Nursing Commons^™

Using Infographics To Improve Completion Rates Of The Sepsis Protocol Bundle, Stephen Newbern

Doctor of Nursing Practice Projects

Hospitals have sepsis protocols that must be implemented when a patient shows positive signs and symptoms of a septic infection. Nurses learn about sepsis in nursing school and rarely further their education beyond this basic understanding of the disease. So, when nurses fail to comply with organizational instructions outlined within a defined sepsis protocol bundle, this often leads to a progression of severe sepsis in a patient and, most likely, increased cost for the healthcare facility. Multiple sepsis protocol bundle failures negatively impact organizational ratings established by The Joint Commission for patient care and are highly associated with increased sepsis …

Re-Educating Healthcare Workers In Long-Term Care Facilities To Improve Hand Hygiene Compliance, Jennifer A. Ukeje

Doctor of Nursing Practice Projects

Hand hygiene is one of the most significant measures for protecting nursing home residents from healthcare-associated infections (HAIs). An estimated 1.6 million to 3.8 million infections occur each year; of these infections, 32% of all healthcare-associated infections (HAIs) are urinary tract infections (UTI), 15% are pneumonia (lung infection), and 14% are bloodstream infections. The high incidence of HAIs in nursing homes is due to multiple factors such as understaffing, inadequately trained staff, staff to resident ratio, lack of antibiotics stewardship, and the increasing clinical complexity of the average nursing home. In addition, most long- term care (LTC) residents are older …

Increasing Compliance On Pain Reassessment At A Rural Hospital Swing Bed Unit, Stephanie Melson

Doctor of Nursing Practice Projects

The overarching goal of this project is to ensure patient pain reassessment is completed on all patients in accordance with the facility and The Joint Commission (TJC) standards after the intervention. The last four surveys of the rural critical access hospital yielded subpar results showing noncompliance with pain reassessment. Utilizing quality improvement measures such as staff education and charting reminders, gaps in practice were found and utilized to optimize the care to patients related to pain and reassessment. The study seeks to improve the pain reassessment skills and compliance of nursing staff at a rural critical access hospital. Initial non-compliance …

Mentoring New Graduate Nurses To Promote Staff Retention, Elsie Anwah

Doctor of Nursing Practice Projects

Nursing mentoring programs promote professional socialization in new graduates to increase patient safety, enhance clinical competency, improve job satisfaction, and reduce turnover. A structured mentoring program helps the new graduate experience a more controlled and intentional learning experience. Implementing a well-designed experience helps to increase job satisfaction and decreased turnover. The mentorship program utilized Patricia Benner’s theory ‘From Novice to Expert model.’ The project design was based on quality improvement which followed the focus, analyze, develop, execute, and evaluate (FADE) methodology. The goal of the project was to measure the intent to stay of new graduate nurses through Intent to …

Improving Suicide Risk Assessment Through Educational Program Implementation, Timothy Booth

Doctor of Nursing Practice Projects

Background: Unsustainable behavioral health education focused on comprehensive suicide risk assessment performance contributes to decreased registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients.

Purpose: To educate medical-surgical and progressive care registered nurses in assessing patients for suicide risk factors and warning signs comprehensively.

Design Method: A quasi-experimental designed quality improvement project with evidence-based suicide educational program implementation. Project results yielded a 56.7% increase in registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients. Future DNP work will focus on sampling a larger population (N) to decrease opportunities for the skewness of project results …

Can Provision Of Additional Education For Nursing Staff Increase Breastfeeding Knowledge And Feelings Of Self-Efficacy?, Akeba Deqwan Thompson

Doctor of Nursing Practice Projects

Background: Post-partum nurses are responsible for preparing new mothers with the necessary skills to feed and care for their infants and need proper education to effectively and confidently discuss feeding options with their patients.

Purpose: This quality improvement project aims to increase nursing knowledge of breastfeeding and their feeling of self-efficacy in promoting breastfeeding as an option to new mothers.

Design Methods: A quasi-experimental design including a pre-test/post-test used to quantify the effect of education on therapeutic communication, nursing responsiveness, and feelings of self-efficacy.

Conclusion: An overall increase in feelings of self-efficacy and knowledge of breastfeeding was noted amongst nursing …

Implementing An Antibiotic Stewardship Education Program To Decrease Antibiotic Prescriptions In An Urgent Care Clinic, James Gramling

Doctor of Nursing Practice Projects

Antibiotics are often prescribed for respiratory infections. These infections often have a viral rather than a bacterial source. Overuse of antibiotics is associated with increased potential for adverse effects, increased healthcare costs, and increasing antibiotic resistance. The purpose of this DNP project was to determine if implementing an antibiotic stewardship program at an urgent care clinic would decrease the number of antibiotic prescriptions written for acute respiratory tract infections. An educational session consisting of didactic and PowerPoint presentations was provided to each provider at the urgent care clinic. Medical records were reviewed for four weeks after completion of the session …

A Quality Improvement Project To Improve The Management Of Patients At Risk For Falls, Crystal Medici

Doctor of Nursing Practice Projects

Background: Falls are one of the most common adverse events in the hospital. Falls can result in injury, increased hospital length of stays, increased costs and use of hospital resources, and death. The risk of falling is even higher for hospitalized patients due to unfamiliar environments, new medications and treatments, acute illness symptoms, surgery, bed rest, lines, tubes, and catheters.

Purpose: This quality improvement project aimed to increase awareness of the importance of fall prevention in the hospital setting and educate nursing staff on fall prevention to decrease patient falls.

Methods: This project utilized a quasi-experimental study design that includes …

Differences In Student Perceptions With Virtual Clinical Simulation, Melissa Wheeles

Doctor of Nursing Practice Projects

Background: Simulation has been a part of nursing education since its inception, with virtual clinical simulation gaining expanded use since the Coronavirus Pandemic. Once considered only a supplemental teaching method, this form of education has become an imperative means of program progression for nursing students when hospital clinical spaces are limited.

Purpose: The purpose of the study is to evaluate potential differences in nursing student perceptions of anxiety and self-confidence with clinical decision making in virtual clinical simulation compared to traditional face-to-face clinicals.

Design Methods: A descriptive, quantitative study using the NASC-CDM© tool completed by 5th (final) semester …

Fall Prevention: The First Line Of Defense. Integration Of Innovated Strategies To Decrease Falls For The Hospitalized Patient, Milledge Smalls

Doctor of Nursing Practice Projects

Background: Falling is defined as an accidental encounter with the ground or other surfaces. Individuals with dementia are at a greater risk for falls due to conditions such as neurological impairments in perception or cognition. Presently, 50 million people live with dementia worldwide, which is projected to increase to 152 million by 2050 because of a rise in life expectancy and an aging population. The incidence of falls has rapidly become a major public health problem around the world. Approximately 30% of people older than 65 years of age fall each year, and patients with dementia cost the nation $236 …

Preventing Complications Of Undiagnosed Diabetic Peripheral Neuropathy In Rural Healthcare Settings, Kendra Ward Harris

Doctor of Nursing Practice Projects

Background: Diabetic peripheral neuropathy (DPN) affects the lives of approximately 50% of all persons diagnosed with diabetes. Patients who are minorities, residents of rural communities, low income, or non-compliant with treatment, have a higher risk of developing DPN. The long-term effects interfere with the patient’s abilities to carry out activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Patients incur debt from medical expenses, depression from the inability to perform self- care, and became withdrawn because of their distorted body image.

Purpose: The purpose of this project was to use the Michigan Neuropathy Screening Instrument (MNSI) …

Efficacy Of Handoff Education For Icu Nurses When Transferring Patients To The Operating Room, Sandra Ruth Horace

Doctor of Nursing Practice Projects

Background: The transition of care from the Surgical Intensive Care Unit (SICU) to the Anesthesia team in the Operating Room (OR) is a vulnerable time for patients. There is currently no formal process for the patient transitioning from the Surgical ICU to the OR. The disarray of this transition can lead to serious omissions in communication and be harmful to the patient.

Purpose: Currently, there is no formalized or universal process for handoff communication between the SICU team and the Anesthesia team. This project aimed to provide handoff education for SICU nurses when sending a patient from the OR. This …

Effect Of Increased Confusion Assessment Method For The Intensive Care Unit Delirium Assessments On Patients In The Surgical Intensive Care Unit, William Lemon

Doctor of Nursing Practice Projects

Delirium is an acute syndrome of the central nervous system (CNS) that affects patients of all ages and all hospital areas. Furthermore, delirium can lead to frequent complications for these patients, especially those in intensive care units (ICU) (Kanova, Sklienka, Burda, & Janoutova, 2017). Nationally delirium affects 20-80% of patients that require ICU care (American Nurses Association, 2019). In the Surgical intensive care unit (SICU) at the acute care hospital used in the project, the average number of patients suffering from delirium is about 23%. The purpose of this project was to provide a more in-depth analysis of delirium, and …

Hypertension Education And Management Intervention (Hemi) In The Urgent Care Setting, Conrad L. Cash

Doctor of Nursing Practice Projects

Background: Hypertension, being a very prominent disease, is a common problem found during urgent care visits. By beginning in the urgent care setting, hypertension management can be started early; thereby preventing complications from uncontrolled hypertension.

Purpose: This DNP project aimed to improve patient knowledge of hypertension and overall blood pressure readings by providing one-to-one provider-patient education.

Design Method: This DNP quality improvement project was a pre- and post-test design using quantitative data. The goal was to access if there was a change in patient education pre, post, and three months follow-up along with a change in blood pressure.

Results: …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Preventing Unplanned Pregnancies: The Impact Of Prevention Education, Eliza Dudley

Doctor of Nursing Practice Projects

Teenage pregnancy and unplanned parenthood are social issues in many communities, states, and developed and undeveloped countries. The impact of early, unplanned pregnancy is detrimental to the adolescent's health, mental health, and physical well-being. Teenage pregnancy may be considered a social issue that is often the result of inadequate sexual and reproductive education, both in adult parents and teenagers. Despite recent reductions in teenage pregnancies, in recent years, more than 20 million teenagers experienced parenthood before graduating from high school. Programs are needed to prevent the possible stigma, physical and emotional risks of unplanned teenage pregnancy, lower adolescent pregnancy rates, …

Increasing Lung Cancer Screening Referrals In Patients With Tobacco Use Disorder, Emily Thornberry

Doctor of Nursing Practice Projects

Lung cancer in the United States is a substantial cause of mortality. According to the American College of Radiology’s Lung Cancer Screening Registry, only 1.9% of eligible patients were screened for lung cancer in 2016. The National Comprehensive Cancer Network and U.S. Preventative Services Task Force (USPSTF) guidelines recommend lung cancer screening (LCS) in high-risk patients. The USPSTF recommends screening current and former smokers aged 55-80 years who have smoked for 20 or more pack-years, and for former smokers, those that have quit within 15 years.

Unifying Vision: Strategies That Influence Nurse Self-Care Practices In Intensive Care Unit Nurses, Latoya Parks

Doctor of Nursing Practice Projects

Background: The notion of self-care should include more than physical health; the concept should also include emotional, mental, and spiritual self-care. Self-care behaviors are tailored to an individual's perceptions and values.

Purpose: The primary focus of this project aimed to improve nurse’s self-care practices. Through interviews with executive leadership at a large urban hospital, the project facilitator identified the need for easy access to self-care strategies for ICU nurses.

Design Method: The Plan-Do-Study-Act (PDSA) Model for Quality Improvement was used for this project. A systematic review of the literature was performed to ascertain the effectiveness of self-care strategies for …

The Evaluation Of Nurse Residency Program On New Graduate Nurse Retention, Trenisha Wilson

Doctor of Nursing Practice Projects

Healthcare settings are facing a major challenge in recruiting nurses in this demanding field. Nurse residency programs are designed to assist new graduate registered nurses with their transition to nursing practice. The nurse residency program assists new graduate nurses to develop their nursing skills, enhance their overall performance, and decrease turnover rate.

Purpose: The purpose of this project is to evaluate the effectiveness of the Veteran Affair Medical Center’s ability to retain new graduate nurses after attending a new graduate residency program.

Design Methods: This study is a retrospective pre-test and post-test design of the impact of the …

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …

Decreasing The Impact Of Diabetes In The Adult And Older Adults Rural Health Population Utilizing Phone Calls As Part Of The Chronic Care Management Program, Adrienne Shambray

Doctor of Nursing Practice Projects

This quantitative study was developed in order to evaluate the impact of phone calls on patient outcomes using the Chronic Care Management program (CCM). In January 2015, the Centers for Medicare and Medicaid Services (CMS) implemented the (CCM), with the goal of improving health and quality of care for high-risk patients. The administration and physicians at the clinic of focus for this project recognized a need for the facility to help improve and manage these patients’ care to prevent issues such as hospital readmission. This project aimed at following patients in the program with the chronic condition of diabetes mellitus …

Early Detection Of Sepsis In Direct Admit Hospitalized Patients: Implementing A New Sepsis Screening Checklist, Connie Lasley

Doctor of Nursing Practice Projects

Background: Early detection of sepsis in hospitalized patients in small rural hospitals can save lives. Subtle changes in patients can go undetected by nurses and doctors, leading to septic shock, increasing the length of stay in the hospital or death. In a small Alabama hospital, nurses were missing the early signs and symptoms of developing sepsis due to a lack of a monitoring system and proper education regarding sepsis.

Objective: The development of a sepsis screening checklist to place on each direct admitted patient’s chart to collect vital signs every four-hours each 12-hour shift to alert nurses of early signs …

Methods Of Educating Nursing Students On Proper Handwashing To Enhance Infection Control During The Covid Pandemic, Yulanda King

Doctor of Nursing Practice Projects

Background: Medical professionals have commonly been urged to use soap and water to sanitize their hands to prevent contamination and disease transmission. However, thorough handwashing requires a couple of minutes to clean hands thoroughly. Considering that health professionals must sanitize their hands' multiply times during a day, handwashing consumes a significant amount of time away from bedside care. Time spent away from patients may also result in a substantial decrease in the quality of healthcare services provided by the medical institution.

Purpose: This project evaluates the current policy and procedure for appropriate use of handwashing versus hand sanitizer in the …

Postpartum Depression: Development Of A Screening Protocol In The Neonatal Intensive Care Unit, Kelsey T. Langdale

Doctor of Nursing Practice Projects

Postpartum depression (PPD) affects approximately 19% of all postpartum women. Evidence indicates an increased risk for mothers of hospitalized infants, with estimates ranging from 28% to 67%. The American Academy of Pediatrics and Bright Futures recommend mothers be screened for postpartum depression at the infants’ well-child appointments. During hospitalizations, there are no well-child appointments; thus, no postpartum depression screening. This project aims to 1) improve knowledge of PPD in the staff of the Neonatal Intensive Care Unit (NICU) and 2) investigate the staff’s interest level in implementing a PPD screening protocol. Utilizing the Plan-Do-Study-Act (PDSA) framework, a protocol was developed …

Burnout, Self-Efficacy, And Resilience In Haitian Nurses: A Cross-Sectional Study, Marie Therese Georges

Loma Linda University Electronic Theses, Dissertations & Projects

Though nursing burnout is a global problem, research on nurse burnout in Haiti is scarce. Haitian nurses operate in a resource-poor work environment in the context of multiple personal and social challenges. This study assessed burnout (emotional exhaustion, depersonalization, and personal accomplishment) and identified its influencing factors among a sample of Haitian nurses. A cross-sectional survey in French and Haitian Creole was conducted in five Haitian hospitals using forward and back translated scales measuring burnout (i.e., emotional exhaustion, depersonalization, personal accomplishment), self-efficacy, nursing work environment, resilience, and demographic factors. Haitian nurses (N = 179) self-reported moderate emotional exhaustion (M = …

Diabetes Education Empowerment Program (Deep): Evidence-Based Practice Measures For Self-Care Management, Nakeshia Rutledge

Doctor of Nursing Practice Projects

Background: Prediabetes and Type 2 diabetes (T2DM) are major health challenges among the patient population at a family medical clinic in northwest Alabama. Poorly managed T2DM can cause complications which could decrease individuals’ quality of life and lead to mortality.

Purpose: The purpose of this project was to assess the feasibility and efficacy of a self-management intervention aimed at empowering prediabetic and T2DM patients to achieve better diabetes management and glycemic control (hbA1c < 5.7 percent).

Design Methods: A mixed-methods design was utilized with pre/post-questionnaires for analysis of data collected before and after the implementation of an educational intervention on diabetes self-management …

Pregnant Women's Experiences With Gastrointestinal Discomforts And Strategies They Use To Cope, Heidi Jo Paquette

Dissertations (1934 -)

Problem The experience of gastrointestinal (GI) discomforts of pregnancy is almost universal. Heartburn, constipation, nausea and/or vomiting are the most common, with variation in frequency and intensity by trimester. GI discomforts of pregnancy are understudied. Most research on GI discomforts of pregnancy has employed quantitative instruments, before and after specific therapeutic approaches. Little research has focused on women’s experiences of GI discomforts of pregnancy and self-management strategies. Women are experts in their experience of their own pregnancies and their voices are rich sources of data, but have been largely ignored in the study of GI discomforts of pregnancy. Methodology The …

Securing Nasogastric Tubes In Children, Julie Ann Lavoie

Dissertations (1934 -)

Nasogastric tubes (NGTs) are commonly placed in children at risk for malnutrition in order to provide temporary nutrition support until the child achieves independent oral feedings or requires durable tube placement. Accurate securement of NGTs is necessary to safely provide nutrition, particularly in infants and toddlers who are at highest risk for dislodging their NGT. Dislodgement of an NGT has a cascade effect on the medical management, requiring increased exposure to the healthcare system with every replacement. Nasal bridles are widely used to secure NGTs in adults but are not widely used with children. The purpose of this retrospective, correlational …

Geographical Variations And Factors Associated With Recent Hiv Testing Prevalence In Ghana: Spatial Mapping And Complex Survey Analyses Of The 2014 Demographic And Health Surveys, Jerry John Nutor, Henry Ofori Duah, Precious Adade Duodu, Pascal Agbadi, Robert Kaba Alhassan, Ernest Darkwah

College of Nursing Faculty Research and Publications

Objective To examine the factors associated with recent HIV testing and to develop an HIV testing prevalence surface map using spatial interpolation techniques to identify geographical areas with low and high HIV testing rates in Ghana.

Design Secondary analysis of Demographic and Health Survey.

Setting Rural and urban Ghana

Participants The study sample comprised 9380 women and 3854 men of 15–49 years.

Results We found that 13% of women and 6% of men of Ghana had tested for HIV in the past 12 months. For women, being within the age groups of 15–39 years, being currently married, attainment of post-secondary …

Socio-Economic And Geographical Inequalities In Adolescent Fertility Rate In Ghana, 1993–2014, Bright Opoku Ahinkorah, Eugene Budu, Henry Ofori Duah, Joshua Okyere, Abdul-Aziz Seidu

College of Nursing Faculty Research and Publications

Background

Despite public health interventions to control adolescent fertility, it remains high in sub-Saharan Africa. Ghana is one of the countries in sub-Saharan Africa with the highest adolescent fertility rates. We examined the trends and socio-economic and geographical patterns of disparities in adolescent fertility in Ghana from 1993 to 2014.

Methods

Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the 1993–2014 Ghana Demographic and Health surveys were analyzed. First, we disaggregated adolescent fertility rates (AFR) by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely …