Nursing Commons^™

Implementing Staff Education To Reduce Stress And Increase Resilience, Samantha Lambert, Mariana Corpus, Sherry Chesak, Susanne M. Cutshall, Diane M. Forsyth, Habibo A. Haji

Nursing DNP Projects

Purpose: Persistent levels of high stress among nurses impact work activities and job performance, leading to burnout, compassion fatigue, lower job satisfaction, high workplace turnover, and diminished quality of patient care (Lin et al., 2018). Nurses who demonstrate resilience are better able to adapt to unexpected events with a positive attitude, self-esteem, and tolerance (Huang et al., 2020). The purpose of this project was to decrease stress levels and improve resilience among nursing staff, utilizing education on holistic stress management and resilience techniques.

Methods: A four-hour mindfulness-based education course was provided to staff members (N=76). Components included an initial two-hour …

Bullying In The C-Suite: A Nurse Leader Perspective, Kimberly Ann Colonnelli

Doctor of Nursing Practice (DNP) Projects

An estimated 35% of American workers have experienced bullying, and in 80% of those situations, the perpetrator was a supervisor or boss. 1 However, the reality is that bullying can come from anyone in the workplace, including subordinates. Victims are generally well liked and good performers, making them feel like threats to a bully’s power base. Bullying, unlike harassment, is not a legally defined behavior, so no laws currently exist to punish it. Victims are, therefore, at the mercy of their bosses, supervisors, co-workers, and human resource departments for protection or relief. Bullying is not a singular event, but rather …

Covid-19: Does The Timing Of Intubation Affect Overall Outcomes, Jennifer Burvee

Nursing Masters Papers

COVID-19 also known as coronavirus disease of 2019 is a viral illness caused by novel coronavirus SARS-CoV2 that was discovered in December 2019 in Wuhan, China. To date, there have been over 250 million cases worldwide. The severity of COVID-19 ranges from mild symptoms to critical illness warranting hospitalization within an intensive care unit to death. Current treatment modalities include supportive cares, monoclonal antibodies, interleukin inhibitors, convalescent plasma, therapeutic anticoagulants, anti-inflammatory medications and/or corticosteroids. A common complication due to COVID-19 is acute respiratory failure resulting in pulmonary insult which start as cough but progress to the need for supplemental oxygen …

Manager Onboarding To Improve Retention, Knowledge, And Confidence To Lead, Christine Asiimwe

Doctor of Nursing Practice (DNP) Projects

Objective: The purpose of this paper is to review the literature on manager onboarding best practices and their impact on turnover intention, knowledge, and confidence to lead teams in primary healthcare settings.

Background: Primary care onboarding is often insufficient due to competing operational priorities, time constraints, lack of mentorship, and cost. With primary care increasingly the setting for affordable, coordinated, end-to-end patient care, primary care managers must be well-prepared to lead the care team.

Methods: A review of the literature identified best onboarding practices associated with job satisfaction and turnover, reduced time to proficiency, increased knowledge, and confidence to lead. …

Development And Implementation Of An Evidence-Based Practice Mentor Fellowship, Stacy L. Alves

Doctor of Nursing Practice (DNP) Projects

Background: The Institute of Medicine (2008) set a goal that 90% of healthcare decisions would be based on the best evidence possible by 2020, yet many challenges remain. Common barriers include clinicians’ beliefs about the value of evidence-based practices, their competency to implement it, and systems issues such as time, resources, and organizational value and preparedness (Melnyk et al., 2017).

Local Problem: A hospital within an integrated health care system sought to increase the use of EBP for clinical decision making. A gap analysis revealed a lack of sufficient EBP mentors to lead efforts to promote system-wide EBP implementation.

Context: …

Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner

Master of Science in Nursing Final Projects

Abstract

Percutaneous coronary interventions (PCIs) are considered life-saving techniques in the event of myocardial infarction and remain the standard of care for managing acute heart attack. Given the success of the procedures, decreased complications, and the economic advantage over open-heart surgery, coronary interventions continue to be the preferred treatment choice. However, amidst the growth and success of these procedures, readmissions after percutaneous coronary interventions have been identified and still prevail among hospitals. Hence, the goal was to conduct an integrative review to identify and synthesize literature on the interventions that help reduce readmissions after percutaneous coronary interventions and illuminate nurses' …

Acculturation Strategies And Pap Screening Uptake Among Sub-Saharan African Immigrants (Sais), Adebola Adegboyega, Jia-Rong Wu, Gia Mudd-Martin

Nursing Faculty Publications

Although regular cervical cancer screening can prevent cervical cancer, screening utilization remains low among immigrant population including sub-Saharan African immigrants (SAIs). Acculturation is a complex process, which can lead to adoption of positive or negative health behaviors from the dominant culture. Acculturation strategies are the varying ways in which individuals seek to go about their acculturation by either maintaining or rejecting their own cultural values ip or accepting or rejecting the host culture's cultural values. Cervical cancer screening behaviors among SAI women may be influenced by their acculturation strategies. We conducted a secondary analysis of data to examine the relationship …

Effect Of A Rehabilitation Program On Quality Of Life Among 2nd Degree Burn Adolescents Quasi Experimental Study, Sara Sayed Abdalla

Nursing

No abstract provided.

Patient Placement Matters: A Systematic Review Of The Impact Of Multiple Patient Placement, Jacqueline Strinden

DNP Qualifying Manuscripts

Abstract

Background

Inattention to the frequency of patient movement has been correlated with system-induced harm events, diminished favorable health outcomes, and reduction in patient and staff satisfaction. The incidence of adverse events increases significantly when multiple unnecessary lateral relocations result from secondary efforts to relieve hospital capacity constraints and improve efficiency.

Methods

A systematic review of literature was conducted to evaluate the impact of adverse events, patient and staff perceptions, and resource utilization on frequent patient placement events.

Results

Results of the analysis demonstrate that increased adverse events, negative patient and staff perceptions, increased workload, and resource utilization is significantly …

Impact Of Theory-Based Interventions On Meaningfulness Of Undergraduate Nursing Pharmacology Student Learning, Betsy L. Mauldin

Nursing Theses and Dissertations

Objective: Nursing pharmacology is a complex and content-dense course, often cited as difficult for nurse educators and students and a reason for not progressing in nursing curricula. Even nurses who experience high academic performance report feeling ill-prepared to adequately perform medication management for nursing practice in the current fast-paced environment. The objective of this five-chapter portfolio is to explain the development and implementation of a two-pronged intervention to facilitate meaningful learning of pharmacology principles within nursing students. Chapter 1 describes an overview of the approach to the intervention.

Methods: Chapter 2 describes one prong of the study intervention, the Pharmacology …

Consultation/Liaison Psychiatry During Covid-19, Robert Frierson, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

Consultation/liaison psychiatrists care for people with co-existing medical and psychologic difficulties. The coronavirus pandemic is stressful for patients and their psychiatric caregivers. Patients have lost support systems and harbor fears about exposing family to the virus. COVID-19 sometimes exacerbates previous psychiatric conditions, while diminishing intimacy with physicians. Everyone is oversaturated with COVID-19-related news focusing on rising concerns about the illness and about jobs, school, and housing insecurities.

The psychiatrist maintains a hospital presence despite fear of contracting the disease. Challenges include addressing staff morale, evidencing empathy despite telecommunication devices, and treating anxiety, depression, sleep phobias, post intubation flashbacks, COVID-19-induced cognitive …

Critical Thinking In Nursing Education: An Integrative Review, Beth Maina

Master of Science in Nursing Final Projects

Aim. This integrative review aimed to review studies on critical thinking and how it is essential in nursing education. The research question that guided this integrative review was: What teaching strategies positively influence critical thinking development in new graduate nurses?

Background. Critical thinking is an essential skill in the nursing profession which helps nurses to prioritize and perform life- saving interventions for the patient. This desirable competency is an expected outcome upon graduating from nursing school. However, there is growing concern that new graduate nurses lack this essential skill.

Data Sources. Articles were located by searching electronic data bases …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Diabetes Prevention Program, Ashley L. Stine

MSN Capstone Projects

The prevalence of diabetes in Texas has increased 40 percent over the last decade and will continue to rise as of 2019. New onset diabetes, chronic, and children with diabetes has significant rise in hospitalization rates. COVID and its restraints of limiting physical activity, restrictions of gyms and sedentary lifestyles. Chronic diabetics who were frequent flyer hospitalizations rates increase due to poor social support, mental health and stressors increased during COVID also. This diabetes prevention program that consists of 16wks for new and current diabetics would decrease complications of diabetes such as DKA, retinopathy, nerve pain, chronic pain, AMS, amputations, …

Practice Development Trajectories Of Experienced Nurses: Adaptive Experts, Routine Experts, And Non-Experts, Dee Mulcahy

Nursing ETDs

This qualitative study examined practice development among experienced, acute care nurses (n = 9) with at least 10 years of experience. Using an interpretive biographical approach, with participants’ written practice narratives and in-depth interviews, the study focused on how the work environment and life experiences influenced or impeded practice development. Participants were classified as routine- or adaptive experts (n = 3 of each type) with one intermediate case and two not readily classifiable. Antecedents to becoming a nurse included family influences, personal interests, altruistic values, and financial need. Experience was necessary but not sufficient for adaptive expertise. Compared …

Healthcare Associated Infections: A Benchmark Study, Neal Ziedan

MSN Capstone Projects

When it comes to hospital-acquired infections, whether the hospital has implemented best-practice infection control measures, whether it has introduced best practice infection control measures, or whether it will be held vicariously liable for negligent or intentional failures by staff to follow the infection control measures in place, is the determining factor. If a hospital and its administrators fail to develop or implement best practice infection control methods, resulting in patient harm, they may be held directly liable. Patients may be held vicariously liable if hospital employees fail to comply with infection control measures implemented by the hospital during the course …

Increasing Healthcare Providers' Intent To Utilize Alternative And Complementary Pain Management With Their Patients, Holli Boyles

Doctor of Nursing Practice Scholarly Project

The purpose of this scholarly project is to increase the willingness of healthcare providers to introduce alternative and complementary pain management to their patients. Two patient video tools were constructed and offered to healthcare providers to evaluate and potentially utilize the final products in their practice. One tool introduced music therapy, the other mindful meditation, along with resources for patients to investigate and learn from on their own. A total of seven healthcare providers responded to the project with a commitment to potentially utilize the final video and provided their feedback on the video tools. No changes were made to …

The Relationship Between Collective Nursing Knowledge And Nurse Turnover: An Application Of Nursing Intellectual Capital Theory, Pamela Russman-Chambers

Doctorate of Nursing Science Dissertations

The value of a healthcare organization is vested in the expertise, intellect, and wisdom of employees. Nursing knowledge resides both within the individual nurse and the collective knowledge embedded in organizational structures and practice environments. Healthcare organizations rely on their ability to utilize this knowledge to deliver high-quality care to patients. Hospitals wanting to gain a competitive advantage and achieve financial stability must be adept at acquiring, cultivating, and using the nursing knowledge stocks of the organization. When this knowledge can be utilized to mitigate healthcare issues and improve patients' health, this collective knowledge or intellectual capital is often the …

Identifying And Evaluating Pain Management In Hospitalized Older Adults With Hip Fractures: An Integrative Review, Monique Guinocor

Master of Science in Nursing Final Projects

Hip fractures are known to have the highest health morbidity and mortality, especially in the aging population. Having a hip fracture comes with insurmountable pain. Older adults experiences pain differently from other populations due to physiological changes, but this population experiences an undertreatment and mistreatment for pain, resulting in negative outcomes. Current methods for pain control include pharmacologic and nonpharmacologic interventions. Exploring different interventions for pain management is necessary so providers can implement methods that are effective in pain relief without inducing complications. The aim of this integrative review is to identify current pain management interventions and determine their effectiveness …

Implementation Of Teach-Back For Discharge Teaching In A Critical Access Hospital: A Quality Improvement Project, Katie Beth Notch

Theses and Dissertations

A lack of comprehension of discharge instructions may cause high readmission and emergency room revisit rates for organizations. At the project site, there was no current evidence-based practice to ensure patient comprehension of discharge instructions. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if the implementation of the Institute for Healthcare Improvement (IHI) Always Use Teach-Back Toolkit would impact emergency room revisit rates among adult medical-surgical patients in a critical access hospital in rural Minnesota over four weeks. Afaf Meleis’ transitions theory and the Iowa model for evidence-based practice were the scientific underpinnings of the project. …

Understanding Ot’S Role In Fall Prevention And Analyzing The Perceived Barriers From Nurses And Occupational Therapists In An Inpatient Setting, Kyle B. Esguerra, Becki Cohill, Susan Macdermott

Fall 2021 Virtual OTD Capstone Symposium

The aim of this project was to analyze current fall prevention strategies, work and environmental-related barriers, and OT’s role in fall prevention in a hospital setting. Two online surveys consisting of quantitative questions (multiple-choice, select-all-that-apply, and Likert scale) with the option for open-ended answers were given to OT practitioners and nurses with inpatient experience. A total of 341 OT practitioners and 21 nurses completed the survey. The results were transferred to a password-protected Microsoft Excel document in preparation for analysis. Data analysis derived several themes including lack of resources, lack of training, inter-professional collaboration, workload, work culture, cognitive and physical …

Leveraging High Reliability And Transformational Leadership To Create A Healthy Work Environment, Megan Gillespie, Megan Gillespie

DNP Qualifying Manuscripts

Background: Nurse leaders must create a collaborative work setting to promote a healthy work environment (HWE). The Joint Commission reported in 2014 that 71% of physicians and nurses reported disruptive behavior was linked to medical errors. The culture of a team sets the foundation of safety for patients and nurses. A HWE is necessary to ensure agility, progress and effectively strive for zero harm. Nurse executives are challenged to empower front-line leaders to create a HWE conducive to open communication, psychological safety and results in a setting where employees can thrive.

Problem Description: There is an epidemic of bullying and …

Psychological Distress During The Covid-19 Pandemic In Nursing Students: A Mixed Methods Study, Mayantoinette Watson

Dissertations

During such an unprecedented time of the largest public health crisis, the COVID-19 pandemic, nursing students are of the utmost concern regarding their psychological and physical well-being. Questions are emerging and circulating about what will happen to the nursing students and the long-term effects of the pandemic, especially now that hospitals are being overwhelmed with COVID-19 cases and patients as well as a significant need for nursing staff (Jividen, 2020). Expectations, demands, change, and the fear of the unknown during this unprecedented time can only contribute to the many stressors that accompany nursing students through laborious clinical and didactic courses …

Pcos: What They Should Be Telling You, Gracie Leavitt

Fall Student Research Symposium 2021

It is speculated that out of 14 million women in the United States, 70% are being affected by Polycystic Ovarian Syndrome, and yet it continues to be one of the most misdiagnosed or undiagnosed diseases. PCOS is a condition that stems from the endocrine system and is often determined by cysts in the ovaries, but studies have proven that that isn’t always the case nor the determining diagnostic criteria. Women aren’t given enough information when being diagnosed with PCOS, nor substantial treatment options. In a world with incredible medical advances and research happening continuously, PCOS seems to be lacking in …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

Editorial Board

Nursing & Health Sciences Research Journal

No abstract provided.

Barriers Of Bronson School Of Nursing Program, Karla Kline

Honors Theses

Aside from the rigorous coursework of nursing school, nursing students experience various barriers that impact their academic success. Barriers to successful completion of traditional Bachelor of Science of Nursing (BSN) programs include isolation, lack of peer connections, lack of faculty connections, lack of family support, lack of financial support, and mental health struggles (Shaw, 2015) (Seal & Woods, 2021). This research will aim at assessing and exploring these barriers students are facing, along with the additional or exacerbated barriers the COVID-19 pandemic has surfaced.

This study will expand on the research conducted by Shaw (2015), in which she examined the …

Advance Care Planning Evidence Based Practice Benchmark, Natalie K. Waggoner

MSN Capstone Projects

America is aging, with the estimated number of patients over the age of 65 to reach 72 million by 2030, approximately 20% of the population (Sade, 2012). This demographic shift characterized by an increasing elderly population has elevated the subject of death and dying to a crucial component of health care delivery. A study done by Silveira et al. (2010) demonstrated that 70% of individuals aged 60 and older were unable to participate in treatment decisions during their final days. However, most individuals in the United States have no advance directive.

The goal of this evidence-based practice intervention is to …

Stroke Depression And Rehabilitation Willingness: Benchmark Study, India J. Lewis

MSN Capstone Projects

The purpose of this paper is to examine, identify, and treat patients with post-stroke depression. Post-stroke depression can affect a patient's willingness to perform activities of daily living, this may result in poor functional outcomes on discharge. Depression is not regularly screened during the acute stroke phase, therefore not regularly treated with the intent to improve functional outcomes. The Patient Health screening questionnaire (PHQ-9) is an available tool that can assist in recognizing and treating depression. This project will determine that the current literature supports implementation of a protocol needed to improve rehabilitation participation.

Implementation Of A Pre-Anesthesia Take-Home Evaluation (Pathe) As A Means Of Process Improvement: A Best Practice Recommendation, Russell Gray, Hunter Brown, Trey Galloway

Doctoral Projects

The pre-anesthesia evaluation (PAE) is a vital component to anesthesia providers when choosing an appropriate anesthetic plan for patients requiring surgery. The PAE, pre-anesthesia risk-factor assessment, and provision of pre-anesthesia instructions are standards of care implemented in order to assess the patient’s likely outcome of surgery and anesthesia as well as stratify any known risk factors to optimize surgical/anesthetic outcomes. Any disruption in this process could potentially lead to decreased patient/provider satisfaction, reduced patient compliance with pre-anesthetic instructions, reduced patient safety, and unnecessary financial burden.

After the completion of a literature review, the need for a best practice recommendation was …