Nursing Commons^™

The Impact Of Psychological Interventions Given To Icu Patients To Help With Pain Management, Kelly Liu

Nursing | Senior Theses

Pain management among the critically ill population is a significant issue in the intensive care setting. Whether the pain is acute or chronic, nurses tend to be the first-hand responders to help with pain management in the intensive care unit (ICU). With barriers ranging from patients’ inability to verbalize pain to nurses’ experience with obstacles to assessment such as sedation, confusion, or other concerns, pain management is a serious issue. Although pharmacological interventions such as opioids and analgesics help with pain control, in this thesis, we will focus on the impact of nonpharmacological and psychological nursing interventions and how it …

Evidence-Based Practice Guideline Development: Selection Of Local Anesthetics And The Additive Dexamethasone In Brachial Plexus Blocks, Alexandra Mcguire

Doctor of Nursing Practice Scholarly Projects

Brachial plexus blocks (BPB) are a type of regional anesthesia that inhibits the sensory and motor function of the upper extremity. The efficacy of a BPB depends on the type and dose of local anesthetics (LA), as well as the use of any additive agent. The selection of LA depends on the type, concentration, and volume of LA. Certain additives, such as dexamethasone, when added to BPB, were shown to increase motor and sensory block duration.

A chart audit conducted by the pharmacy and anesthesia departments revealed a significant variability of clinical practice in the use of LA and additives …

Hepatitis C Screening, Confirmation, And Referral Improvement Project, Maria E. Mcmahon

Doctor of Nursing Practice Scholarly Projects

Hepatitis C is an illness caused by the blood-borne Hepatitis C virus (HCV), and usually becomes a chronic condition. Left untreated, HCV can lead to severe liver disease and liver failure. Newer treatments are effective and well tolerated, but most people with chronic HCV are not accessing treatment due to several factors that will be discussed. The primary objectives of this quality improvement project were to improve the treatment cascade, provide education to providers and patients, and facilitate screening, virus confirmation, and referral to treatment, in a Federally Qualified Health Center.

Nursing Students, Bullying, And Burnout: A Study On Bullying By Medical Staff Members Against Nursing Students In The Clinical Setting And Its Relation To Nursing Student Burnout, Kihley Bellamy

Undergraduate Honors Theses

The present study investigated the existence of bullying by medical staff members in the clinical setting as experienced by nursing students, the existence of burnout among these students, and if such students perceive feelings of burnout as directly related to experiences of bullying. Undergraduate main campus traditional Bachelor of Science in nursing students at East Tennessee State University in their second, third, fourth, or fifth semesters were invited to participate in the study. Participants (n=52) were required to complete an online survey that regarded bullying, burnout, and how participants perceive the relation between the two variables. The study shows that …

The Effects Of The Transition From Pre-Nursing To Nursing On Mental Health, Andrew J. Davis, Paige R. Mullins, Kimberly A. Sell

Undergraduate Honors Theses

Mental health is an ever-growing crisis among adolescents and young adults, with suicide as second leading cause of death and the number of those negatively affected continually on the rise. Transitions are one of the major stressors prevalent among these age groups, placing individuals at risk for mental health deficits. This quantitative voluntary response comparative study assesses the transitional mental health of pre-nursing students and students in the nursing program at East Tennessee State University. Emailed to all with a declared major of pre-nursing or nursing, this study measured mental health using evidenced based assessment tools. The PHQ-9 for depression …

A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis

Undergraduate Honors Theses

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …

Increasing Adherence Of Chg Bathing: An Evidence-Based Practice Quality Improvement Project, Melissa Benedetto

DNP Projects

Introduction

Patients admitted to hospitals are at risk for developing Healthcare-acquired Infections (HAIs). Evidence suggests that these infections, including Central Line Associated Infections (CLABSIs), increase the cost of patient care and have a negative impact on patient outcomes. Daily chlorhexidine (CHG) bathing has been identified to help decrease HAIs in the hospital for patients in the Intensive Care Unit (ICU), those with Multi-drug Resistant Organisms (MDROs), and/or patients with a Central Venous Catheter (CVC).

Purpose

The purpose of this project is to implement an intervention to assess and improve CHG bathing adherence for hospitalized patients. Patients targeted include those at …

Nursing Students’ Cultural Awareness And High-Fidelity Simulation Skills, Shorok Hamed M Alahmedi

Nursing Dissertations - Archive

Cultural awareness is learning to be self-aware of other cultures and even an individual’s own culture. Nursing students learn about influences of values and beliefs, and the impacts of culture as they consider how to care for patients of other cultures. However, as students are learning cultural awareness for patient care they may struggle with some of their own cultural values and beliefs that may affect them in ways that they are not aware. This descriptive correlational study involved two research questions that examined undergraduate nursing students’ (n = 51) cultural awareness, and the association between undergraduate nursing students’ cultural …

Sexually Transmitted Diseases Consultation And Education For Adolescents And Young Adults, Maryrose Chinedu Obidiaku

Nursing Dissertations - Archive

Sexually transmitted diseases (STDs) have drastically increased in recent years nationwide and worldwide. Adolescents and young adults (AYAs) ages 15-24 make up just over one-quarter of the sexually active populace. Additionally, AYAs account for half of the 20 million new sexually transmitted infections in the United States. Compared with older adults, sexually active adolescents aged 15–19 years and young adults aged 20–24 years are at higher risk of getting STDs. Lack of knowledge of risk and protective factors and high-risk sexual health practices and behaviors significantly contribute to AYAs' STD acquisition. Hence, increasing STDs awareness and prevention is essential in …

Impact Of Legislative Policy On Young Women’S Breast Cancer Health, Vane Omosa

Nursing Dissertations - Archive

Breast cancer is the second most common type of cancer among women in the United States (CDC, 2021). Approximately 12% of US women will be diagnosed with breast cancer during their lifetime and 3% will die from invasive breast cancer (American Cancer Society, 2021). It is one of the leading causes of cancer deaths in women, with an estimated 42,000 women dying annually in the US. Young Black women have lower survival rates, higher risks of metastatic recurrence, and a higher mortality rate (Young Survival Coalition, 2021). This quality improvement project utilized retrospective data to examine the impact of the …

Shared Decision-Making Decision Aid Intervention To Improve Diabetes Medication Adherence, David Baba

Nursing Dissertations - Archive

A quasi-experimental study was conducted to investigate the effectiveness of a shared-decision-making (SDM) intervention using a decision aid (DA) with medication adherence and social support of African American/Black adults with type 2 diabetes. Orem's self-care theory and self-care deficit theory were the guiding frameworks to conceptually define and explain medication adherence as a self-care demand and shared decision making and social support as conditioning factors for promoting medication adherence. The medication adherence and social support levels of 31 men and women with diabetes were measured before and three months after implementing the SDM intervention. Participants' hemoglobin A1c test results were …

An Exploration Of Covid-19 Impact On Healthcare Workers’ Mental Health In China, Jenny Yang

Nursing | Senior Theses

Background

In December 2019, the first confirmed human case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 occurred in Wuhan, China. By March 2020, the World Health Organization (WHO) had classified the COVID-19 outbreak as a pandemic due to the rapid spread of the virus to other countries. Many people have been affected by the COVID-19 pandemic in various aspects, especially front-line healthcare workers. Hospital working conditions are constantly changing to cope with the problems that arise from the pandemic. These problems can result in an unsafe patient-to-nurse ratio, understaffed healthcare workers in hospitals, equipment shortage, and increased …

Reducing Medication Non-Adherence With Improved Health Literacy Interventions: An Evidence-Based Practice Quality Improvement Project, Unity Wiles

DNP Projects

Introduction

Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate healthcare decisions and follow instructions for treatment. Patients with low health literacy have been predicted to have poor health outcomes. The inclusion of the single-item literacy tool into the admission process of this project involved the patient-centered-care characteristics of improved patient experience, lower health cost, improved clinical experience, and better outcomes.

Purpose

The National Action Plan to improve Health Literacy seeks to engage organizations, professionals, policymakers, communities, individuals, and families in a linked multi-sector effort to improve health literacy. Low …

Navigating The Cold And Flu Aisle: An Evidence-Based Approach For Nurse Practitioners, Elizabeth Edwards

Student Works

Background: The most common illness know is the common cold. Antibiotics are inappropriate for treating the common cold, but there are many over-the-counter medications available. These over-the-counter medications have not been shown to decrease the length of a cold, though they can ease symptoms. In this paper, we aimed to review the active ingredients in recommended OTC cold remedies for the general population and assess the evidence for their effectiveness. We hope this information will provide NPs with evidence-based strategies to help their patients be better prepared to navigate the cold and flu aisle.

Methods: The US News 2020 …

Faculty Perceptions Of Teaching Clinical Reasoning At The Patient Bedside, Rebecca Gale White

Educational Leadership & Workforce Development Theses & Dissertations

Nurse educators meet frequently in conference settings and peer groups seeking an answer to “How do you do clinical?”. The purpose of this qualitative, phenomenological study was to explore faculty perceptions of clinical teaching experiences at the patient bedside at a level one or two associate’s degree nursing program by faculty within the Virginia Community College System (VCCS) that teach a rural student population.

Rural students struggle with work-life barriers that complicate their educational journey. This was compounded by the COVID-19 pandemic that presented new challenges to the way nursing education could be delivered creating a need for on line …

The Relationship Between Perceived Support And Post Traumatic Growth Among Nurses During The Covid-19 Pandemic, Anna Nieman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Nurses continue to experience significant challenges related to the COVID-19 pandemic, putting them at risk of occupational stress, burnout, and turnover. The post-traumatic growth model focuses on growth and knowledge that comes from experiences of stress and trauma.

Aim: Identify post-traumatic growth (PTG) in a population of nurses affected by the COVID 19 pandemic.

Method: PTG was measured by the Post-Traumatic Growth Inventory, a 21-item questionnaire with five factors: relating to others, new possibilities, appreciation of life, personal strength, and spiritual change. Participants (n=22) responded on a 6-point Likert scale, 0 for no change and 5 for great degree …

An Overview Of Extended Ventilation Requirements Related To Comorbidities., Kaitlyn Horrell

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Mechanical ventilation is a machine that that allows patients to breathe when they are unable to adequately do it themselves. This could be due to illness or injury. Ventilators pump oxygen into the lungs through a tube that travels through the trachea. When a patient is put on a ventilator, they will be placed in the Intensive Care Unit. While ventilation is typically a short-term intervention, some patients require ventilation for extended periods of time, and some may not come off the ventilator, eventually dying. Dozens of patients were ventilated in the ICU at Mercy, and most of them spent …

Weight Management Program Using Myfitnesspal© In A Rural Primary Care Setting, Taylor Rittman

The Eleanor Mann School of Nursing DNP Capstone Projects

Obesity is a growing health concern that is linked to the development of chronically debilitating physical and mental illnesses. Obesity is a result of a long-term positive imbalance between energy intake and energy expenditure. Evidence has shown more than one third of U.S. adults suffer from obesity. Primary care providers in the United States report being overburdened in treating obesity, citing a lack of time, structured approach, and structured resources. Furthermore, the disparities in obesity are even more prevalent in rural areas where older adults are the fastest growing part of the population at risk for this disease. Evidence indicates …

Colorectal Cancer Screening In The Latino Population At A Family Medicine Clinic: A Quality Improvement Project, Michael S. Vinson

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Colorectal cancer (CRC) is a preventable and curable disease that affects all genders, races, and ethnicities, and its impact on society can be reduced with early screening. The Latino population is at greater risk compared to groups or ethnicities due to social determinants and health disparities within the community. Review of Literature: Language barriers, low education levels, persistent social stressors, poor healthcare navigation, and structural barriers make it difficult for this population to be properly screened at appropriate intervals. Purpose: This quality improvement (QI) project was designed to combat reduced screening rates seen in the Latino population. The target …

To Flash Or Not To Flash, Christy Overly

The Eleanor Mann School of Nursing DNP Capstone Projects

In 2015, healthcare-associated infection (HAI) prevalence survey found that there were an estimated 110,800 surgical site infections (SSIs) associated with inpatient surgeries in 2015. Consequently, instruments and implants sterilized by immediate use steam sterilization (IUSS) have been found to increase the patient’s risk for an SSIs. Due to these risks, the Joint Commission (TJC) determined that organizations should implement evidenced-based protocols to reduce IUSS use. A needs assessment revealed a gap in care in that the increasing SSI rates appeared to be correlated with the misuse of IUSS at the physician owned surgical hospital in Tulsa, Oklahoma. This Doctor of …

Effectiveness Of A Frailty Assessment Index To Predict Early Readmission Rates In Frail And Older Adult Renal Transplant Patients, Marilyn Barnett

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: Renal transplantation is a complex intervention integrating both medical and surgical modalities, and is considered the treatment of choice for many individuals with end-stage renal disease. The complicated care of patients undergoing renal transplantation puts them at risk for adverse outcomes including infection, allograft loss, and a greater risk for some types of cancer. Evaluating patients to ensure they have the ability and support to cope with the stress of surgery and recovery, is an important part of determining the most appropriate candidates to receive the limited supply of organs available. Frailty has increasingly been identified as a predictor …

Development And Implementation Of A Protocol For Denosumab Administration In An Outpatient Infusion Clinic, Erin Stavrakas

The Eleanor Mann School of Nursing DNP Capstone Projects

Denosumab, or Prolia, is a medication given to increase bone mineral density (BMD) and prevent fracture risk in patients with osteoporosis. Guidelines for monitoring of side effects, data on long-term effects, and appropriate precautions are still being researched and developed. Healthcare teams are often unaware of preventative care measures to guide informed clinical decision making and patient care management. The recognized gap in care also reduces the standardization of health care delivery in clinics administering Prolia; this gap can lead to errors and miscommunication between patients and healthcare teams an increased risk for side effects. The aim of this translation …

Development Of A Nurse Practitioner Driven Program For Cardiology Providers To Increase Knowledge And Awareness Of Neurodevelopmental Assessment Needs In Children With Congenital Heart Defects, Michele Readman

Doctor of Nursing Practice Final Manuscripts

Children diagnosed with congenital heart defects are at increased risk for neurodevelopmental delays. Timely referral of patients to a neurodevelopmental clinic for initial evaluation and referrals to support services can improve learning outcomes, provide early intervention for neurodevelopmental disorders, and mediate factors affecting low quality of life. Nationally, a substantial proportion of pediatric cardiologists are not referring children for neurodevelopmental evaluation. A review of patient referrals to a Cardiac Neurodevelopmental Clinic within an urban children’s hospital demonstrated an opportunity to improve provider awareness and knowledge of referral recommendations. Using the Iowa Model of Evidence-Based Practice to Promote Quality Care, an …

Health Disparities In Adults With Developmental And Intellectual Disabilities, Tulsi Patel

Nursing | Senior Theses

This paper reviews literature pertaining to the treatment of people with developmental disabilities. It will emphasize the inadequacies of health care in this population. The literature that will be discussed focuses on disparities in care via proxy, sociodemographic and clinical factors associated with disparities, assessing the needs of this population, the prevalence of disabilities in rural and urban settings, and the comparison of health disparities between adults with and without developmental disabilities.

For the purpose of this paper, a few terms will be defined. Developmental disabilities (DD) will be defined as “a group of conditions due to an impairment in …

The Impact Of Covid-19 On Nurse Leadership Characteristics, Karen Fowler, Leslie K. Robbins

Nursing Faculty Publications

Background: Nurse leaders are vital for improving nursing efficiencies and the quality of care that they provide during a crisis and its aftermath. The value of positive leadership characteristics has never been more critical than during the COVID-19 pandemic. Functioning in a crisis mode required nurse leaders to demonstrate the necessary skills for clear communication and solid leadership. Therefore, nursing leadership, especially in emergencies such as the COVID-19 pandemic, needs to be transformative in the sense that leaders are informational, motivating, and able to advance the organization, notwithstanding a global pandemic. Timely leadership research during and after COVID-19 is crucial …

Operating Room Nurses Sleep Health: An Evidence-Based Practice Sleep Health Education Project, Gabriella M. Castignoli

DNP Projects

Background: "Sleep Health" is a new Healthy People 2023 priority due to notable poor sleep health across the nation, with more than 25% of U.S. adults reporting insufficient sleep. Adequate sleep is necessary to work effectively and safely, with operating room (OR) nurses at high risk for inadequate sleep due to atypical work schedules.

Purpose: This project aims to establish the importance of sleep health for OR nurses at a community-based hospital and improve sleep health perception and sleep health through sleep health education with staff.

Methods: The IOWA model for evidence-based practice and quality improvement tools, Plan-Do-Study-Act, and the …

Increasing Opioid Abuse Screening In Primary Care Clinic: An Evidence-Based Quality Improvement Project, Carlos Milla

DNP Projects

Introduction

To address substance abuse multiple organizations recommend increase drug abuse screening as part of routine health care. CAGE AID is five-question tool used to screen for drug and alcohol use, answering yes to two or more questions indicates further assessment is advised. Unfortunately, most primary care centers do not use screen for substance abuse using validated instrument tools such as the CAGE-AID tool.

Purpose

The purpose of this evidence-based practice (EBP) project is to implement the CAGE-AID Substance abuse screening tool by nurse practitioners students in a family clinic located in Bridgeport in order to increase to number of …

Implementation Of A Nurse Driven Palliative Care Consult: A Quality Improvement Project, Socnite Sebourne-Francis

DNP Projects

Background: Palliative care consult (PCC) is an approach that can improve the quality of life and symptom management of patients facing life-threatening illnesses. At a 20-bed medical oncology unit in Connecticut, patients with poor prognosis and worsening symptoms have high re-admission rates within 30 days of post-hospital discharge; yet healthcare providers fail to initiate PCC.

Purpose: This project hypothesizes how implementing a nurse-driven PCC on admission or hospital stays compared to the timing of a physician to a physician PCC improves a plan of care for oncology patients? Will it result in a decrease in 30-day re-admission rates? The …

Improving Specialist Referrals In Outpatient Primary Care: An Evidence-Based Practice Quality Improvement Project, Kimberly Gaznabie

DNP Projects

Background: In the United States, more than a third of patients receive specialty referrals per year, constituting more than half of outpatient visits. Patients require efficient, immediate referrals for specialty-based treatment plans and the prevention of worsening conditions.

Purpose: This evidence-based practice improvement project aimed to improve the specialty-provider referral system for a community-based outpatient primary care clinic.

Increasing The Utilization Of A Cardiovascular Risk Assessment & Screening Tool Through Education In A Primary Care Setting: A Quality Improvement Project, Taylor A. Massey

DNP Projects

Background and Significance: The World Health Organization (WHO) (2021) reports that 55.4 million people died worldwide in 2019; cardiovascular diseases due to ischemic heart disease and stroke were the top two leading causes of these deaths. Experts predict that by the year 2030, more than 22.2 million people will die annually from cardiovascular disease (Ruan et al., 2018). Noninvasive cardiovascular screening tests, such as the "Pulse4Pulse" screening tool, are a way to help providers identify patients at high-risk for cardiovascular disease and initiate treatment to reduce future risk.

Purpose: To increase provider utilization of the "Pulse4Pulse" screening test in a …