Nursing Commons^™

Qualitative Data Analysis For Health Research: A Step-By-Step Example Of Phenomenological Interpretation, Sue Monaro, Janice Gullick, Sandra West

The Qualitative Report

Phenomenological studies have been critiqued when analytic activities and intersection with the underpinning philosophy lack clarity. This methodological discussion paper describes data analysis in hermeneutic interpretive phenomenology. Data management strategies (transcript preparation, coding, philosophy application, tabling/concept maps, and Microsoft Word) and data analysis processes (reduction, display, and conclusion drawing/verification) are illustrated. Deconstruction, reconstruction, and reorganisation of themes/subthemes using hierarchical heading styles to populate the navigation pane and philosophical tenets acted as analytic hooks. This paper has outlined data analysis in hermeneutic interpretive phenomenology, including the use of MS Word and its functionality, which was supported by other data display strategies …

Social Determinants And Sexual Health In Adolescents, Makaylee Kempema, Camryn Janssen, Haley Evans, Bekah Horstman

Celebration of Research

After discovering a noticeable need for sexual health education and disease prevention for adolescents in the Promise Community Health Center community, we as a group set to work on researching how to address and combat this need. Ten articles pertaining to this issue highlighted four main factors in adolescent sexual health: practices and barriers to adolescents seeking information about sexual health, how they can most effectively learn about sexual health, parental influence on adolescent sexuality, and the healthcare provider’s effect on an adolescent’s sexual health visit. With these findings the project was able to identify interventions that Promise Community Health …

Importance Of Patient Bodyweight In Hospitals, Abby Petersen, Hannah Van Iperen, Brittany Berry, Karie Stamer

Celebration of Research

Ten research articles that included information about patient weights, weight errors, and importance on weight in relation to nutritional status, fluid assessment, and medication doses were reviewed to create a policy. The results of the articles conclude that within healthcare, the facilities are not doing enough in making sure each patient is being weighed during their hospital stay. Nurses and other patient care staff should be properly educated and trained on how to obtain body weights to reduce the instances of inaccuracy.

Addiction Generation: Stimulant Abuse In College Students, Jemma Kenobbie

Celebration of Research

Illicit use of prescription stimulants has come to the attention of clinicians, school administration, and the judicial system in recent years. Illicit stimulant use is defined as the use of prescription stimulants without a legitimate prescription or using stimulants inconsistent with the prescribed treatment plan, including diversion and inappropriate administration methods. These prescriptions have been known to cause serious side effects when taken incorrectly, yet their popularity as “study buddies” among college students has risen. The most current research has found that the percentage of undergraduate students abusing stimulants ranges from 8-43%, with an average of 17% of students abusing …

Bouffants Vs. Cloth Surgical Caps In The Prevention Of Infection, Audrey Leyen, Maura Mould, Brenna Rauwerdink

Celebration of Research

The purpose of this Evidence-Based Practice Project is to gather information from previous studies in order to find out what practice is most effective in preventing infections acquired in the Operating Room during surgery and provide the information that will allow Sioux Center Health to better their practices and provide a safe surgical environment for both patients and operating room staff.

Optimizing Vernix Caseosa In Neonates, Shaeli Herman

Celebration of Research

Vernix caseosa is a “white, creamy, naturally occurring biofilm covering the skin of the fetus during the last trimester of pregnancy” (Singh & Archana, 2008). While there are many variations of birth plans that one may choose regarding their pregnancy, the health and wellness benefits of leaving the vernix caseosa on the neonate immediately following birth can be substantial. This is especially important when considering the thermal needs of a neonate along with the risk that could occur if those thermal needs are not met. The vernix caseosa, which forms around the twenty first week of gestation, also serves as …

Climate Change And Infectious Diseases, Brennan Haggerty, Jake Lynott, Carsyn Hamstra, Taylor Mccarthy

Celebration of Research

The impact of climate change on human health is a relatively new topic within the field of research. Several research studies indicate rises in temperature, droughts, increase in vector-borne diseases, and heatwaves are becoming more prevalent. Despite the fluctuations in climate, little information is being conveyed to the public regarding the effects of such on human health. This review sought to identify and assess what is currently understood about climate change and the impacts of it on human health. A literature review was designed and conducted using EBSCOhost and Worldcat. Out of all the articles identified, ten articles met the …

Virtual Reality Goggles For Pediatric Patients, Madison Klatt, Devyn Kemble, Hannah Blanchard

Celebration of Research

We were presented with the research question of if virtual reality goggles in pediatric settings were effective. Our data was gathered from scholarly research articles pertaining to virtual reality use in pediatric patients experiencing pain, fear, and anxiety. The settings that virtual reality was used in varied from venipuncture, scans, sickle cell crisis, wound care, dressing changes, and blood draws. The quantitative, qualitative, and mixed methods studies that we looked at showed decreased pain, fear, and anxiety. They also found that virtual reality was a beneficial distraction technique. The results support the use of virtual reality goggles in pediatric settings, …

Optimizing Electronic Medication Prior Authorization: Reducing Prescription Delays, Arnold Butiu

Doctor of Nursing Practice Projects

Background: Within the United States, chronic disease in children has doubled over the last 20 years. Many diseases defined as chronic (attention deficit, epilepsy, and diabetes) require daily medication regimens for optimal management. To be covered by insurance, many of these medications require prior authorization (PA) from the patients’ pharmacy benefits policy. Delays in processing and receiving PA orders can lead to worsening disease and inadequate disease management.

In 2014, a pediatric academic medical center in the Midwest found that processing medications from prescription order to PA approval took nurses an average of over 90 hours. In August 2020, the …

Uncovering The Educational And Self Management Need In People With Inflammatory Bowel Disease, Zachary Palumbo

Doctor of Nursing Practice Scholarly Project

The purpose of the study was to assess the current knowledge of inflammatory bowel disease (IBD), self-management skills, and resources for IBD in people suffering from the condition. Self-management skills and education have been shown, along with medical treatment, to show improvements in symptom activity and overall quality of life (Conley & Redeker, 2016).The study used Orem’s Self-Care deficit theory as the theoretical framework. A mixed methods design was chosen for this particular study. The project provided an educational video and a pre and post-survey through email. The questionnaire and pre-test (Appendix A) was given before the education, and Appendix …

Promoting Client-Centered Learning And Education Of Teenage Mothers, Katie R. Hartline

OTD Capstone Projects

This doctoral capstone project was completed through a partnership with Nurses for Newborns, a nonprofit organization that sends registered nurses to the homes of families who have a greater risk of infant mortality. By delivering prenatal/postnatal care, education, infant developmental assistance, educational resources, community resources, and facilitating long-term plans with the families, Nurses for Newborns takes active measures to prevent child abuse, neglect, and infant mortality. This project was driven by the organization’s need to increase engagement, participation, and learning outcomes by their teen mother clientele. The primary focus of this project was to create a client-specific booklet to promote …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Pre-Implementation Of Cocare Help, Thomas D. Finn, Autumn Baldwin, Elizabeth Hill

Doctoral Dissertations & Projects

Background: Delirium is a change in consciousness characterized by rapid onset and fluctuating attention, causing impairment in the ability to process and recall information, occurring in 30% of hospitalized older adults. Delirium can increase falls, length-of-stay, mortality, and cost. The CoCare Hospital Elder Life Program® (HELP) is an evidence-based bundle of interventions targeting cognitive impairment, sleep deprivation, immobility, visual/hearing impairment, and dehydration, embedding geriatric principles in care to prevent delirium.

Objectives: To further analyze the pre-implementation of the HELP in order to optimize success of program administration.

Methods: Mixed methods were used to collect retrospective/prospective data (interviews (N=25], surveys [N=25], …

Discharge Care Bundle To Reduce Copd 30-Day Readmission Rates In A Hospital Acute Care Unit, Dao Vang

Student Scholarly Projects

Practice Problem: Chronic obstructive pulmonary disease (COPD) readmissions severely impact patients’ health, mortality, and quality of life and increase unnecessary healthcare use and spending. Utilization of a protocol and discharge care bundle to reduce the readmission rate for COPD patients is critical to combat the problem.

PICOT: The PICOT question that guided this project was in adult patients 65 years or older admitted to a hospital acute care unit for acute exacerbation of COPD (P), does a protocol and discharge care bundle (I) compared to no protocol and no discharge care bundle (C) reduce the 30-day hospital COPD readmission rate …

Exploring Compassion For The Community And Diversity Through Nursing Experiential Learning, Jaime Sinutko, Nadine Wodwaski, Brooklin Adams

Experiential Learning & Teaching in Higher Education

Background: The aim of Jesuit education is total growth leading to action (Jesuit Institute, 2014a), plus higher Jesuit education seeks to transform students through examining the world around them. The promotion of experiential learning is noted in Ignatian Pedagogy (2014a) by urging the whole person to enter the learning experience. Nursing education, at a Jesuit University, involves educating the whole person within a service-oriented profession. Thus, experiential learning in a nursing course at a Jesuit University is an active component of Ignatian pedagogy, promoting Jesuit values and Catholic identity. This has been challenging since the COVID-19 pandemic forced universities to …

A Chronic Obstructive Pulmonary Disease Pilot Using Risk Stratification To Improve Resource Allocation And Reduce Readmissions, Linda Gould

Doctor of Nursing Practice Projects

Background: Chronic Obstructive Pulmonary Disease (COPD) impacts 250 million people, is associated with high hospital readmission rates, and costs over $50 billion annually. Purpose: Apply risk stratification identifying higher risk patients to prioritize complex, time-consuming interventions and resources. Methods: Patients hospitalized with COPD were risk stratified using PEARL. Moderate-high risk patients were referred to specialty nurse practitioners, who used real-time interventions and motivational interviewing during intense weekly visits over 30 days targeting self-management, patient-specific risks, and resources. Results: No patients were readmitted or died during the pilot using risk stratification with patient-specific tertiary preventive care to …

Improving Access And Delivery Of Mental Health Care To Veterans Through A Care Coordination Pilot At A Texas Department Of Veterans Affairs Hospital, Jacqueline Buval

Doctor of Nursing Practice Projects

Background: Mental health (MH) disorders are among the leading cause of disabilities in adults, with an even greater prevalence among Veterans who served in combat. Forty percent of troops returning from combat zones report suffering from post-traumatic stress disorder (PTSD) or depression and 33% report trouble accessing MH care. Access to care is directly influenced by care coordination procedures in health care systems. If care coordination is poor or lacking, patients remain in settings that are inappropriate for their level of care. Implementing a care coordination program can improve care transitions, provide the necessary support for patients to successfully …

The Knowledge And Attitudes Of Oncology Nurses On Advance Directives, Bailey Nettles

Dissertations

Advances in healthcare technology has changed how healthcare professionals care for patients, increasing the importance of Advance Directives (ADs). ADs are legal documents describing patient end-of-life care wishes. Despite the usefulness of ADs, particularly in oncology settings, most patients do not have one.

This qualitative content analysis study examined knowledge and attitudes of ADs among oncology nurses to obtain a better understanding of ADs. Literature on ADs and nurses is dominated by quantitative research. This study addresses knowledge gaps best filled by qualitative methods.

Ten experienced oncology nurses answered eleven open-ended questions using online video conference interviews. The eleven questions …

Ouch: Overcoming Uncontrolled Chronic Migraine Headaches, Angel Pineda

Cohort X

Migraines are a common type of primary headache that affects over 36 million people in the United States and one billion people worldwide. While oral preventative treatments have been considered first-line therapy for chronic migraines, anti-calcitonin gene-related peptide monoclonal antibodies have recently emerged as an effective treatment option. The purpose of this quality improvement project was to improve the therapy adherence and quality of life outcomes for patients with chronic migraines by facilitating a transition from oral migraine prevention therapy to treatment with an anti-calcitonin gene-related peptide monoclonal antibody agent. This project was developed utilizing the Focus, Analyze, Develop, and …

Utilizing Motivational Interviewing Intervention To Improve Compliance With Self-Care Among Hispanic Adults With Obesity, Type 2 Diabetes Mellitus, And Hypertension, Mariagorety O. Nwiloh

Cohort X

Obesity, hypertension, and type 2 diabetes mellitus (type 2 DM) have continued to plague the healthcare system and the economy of the United States of America. They are most common among African Americans and Hispanic Americans. The objective of this quality improvement project was to improve compliance to self-care regarding self-monitoring of blood glucose, blood pressure, and exercise to achieve target fasting blood glucose (FBG) ≤ 120 mg/dL, blood pressure (BP) ≤ 130/80mm Hg and a weight loss of ≥5 pounds among adult Hispanics aged 18- 65 years old. A weekly motivational interviewing (MI) session was conducted for 6 weeks …

Implementing An Evidence-Based Fall Prevention Plan To Address Unintentional Hospital Falls On A Medical/Surgical Unit, David Haskell

Doctor of Nursing Practice Projects

Background: Falling in the hospital setting is a leading cause of death and disability for patients. For many health care organizations, patient fall prevention strategies have become a priority focus to improve patient outcomes and associated costs.

Project Design: The project was designed to implement a quality improvement project on an adult medical/surgical unit, providing educational activities to nursing staff, and applying a standardized fall prevention plan of care “toolkit” for fall prevention interventions.

Results: Audits completed on 863 patient admits to a 36-bed Medical/Surgical unit during the three-month timeframe, showed the implementation of the project resulted in the creation …

Mindfulness-Based Stress Reduction To Decrease Burnout In Emergency Nurses: A Quality Improvement Project At An Academic Medical Center, Desireé M. Mccue

Doctor of Nursing Practice Projects

Nursing burnout, categorized by increased emotional exhaustion (EE), depersonalization (DE), or decreased personal achievement (PA), is rising in the United States. Emergency Department (ED) nurses at an academic medical center in the western United States experience burnout related to workplace violence and trauma exposure exacerbated by a global pandemic. Burnout can lead to adverse health impacts for nurses, increased institutional costs, and adverse patient outcomes.

Improving mindfulness or awareness of the present can reduce burnout in ED nurses. A mindfulness pilot project was conducted with staff nurses (n=20) and nurse leaders (n=4) in the ED. Participants attended Mindfulness-Based Stress Reduction …

Deploying A Validated Postnatal Depression Screening Tool & Guideline To Improve Evidence Based Screening For Postpartum Depression In Ambulatory Care, Debbie Ketchum

Doctor of Nursing Practice Projects

Problem Description: Postpartum depression (PPD) is a significant public health problem that is potentially disabling and can be life-threatening. It is one of the most common diagnoses for maternal morbidity and mortality, affecting one in ten women in the United States. Currently, there is no universal process for the identification of PPD within the ambulatory clinics in this regional health system caring for obstetrical patients. A quality improvement project was developed and implemented with a pilot group in the ambulatory setting.

Rationale: Without a standard process for screening, patients and their newborns may be at increased risk for detrimental consequences …

Impact Of Expedited Partner Therapy, Sutha M. Fernando

Cohort X

Sexually transmitted infections (STIs), including Chlamydia trachomatis and Neisseria gonorrhoeae, have reached record high rates in the United States. Sexually transmitted infections disproportionately affect reproductive-aged males and females 15–44 years of age, who account for 65% and 42% of the total reported C. trachomatis and N. gonorrhoeae cases, respectively. These infections are the most common treatable sexually transmitted infections in the United States. The purpose of this evidence-based practice project was to decrease the rates of recurrence of STIs in males and females older than 17 years at a private family practice clinic in Carrollton, Texas, in the Dallas metropolitan …

Silver Alloy-Coated Urinary Catheters: Preventing Urinary Tract Infection, Assumpta I. Iwe

Cohort X

Background: A urinary tract infection (UTI) involves any part of the urinary system, including the urethra, ureter, kidney, and bladder. Urinary tract infections are the most common healthcare-associated infection reported to National Healthcare Safety Network (NHSN). A UTI is also the second most frequent infection in long-term care (LTAC) facilities, making it the most common cause of bacterial infection or sepsis and hospitalization. Patients with urinary catheters are at an increased risk of infection, and standard catheters reduce the body’s natural ability to cleanse the urinary tract of microorganisms. Bacteria can colonize into biofilms that attach themselves to the catheter …

Type 2 Diabetes: Motivational Interviewing Improving Clients’ Dieting And Exercise, Azeb Lema

Cohort X

Background: Type 2 diabetes continues to be a prevalent chronic disease in the world, leading to increased rates of mortality and morbidity. In context of type 2 diabetes (T2D) management, patient empowerment is broadly investigated in the medical literature to date. This concept emphasizes patient autonomy and an individual approach to patient care. In turn, motivational interviewing (MI) is a patient-centered approach that aims to modify patients’ behaviors. The effectiveness of MI in modifying patients’ behaviors diagnosed with T2D has been documented in many sources. MI aims to reduce patients’ internal resistance to change health and lifestyle habits and provide …

Basal-Plus Insulin Regimen: Helping Patients With Diabetes Mellitus Type 2 To Maintain Blood Glucose Levels During Hospitalization, Marcia Watts Hammons

Cohort X

Diabetes mellitus type 2 (DM2) patients are at risk of episodes of fluctuating blood glucose levels when in the hospital. On admission at the target practice site, the home dose of oral hypoglycemic medication is typically stopped and replaced with sliding-scale insulin therapy. Hyperglycemia among the hospital population of DM2 patients is common, causing delayed healing times, increased length of stay, increased costs, and other medical detrimental factors. A doctor of nursing practice project was based on the findings from a randomized controlled trial of a basal-plus insulin protocol that lowered the mean blood glucose level for noncritically ill hospitalized …

Management Of Uncontrolled Type 2 Diabetes Mellitus With Combination Therapy With Metformin And/Or Glucagon-Like Peptide-1 Receptor Agonists/ Sodium-Glucose Cotransporter-2 Inhibitors, Bertha L. Contreras

Cohort X

The management of chronic medical conditions in a primary care practice requires knowledge and commitment, particularly when providing services for the underserved. Type 2 diabetes mellitus (T2DM) is a complex and difficult condition that can result in complications that affect multiple organ systems. Numerous studies have described GLP-1RAs and SGLT-2is as complementary agents that can be used to prevent the multi-organ complications associated with T2DM. The purpose of this Quality Improvement (QI) Project is to introduce combination therapy with metformin and GLP-1RAs or SGLT-2is as part of an overall effort to address hyperglycemia in patients with uncontrolled T2DM. The foundations …

The Use Of Valium In Alcohol Withdrawal, Holly Powers

Cohort X

Background: Benzodiazepines are the primary medical intervention used in the hospital for inpatients suspected of acute alcohol withdrawal during their admission. Per Shu et al. (2015) a study completed in the 1960 compared Librium with placebo as well as other drugs which showed the therapeutic efficacy of benzodiazepines in alcohol withdrawal. “Alcoholism has been reported in 20% to 50% of hospitalized medical patients” (Maldonado, 2012), moreover, the data indicate that 39% of ICU admission are alcohol-related (Muzyk et al., 2011). This is noted in an inpatient unit where alcohol withdrawal is common, Ativan is the benzodiazepine of choice along with …

Implementation Of An Evidence-Based Screening And Treatment Algorithm For Chronic Constipation In A Skilled Nursing Facility, Lucia Belleza De La Paz

Cohort X

This quality improvement (QI) project was an evidence-based screening and treatment algorithm for chronic constipation at a skilled nursing facility. The project aimed to decrease the occurrence of constipation using an evidence-based screening tool, Rome IV criteria for chronic constipation, and a modified algorithm for managing chronic constipation in a skilled nursing facility population setting. The project will provide skilled nursing facilities with a practical and straightforward management algorithm for patients with chronic constipation as described by Rome IV criteria.

Background During a review of bowel movement records from a 129-bed capacity nursing home with post-acute care subspecialty hospital, the …

Prophylactic Bioimpedance Spectroscopy For Breast Cancer-Related Lymphedema, Maria M. Marquez

Cohort X

The purpose of this quality improvement project was to implement the standardized use of Bioimpedance Spectroscopy (BIS) for the early detection and management of breast cancerrelated lymphedema (BCRL). BCRL is a common complication of breast cancer treatments resulting from damage to the lymphatic system. While three of every four patients that develop lymphedema typically do so within the first three years after treatment, this complication can develop at any time during or after therapeutic intervention. The National Comprehensive Cancer Network® Clinical Practice Guidelines and others suggest that bilateral baseline limb measurements should be performed on patients at high risk for …