective chart audit of all facility surgical patients receiving anesthesia care (n = 94), excluding ophthalmology patients, was conducted prior to COVID-19 restrictions to establish baseline PONV incidence. An evidence-based, simplified PONV prevention protocol was developed and implemented. …

Impact Of A Comprehensive Clinician Educational Program On Health Literacy And Patient Satisfaction, Jennifer Yokopenic

DNP Scholarly Projects

BACKGROUND: The Institute of Medicine has defined health literacy as “the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”. Health literacy is a significant social determinant of overall health and can be particularly challenging in the critical care environment. According to the U.S. Department of Health and Human Services, only 12% of adults have proficient health literacy, 53% have intermediate health literacy, 21% have basic health literacy ability, and 14% have below basic health literacy (AHQR.gov, 2008).

METHODS: A pre- and post-intervention survey of satisfaction with clinician communication and assessment of …

Reducing Turnaround Time From Pathology Collection To Patient Awareness In Gastroenterology Practice, Adrianna Hyams

DNP Scholarly Projects

Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.

Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project. …

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …

Addressing Medical Mistrust In In-Patient Psychiatric African American (Aa) Patients, Eselle Molua

DNP Scholarly Projects

Abstract

Background: Medical Mistrust (MM) is associated with patient dissatisfaction, treatment nonadherence, and poor health outcomes. In the United States, MM is prevalent in African American patients in In-Patient Psychiatric settings. Caregiver training and education on MM and cultural sensitivity can help identify mistrust and provide strategies to increase trust and reduce mistrust.

Purpose: The aim of this project was to implement an educational tool to improve caregiver awareness about knowledge of MM. By doing so, it was the goal to enhance cultural sensitivity skills and patient-centeredness in the African American population at the adult psychiatric unit in Northwest …

Implementation Of Community Health Worker Education Toolkit To Promote Compliance In Managed Care Organization, Lamonica Johnson

DNP Scholarly Projects

Community health workers provide case management and care coordination services to high-risk members enrolled in Louisiana Department of Health’s Medicaid program. Centers for Medicare and Medicaid Services require states entering contracts with managed care organizations to conduct external quality reviews by an independent External Quality Review Organization. Healthcare Effectiveness Data and Information Set are quality metrics managed by the National Committee for Quality Assurance. These metrics are reported annually and required by Louisiana Department of Health. Community health workers are required to demonstrate quality accreditation and meet state specific requirement compliance through documentation. The aim of this project was to …

The Flame, 2021-2022, Mennonite College Of Nursing

The Flame (1985-present)

The Flame is a newsletter of Illinois State University's Mennonite College of Nursing

Staff Education To Improve Pain Management In Skilled Nursing Patients, Keitta Evans

Walden Dissertations and Doctoral Studies

One of the key ethical principles in nursing is the promotion of health and wellness and ensuring that patients are free from unnecessary pain and suffering. It is estimated that at least 65% of patients in skilled nursing centers in the United States report the presence of pain, indicating that there are opportunities for improvement with effective pain management within this practice setting. A key factor that has been identified as an opportunity for improvement is education for clinical staff who practice within this setting. This Doctorate of Nursing Practice (DNP) project provided education to a group of clinical team …

Nursing Interventions For Reducing Falls Among Older Adults On Polypharmaceutical Agents, Kevin O. Onuekwusi

Walden Dissertations and Doctoral Studies

In the United States, the cost of treating a resident of a long-term care facility (LTC) after a fall with injury is between $10,000 and $26,000. Current nursing interventions for fall prevention among older adults aged 65 years and over at the local LTC do not address the risk of polypharmacy and are focused on environmental and intrinsic factors. The purpose of this systematic literature review was to find the nursing interventions that have been used to reduce falls in older adults aged 65 years and over in nursing homes and LTCs who are on polypharmaceutical therapy. Primary research articles …

Caring For The Caregiver: Second Victim Recovery Following A Serious Medical Error, Beulah Patrice Vance

Walden Dissertations and Doctoral Studies

In 1999, it was estimated that 98,000 deaths were attributed to medical errors and were the fourth most common cause of death in the United States. In 2016, medical errors were estimated as the third leading cause of death, with a mean death rate of 251,454 each year. Nurse involved in errors are known as second victims. Almost one in seven staff members reported that they had experienced a patient safety event within the last year that caused personal problems such as anxiety, depression, or concerns about their ability to perform their job. This project explored whether nurses are able …

Comparative Analysis Of Systemic Lupus Erythematosus Support Group Type On Quality Of Life, Mary Louise Giles

Walden Dissertations and Doctoral Studies

When individuals are diagnosed with systemic lupus erythematosus (SLE), they tend to go through emotional, psychological, and physical anguish that requires support. Studies have shown that a support group can provide SLE patients with an outlet in which they can share firsthand feelings and experiences and receive emotional support but it is not known if how the individual with SLE accesses online or face to face support makes a difference. The purpose of this study, guided by the Chronic Care Model, was to determine if there were differences in quality of life (QoL) for persons with SLE participating in an …

Increasing Access To Diabetic Self-Management Education Using Telehealth In Rural Kentucky, Gina Good

Walden Dissertations and Doctoral Studies

The lack of diabetic self-management education (DSME) can affect generations of families who have suffered from diabetes. More than 80% of Appalachian Kentucky counties lack access to DSME and care due to high incidence of diabetes. The purpose of this quality improvement project was to determine whether the use of telehealth increased patient access to DSME in Southeast Kentucky. Application of Peplau’s theory of interpersonal relations to patient relationships in nursing practice provided a framework for the project. De-identified retrospective data 6 weeks before intervention and 6 weeks postintervention were collected by the project facility for secondary data analysis to …

Clinical Practice Guidelines For Assessing And Reporting Workplace Violence Against Nurses, Janice Lynn Canfield

Walden Dissertations and Doctoral Studies

AbstractWorkplace violence consists of physically and psychologically damaging actions while on duty. In healthcare, under a cloak of secrecy concerning workplace violence, an underreported epidemic exists. This problem is important to address because workplace violence can affect the quality of care delivered and patient care outcomes.. The purpose of this project was to develop a nursing clinical practice guideline (CPG) to assist hospital-based nurses to identify risk factors for workplace violence, identify strategies to mitigate violence, and report workplace violence. This CPG can be an effective tool for nurses to better understand the scope and nature of violence in the …

Nurse-Patient Ratios And Falls In The Acute Care Setting: A Staffing Educational Program, Trinia Shawell Williams

Walden Dissertations and Doctoral Studies

AbstractThe correlation between patient falls and nurse-patient ratios in acute care has been a prevalent topic for decades. The lack of nurse-patient ratio guidelines to direct nurse staffing has restricted nursing leaders’ efforts to address this issue. The purpose of this staff education project was to educate nursing leaders on nurse-patient ratios and their association to patient falls. The practice-focused question centered on whether education would increase nursing leaders’ knowledge about appropriate staffing ratios and practices to reduce falls at a long-term acute care facility. Rogers’s diffusion of innovations theory was the change model used to guide this project. There …

Exploring The Effects Of Generation And Leadership Style On Nurses’ Organizational Commitment, Kim M. Hedley

Walden Dissertations and Doctoral Studies

There is an impending shortage of nurses; therefore, healthcare leaders must use strategies that promote staff nurses’ organizational commitment (OC) to retain a clinically competent workforce. The purpose of this quantitative descriptive cross-sectional study guided by the transformational leadership theory and generational theory was to determine whether OC differs according to generational cohort (GC) and leadership style (LS) and then explore the combined effects of GC and LS on staff nurses’ OC. One-hundred sixty acute care staff nurses in the United States responded to the survey that included the Multifactor Leadership Questionnaire 5x-Short and Three-Component Model Employee Commitment Survey. A …

Effects Of Education On Rural Emergency Department Preceptors’ Self-Efficacy And Knowledge, Katherine Marie Jasper

Walden Dissertations and Doctoral Studies

The Emergency Nurses Association recommends nurse preceptorship programs for emergency departments (EDs) to give nurses the skills needed for precepting new nurses; however, many rural areas do not have nurse education for preceptorship, and no standardized training is available for preparing preceptors for their roles. Rural ED preceptors therefore lack knowledge and skills needed for precepting new nurses. The purpose of this study, guided by Benner’s skill acquisition and self-efficacy theory, was to determine if there were significant differences in 33 rural ED nurse preceptors’ knowledge and self-efficacy after they completed an online informational PowerPoint presentation. The PowerPoint education program …

A Systematic Review Of Tobacco Cessation Strategies Tailored For Military Personnel, Ni Ketut Supiyati

Walden Dissertations and Doctoral Studies

AbstractA Systematic Review of Tobacco Cessation Strategies Tailored for Military Personnel by Ni Ketut Supiyati

MS, Walden University, 2000

Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021

Use Of Critical Thinking Strategies By Nurse Educators, Josephine Tundun Akintonde

Walden Dissertations and Doctoral Studies

AbstractNew graduate nurses often lack the clinical decision-making skills that are essential for developing clinical competency. Critical thinking abilities are essential for nursing excellence and professional competency. However, little is known about nurse educators' techniques and teaching practices for developing students’ critical thinking. The purpose of this phenomenological study, guided by constructivist learning theory, was to understand the lived experiences of nurse educators who used critical thinking teaching strategies in a baccalaureate nursing program to develop critical thinking skills in nursing students. Thirteen nurse educators from baccalaureate nursing programs were interviewed using open-ended questions. Interviews were transcribed and manually coded. …

An Integrated Approach To Hand Hygiene, Tarsha Renee Stewart

Walden Dissertations and Doctoral Studies

AbstractHealthcare-associated infections (HCAIs) threaten the quality and safety of the services provided. HCAIs are infections that occur while a patient is receiving treatment for another condition in any type of healthcare. The Centers for Disease Control estimates that approximately one in every 20 inpatients will become infected with an HCAI during their hospital stay. Proper hand hygiene is the most significant intervention in preventing HCAIs. Despite hand hygiene's effectiveness, evidence suggests that only 50% of healthcare workers are compliant with proper hand hygiene techniques. The purpose of this project is to increase nurse’s knowledge the via education. Kotter's eight-step change …

Staff Education Program On Smoking Cessation In Patients With Cardiovascular Disease, Jennifer Shipp

Walden Dissertations and Doctoral Studies

Cigarette smoking in the United States constitutes a public health crisis, with millions of people having cigarette-related diseases and comorbidities. Although there is an increased prevalence of uncontrolled smoking among patients with cardiovascular diseases, many healthcare facilities, including the project site, lack adequate screening for tobacco use among cardiovascular patients. The 5As (asking, advising, assessing, assisting, and arranging) model of behavioral change provided the framework for the project. The practice-focused question for this project addressed whether a staff education program specifically designed to instruct healthcare providers on using the 5As intervention with cardiovascular patients would increase their knowledge of smoking …

The Evaluation Of An Amino Acid- Oral Re-Hydration Solution (Enterade®) To Improve Quality Of Life In Solid Tumor Cancer Patients By Reduction Of Chemotherapy Related Diarrhea, Holly Chitwood

DNP Projects

Background: Chemotherapy related diarrhea (CRD) is a common adverse effect of many chemotherapy agents used to treat cancer. CRD negatively affects quality of life (QOL) for cancer patients and often results in treatment delays, hold, dose reductions, and hospitalizations affecting morbidity and mortality. Proper management of CRD with novel therapeutics is needed to improve the quality of life and patient outcomes for this population.

Purpose: The purpose of this study was to evaluate the use of a proprietary amino acid-oral rehydration solution (AA-ORS) known as Enterade® to reduce the severity of CRD, to improve patient reported QOL among patients over …

Large Scale Organizational Intervention To Improve Emergency Department Throughput In A Community Hospital, Karen Elliott

DNP Scholarly Projects

Abstract

BACKGROUND: Emergency Department boarding is a well-documented systemic problem across the country. ED-2b, the time from decision to admit a patient to Emergency Department departure, is specified by the Joint Commission as a quality measure for Emergency Department boarding. ED-2b metrics have been a longstanding challenge at this community hospital outside the nation’s capital. The aim of this study was to reduce median ED-2b times by 10% compared to fiscal year 2020 (FY20). To accomplish the reduction in time, a multidisciplinary throughput committee was developed with subsequent action plans designed to improve Emergency Department throughput.

METHODS: The Plan Do …

Improving Emr Usability And Clinical Efficiency Using An Immunization Tool For School Nurses In A Primary School Setting, Cathy Loiselle

DNP Scholarly Projects

BACKGROUND: School nursing has a foundation in population health and an essential role within the community, which needs to be structured by the developing field of health informatics in order to compete and communicate with all stakeholders. This quality improvement project specific aim was to improve the electronic medical record (EMR) usability and clinical efficiency.

METHODS: A school district with three elementary, one high and one middle school was chosen, using the school information system (SIS)/EMR currently in place at each school health office. The school health staff participating in this project included 5 registered nurses and 5 clinic assistants. …