Nursing Commons^™

Maximizing Mobility In The Icu, Stephen Kupiec

Master's Projects and Capstones

Problem: In a large tertiary medical center in Northern California, the patients in the 20-bed ICU achieved averaged maximum mobility (AMM) scores well below the regional target. These patients had longer lengths of stay in the ICU and spent more days on ventilators, as compared to patients in other ICUs in the region. Barriers to mobilization included patient diagnosis, sedation practices, staff burnout, insufficient staffing, a knowledge deficit around the safety and benefits of mobility, lack of standard workflows, and lack of interdisciplinary collaboration.

Context: A microsystem assessment focused on metrics-that-matter to determine the focus of this quality improvement project. …

The Impact Of Nurse-Led Initiative Interventions On Cauti, Dalveer Kaur

Master's Projects and Capstones

Problem: National Healthcare Safety Network (NHSN) has reported U.S. hospitals having 0.2 to 4.8 per 1000 catheter-days for adult inpatient units. The insertion of a catheter and delay in removal have a significant impact on morbidity, mortality, length of stay, and reimbursement.

Context: Post-Acute Care Unit (PACU) is a microsystem that provides rehabilitation services for a patient with various post-surgical procedures. The staff of this unit was well aware of policies of catheterizations that led to prolonged use of urinary catheters and an increased rate of CAUTIs in the last quarter of this year. This project aims to increase staff …

Communication Strategies To Promote Infection Control Compliance: My Health Is In Your Hands, Ezra Macabio

Master's Projects and Capstones

Abstract

Problem: The facility has less than 70% adherence to handwashing hygiene every week. Moreover, staff does not comply with the required PPE, affecting their infection-control performance and compliance to circumvent COVID-19. Furthermore, the microsystem lacks information flow and communication systems focusing on hand hygiene, and PPE usage significantly affects the healthcare staff's ability to perform such vital practices.

Context: Herman Health Care Center provides multiple services to its residents depending on medical needs after patient hospitalizations, such as short-term rehabilitation and long-term skilled nursing services. The COVID-19 pandemic had a remarkably negative impact on the skilled nursing facility. The …

Social Determinants Of Health Assessment For Skilled Nursing Patients, Heather Welch

Master's Projects and Capstones

Section I: Abstract

Problem: Skilled nursing facility (SNF) patients are vulnerable, aging, and have complex medical histories. Readmissions from an SNF impact healthcare costs and hospital resources and indicate poorly coordinated transitions home. Patients discharging from SNFs are at risk for higher social determinants of health (SDOH) disparities, such as limited caregiver support, transportation, housing insecurity, and food access. These SDOH risks can significantly increase an SNF patient's risk for hospital readmissions. Assessing and addressing SNF patients' social needs to reduce 30-day post-SNF readmissions can improve health outcomes and positively impact healthcare costs and a patient's financial liabilities.

Context: Frailty, …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

Evaluating Self-Management Of Adults With Multiple Chronic Conditions Residing In Rural Communities: A Descriptive Cross-Sectional Study, Jessica J. Miller

Theses & Dissertations

Background

Chronic diseases are the leading cause of death and disability in the United States and are on the rise. Multiple chronic conditions are increasing in frequency with 1 in 4 adults affected. Behaviors of adults from rural communities are at an increased risk of developing MCC because of limited access to health care resources and behaviors. Supporting the development of self-management skills can help adults be more active in their own health and promote healthy lifestyle behaviors. The Individual and Family Self-management was the guiding framework for this cross-sectional study.

Purpose

The purpose of this study was to determine …

School Of Nursing News, Georgia Southern University

Nursing: News & Publications (2013-2023)

• RN to BSN Program Recognized for Affordability

Addressing Critical Care Nurse Burnout, Julie Suarez

Master's Projects and Capstones

Problem: Critical care nurses are at higher risk for developing burnout than nurses from other areas of clinical practice. If not addressed promptly, the problem of burnout can worsen, negatively affecting the healthcare provider, organization, and patient outcomes.

Context: Increased stress and burnout observed in the microsystem with the onset of the COVID-19 pandemic prompted consideration of ways to address the well-being of critical care nursing staff with targeted interventions that could be implemented quickly with readily available resources.

Interventions: The project aim was to reduce critical care nurse burnout scores through implementation of evidence-based strategies addressing participative management, camaraderie …

Columbia-Suicide Severity Rating Scale (C-Ssrs) Inpatient Perinatal Clinical Pathway, Kristin M. Schoen

Master's Projects and Capstones

Problem: The potential harm to women and infants due to untreated perinatal anxiety and mood disorders is both a patient safety and a public health concern. Studies show that mental health decline during the postpartum period is associated with increased morbidity and mortality for both the mother and infant. The project aim was to utilize the initial screening of perinatal patients using the Columbia-Suicide Severity Rating Scale (C-SSRS) as the baseline screening tool. The tool will help implement a standardized workflow for patients who screen low, moderate, or high, as this workflow had yet to be developed.

Context: In July …

Type 2 Diabetes And A Plant Based Diet, Adrian Brown

Nursing Student Class Projects (Formerly MSN)

I was diagnosed as a Type II diabetic a few years ago when I was living in South Korea working as an English teacher. I, like many of the diabetics that I now take care of, said many of the same excuses that they tell me:

Patient: I heard that I might be pre-diabetic.

Nurse: You are on metformin and your morning glucose is in the 180s.

Patient: I’m not diabetic.

Nurse: You have peripheral neuropathy.

Patient: I watch what I eat. I’m ok.

Nurse: You have hypertension high cholesterol and don’t exercise.

I've said all over those things. But …

The Art Of Emotional Intelligence: Decreasing Lateral Violence Among Nurses, Cheryl Ann Brugger

Theses and Graduate Projects

Nurses work in stressful and complex work environments and, unfortunately, can be subjected to lateral violence. Lateral violence is described as repetitive actions and behaviors of verbal and emotional abuse or acts of incivility from one nurse(s) to another on equal levels of the organizational structure; the behaviors are meant to threaten, harm, or intimidate. Nurses will not stay in an environment that is negative, hostile, and demoralizing; lateral violence can decrease nursing retention rates and increase turnover and job dissatisfaction. Nurses leaving the profession contributing to shortages, poor patient outcomes, and safety concerns. Enhancing nurses’ emotional intelligence may assist …

Racism As Public Health Crisis: Assessment And Review Of Municipal Declarations And Resolutions Across The United States, Dara D. Mendez, Jewel Scott Phd, Rn, Fnp-C, Linda Adodoadji, Christina Toval, Monica Mcneil, Mahima Sindhu

Faculty Publications

Racism in the United States has been cited as a key driver of racial health inequities. Racism as a public health crisis has been in the forefront, particularly with respect to state and municipal governments that have developed legislation, resolutions, and declarations. This policy brief includes a review of resolutions and declarations across the US related to Racism as a Public Health Crisis through the end of September 2020. There were 125 resolutions reviewed for content related to the history of racism, reference to racial health equity data, content related to action steps or implementation, and any accompanying funding or …

Closing Communication Gaps For Unplanned Surgical Patients: One Pre-Op Checklist At A Time, Seda L. Vash

Master's Projects and Capstones

Problem: Unplanned, inpatient surgical patients were experiencing poor outcomes and dissatisfaction with their overall care. This surgical patient population also lacked communication from their healthcare teams with regard to plans of care throughout their hospital stays.

Context: This was a quality improvement project for the unplanned, inpatient surgical patient population in the Central Valley of California. Approximately 13% of this hospital’s surgical patients required post-surgical care in the inpatient units. These patients, according to unfavorable HCAHPS scores, experienced unsatisfying care and insufficient communication from their healthcare teams, including physicians and nurses.

Intervention: This project implemented an Add-On Communication Tool for …

Racism As Public Health Crisis: Assessment And Review Of Municipal Declarations And Resolutions Across The United States, Dara D. Mendez, Jewel Scott Phd, Rn, Fnp-C, Linda Adodoadji, Christina Toval, Monica Mcneil, Mahima Sindhu

Faculty Publications

Racism in the United States has been cited as a key driver of racial health inequities. Racism as a public health crisis has been in the forefront, particularly with respect to state and municipal governments that have developed legislation, resolutions, and declarations. This policy brief includes a review of resolutions and declarations across the US related to Racism as a Public Health Crisis through the end of September 2020. There were 125 resolutions reviewed for content related to the history of racism, reference to racial health equity data, content related to action steps or implementation, and any accompanying funding or …

Improving Patient Knowledge On Medication Communication, Deborah Cha

Master's Projects and Capstones

Abstract

Problem: Effective medication communication, including potential side effects, is a key determinant of safe patient care and better health outcomes. 3SA scores a 1-2 out of 5-stars for medication communication with the HCAHPS survey from October 2020-March 2021.

Context: As one of the medical-surgical units at this California hospital, it serves the purpose of providing medical and/or surgical management to acutely ill patients. The unit is a 24-bed, 1:5 nursing ratio with medical-telemetry and Covid-19 overflow.

Intervention: The interventions include a structured, evidence-based multi-component program in improving patient knowledge about new medications they receive, the possible side effects of …

Discharge From Hospital To Home: Implementation And Use Of The Ahrq Ideal Chf Discharge Planning And Aha Chf Discharge Checklist, Eric Jason Byrd

Master's Projects and Capstones

Section I: Abstract

Problem: Hospital readmission rates in the congestive heart failure (CHF) population is a quality concern. As excessive readmissions tend to indicate low quality of care, government and private healthcare payers are increasing their focus on 30-day readmission rates as a new quality measure for hospitals.

Context: This was a quality improvement project for a telemetry unit at a medical center in the Central Valley of California. There are 56,551 members in the Central Valley enrolled in the healthcare provider system and 2,567 patients with a primary or secondary diagnosis of CHF. Within the healthcare system, CHF was …

Enhanced Recovery After Surgery Ambulation Project, Jennifer M. Rose

Master's Projects and Capstones

Abstract

Problem: The enhanced recovery after surgery (ERAS) Ambulation Project aims to increase early ambulation of cesarean section patients in the maternal child inpatient unit. The current data has shown inconsistency with the application of the ERAS program with the maternal population. Instituting standardization of care and documentation, along with increasing patient centered care, has the potential to decrease the hospital length of stay (LOS).

Context: This quality improvement project standardizes the education provided to staff nurses and patients; allotting more time for staff to create meaningful relationships with their patients. A microsystem culture utilizing patient centered care …

Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao

Master's Projects and Capstones

Abstract

There are multiple layers of oversight across the healthcare delivery system. Measuring acute hospital readmissions has been identified as an important outcome measure of quality care. Our patients are one of the major stakeholders in the healthcare system. One role of a clinical nurse leader is to integrate evidence-based leadership practices that identify and assess outcomes, mitigate risk, enhance health promotion, deliver highly effective patient care, and ensure transparent relationships with stakeholders. Rationales for examining and re-designing the readmission analysis workflow based on the customer’s experience are discussed in this paper. The global aim of the project is to …

Exercise As Self-Care To Combat Nurse Burnout, Jessica Petefish

Theses and Graduate Projects

The demands on nurses continue to grow, inducing stress and other symptoms of burnout. Nurse burnout can cause short and long term physiological and psychological symptoms. Nurse burnout not only affects nurses but has implications for patients and hospitals as well. Exercise has been proven to have many health benefits and the ability to alleviate symptoms of burnout. Nurses on a hematology/oncology unit cited burnout as their reason for leaving the unit. This project proposes a walking program as a self-care method to reduce symptoms of nurse burnout. Utilizing Jean Watson’s Theory of Human Caring and her idea of self-care …

Distress Evaluation During Chemotherapy: The Real-Time Assessment Strategies For Oncology Nurses Among Asian Population In Outpatient Clinics, Ying Huang

DNP Qualifying Manuscripts

Background: Routine oncology visits failed to identify 50-94% of patient’s distress, which creates a considerable burden, impairs emotional well-being and reduces patients’ quality of life. Limited in-person visits during the COVID-19 pandemic have reduced access to care for many patients, further adding to their emotional distress. Untreated distress also leads to elevated stress levels, systemic inflammation, non-compliance with treatment, and higher mortality rates. Early distress screening and multidisciplinary care are recommended to reduce the impacts of distress.

Objectives: To identify the best outpatient practices to address newly diagnosed cancer patients’ unique needs due to distress.

Methods: Databases searched including CINAHL® …

Ischemic Stroke, Brett Winner

Nursing Student Class Projects (Formerly MSN)

Cerebrovascular accident, or stroke, as it is referred to is a serious neurological event that affects almost 800,000 people in the United States annually, of which approximately 87% is ischemic in nature. Ischemic stroke is mostly caused by atherosclerotic plaques that develop due to endothelial injury in vessels that supply blood flow to the brain. An ischemic stroke can be the result of thrombi breaking off from vessels in the brain, emboli from outside the brain, or small vessel stenosis, all of which occlude a vessel within brain and cause tissue ischemia. When perfusion to portions of the brain is …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

Hypertension, Bethany Stemen

Nursing Student Class Projects (Formerly MSN)

Hypertension is called the “silent killer” and can cause organ damage. This poster focuses on signs and symptoms of hypertension, along with the pathophysiology of hypertension. It also gives insight on how to manage and treat high blood pressure and ways to prevent hypertension. Knowledge is power and knowing the impact and ways to treat and prevent a problem is essential.

Responding To Parents' Questions Regarding Polysorbate 80, Aluminum, And Thimerosal In Vaccines, Elli Hugh, Beth Luthy

Student Works

Vaccines save millions of lives worldwide every year. Nevertheless, misinformation regarding vaccine ingredients circulates on various media platforms and may negatively influence parental decisions regarding childhood vaccinations. Three vaccine ingredients commonly associated with parental vaccine concerns include polysorbate 80, aluminum, and thimerosal. Common misconceptions about polysorbate 80 and neurological sequela exist within the vaccine hesitant community. Additionally, aluminum has been incorrectly connected to chronic disease in children. Though proven that thimerosal does not cause autism, vaccine critics have now inaccurately reformed the argument claiming that it is the combination of thimerosal and aluminum that causes autism. The purpose of this …

Exploring And Understanding The Culture Of Young Adults Who Vape: A Focused Ethnography, Beth Tremblay

Electronic Theses and Dissertations

Introduction: Vaping, the act of inhaling an aerosolized liquid, is associated with health risks. The 18- to 25-year-old age group has the highest rate of vaping among adults. Understanding culturally held values, beliefs, and experiences associated with the behavior of vaping in young adults may uncover the social mechanisms that underpin vaping initiation and influence continued use. The purpose of this study was to explore and understand the cultural values and beliefs about vaping among young adults. Method: The method used for this study was a focused ethnography. Young adults who currently vape nicotine (N=24) were recruited via snowball method …

Student Nurse Knowledge And Confidence Regarding Childhood Immunizations, Heather Westergard

Theses and Dissertations

Background: Immunization training is essential for nursing students. However, Brigham Young University's (BYU) Nursing Program lacks data regarding the current curriculum's effect on vaccination knowledge and confidence. Purpose: The purpose of the study is to explore BYU nursing students' knowledge and confidence regarding vaccinations. Methods: Nursing students at BYU in the second and fourth semesters were surveyed using pre-and post-test questionnaires designed to measure student nurses' knowledge of and confidence about immunizations. To help evaluate current curricula established immunization content was taught during both the public health course and pediatric course via direct instruction, assigned reading, quizzes, exams, lab, and …

Mindfulness-Based Intervention And Relapse Rates In Adults With A History Of Substance Use Disorder, Tamieko Ross-Anyaso

Student Scholarly Projects

Practice Problem: Substance abuse disorder (SUD) has become an increasingly prevalent community health problem worldwide, affecting individuals in all geographical regions regardless of age, race, sex, and socioeconomic status, despite decades of efforts to find a solution (Bowen et al., 2014). A lack of treatment engagement and substance‐misuse crisis calls attention to the effectiveness of relapse‐sensitive care and treatments.

PICOT: The question addressed in this evidence-based project was “ In adults over 18 years of age with substance use disorder (P), how does the effect of mindfulness-based treatment (I), compared with no mindfulness-based treatment (C), reduce the risk of relapse …

Improving Mammography Rates Among The Hispanic Population: An Evidence-Based Project Utilizing A Promotora Intervention, Dawn Mirowski

Student Scholarly Projects

Practice Problem: Breast cancer is the leading cause of death in Hispanic women in the U.S., with mammography being the most effective means of reducing breast cancer mortality. Promotoras have been shown to improve health promotion, including mammography, among the Hispanic population.

PICOT: The PICOT question that guided this project was: In Hispanic women 40 years or older (P), how does the use of a promotora intervention (I), compared to no promotora intervention (C), affect mammography rates (O) within an 8-week period (T)?

Evidence: Twenty-one studies that met the inclusion criteria supported the use of promotoras to improve mammography …

The Impact Of Covid-19 On Healthcare Delivery For People Who Use Opioids: A Scoping Review., Karen Alexander, Monika Pogorzelska-Maziarz, Angela Gerolamo,, Nadia Hassen, Erin L Kelly, Kristin L. Rising

College of Nursing Faculty Papers & Presentations

RESEARCH OBJECTIVE: The COVID-19 pandemic disrupted healthcare delivery worldwide with likely negative effects on people who use opioids (PWUO). This scoping review of the original research literature describes the impact of the COVID-19 pandemic on healthcare delivery for PWUO and identifies gaps in the literature.

METHODS: This scoping review of the original research literature maps the available knowledge regarding the impact of the COVID-19 pandemic on healthcare delivery for PWUO. We utilized the methodology developed by the Joanna Briggs Institute for scoping reviews, and content analyses methodology to characterize the current state of the literature.

RESULTS: Of the 14 included …

Acute Respiratory Distress Syndrome, Amanda Kleinfelder

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a life-threatening condition caused by damage in the lungs leading to persistent hypoxemia. The alveoli in the lungs become filled with fluid from damage to the pulmonary capillaries due to inflammatory mediators. The buildup of fluid in the lungs ultimately result in intubation of the patient and mechanical ventilation (Senapathi et al., 2020). ARDS has become more prevalent today with the 2020 Covid-19 pandemic affecting 200 countries resulting is 1.1 million deaths so far (Weiss et al., 2021). Multiple therapies exist for the management of ARDS including prone positioning, deep sedation, and mechanical ventilation …