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2022 Fall Newsletter, Morehead State University. Nursing Department.

Nursing Department Publications Archive

2022 Fall Newsletter of the Department of Nursing at Morehead State University.

Implementation Of A Bowel Management Care Bundle On The Spinal Cord Injury Patient Population During Acute Recovery, Jessica Rene Baldwin

Doctor of Nursing Practice Scholarly Projects

Over 17,000 Americans suffer from spinal cord injuries (SCI) annually. Although the loss of motor function is a blatantly obvious sequela, the loss of autonomic nervous system control, and its direct effects on various body systems, is scarcely understood. The most frequently reported impairment associated with SCI-related bowel dysmotility is Neurogenic Bowel Dysfunction (NBD), affecting approximately 20-60% of the SCI population. NBD is defined as slow colonic time and is hallmarked by constipation and often impaction, leading to life-threatening complications, such as bowel obstruction, fecal impaction, autonomic dysreflexia, and even death. Identifying dysmotility within the SCI patient population and early …

Preventing Pressure Injuries In Prone Positioned Patients In The Critical Care Unit, Tyler Dashiell Huddle

Doctor of Nursing Practice Scholarly Projects

Problem statement – Pressure injuries acquired by critical care patients in the prone position negatively impact their health, increases the length of stay, increases medical costs, decrease hospital reimbursement, and result in poorer patient outcomes.

Purpose – Determine if implementing a checklist before the prone position maneuver and maintenance skincare thereafter decreases pressure injuries in prone-positioned critical care patients.

Methods – Pre-intervention data will be collected retrospectively, and post-intervention data will be gathered in a seasonally similar timeframe for critical care patients in the prone position and the incidence of pressure injuries.

Inclusion criteria – All patients in the critical …

Integration Of The Respiratory Distress Observation Scale For Patients At The End Of Life, Alexandra Mackenzie Starnes

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Dyspnea is a distressing phenomenon experienced frequently in end-of-life patients. Nurses currently rely on their own experiences and observations of other nurses to guide their assessment and treatment of dyspnea. Lack of a standardized tool may lead to inconsistencies and inadequate care.

Purpose: Determine if the implementation of the RDOS will improve the nurses’ ability and self-reported comfort levels to assess and treat respiratory distress in patients at the end of life adequately and consistently.

Methods: A pre-test and post-test design evaluated nurses’ ability and self-reported comfort levels assessing and treating respiratory distress in end-of-life patients. Nurses rated …

A Bedside Handoff Tool To Enhance Fall Safety Measures In The Emergency Department, Isha Adora Godbold

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The Emergency Department (ED) is a fast-paced environment where the risk of communication failure enhances due to the variation in patient acuity, variety of shift options, and constant interruptions (White- Trevino & Dearmon, 2018). Ineffective communication can lead to increased adverse events, medical errors, and poorer patient health outcomes (Campbell & Dontje, 2019). Additionally, medical errors, such as falls, are more likely to occur during handoff when nurses change shifts (Campbell & Dontje, 2019). The most reoccurring medical error in the ED is patient falls.

Purpose: This quality improvement project aims to introduce a structured handoff rounding

tool, …

Impacting Nurse Job Satisfaction And Engagement Through Shared Governance, Meghan K. Douglas

Doctor of Nursing Practice Scholarly Projects

Problem: Shared governance (SG) has been identified as an effective process to promote shared decision-making between direct care nurses and nursing leadership. However, barriers were identified at a large hospital system in the Southeastern United States (US) that postponed the full implementation of SG. This prevented nurses from having input on policies and actions that directly affected their work. Purpose: The purpose of this evidence-based project (EBP) was to determine if unit-based SG improved job satisfaction and engagement for nurses on inpatient medical-surgical units at a large hospital system in the Southeastern US. Method: Five medical-surgical units were identified to …

Take A Seat To Improve Patient-Centered Communication, Emma E. El-Shami

Doctor of Nursing Practice Scholarly Projects

Problem Statement: At a hospital in Upstate South Carolina, the patient experience surveys identify nurse-patient communication on the post-operative unit needs improving. Over three months of Summer 2021, 83.5% of patients reported that their nurses listened carefully, 82.4% stated there was comfort with talking with nurses, and 80.8% of patients reported that nurses explained things in a way they could understand. Purpose: This project aims to determine if the "Commit to Sit" Initiative compared to usual practice will affect patient satisfaction scores. Methods: Nurse-patient communication components of the patient satisfaction survey were assessed before and after the "Commit to Sit" …

The Impact Of Mindfulness Meditation Exercises On Managing Stress Among New Graduate Nurses, Sharonda Marshay Jamerson

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Studies reveal, approximately 33.5 % of new graduate nurses suffer from stress and burnout, forcing the nurse to leave the workforce within the first two years of transitioning into the role of a professional nurse (Heins, 2019). The Chief Nursing Officer of a large healthcare system in South Carolina confirms new graduate nurses are suffering from stress and burnout while transitioning into the role of the professional nurse (Personal communication, March 5, 2021). Purpose: The purpose of this project is to provide new graduate nurses' mindfulness meditation exercises to help manage stress as mindfulness meditation has been proven …

The Impact Of Mindfulness Meditation On Registered Nurse Burnout, Kelli R. Scheibenhoffer

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Nurse burnout has been reported in hospitals across the nation and is prevalent around the globe. In 2019, the World Health Organization (WHO) declared nurse burnout a condition calling for recognition and treatment. Nurses working in an inpatient setting may experience higher levels of burnout than in other settings. Hospitals with nurse burnout jeopardize the number of functioning employees, patient safety, and quality of care. Introducing preventative factors such as mindfulness could shield nurses, improve patient care, and cut hospital costs. Purpose: This evidence-based project aimed to determine the effect of using meditation via the Headspace app with …

Impacting Rn Intent To Leave By Developing Emotional Intelligence In Frontline Nurse Leaders, Kristin W. Smith

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Registered Nurse (RN) turnover is defined as the frequency at which RNs leave the organization within a specified timeframe (Shimp, 2017). Turnover can correlate negatively to patient satisfaction and outcomes, mortality, and overall healthcare costs (Copanitsanou et al., 2017). Frontline leaders, especially those with high emotional intelligence (EI), can have a significant positive influence over RN turnover, yet there is little focus or standard approach on frontline leader EI development (Mansel & Einion, 2019).

Purpose: This DNP project aims to determine if providing professional development focused on emotional intelligence to frontline nursing leaders will impact RN intent to …

Organizational Readiness For Implementing A Postpartum Depression Screening Protocol In The Nicu, Deanna L. Suber

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Postpartum depression (PPD) is a major depressive disorder that is the most common complication following childbirth, occurring in about 16% of new mothers (Berns et al., 2021). Mothers with infants in the Neonatal Intensive Care Unit (NICU) are 40% more likely to develop PPD but are not typically screened for this complication (Berns et al., 2021; Cherry et al., 2016; Garfield et al., 2021). Implementing a PPD screening protocol in the NICU could help increase the detection of PPD in this population but would first require an evaluation of organizational readiness to ensure sustainability. Purpose: The purpose of …

Evaluating The Use And Effectiveness Of Digital Mental Health Resources For Acute Care Nurses, Ashley M. Turbyfill

Doctor of Nursing Practice Scholarly Projects

Statement: The burnout phenomenon has been exacerbated over the last almost two years due to the COVID-19 pandemic (Maunder et al., 2021). Healthcare organizations must respond by implementing evidenced-based mental health initiatives to increase staff coping skills to reduce stress and emotional exhaustion (Galanis et al., 2021). While the project organization can access large-scale aggregate data about resource usage and its overall mental well-being, they cannot assess what percentage of users are nurses and the personal impact on their mental well-being. Due to these limitations, the organization cannot gauge how the nursing staff uses and responds to offered resources. …

Hybrid-Based Cardiac Rehabilitation: Improving Enrollment, Attendance, And Completion Rates, Victoria S. Yandle

Doctor of Nursing Practice Scholarly Projects

Problem: Barriers exist to enrolling and attending a cardiac rehabilitation (CR) program for patients who have recently experienced a cardiac event. These barriers include insurance status, cost, location, availability, convenience, and transportation. Increasing accessibility to CR through the provision of a hybrid-based cardiac rehabilitation (HBCR) program provides an alternative option that may improve enrollment, attendance, and completion rates in the CR program by removing the barriers of location and transportation. Purpose: The purpose of this project was to determine if a HBCR program was feasible for improving overall enrollment, attendance, and participation rate at Prisma Health Heart Hospital (PHHH). Methods: …

Using A Clinical Reminder Tool To Impact Vitamin D Screening, Mercy Roy

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Chronic pain patients with widespread musculoskeletal pain are not adequately screened for possible vitamin D deficiency by healthcare providers. Purpose: This quality improvement project (Q.I.) aimed to improve the screening rates for vitamin D among healthcare providers by implementing a clinical reminder tool within the documentation section of the electronic medical records (EMRs) in an outpatient federally funded pain clinic located in the Southeastern region of South Carolina. Methods: A clinical reminder template was embedded within the EMR documentation to increase screening for vitamin D levels for chronic pain patients among healthcare providers. Data were collected six weeks …

Effects Of Postcode Debriefing On Nursing Burnout And Patient Survival In The Emergency Department: A Single-Center Quality Improvement Project, Margaret Anne Lee

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Emergency department (ED) nurses are routinely exposed to stressful events, including cardiac arrest codes. The American Heart Association stresses the importance of structured debriefing as a continuous quality improvement strategy for patient care. Furthermore, literature shows that debriefing after codes is associated with improved teamwork, decreased nursing burnout, and reduced staff turnover. Purpose: This quality improvement project implemented a structured postcode debriefing tool in the ED after codes to determine if it improved nurse burnout and patient survival rates. Methods: A structured postcode debriefing tool was administered after codes in the ED. All registered nurses employed in the …

Decreasing Pressure Injuries From Respiratory Devices In The Pediatric Intensive Care Unit, Samantha Nicole Elliott

Doctor of Nursing Practice Scholarly Projects

Problem: Patients developing pressure injuries while admitted to the hospital has become a nationwide problem. The national annual cost of treating pressure injuries is $11 billion dollars, with up to $70,000 dollars for stage four pressure injuries (Cooper et al., 2020).

Purpose: The purpose of this project was to implement the use of a silicone foam dressing under respiratory devices, monitored using kamishibai cards (k-cards) to decrease pressure injuries. K-cards are a rounding tool that staff can use to identify barriers that prevent the standard of care.

Intervention: A pre-study, three-month period, was compared to the implementation period in the …

Enhancing Quality Of Life For Ovarian Cancer Patients, Kelly Marie Liguori

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Ovarian cancer is associated with a delayed onset of symptoms and late diagnosis and therefore has increased morbidity and mortality (Momenimovahed et al., 2019). These patients face multiple health complications, frequent hospital admissions, and may suffer from an overall poor quality of life (Marks, 2020). Purpose: This project aimed to determine if implementing FACT-O, a patient-reported quality-of-life screening tool, led to increased pastoral care consults and patient-reported quality-of-life for ovarian cancer patients. Methods: Iowa Model of Evidence-Based Practice was used for this project. Upon admission to 3Tower at CMC Main during a 3-month period, all patients with ovarian …

Screening For Prediabetes In The Inpatient Setting, Mikayla Jordan Moore

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Many patients that utilize the hospital system do not see a primary care provider and, therefore, miss important screenings. The hospital system can provide convenient screenings, or screenings conducted whenever a patient encounters the health system regardless of their chief complaint (Obinwa et al., 2020).

Purpose: Determine whether convenient prediabetes screenings administered to admitted patients on an Intermediate Critical Care Unit (ICCU) detect prediabetes at a higher rate than no formal screenings.

Methods: Participants will be sampled from those admitted to an intermediate critical care unit at a large acute-care facility.

Inclusion Criteria: Any adult patient (>18 …

Loma Linda Nurse - Vol. 30, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | Elizabeth Bossert— Reflecting on a Journey

8 | Gloria Huerta— A Vision for Leadership

10 | Dawn Graves—First Flight

12 | The Path to Excellence

16 | Nursing Anesthesia Around the Globe

LLUSN HIGHLIGHTS

20-25 | ALUMNI NEWS

26-29 | HOMECOMING

30-33 | ACADEMICS

34-35 | FACULTY UPDATES

Improving Patient Outcomes In Substance Use Disorder Through Behavioral Therapy In Depression Development And Impacts Of Social Determinants Of Health During And After Substance Use Treatment, Jerry Ryan Armstrong, Chyanne Napp

Doctoral Projects

Substance Use Disorder (SUD) is a growing problem in the United States (U.S.) and worldwide and relapse is a common occurrence among those facing SUD. Limited scholarly research has been published addressing evidence-based treatment improvement strategies. This study focused on improving SUD treatment through the incorporation of depression tracking from admission to and discharge from inpatient treatment, as well as the incorporation of social determinants of health education during treatment, with an evaluation of relapse rates 30-days after inpatient treatment discharge. Results indicated a significant improvement in depression scores from admission to discharge. Results also revealed improved knowledge regarding social …

Telemedicine Perception: An Identification And Evaluation Of Factors Contributing To The Use Of Telemedicine Services, Katherine Lewing

Doctoral Projects

A morbidity and mortality report made by the Centers for Disease Control (CDC) on the impact of telehealth services during the COVID-19 pandemic throughout 2020 noted several instances in which telemedicine tools had contributed to improved patient outcomes, including: increasing the availability of care to patients otherwise left with little access to health care, decreasing unnecessary patient visits, and reduced disease exposure to patients and staff directly at risk (CDC, 2020).

As the utilization of telemedicine becomes more important and prevalent in U.S. health care systems, it is important to recognize factors that inhibit patient usage. Factors such as inadequate …

Objective Structured Clinical Examination For Arterial Line Placement, Delorean Calloway

Doctoral Projects

The University of Southern Mississippi (USM) is lacking a uniform guideline for arterial line placement. This DNP project promotes the addition of an objective clinical structured examination into the nurse anesthesia curriculum for future student registered nurse anesthetists (SRNAs) to gain comprehension and clinical experience in a simulation lab prior to practicing on real patients. Peer-reviewed literature and evidence-based practices have been researched and organized into a learning tool and checklist to be used as a step-by-step guideline. Having a guideline such as an OSCE in place can increase student competency and foster a culture of safety leading to better …

Improving Intravenous Fluid Resuscitation Compliance Of Severe Septic And Septic Shock Adults In A Rural Emergency Room, Alison Douglas

Doctor of Nursing Practice Projects

Background: The Doctor of Nursing Practice (DNP) project focused on the delay in intravenous fluid (IVF) resuscitation of sepsis and septic shock patients in the emergency room (ER) before inpatient admission.

Purpose: The purpose of this project was to improve the time-sensitive administration of IVF resuscitation of adult patients diagnosed with sepsis or septic shock by enhancing ER nurses’ end-user knowledge of and adherence to evidence-based sepsis treatment recommendations over approximately six weeks (42 days).

Methods: Retrospective chart reviews were performed in December 2021 and focused on IVF resuscitation times. Pre-intervention questionnaires were completed, assessing baseline nursing knowledge. Nurse education …

Empowering Emergency Department Nurses To Utilize The Steadi Program For Fall Prevention, Edmond M. Woods

Doctor of Nursing Practice Projects

Background: A fall is defined as an event that results in a person coming to rest inadvertently on the ground, floor, or other lower levels (World Health Organization, 2022). Nationally the incidence of falls among older adults has steadily increased over the last ten years. According to the Centers for Disease Control and Prevention (CDC), "Falls among older adults aged 65 years and older caused over 34,000 deaths in 2019, making it the leading cause of injury contributing to death for that group" (CDC, 2019, para 1). These individuals who fall for the first time often have another fall unless …

Implementing The Use Of The Emergency Severity Index Triage Tool In Urgent Care, Sakeena Spencer

Doctor of Nursing Practice Projects

Background: The urgent care sector has quickly grown in the last decade. Patients who visit healthcare facilities seeking treatment for exacerbations of chronic conditions or episodic illnesses such as asthma without scheduled appointments receive healthcare services from Urgent Care Centers (UCC) or Emergency Departments (E.D.s). Upon visiting the UCC, these patients report life-threatening symptoms; hence require immediate medical attention. UCC healthcare workers should distinguish between non-acute and acute patients to prioritize providing healthcare to patients, ensuring they are not at risk for fatal outcomes. Using the Emergency Severity Index (ESI) triage tool while delivering healthcare services to these patients has …

The Effect Of Isolation On The Mental Health Of Older Adults, Christina Yates

Senior Honors Theses

As individuals age and lose mobility and cognitive functioning, many require full-time care which their loved ones are unable to provide. This often results in placement into long-term care facilities, and these facilities are notorious for being understaffed. Physical health becomes the only priority, depriving the client of having their mental and emotional needs fulfilled. Family and friends may decrease visitation due to distance or convenience. In 2020, the Covid-19 pandemic closed the doors of many facilities to nearly all visitors. Thus, the only individuals the residents of these facilities experienced interaction with were overworked staff members looking intimidating in …

Implementation Of Routine Screening To Detect Early Cases Of Depression And Anxiety In Hispanic Adolescents In The Primary Care Setting, Latoya Hayward

Doctor of Nursing Practice Projects

Depression and anxiety are among the leading causes of illness and disability in adolescents and are two of the most prevalent mental health conditions in Latino youth. If left unrecognized and untreated, these conditions can lead to decreased quality of life and increased rates of suicide. Researchers recommend early mental health screening to occur in the primary care setting. Through routine screening using evidence-based screening tools (PHQ-9 and GAD-7), the primary goal of this quality improvement project was to increase early detection of depression and anxiety in primary care and initiate early treatment. Project methods included implementation of new workflow, …

Burnout, Collective Efficacy, And The Social Network Of A Unit, Amy Kiefer

Dissertations

Burnout, Collective Efficacy, Social Network, Social Network Analysis

2022-2023 Family Nurse Practitioner Practicum Handbook, Morehead State University. Nursing Department.

Nursing Department Publications Archive

2022-2023 Family Nurse Practitioner Practicum Handbook of the Department of Nursing at Morehead State University.

Health Literacy And Its Association With Human Papilloma Virus Vaccination Among Adults: Findings From The Behavioral Risk Factor Surveillance System, Vinodh Bhoopathi, Bhagavatula Pradeep, Maharaj Singh

College of Nursing Faculty Research and Publications

Health literacy is associated with the utilization of preventive health services. We examined the association between health literacy (HL) levels and receipt of at least one dose of the human papilloma virus (HPV) vaccination. We analyzed the data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) among adults aged 18 to 32. The primary outcome variable was the ‘yes/no’ response to the question that assessed whether the participant received at least the first dose of HPV vaccination. The primary independent variable was a summative HL score (range 3 through 12) we created for each respondent by adding the scores …