Nursing Commons^™

Reducing Observation Unit Length Of Stay Hours: A Quality Improvement Project, Rena D. Cantrell

Master of Science in Nursing Theses and Projects

An acute care observation unit provides care for patients admitted via Emergency Center (EC) or direct admission from a healthcare provider’s office who do not yet require inpatient status. The goal length of stay (LOS) for these patients should be less than or equal to 24-48 hours. This project is being developed for a 22-bed observation unit in the Southeastern United States to decrease current LOS hours. Currently, the goal LOS for this unit is 24 hours, not to exceed 48 hours, and for patients admitted with a chest pain diagnosis, no longer than 19 hours. A plan to expand …

Perceived Effects Of Covid-19 On K-5 Educators And Learners, Fairbee Mintz

Master of Science in Nursing Theses and Projects

The COVID-19 pandemic disrupted traditional teaching methods at all academic levels bringing about unprecedented changes in the way education was delivered. In-person learning was halted all over the world as educators scrambled to transition to virtual education. The purpose of this Master of Science in Nursing research was to examine the perceived effects of systematic learning changes caused by the COVID-19 pandemic on primary and secondary educators and students as reported by educators. This research will then be applied to implications for future nursing educators and students. Nine K-5 educators were interviewed via Zoom in the spring of 2021 and …

Reduce Nurse Burnout During Covid-19: Implementation Of The Stop Method, Heather Smallwood

Master of Science in Nursing Theses and Projects

Historically, inpatient nurses experience significant levels of stress and exhaustion which can lead to burnout. Currently, nurses are at the frontlines of the COVID-19 pandemic. The workloads have increased, physical and mental burdens have increased, and fear of contracting the virus is an added stressor. There is an immediate need for mental health support and interventions to improve the well-being of nurses. The purpose of the project is to evaluate the benefits of a mindfulness-based intervention, such as the STOP technique to reduce stress and burnout among nurses. An inpatient COVID-19 unit at a large hospital will have 60 nurses …

The Struggle To Alleviate Nurse Burnout, Shawn Harmon

Master of Science in Nursing Theses and Projects

This project assumes the purpose of defining, reviewing, and performing a three-part activity to alleviate some fraction of a detrimental disorder that has plagued the nursing profession for years identified as nurse burnout. This debilitating stress induced by burnout can lead to decreased job satisfaction. If burnout is left unchecked, it may result in nurses leaving the profession altogether. The meaningful results, if realized, will be presented to the administrative leaders to implement changes as they see fit. The goals are to see positive results translate into interventions by the hospital that will, over time, increase job satisfaction for every …

Efficacy Of Dexmedetomidine As An Opioid Sparing Adjunct To Regional Anesthesia For Shoulder Surgery, Matthew Austin

Nurse Anesthesia Student Capstones

Regional anesthetics are often the preferred route for patients who are having orthopedic shoulder procedures (Rai & Bhutia, 2017). Traditionally, plain local anesthetics, like bupivacaine or ropivacaine, are used as the local anesthetic of choice because of their fast onset and relatively predictable duration of action. However, several different additives have been trialed to prolong the duration or improve the density of regional blocks. When looking at additives to regional anesthetic techniques, side effects and duration of the block can be unpredictable and unpleasant. For example, additives like fentanyl, morphine, and dexamethasone have been trialed in regional techniques and have …

Patient Factors Associated With Different Hospice Programs In Korea: Analyzing Healthcare Big Data, Young-Taek Park, Daekyun Kim, Su-Jin Koh, Yeon Soon Kim, Sang Mi Kim

Nursing Faculty Publications

The Korean government has implemented a pilot project that introduces a new type of hospice care program called “Consultative Hospice Care” (COHC) since August 2017. The COHC is a new type of hospice program for terminally ill patients in acute care wards, which is different from the Independent Hospice Unit (IHU) care. This study aimed to compare the characteristics of two groups of hospice patients: COHC care only and both IHU care and COHC groups. Healthcare claim data from 1 April 2018 to 31 March 2020 were retrieved from the HIRA data warehouse system. The main outcome variable was patients …

Childhood Trauma And Chronic Disease, Breanna Urena

Graduate Research Projects

No abstract provided.

Does Tight Glycemic Control Slow The Progression Of Chronic Kidney Disease?, Elani Dodd

Graduate Research Projects

No abstract provided.

Implementing An Evidence-Based Preceptor Program To Improve The Orientation Process, Emily Nobles

Graduate Research Showcase

This Quality Improvement project conducted at a 245-bed acute care hospital in the southeastern United States, aimed to develop an evidence-based preceptor program to improve retention rates. Specific goals were to create a positive experience for preceptors and preceptees by improving the training, support, and recognition. Secondary goal was to increase the number of trained preceptors. The training focused on safe practice, employee satisfaction, and self-efficacy. Retention data supplied by HR for 2020 showed increasing trend of nursing turnover with a 33% total nursing turnover, and 50.25% turnover rate for nurses with less than three years of experience. A 2019 …

"Healthy Skills 4 Life" Program: A Pilot Study And Program Evaluation, Wendy Hines

Doctor of Nursing Practice Projects

This project piloted and evaluated “The Healthy Skills 4 Life” (HS4L) program within a middle school population. HS4L is an innovative holistic health curriculum focusing on four key areas of healthy behavior: nutrition, physical activity, stress management, and sleep hygiene. A middle school physical education teacher was supplied with the HS4L instructional materials and support needed to independently implement the program. The HS4L program allowed the students to self-assess wellness behaviors and create an action plan for improvement focusing on healthy lifestyle concepts. The implementation was evaluated utilizing the "Healthy Skills 4 Life" Feedback survey. The total average …

The Use Of A Code Lavender Space To Promote Self-Care, Em Toe

Doctor of Nursing Practice Projects

The nursing shortage has been an ongoing issue across the nation. The workforce has lost valuable employees, especially in rural areas, due to staff shortages and lack of self-care. Implementing therapeutic interventions such as a Code Lavender Room aims to implement self-care during working hours to increase nursing retention in the long term. The goal of this quality improvement project was to provide a safe place for employees to go to relax and reset during working hours. A survey was used to analyze the Code Lavender Room's effectiveness in self-care and how likely the staff are to continue to use …

Addressing Compassion Fatigue In Critical Care Nurses, Melissa Bowen

Doctor of Nursing Practice Projects

Compassion fatigue causes a ripple effect that impacts caregivers, patient outcomes, and the reliability of healthcare organizations. Jarrad et al. (2018) suggests the physical, emotional, spiritual, social, and organizational consequences of compassion fatigue are so extensive that they threaten the integrity of the nurse. Addressing compassion fatigue in critical care nurses is an indispensable part of maintaining the integrity and trust of the healthcare profession. It is imperative to care for the caregivers to warrant a solid foundation for optimal patient outcomes and engagement. Self-education and awareness, nursing leadership involvement, and self-care are integral to ensuring that compassion fatigue does …

Obstructive Sleep Apnea Education To The Rural Community, Brandi Harris

Doctor of Nursing Practice Projects

This project was executed to provide obstructive sleep apnea education to the men and women of the rural community. Many residents of rural communities remain undereducated and unaware of diseases and disorders in which they are subjected to or have increased risks for. Obstructive sleep apnea affects approximately twenty-two billion Americans. Of those affected, nearly eighty percent remain undiagnosed and untreated (Nagappa et al., 2015). Victims of the sleep disorder fail to acknowledge signs and symptoms of obstructive sleep apnea, many oblivious to the etiology, risk factors, symptoms, and pathophysiology of the disorder. Presenting education to residents of the rural …

Increasing Knowledge And Comfort Levels Of Icu Nurses In Goals Of Care Discussions Through Palliative Care Education, Stephanie Harrison

Doctor of Nursing Practice Projects

Critical care nurses are tasked with treating patients during the most complex times, typically beginning with aggressive treatment measures and in many cases, transitioning to end-of-life care. According to the literature review, critical care nurses report they frequently provide care that they feel is futile and palliative care resources are underutilized in the intensive care unit. They also report limited education/training and comfort in understanding their role in goals of care conversations and end-of-life care despite their vital role in providing direct patient care. The goal of this project was to implement an education program using the IMPACT-ICU toolkit to …

Game-Based Learning Effects On Nclex-Rn Perception Of Preparedness And Pass Rates, Alexis Utley

Doctor of Nursing Practice Projects

Background: The National Council Licensure Examination for Registered Nurses (NCLEX-RN) has been used to measure the quality of a nursing program’s effectiveness in preparing nursing students to pass the exam since 1988. The combined average pass rate percentage for the Hunt School of Nursing (HSON) nursing programs for the year 2021 was 88%.

Method: Information on feelings of preparedness and time to test after graduation was collected via survey prior to the game-based learning (GBL) activity. This same information was collected post GBL and compared to the pre-survey results. NCLEX-RN pass rate data was collected 1 month after graduation.

Results: …

Using A Deterioration Index Score To Improve Patient Outcomes, Amanda Doub

Doctor of Nursing Practice Projects

Quick recognition and response to clinical deterioration have a significant impact on patient mortality and outcomes. Nurses’ confidence in their ability to recognize signs and symptoms of deterioration and activate rapid response teams (RRT) is vital in preventing code blues and transfers to a higher level of care. The objective of this project was to determine the effect of an educational intervention on nurse acknowledgment of the deterioration index score and nurse confidence in intervening to improve patient outcomes by alerting the Rapid Response Team (RRT) within two months for adult patients on a medical-surgical unit. Findings from the project …

Implementation Of The National Institutes Of Stroke Scale (Nihss) In A Cardiovascular Intensive Care For Post Carotid Intervention Patients, Lisa Morgan Msn, Rn, Cnrn, Agcns-Bc

Nursing Publications, Posters, & Presentations

Poster addresses following problem: Post carotid intervention patients in the Cardiovascular Intensive Care Unit (CVICU) were not routinely assessed with the NIHSS.

Change in process implemented through improvement protocol.

APRN Implications: Improved collaboration between nursing and the medical team.

The Roles And Contributions Of Certified Transport Registered Nurses In Critical Care Ground Transport Today., Jennifer Esslinger Bsn, Rn, Cfrn, Ctrn, Sue L Parrigin, Amy Grand, Kimberly D Bronow, Jacqueline C Stocking

Nursing Publications, Posters, & Presentations

Registered nurses are core members of critical care ground transport teams because of their education, experience, and scope of practice. Advances in medicine, technology, and equipment, combined with regionalization of specialized care and, most recently, the coronavirus disease 2019 pandemic, necessitate that transport nurses possess specialized knowledge, skills, and abilities. National specialty certification in ground transport nursing via the Certified Transport Registered Nurse (CTRN) offers registered nurses a process to validate their expertise. The most recent transport nursing role delineation study, which was conducted by the Board of Certification for Emergency Nursingin 2019, provided the foundation for the revised CTRN …

A Self-Compassion Intervention For University Students: A Dnp Project, David Coffey

Doctor of Nursing Practice Projects

University students are reporting increased levels of anxiety, depression, and suicidal ideation. Trends for mental health distress among this population have been increasing over the past few years. The COVID-19 pandemic has worsened this trend. It is important to provide college-age students with the knowledge and skills for self-compassion necessary to navigate the difficult transition from high school to university. Self-compassion skills have been shown to positively affect mental health outcomes, specifically anxiety and depression. A brief, two-part intervention was developed focusing on the major components of self-compassion and offered to university students over a two-week period. Results of the …

Hiv-Related Shame: A Grounded Theory Study Exploring The Impact Of Psychoeducation On The Lives Of People Living With Hiv, Melissa Stuntz

DNP Research Projects

Abstract

Over the past 40 years there have been significant advances in medical care for HIV. However, many people living with HIV (PLWH) experience internalized stigma in the form of HIV-related shame. This shame has been found to negatively impact mental health, patient relationships, and adherence to healthcare. This grounded theory DNP scholarly project was aimed at developing a novel theoretical framework and practice to improve quality of life including increased viral load suppression in PLWH. To this aim, a psychoeducation curriculum based on shame resilience theory was implemented with two participants in an inner-city healthcare clinic. While the shame …

Massive Blood Transfusion Practises: A Survey Of Level 1 Trauma Centers, Rebecca C. Parker

DNP Research Projects

Abstract

Background: Traumatic injury is the leading cause of death for individuals under the age of 45 years old, regardless of race, origin, or sex (CDC, 2019). Among patients who sustain traumatic injury, hemorrhage remains the leading cause of death (American College of Surgeons [ACS], 2014). Hemodynamic stability may be achieved through administration of blood products such as packed red blood cells (PRBC), plasma, and platelets (PTL). Patients with severe exsanguination may require administration of blood products in large quantities, also known as a massive blood transfusion (MBT).

Local Problem: Nationally, traumatic injury accounts for over 150,000 deaths annually (American …

Impact Of Care Handoff Methods On Emergency Department Throughput Times, Shelby Graves

DNP Research Projects

Abstract

Background: Emergency department (ED) overcrowding leads to detrimental results including increased morbidity and mortality, delay in evaluation of treatment, increased cost of care, increased length of stay, diminished staff satisfaction, increased ambulance diversion, and reputation damage for the entire institution (American College of Emergency Physicians, 2019). A study performed at three high volume community hospitals revealed inefficiency of nursing handover as one of the many contributors to prolonged ED length of stay (Salehi, 2019).

Local Problem: According to the 2018 Emergency Department Benchmarking Alliance (EDBA) data survey the average length of time from patient arrival to admission disposition was …

Evaluating Provider Knowledge On The Impact Of Vitamin D Deficiency In Chronic Health Conditions, Shelly Alamry

DNP Projects

Vitamin D deficiency affects nearly one billion individuals globally. It is an essential vitamin to maintain bone health as well as the overall health of the body. Recent research reveals the significance of vitamin D deficiency in chronic health conditions like osteoporosis, depression, breast cancer, dementia, and viral infections like COVID-19. The Doctor of Nursing Practice (DNP) project aimed to evaluate if education regarding vitamin D deficiency was effective in improving provider knowledge, increases practice confidence levels, and results in self-reported practice changes. An educational session and two questionnaires were administered to healthcare providers in the state of Mississippi. Before …

Effectiveness Of Provider Education Concerning Prediabetes Treatment In Mississippi, Marlana Mcfarland

DNP Projects

Prediabetes is defined by the American Diabetes Association (ADA) as having an A1C of 5.7-6.4% or a fasting plasma glucose of 100-125 mg/dl. Prediabetes greatly increases the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (ADA, 2019). The purpose of this Doctor of Nursing Practice (DNP) project was to determine if providing education to PCPs, practicing in MS, regarding the implementation of a prediabetes treatment algorithm improved their knowledge and implementation of the ADA guidelines. The intention was to bring increased awareness of ADA guidelines regarding the current treatment recommendations for patients with prediabetes to PCPs. A …

“I Can’T Catch My Breath’...The Use Of Noninvasive Ventilation As Adjunct Therapy To Reduce The Need For Intubation., Erika Meza Rodriguez

Cohort X

Noninvasive ventilation (NIV) is currently used as an adjunct therapy for treatment of respiratory failure with or without hypoxia. NIV is use a support for patients with severe is used acute respiratory failure) associated with Coronavirus-19, exacerbations of chronic obstructive pulmonary disease, acute cardiopulmonary edema and hypercapnia as well as to avoid reintubation of patients who were recently extubated. Published evidence that supports the use of noninvasive ventilation was collected from a comprehensive search of MEDLINE, EMBASE, PubMed, Cumulative Index Nursing and Allied Health Literature (CINAHL) and Cochrane databases. The purpose of the quality improvement (QI) project was to implement …

The Bipolar Crash: Treating Bipolar Depression, Juan E. Anzures

Cohort X

Bipolar Disorder (BD), in the depressive phase is among the most common mental disorder diagnosed in patient’s I treated based on the insight gained after completing a 10-day reflective practice log at Emergence Health Network, outpatient services. In my clinical practice, I noticed that when patients with bipolar depression were on certain antipsychotics, i.e., Aripiprazole, their bipolar disorder, depressive phase symptoms were not improving. Bipolar depression is a debilitating mental disorder and if effective treatment is not implemented, the disease can provoke a suicide death. After an intensive literature review, I found the following guidelines for the effective treatment of …

Violence Prevention Task Force: A Health System’S Journey Towards Zero, Lisa Davis, Denise Holyoak

VCU Health Nursing

VCU Health's mission is to be the safest most caring hospital with zero events of preventable harm to patients, team members, and visitors. Our goal cannot be achieved if our staff suffer from workplace violence injuries thus, our executive leaders sponsored a Violence Task Force in 2017 comprised of leaders and bedside staff from all disciplines to implement evidence-informed strategies to aid in the prevention, response or recovery to a violent event. Review of data and measures of our outcomes are based on our worker's compensation, behavioral rapid response, and safety culture surveys. Event drill-downs are achieved by our post-assault …

The Benefits Of Gender-Affirming Healthcare, Emily Lunny

Student Research Poster Presentations 2022

No abstract provided.

Finding Innovative Ways To Battle The Opioid Crisis, Nicholas Neidlinger

Student Research Poster Presentations 2022

No abstract provided.

How Efficient Is Telemedicine At Qi In The Critical Care Setting?, Christopher Sedeski

Student Research Poster Presentations 2022

No abstract provided.