Nursing Commons^™

Malignant Hyperthermia, Brennon Pinion

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia is a rare but potentially fatal disorder that is triggered by the use of certain anesthetic medications. It is caused by a mutation in specific proteins in skeletal muscle that causes prolonged contraction, leading to a hypermetabolic state. This condition can have deadly effects like kidney failure, hemodynamic instability, and cardiac arrest. It is normally discovered during surgery and must be treated right away. The discovery of the treatment of Malignant Hyperthermia has dramatically decreased the fatality of the disorder, but treatment must be given immediately. For patients who develop Malignant Hyperthermia to have the highest chance of …

Myasthenia Gravis, Jonathan Garcia

Nursing Student Class Projects (Formerly MSN)

Poster Abstract

Jonathan C. Garcia

Department of Nursing, Otterbein University

NURS 6810 – Advanced Pathophysiology for the Advanced Practice Nurse

Dr. Deana Batross and Dr. Shivani Bhatnagar

July 29, 2022

Abstract

Myasthenia Gravis (MG) is a rare autoimmune neuromuscular disorder caused by the destruction or decreased availability of nicotinic acetylcholine receptors in the post-synaptic neuromuscular junction. Muscular weakness that worsens with activity and improves with rest is a hallmark of MG. MG patients are at increased risk for many postoperative and anesthesia-related complications. However, risk can be mitigated when providers thoroughly understand MG's pathophysiology and implications on the anesthetic plan. …

Creating A Pre-Illness Covid-19 Action Plan: A Web-Based Public Education Initiative, Brian S. Hustad

DNP Research Projects

Abstract

Background: The COVID-19 pandemic took the world by storm in the beginning stages of 2020. Public health agencies were overwhelmed, undermanned, and therefore slow to respond. Information began to flow at an unprecedented rate. Yet, very limited resources were put into place to present this information or to instruct the public on evidence-based prevention, treatment, or care at home during active infection.

Intervention: A project website was created and accessed through a QR code on the project flyer or by entering the URL into any browser. Participants were able to access three evidence- based video modules, which introduced the …

Use Of Point-Of-Care Ultrasound For Lung Assessment: A Practice Change Educational Program For Advanced Practice Providers And Students, Mark W. Owen

DNP Research Projects

Abstract Background: With over 130 million emergency room (ER) visits per year in the United States, many emergency departments (ED) are struggling with overcrowded conditions. Contributing to overcrowded conditions are those presenting with dyspnea, who are nearly 4 million in number. ED crowding has serious implications. Exploring and implementing evidence-based methods to alleviate congestion is critical. Problem: One method being explored is the integration of point-of-care ultrasound (POCUS) into the stretcher side assessment of dyspneic patients. Multiple pathologies can cause dyspnea and rapidly isolating the underlying etiology is critical. Various studies have demonstrated the efficiency of POCUS at identifying lung …

The Effects Of 465nm Blue Light On Sleepiness & Fatigue, Mark E. Childress

DNP Research Projects

Abstract

Background: Exhaustion is now accepted in nursing culture. Staff suffering from sleepiness and fatigue are more likely to commit medical errors and sentinel events. Emergency department nurses have the greatest risk of committing these errors. Currently, there is no relief provided to shift workers beyond a single 30-minute meal break within a 12-hour period. Other researched mitigation strategies have either failed or are unrealistic in this environment.

Local Problem: Emergency Department nurses at Parkridge Medical Center in Chattanooga, TN suffer from chronic sleepiness and fatigue that is exacerbated by shift duration, excessive workload, a stressful environment, and lack of …

Enhancing Hospitalists' Knowledge In Relation To Palliative Care, Herline Raphael

DNP Research Projects

Abstract

Palliative care was not the specialty of many hospitalists; thus, communication was hindered regarding ELC and advanced directives. Despite healthcare utilization in the United States, inadequate treatment of serious illnesses continues due to the lack of provider education and understanding of ELC (palliative and hospice care). Hospitalists are not formally or informally trained to care for patients that need palliative or hospice care. A quantitative, quasi- experimental and qualitative approach was utilized to determine if hospitalists who received educational training on palliative care communication and collaboration improved knowledge, skills, and collaboration when caring for end-of-life or critically ill patients. …

Improving Nutrition Literacy In Primary Care, Kami D. Dykes

DNP Research Projects

Abstract

By the year 2030, nearly one in every two adults will have obesity (Body Mass Index [BMI] ≥30 kg/m².), and one in four adults will have severe obesity (BMI ≥35 kg/m²) (Ward et al., 2019). Equally troubling is that obesity poses a threat to the health of individuals, decreases the quality of life, shortens life expectancy, causes and worsens comorbidities, and increases all- cause mortality (Abdelaal et al., 2017). Studies have shown a link between BMI, nutritional knowledge, and dietary practices. Nutrition literacy is a newer term that refers to the complex relationship between nutrition …

Complete Health Improvement Program To Implement Lifestyle Medicine, Robert Hobbs Jr

Doctor of Nursing Practice Projects

The health of many Americans continues to worsen. Over the past 20 years there has been a fifty percent increase in the incidence of Type 2 Diabetes Mellitus in the US. America has an increase in obesity rates, and lower mortality rates compared to other countries that spend less per capita. Currently the US healthcare system only contributes about 20% of the overall care of patients. Provider burned out is increasing and many remain uneducated regarding lifestyle medicine. Since up to 90% of chronic diseases are lifestyle related, a different approach to chronic disease care is needed. The Complete Health …

Decreasing Falls: Communicating Safety With Patient-Directed Visual Cues, Signs, And Symbols, Lizelle Hill

Doctor of Nursing Practice Projects

Patient falls during hospitalization are a major clinical problem that occurs frequently. It is estimated that between 700,000 and 1,000,000 patients fall in hospitals each year. Between 30% and 50% of patients who fall in hospitals are injured. Consequently, falls with serious injury are among the most frequent hospital-reported sentinel events. Hospitals also suffer from patient falls as the Centers for Medicare and Medicaid Services no longer reimburse for costs related to preventable falls or fall-related injuries. Given the significant negative impact of falls on patients and healthcare organizations, hospitals continue to look for interventions to decrease falls. Research strongly …

Online Support For Families Affected By Opioid Use Disorder, Sharonda Hill

Doctor of Nursing Practice Projects

Families who care for children with neonatal abstinence syndrome (NAS) face many challenges and may be lacking support. The purpose of this project was to provide evidence-based information to families caring for NAS children through an established online support group, To the Moon and Back. Nola Pender’s Health Promotion Model was the theoretical model used to guide this project. An intervention to deliver support and information was implemented through three sessions. During these sessions participants were educated on evidenced-based tools to help their children with behavioral self- regulation and communication with providers. Data was collected through pre and post assessments …

Use Of Academic Detailing To Improve Reporting Of Peri-Operative Events, Allyn Sara Miller-James

Doctor of Nursing Practice Projects

Problem: Four million people worldwide die within thirty days of surgery. The EPIC Corporation has created the opportunity to collect and analyze data on the peri-operative care of patients. Initially, implementation of the program has identified barriers to event reporting by anesthesia providers. Barriers identified in the literature and in semi-structured interviews are fear of liability and retribution by patients, employers, and governing bodies. Significance: Despite national efforts to increase the reporting of medical errors, they remain grossly under- reported. The integration of the National Anesthesia Clinical Outcomes Registry (NACOR) events data collection tool into the EHR for anesthesia providers …

Simulation To Improve Dementia-Related Care Of Veterans, Brandy Wardrip

Doctor of Nursing Practice Projects

Millions of Americans, including Veterans, are diagnosed with dementia. Healthcare staff may benefit from dementia-related training. This Doctorate in Nursing Practice (DNP) project evaluated the effectiveness of the Virtual Dementia Tour (VDT) as a learning tool to improve staff’s knowledge of dementia, enhance their empathy and attitudes when interacting with Veterans diagnosed with the disease, and increase awareness that behaviors commonly seen with dementia may be forms of communication. Interprofessional healthcare staff (N=33) at a Veterans hospital participated in the experiential simulation. A pre-and post-test design utilized the Dementia Knowledge Assessment Scale (DKAS) and the Dementia Attitude Scale …

Providing Mbsr Tools To First Year Adn Nursing Students: A Dnp Project, Katherin Brandt

Doctor of Nursing Practice Projects

Abstract

As part of the educational training provided to nursing students it is important to not only provide information regarding stress management, but also to give them tools that they can use to handle stressful situations more effectively. Literature supports the use of mindfulness techniques practiced regularly to decrease stress and anxiety. This DNP project developed, implemented, and evaluated the addition of Mindfulness-Based Stress Reduction (MBSR) techniques into the curriculum of the first-year Medical Surgical nursing course in a prelicensure Associate Degree Nursing program. The project was guided by Watson’s Theory of Human Caring and the Model for Improvement (PDSA …

Streamlining The Referral Process For A Mental Health Clinic: A Dnp Project, Ashley Barr

Doctor of Nursing Practice Projects

Abstract

Mental health providers are in short supply in the United States. Access to mental health is impacted by the process used to refer patients. To bridge this gap, this DNP Project sought to increase mental health referrals to the partnering organization through strategic outreach to primary care and an online social media presence. After IRB approval, outreach to twenty-one primary care providers across eleven clinics was completed, a social media campaign was conducted, and the intake form for the partnering organization was updated for tracking the source of the referral. Results of the interventions included high satisfaction on the …

Perioperative Malignant Hyperthermia, Mitchell Mccorkle

Nursing Student Class Projects (Formerly MSN)

Abstract

Malignant Hyperthermia (MH) is a rare inherited disorder in which exposure to triggering agents such as volatile anesthetics or depolarizing neuromuscular blockers causes a hypermetabolic reaction leading to patient fatality. MH susceptible patients have a genetic mutation on the ryanodine one receptor (RYR1) in skeletal muscle, allowing uninhibited calcium release (Smith, Tranovich, & Ebraheim, 2018). Increases in free calcium result in an uncontrollable sustained muscle contraction through the excitation-contraction coupling of myosin and actin. Sustained muscle contraction rapidly consumes adenosine triphosphate stores and stimulates conversion to lactate producing anaerobic metabolism (Smith et al., 2018). Immediate recognition and treatment of …

Substance Use Disorder In The Crna, Bridget Hayes

Nursing Student Class Projects (Formerly MSN)

Substance use disorder (SUD) affects the anesthesia community disproportionally as compared to the general public (Rupprecht, 2022). It is estimated that SUD will affect 10%-15% of all anesthesia providers at some point in their careers (Rupprecht, 2022). One way that SUD affects the human body is the alteration of microRNAs, which are small segments of RNA that exist to regulate gene expression (Gowen et al., 2020). This poster will discuss how miRNAs change in the SUD-affected individual, anesthesia-specific risk factors, and signs and symptoms to identify when this disorder has affected someone else. Resources for help are available from the …

Cystic Fibrosis, India Hutchison

Nursing Student Class Projects (Formerly MSN)

Cystic fibrosis (CF) is a complex disease caused by an autosomal recessive gene mutation that results in the dysfunction of chloride transport proteins in epithelial tissues. The resultant highly viscous secretions can cause respiratory, gastrointestinal, endocrine, and reproductive complications. Although modern treatment has become more individually targeted and the average life expectancy has increased in recent years, no cure has been discovered. It affects over 80,000 people worldwide, with 30,000 affected individuals living in the United States alone. This poster aims to provide a brief overview of the pathophysiologic processes, treatment therapies, and nursing considerations for Cystic Fibrosis.

Chronic Obstructive Pulmonary Disease (Copd), Whitney R. Stant

Nursing Student Class Projects (Formerly MSN)

To make a safe anesthetic plan, a nurse anesthetist must evaluate a patient's medical history. Anesthesia providers will encounter patients with COPD requiring anesthesia. It is necessary that nurse anesthesia understands the pathophysiology and peri-operative considerations to provide safe care to COPD patients. The poster provided can be a tool to review the pathophysiology and nursing implementations of COPD. It provides information for the nurse anesthetist to apply to the perioperative setting to improve patients’ surgery outcomes. An anesthetist is always striving to provide quality anesthesia care to their patients. COPD patients require extra preparation to prevent complications from arising …

Cauti: Are We Testing Appropriately?, Christoph Lecznar

VCU Health Nursing

Purpose: The purpose of this evidence-based quality improvement project was to decrease catheter associated urinary tract infections in a 28 bed Surgical Trauma Intensive Care Unit in a Level One Trauma Academic Medical Center.

Background: Catheter Associated Urinary Tract Infections (CAUTI) are deemed never events by the Centers for Medicare & Medicaid Services. Centers for Disease Control and Prevention estimates 17-69% of CAUTIs are preventable. Current recommendations for CAUTI reduction include: Education strategies, chlorhexidine gluconate bathing and catheter care, catheter avoidance, policies for insertion, and urine culture testing stewardship. Our unit experienced an increase in CAUTI incidence in May and …

The Lived Experience Of Simulation In Nursing Education Related To Postpartum Depression And Healthcare Disparities, Erin Tonkin

Honors Undergraduate Theses

Background: Postpartum mothers are often initially screened for postpartum depression (PPD) but lack adequate follow up visits after discharge from the hospital post-delivery, despite the variety of complications that can arise from it. Additionally, healthcare disparities (HCD) have been shown to limit access to and the quality of healthcare for minority patients. Simulation-based education offers learners an opportunity to practice screening for PPD with the goal of improving the quality of care for these patient subgroups in future practice. Purpose: The purpose of this study was to explore the lived experience of SBE with prelicensure student nurses in an effort …

Implementation Of A Decision Tree To Address Moral Distress, Tijuana Milton, Flor Culpa-Bondal, Sheryl Winn, Debra Hagerty

Graduate Research Showcase

Problem: According to the American Association of Critical-Care Nurses (AACN), moral distress (MD) is a major issue in the healthcare profession (2015). Many healthcare workers (HCW) are not aware of MD. The inability to recognize MD may lead to departing the profession.

Purpose: To offer an educational workshop about MD 1) explore the frequency and level of MD (2) establish a decision tree to mitigate MD.

Background: MD occurs when a person understands what they should do but cannot, due to organizational policies. The pandemic has exacerbated MD.

Design: A mixed-method study: Measure of Moral Distress for -Healthcare Professionals (MMD-HP) …

Promoting Alternative And Evidence-Supported Birthing Options In Healthcare Facilities, Ashley Johnson Ross

Master of Science in Nursing Theses and Projects

The project examined the standard birthing process for low-risk, natural labor, and births at healthcare facilities. All deliveries should not be treated the same with the supine-lithotomy birthing position or over-medicalized, obstetric practices, as evidence-based research advises against such practices. The goal of the project intended to deviate from standard birthing practices and implement alternative, evidence-supported birthing options at healthcare facilities. The goal of promoting alternative, evidence-supported birthing options in healthcare facilities by maternity staff, would come after thoroughly educating maternity staff and providers with intel and benefits affiliated with alternative birthing options. Evidence reveals alternative birthing options, such as …

Smoking Cessation: A Nurse-Led Approach To Address Gaps In Patient Care, Katie L. Durham

Master of Science in Nursing Theses and Projects

Currently, the rate of smoking in the US is 13.7%. While this value represents the lowest rate of smoking in documented US history, cigarette smoking remains the leading cause of preventable death, disease, and morbidity. Healthy People 2030 has set a goal to reduce the rate of smoking to 5%. Though many patients report wanting to quit smoking, nearly half report they did not receive advice from a healthcare professional to do so. Many recommended smoking cessation tools and resources remain underutilized by both clinicians and patients. To help mitigate this issue, this project sought to develop a nurse-led smoking …

Reducing The Use Of Physical Restraints Of The Elderly In The Acute Care Setting, Rachael Malone

Master of Science in Nursing Theses and Projects

The aim of this MSN project is to identify and improve the gaps in education regarding physical restraint use in the acute care setting on the elderly patient population. When admitted into hospitals, elderly patients are at much greater risk for being placed in physical restraints due to little education regarding alternative measures to physical restraints and inappropriate assessments. The purpose of this project is to implement education about the detrimental factors and consequences patients may suffer once placed in physical restraints and improve the use of alternative measures to physical restraints. This project will be evaluated by acute care …

Promoting Organ Donation Among Adults, Susan Hammitt

Master of Science in Nursing Theses and Projects

Organ donation is an important component of the American healthcare system however, the issue of low organ donation rates among the average American population is an ever-growing problem. In the United States, more than 135,000 people are waiting for an organ transplant, and as of 2019, only 39,000 donors have consented to donation. The purpose of this project is to develop an evidence-based approach to promote organ donorship among adults. The goal is to promote organ donation through hospital-based educational intervention to give patients, their families, and hospital staff the information to help promote consent for donation.

Medication Reconciliation: Protecting The Geriatric Population, Charles Jennings

Master of Science in Nursing Theses and Projects

This project was designed to address the issue of medication errors that occur during the transition from an acute care setting to an assisted living setting. Geriatric adults are often supported by a complement of medical specialists and subspecialists. As a result, reconciling medications following a hospital discharge can be challenging. To further complicate the problem, oftentimes, the primary care provider is not highly engaged with the specialists and subspecialists. The World Health Organization (WHO) has prioritized this issue through the introduction of the Medication Without Harm initiative. This initiative is focused on reducing adverse drug reactions (ADRs) and adverse …

Improving Communication Skills Of New Graduate Nurses: Using Sbar Format, Meredith Lyanne Parker

Master of Science in Nursing Theses and Projects

New graduate nurses face many challenges as they transition to professional practice (Mongale et al., 2018). Support from transition to practice (TTP) programs can have a tremendous impact on the success of a new graduate nurse and improve retention rates (Silvestre, 2017). Research identifies a gap in new graduate knowledge of communication skills (Song & McCreary, 2020). Education on improving communication using a standard format can impact patient outcomes and improve provider confidence (Marshall et al., 2008). Research also links provider confidence and proficiency to improved outcomes (Owens & Keller, 2018). Benner’s Novice to Expert Theory provides a theoretical foundation …

Implementing Rapid Response And Medical Emergency Simulation Training For Medical-Surgical Nurses, Brandon Burnett

Master of Science in Nursing Theses and Projects

This project is based on the problem of nursing competence and confidence within medical emergency and rapid response scenarios. This problem affects all patients, but specifically the medical-surgical patient population of which rapid assessment and intervention can lead to a change in patient mortality. The goal of the project is to use simulation, a common tool in undergraduate nursing education, to improve nursing competence and confidence after participation. The nurses will be cycled through three simulated scenarios, followed by a debriefing, and then moved to the next simulation. The nurses’ performance will be evaluated using evaluator checklists for each of …

A Day In The Life Of A Hospital Bedside Nurse: A Different Look At Nurse Stressors, Angela R. Higdon

Master of Science in Nursing Theses and Projects

This project is intended to be an example of the affects on the nursing work environment after years of technological advancement, healthcare reform, and process improvement. The bedside nurse work environment is riddled with a multitude of interruptions, intricate processes, and complicated documentation to prove quality care and compliance to regulatory agencies and for tracking purposes. These demands are significant as nurses are continuously reprioritizing work to meet the needs of the patient while also meeting the organizational and regulatory demands. The demands on nurses often lead to delays in patient care and sometimes omission of certain less acute patient …

Combating The Challenge Of Maintaining Active-Duty Military Medical Force Readiness, Thomas Jones

Master of Science in Nursing Theses and Projects

The United States of America’s military involvement in conflict is at one of its lowest points in over 2 decades. This presents a challenge for members of the military medical force to maintain the medical readiness skills they are expected to be proficient at in a moment’s notice to care for casualties in the nation’s next crisis or conflict. In addition to other pre-established methods, this project seeks to provide a unit-level training opportunity for Air Force active-duty medical members such as those in the United States Indo-Pacific region to practice certain medical readiness skills while continuing their steady-state daily …