Nursing Commons^™

The Perceptions Of Adult Patients Who Experience Needle Fear During Cosmetic Injections, Julia Hoy

Walden Dissertations and Doctoral Studies

AbstractAdult patients receiving cosmetic injections frequently experience needle fear symptoms which results in patient discomfort, suffering, and poor injection outcomes. The needle fear experience contributes to a decreased quality of life and possible avoidance behaviors involving other medical treatments requiring needles. Researchers have conducted quantitative studies which explored interventions on pain reduction but there are no qualitative studies from the perspectives of adults experiencing needle fear. The purpose of this research study was to explore the perceptions of needle fear in adult patients receiving cosmetic injections in a medical office setting. The interpretative phenomenological approach was used to provide an …

End-Of-Life Education For Long-Term Care Nurses, Naquita Altidor Jacques

Walden Dissertations and Doctoral Studies

Long-term care (LTC) nurses play a crucial role in preserving the quality of life of terminally ill patients. However, many identify deficits in skills, education, and training for end-of-life (EOL) care. The objective of this project was to educate LTC nurses caring for individuals reaching the end of their lives on EOL care. The practice-oriented question concerned whether an evidence-based educational program improved nurses’ knowledge related to EOL care and confidence in caring for EOL patients and families. The End-of-Life Nursing Education Consortium's evidence-based educational module was used to provide the content. Rosswurm and Larrabee’s model for change to evidence-based …

Adherence To American Cancer Society Guidelines For Colorectal Cancer Screening Ages 40–49, Delores Mcleod

Walden Dissertations and Doctoral Studies

AbstractThere is a problem with risk awareness for ages 40–49 for colorectal cancer based on the American Cancer Society’s (ACS’s) most recent guidelines. Because there has been an increase in mortality and morbidity from colorectal cancer between ages 40 to 49 in men and women, this DNP project addresses the meaningful gap-in-practice characterized by the lack of sufficient and efficient practice approaches among practitioners regarding recommended screenings for colorectal cancer (CRC) as per ACS’s recent guidelines. The practice-focused question that guided the current project is “Will the health care professionals and staff improve their knowledge concerning the risk awareness of …

An Educational Program To Enhance Knowledge And Communication For Nursing Staff Who Care For Dementia Patients, Behnaz Mohammadi

Walden Dissertations and Doctoral Studies

AbstractDementia is a progressive chronic disease that requires skilled nursing care. Staff at a skilled nursing facility were not using best practices to prevent and manage the psychological and behavioral symptoms of dementia. The purpose of this DNP project was to implement a dementia care education to address this gap in knowledge. The question for the evidence-based educational project was whether the program increased knowledge, promoted positive attitudes, and increased confidence in dementia care staff. A 5-hour workshop was presented in person, twice in two weeks. The person-centered care model served as a framework for the project. Nursing staff (N …

Improving Patient Safety In The Post-Anesthesia Care Unit By Identifying Nurses’ Perceived Barriers To The Implementation Of Barcode Medication Administration, Colleen Gauvin

Master's Theses and Capstones

Background: In the landmark report To Err is Human: Building a Safer Health System published by the Institute of Medicine in 1999, it was estimated that 98,000 Americans die annually due to medical mistakes (Institute of Medicine et al., 2000). Since then, major advancements have been made to improve patient safety in the United States relating to safe medication administration. Barcode medication administration (BCMA) is a technology that was designed to help decrease medication errors by automating the five rights of medication administration (Thompson et al., 2018). BCMA was first utilized at a Veteran Affairs (VA) Medical Center in …

Reducing Patient Handoff Inadequacies Using An Electronic Medical Record Based Standardized Handoff Tool In The Critical Care Unit, Mariah E. Needham

Master's Theses and Capstones

INTRODUCTION: Inadequate handoff communication is a contributing factor in sentinel events and adverse patient outcomes. Research has shown that the use of a standardized handoff tool can improve quality of handoff communication. This quality improvement (QI) project sought to standardize handoff and reduce the risk of adverse patient outcomes by utilizing the I-PASS handoff tool available in the electronic medical record (EMR).

AIM: The aim of this quality improvement project was to improve the accuracy of nurse-to-nurse patient handoffs.

METHODS: The outcomes measured by the post-intervention survey were the number of reported handoffs received with omissions, the percentage of staff …

Improving Disinfectant Cap Use On Central Lines In The Icu To Reduce Patient Risk For Clabsi: A Quality Improvement Project, Tali Cherim

Master's Theses and Capstones

BACKGROUND: Central line-associated bloodstream infections (CLABSI) are the most common type of preventable healthcare-associated bloodstream infection, and may increase length of stay (LOS), facility treatment costs, and patient mortality rates. Intensive Care Unit (ICU) patients are especially vulnerable to CLABSI due to their critical health conditions and other comorbid factors. A literature review provided evidence supporting the use of alcohol-impregnated disinfectant caps, such as SwabCap®, on central line (CL) ports to significantly reduce patients’ risk for CLABSI. This quality improvement project took place within an adult ICU of a Level II trauma facility in New England, where the Infection Prevention …

Improving The Patient Repositioning Process: A Quality Improvement Project, Sydney Elizabeth Mcgough

Master's Theses and Capstones

Background: Research has shown that visual turn reminders can improve patient repositioning to prevent pressure injuries. The aim of this quality improvement project was to improve adherence to repositioning by increasing the perceived usefulness of the visual turn reminder.

Methods: A pre-intervention survey was distributed to 70 staff members with 22 responses. Staff were given the opportunity to recommend changes to the visual reminders and were informed that feedback would lead to the identification of common themes. Based on feedback, high visibility turn reminders were developed and implemented on the unit. A post-intervention survey was distributed to the same 70 …

Enhancing Patient Safety By Promoting The Use Of The Electronic Medication Administration Record During The Preparation Of Injectable Medications: A Quality Improvement Project, Michael Ferrone

Master's Theses and Capstones

Background: Patient safety is a top priority for registered nurses (RNs) while caring for individuals in the healthcare setting. Of the various responsibilities of an inpatient RN, administering injectable medications pose significant risks to patients if done incorrectly. Given these known risks, the RNs of an inpatient medical-surgical microsystem were studied during the process of preparing these medications.

Local Problem: Through observations (N = 20), it was noticed that 13 (65%) of the preparations were done at a location referred to as the nurse server counter. This is problematic since this location does not provide the RN with access …

Advanced Practice Nursing Roles, Regulation, Education, And Practice: A Global Study, Kathy J. Wheeler, Minna Miller, Joyce Pulcini, Deborah Gray, Elissa Ladd, Mary Kay Rayens

Ellmer School of Nursing Faculty Publications

Background and Objectives: Several subgroups of the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network (ICN NP/APNN) have periodically analyzed APN (nurse practitioner and clinical nurse specialist) development around the world. The primary objective of this study was to describe the global status of APN practice regarding scope of practice, education, regulation, and practice climate. An additional objective was to look for gaps in these same areas of role development in order to recommend future initiatives.

Methods: An online survey was developed by the research team, and included questions on APN practice roles, education, regulation/credentialing, and practice climate. The …

Improving Colonoscopy Bowel Preparation In Adults Undergoing Screening Through Health Literacy Education, Kimmarie James-Ross

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths among men and women in the United States. Colonoscopy is the gold standard for CRC screening; however, the diagnostic efficiency of a colonoscopy is highly dependent on bowel preparation (prep) quality. Up to 30% of colonoscopy patients present with poor bowel prep. Poor bowel prep is a significant clinical practice problem that can lead to missed lesions, increased risk for CRC, increased risks for procedure-related complications, ineffective use of resources, and increased health care costs. A huge barrier to effective colonoscopy is low health literacy. This quality improvement project …

Evidence-Based Approaches To Screening For Polypharmacy In Older Adults, Carmelo Maddy

Walden Dissertations and Doctoral Studies

AbstractPolypharmacy is the concomitant use of five or more medicines and is associated with a higher risk of being prescribed potentially inappropriate or interactive medications. Polypharmacy in adults over 60 years of age may correlate with adverse outcomes of multimorbidity such as functional impairment, low quality of life, high healthcare use, and increased costs. Health practitioners need to be aware of tools and methods to manage polypharmacy-related issues to optimize patient safety. The gap in practice is that a primary care practice did not have a comprehensive clinical guideline for a systematic and ongoing assessment of appropriateness of medication use …

Characteristics Of Athletic Training Students' Patient Encounters During Immersive And Nonimmersive Clinical Experiences: A Report From The Association For Athletic Training Education Research Network, Bailey C. Jones, Julie M. Cavallario, Cailee E. Welch Bacon, Stacy E. Walker, R. Curtis Bay, Bonnie L. Van Lunen

Rehabilitation Sciences Faculty Publications

Context: The 2020 Standards for the Accreditation of Professional Athletic Training Programs from the Commission on Accreditation of Athletic Training Education require programs to include at least one immersive clinical experience (ICE) in their clinical education curricula. Yet, it is unknown whether ICEs provide more opportunities and benefits than nonimmersive clinical experiences (N-ICEs). The purpose of this study was to compare characteristics of patient encounters (PEs) that occurred during ICEs and N-ICEs.

Design: Multisite panel design.

Setting: Twelve professional programs (5 undergraduate, 7 graduate).

Patients or Other Participants: Three hundred thirty-eight athletic training students logged PEs in the E*Value system. …

Impact Of Parent Presence On Stress In Infants In The Neonatal Intensive Care Unit, Susan M. Horner

Dissertations

The purpose of this study was to examine potential relationships between cumulative stress exposure in infants in neonatal intensive care units (NICU), as measured using a resting salivary cortisol level at NICU discharge, and the amount (hours per week) or frequency (days per week) of parent presence and skin-to-skin care (SSC). This descriptive study was conducted via a secondary analysis of a dataset representing 78 NICU families from a tertiary level NICU in the Midwest. Median length of stay was 33 days, and a resting salivary cortisol level collected at one month of age was used for infants not discharged …

Increasing Perioperative Nurse Knowledge Of Preoperative Urine Pregnancy Testing: A Quality Improvement Project, Brooke K. Hall

Master's Theses and Capstones

Background: Nurses in the perioperative environment are responsible for assessing patients prior to undergoing surgery. Preoperative urine pregnancy testing is utilized to determine the pregnancy status of patients. Various risks of anesthesia and surgery exist for pregnant patients and the fetus. The perioperative nurse must be knowledgeable about these risks and ensure preoperative urine pregnancy tests are obtained when appropriate.

Local Problem: Within this microsystem, a gap in knowledge of perioperative nurses related to the nature and significance and institutional policy for preoperative urine pregnancy testing was identified.

Aim: The aim of this project was to increase knowledge of preoperative …

Increasing Patient Satisfaction With Noise Reduction On Medical Surgical Units: A Quality Improvement Project, Chennah Sharpe

Master's Theses and Capstones

Background: Noise has been linked to negative impacts on patient’s rest, length of stay (LOS), the immune system’s ability to fight infections, pain and anxiety levels, and readmission rates. Quality improvement projects in non-intensive care units are needed to determine major causes of noise and factors which impact patients’ rest, perception of noise, and satisfaction with medical-surgical unit care.

Aim: The global aim of this quality improvement project was to increase medical-surgical patients’ satisfaction by reducing the impact of noise in their inpatient stay. The specific aim was to increase the percent of patients, who responded Always to the Hospital …

Standardizing Nursing Hand-Off Report Using I-Pass On A Behavioral Health Unit: A Quality Improvement Project, Sarah Pennisten

Master's Theses and Capstones

Background: Deficient or ineffective communication in clinical hand-off has been established by prominent international health organizations as a significant cause of adverse clinical events, compromising clinical safety, an ongoing common problem for healthcare professionals and institutions. Existing literature unanimously called for improvement in hand-off communication to improve patient outcomes and recommended beginning such efforts by building various types of structure into hand-off (McCloughen et al., 2008).

Aim: The aim of this quality improvement project was to improve clinical communication among nurses transferring care of patients in acute psychiatric care.

Methods: Utilizing the Plan, Do, Study, Act framework over a total …

Increasing Rn Attendance In Family-Centered Rounds: A Quality Improvement Project, Katherine Power

Master's Theses and Capstones

No abstract provided.

Decreasing Delays Within The Perioperative Unit Caused By Cases Of Hypoglycemia Through Nursing Continuing Education: A Quality Improvement Project, Jesse Bardis

Master's Theses and Capstones

No abstract provided.

Promoting Postpartum Knowledge And Support Through The Provision Of Educational And Support Resources During The Postpartum Admission Stay: A Quality Improvement Project, Danielle Woodman

Master's Theses and Capstones

BACKGROUND: The postpartum period is often imbued with heightened emotions, unfamiliar challenges, and an abundance of uncertainty. Postpartum depression and anxiety are well discussed in literature, yet postpartum mothers may lack knowledge of these conditions and their associated risk factors, signs, and symptoms as well as the support resources which are available to them. Improved postpartum support and awareness may alleviate the prevalence, severity, and progression of these conditions into more severe cases.

LOCAL PROBLEM: Within the given microsystem, a gap in postpartum educational and support resources exists due to a lack of resource awareness and ease of accessibility.

METHODS: …

Quality Improvement Initiative Through Staff Development: Using Education To Increase Preoperative Handoff Communication, Victoria L. Mcgovern

Master's Theses and Capstones

Abstract

Background: Handoff communication is essential for patient safety, especially in the perioperative setting as a critical care environment. Preoperative communication between operating room nurses and preoperative room nurses was suboptimal in a local microsystem as evidenced by pre-intervention data collection where 82% of cases did not participate in handoff, 11% with partial adherence of policy and only 7% in full adherence. The global aim of this project was to improve the handoff communication between the preoperative nurse and operating room nurse in the surgical day center (SDC) within the chosen microsystem to promote patient safety and positive patient outcomes. …

Ophthalmic Nursing Education: The Key To Unlocking Patient Access To Retina Services, Jacob P. Mcginnis

Master's Theses and Capstones

Background: Ophthalmology, the medical field dedicated to the human eye and visual system infrequently uses nurses due to a lack of nursing knowledge about ophthalmology.

Local Problem: An ophthalmic microsystem in the Northeastern United States is experiencing increased demand for services and decreased access to their retina section. The microsystem does not utilize nurses in the clinic because of education and training barriers. The specific aim of this quality improvement (QI) project is to increase nursing knowledge about ophthalmology from baseline to an overall passing score of 80%.

Methods: This QI project sought to see if registered nurses could …

Improving Health Literacy Among Veterans Through An Educational Campaign On Urgent And Emergent Care: A Quality Improvement Project, Emily Dimarino

Master's Theses and Capstones

Background: Inappropriate use of the VAMC UCC can translate to delays in care and costly transfers. A local VAMC UCC noted that many of their veterans presented for care at the UCC rather than choose to seek care at a local emergency department. This quality improvement project focused on the impact of educational handouts in improving understanding of the VAMC UCC capabilities to overall reduce inappropriate visits and delays in patient care. Methods: Veteran participants utilizing the UCC (n = 10) completed pre-intervention surveys regarding their current health literacy using the Brief Health Literacy screening tool (BRIEF), as well as …

Documenting Body Mass Index And Lifestyle Counseling For Pediatric Patients: A Quality Improvement Project At A Federally Qualified Healthcare Facility, Taylor R. Graziano

Master's Theses and Capstones

Background: Screening and monitoring growth throughout childhood and adolescence, as well as providing the necessary education on positive lifestyle choices is vital in combating the childhood obesity epidemic. Counseling children on the importance of nutrition and physical activity also helps to prevent numerous comorbid conditions associated with obesity. The United States. Preventive Services Task Force recommends that healthcare workers screen for obesity at least annually in all patients 3-17 years of age, as well as offer lifestyle counseling regardless of Body Mass Index ranking.

Aim: The aim of this quality improvement project was to improve the current percentage of pediatric …

Improving Breastfeeding Establishment By Reducing The Use Of Bottles And Artificial Nipples With Medically Needed Supplementation In Full-Term Breastfed Infants: A Quality Improvement Project, Sara Fazzi Garcia

Master's Theses and Capstones

Background: Breastfeeding has long been strongly recommended by national and international organizations as a prevention of many common and chronic diseases. Baby-Friendly Hospital Initiative (BFHI) was developed to motivate hospitals to protect, promote, and support breastfeeding. This Quality Improvement (QI) project aims at supporting the continuation of the Baby-Friendly designation at the organization is being implemented, by focusing on reducing the use of bottles and artificial nipples for medically necessary supplementation for full-term breastfed newborns.

Methods: The Plan-Do-Study-Act (PDSA) framework was utilized to guide this quality improvement project.

Intervention: Educational posters on the interference of the use …

Let’S Get Moving To Reduce Falls: Nurses Increase Patient Mobilization After Brief Training, Thomas Langley

Master's Theses and Capstones

BACKGROUND: Patients in hospitals are at a high risk for falls. There are many reasons for this, but one common reason is that patients in hospitals spend a lot of time being inactive. The less time patients spend being mobile, the less capable they are of maintaining mobility and the more likely they are to fall. During the first two years of the COVID-19 pandemic, Wildcat Hospital experience their fall rates increase two- to three-fold on inpatient units.

METHODS: This quality improvement project was guided by the Plan, Do, Study, Act (PDSA) framework to improve nurse knowledge of mobility and …

Implementing Educational Initiatives To Decrease Contamination And Costs In The Blood Culture Specimen Collection Process, Hannah M. Mcguire

Master's Theses and Capstones

Background: The diagnosis of sepsis in a patient presenting with symptoms includes the collection of blood cultures which identifies the presence of specific infectious agents. The culture result will identify the organism as well as report sensitivity to various antimicrobial agents to allow the healthcare provider to determine the specific set of treatments, specifically antibiotics, that will be included in the medication regimen in combating the infection. When blood specimens become contaminated in the collection process, it hinders the success of rapidly treating these patients as repeat cultures will likely need to be completed for accurate treatment. This becomes a …

Does Urgent Care Depression Screening Lead To Increased Depression Diagnosis?, Eric Haertling

Doctor of Nursing Practice Projects

There is a knowledge gap in the administering of depression screening within the urgent care setting. The Patient Health Questionnaire (PHQ) depression screening can identify patients with depression, but evidence has been limited in identifying an increase in depression diagnosis with the implementation of depression screening. This project aims to determine if routine depression screening with the PHQ increases depression diagnosis in the urgent care setting. The translational science project was performed in a rural urgent care in north-central Arkansas between January 2022 to February 2022. A total of 2,135 records were included in the project, with eight ICD-10 codes …

Themes And Associations Concerning The Covid-19 Pandemic: Autoethnography, Amber Mcgannon, Ebunoluwa O. Adedeji

Williams Honors College, Honors Research Projects

Per the college of nursing, my proposed project will discuss living during uncertain times and unusual times of change. This APA formatted paper will be an autoethnography, meaning that we will review the perspectives of COVID through the lens of culture, research, and our own perspectives and experiences. Everyone has experienced changes during the COVID-19 pandemic due to self-isolation. Examples of change include changes in learning, working, thinking, teaching, and behaving. Using acquired nursing skills such as critical thinking, reflection, inquiry, and evidenced-based practice; my partner and I will dissect and discuss these changes and how they have affected ourselves, …

Auto- Ethnography With A Deep Dive Into Changes Mental Health During The Pandemic And A Look Into The Way The Pandemic Has Shaped Nursing Protocols For Recent Nursing College Graduates, Audrey Shaffer, Sarah Bereznay

Williams Honors College, Honors Research Projects

In this project we completed a deep dive into how the Covid-19 pandemic reshaped our mental health and has affected our preparation for careers as registered nurses through a series of auto- ethnographic narrative journals using scholarly articles to support this idea. By utilizing personal narratives, we analyzed and reflected upon the cognitive and mental changes we experienced throughout this pandemic. We fulfilled this by comprising two personal narratives with inquiries pertaining to each shared narrative by utilizing the common themes of being nursing students and living through a pandemic. Within these personal narratives, we discussed how the pandemic influenced …