Nursing Commons^™

Adults With Preexisting Diagnosis Of Heart Failure In The Environment Of Coronavirus Disease 2019, Ronald Phillips

Dissertations

Background: Heart disease continues to be the leading cause of death among adults in the United States and other industrialized countries. Heart failure (HF) is a form of heart disease and has become an epidemic with complications and medical care costs increasing at an alarming rate. HF affects more than 5.7 million adults in the United States with an incidence between 550,000 to 670,000 annually, primarily affecting females, African Americans, and adults aged 55 years and older. HF is also associated with a high rate of mortality, estimated to increase, with a risk rate of 13%, 32%, and 64% among …

Wearable Activity Trackers For Women: Motivating Factors For Increasing Physical Activity, Danielle A. Bate

Theses and Dissertations

Half of American women do not sustain recommended levels of physical activity (PA). Wearable activity trackers (WATs) may increase both awareness of, and PA if worn daily. Thus, WATs should include features and designs that encourage daily use. This study aimed to determine WAT features and designs most appealing to women and the motivational effects of various WATs. For this mixed-method pilot study, 15 women each trialed three WATs; documented daily PA levels; and rated their satisfaction with each device's comfort, features, and motivational effect. Additionally, participants shared experiences and feedback in focus groups. Features that promote adoption of WATs …

Impact Of Resiliency Training On Combating Burnout, Kimberly Labinsky

MSN Capstone Projects

Occupational burnout has long since been a problem but has only recently been acknowledged as the spark behind the fire that has led to our critical nursing shortage. Considering the emotional aftermath of the pandemic and the hardships that a strained economy will bring, we must learn how to extinguish these flames rather than adding fuel to this complex problem. Burnout is causing a vicious cycle within the healthcare workforce that will lead to detrimental effects on quality patient care. We must learn how to break the cycle.

The cycle starts with experienced nurses leaving unprecedented numbers and units primarily …

Continuum Of Maternal And Newborn Health In Sierra Leone: A 2019 National Survey, Quraish Sserwanja, Mutisya M. Linet, Lilian Nuwabaine, Kassim Kamara, Ronald Mutebi, Milton W. Musaba

School of Nursing & Midwifery, East Africa

Introduction

Globally, Sierra Leone has some of the worst maternal and child health indicators. The situation is worsened by a dearth of evidence about the level of continuum of care, an evidence-based intervention aimed at reducing maternal and perinatal morbidity and mortality. Hence this study aimed to assess the level of and factors associated with continuum of maternal and newborn care in Sierra Leone.

Method

This study analyzed secondary data from the 2019 Sierra Leone Demographic Health Survey. Analysis was restricted to women who had a live birth in the 5 years preceding the survey (n = 7326). Complete …

Use Of The Prepare Tool To Increase Completion Rates Of Advance Care Planning Documentation, Janella Thompson

Student Scholarly Projects

Practice Problem: One in three adults aged 55 and older admitted to the hospital lack advance care planning. Patients without advance care planning may not receive treatment that reflects their personal values, wishes, and preferences

PICOT: The PICOT question that guided this project was in adults 65 years or older (P), how does the implementation of a patient-centered web-based advance planning tool kit (I) compared to the usual practice of addressing advance care planning (C), affect the completion rate of advance care planning documentation (O) within 10 weeks (T).

Evidence: The current evidence has demonstrated that advanced care …

Does Screening Of Patients In The Home Health Setting Prevent Sepsis Readmissions?, Heather Michelle Cook

Doctoral Dissertations and Projects

The purpose of this evidence-based project is to reduce 30-day readmission rates of patients diagnosed with septicemia by using a symptom screening tool in the home health setting. Sepsis is a life-threatening and costly healthcare burden. Through this project the home health department staff were educated on the pathology of sepsis, and the use of the adult sepsis screener to identify at risk patients early and manage their symptoms thereby reducing 30-day hospital readmission rates of patients diagnosed with sepsis.

Impact Of Emergency Department Triage Sepsis Screening Algorithm And Treatment Order Sets: An Integrative Review, Danielle Marie Tester

Doctoral Dissertations and Projects

Sepsis is a life-threatening condition that can lead to tissue damage, end-organ damage, and death if left untreated. The Centers for Disease Control and Prevention defines sepsis as a severe response to an infection. Sepsis is prominent health concerns worldwide, as it continues to be a leading cause of mortality despite having access to health care. This has impelled many health care organizations to improve sepsis-related care and sepsis outcomes by formulating core measures to improve patient care. The purpose of this integrative review is to discuss if initiation of an emergency department triage sepsis screening algorithm and treatment order …

Provider Knowledge And Confidence With Implementing Pediatric Adverse Childhood Experiences (Aces) Screening Tool In An Alaskan Family Practice Clinic, Lisa Marie Wangberg

Doctoral Dissertations and Projects

Adverse childhood experiences (ACEs) have been known to be associated with negative developmental and long-term health sequalae since Felitti and colleagues (1998) presented their groundbreaking research nearly a quarter of a century ago. Pediatric and primary care settings have been relatively slow to implement any type of ACEs screening at regular intervals such as at well-child exams (WCEs). A scholarly project implementation was used to present ACEs education and screening training to pediatric primary care providers in a small, private, rural family health care practice in Alaska. The goal of the project was to determine if providers felt more knowledgeable …

The Use Of Self-Efficacy Evaluations, Self-Care Evaluations, And Motivational Interviewing To Improve Glycated Hemoglobin Values In Type 2 Diabetes Mellitus, Meredith Ann Kelley

Doctoral Dissertations and Projects

When improperly managed, type 2 diabetes mellitus is a serious and chronic health condition with far-reaching repercussions for individuals, families, and societies. In the United States, 34.2 million individuals live with diabetes, and 90%-95% have type 2 diabetes. While the United States healthcare system faces the monumental task of improving diabetic care outcomes and associated costs, publications have established that motivational interviewing (MI) can improve self-efficacy and associated self-care behaviors of type 2 diabetics, resulting in improved hemoglobin A1c values. Thus, this scholarly project’s intent was to track participant hemoglobin A1c values over three months, measure participant self-efficacy and self-care …

Understanding The Effectiveness Of Diabetes Self-Management Education On Psychological Distress And Self-Care Activity Measures: A Focus On Latinx Community, Anita Khadka

Doctoral Projects

The psychological distress that people with diabetes experience makes them twice likely to have clinical depression. Diabetes self-management education and support is an effective strategy to improve psychological distress and increase self-care activity measures. However, there has been limited knowledge on the impact of formal diabetes self-management education and support DSME/S on psychological distress among minority populations such as Latinx. The primary objective of this study is to explore the impact of diabetes self-management education on psychological distress and self-care activity measures. This study also explores the impact of demographic variables of the Latinx respondents on psychological distress and self-care …

Utilization Of A Block Excellence Specialty Team Is B.E.S.T, Lauren E. Pittman

Master's Projects and Capstones

Perioperative registered nurses and anesthesiologists that rely on a process for placing regional anesthesia (R.A.) blocks on the correct side for surgical patients consistently provide high-quality, safe care. Infrequently anesthesiologists place the wrong side peripheral nerve blocks (P.N.B.). Due to the sensitive nature of sentinel events, the frequency of its occurrence at this quality improvement (Q.I.) project site is unavailable. Therefore, a report by Harris et al. (2021) was referenced for the incidence of wrong side blocks (W.S.B.), which were recorded in worldwide, national, and multihospital health care system cohorts as 3.63/10,000, 1.6/10,000, and 1.28/10,000 respectively. The PreOp/PACU nursing staff …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

Intervention To Increase Home Preparation For Colonoscopies, Joshua Victor Stone

Master's Projects and Capstones

Abstract

Problem: Inpatient colonoscopies are costly to healthcare systems and inconvenient for eligible patients. The cost for a two-night inpatient bed is currently $4800.00 currently. The department manager led a five-month quality improvement project that was initiated in one 180-bed community medical center in Northern California to increase outpatient options, reduce the census and decrease the admission rate.

Context: Overburdened medical facilities often miss the opportunity to utilize ambulatory procedures due to competing operational priorities. In this setting, the Care Without Delay (CWD) department microsystem addresses barriers that impact operational throughput, efficiency, and unnecessary admissions.

Intervention: A …

Audit And Feedback For Blood Glucose Point Of Care Testing, Faith A. Onwuka

Student Scholarly Projects

Practice Problem: Patient identification errors in point-of-care testing (POCT) is responsible for test results being missed or transferred to the wrong patient’s chart. A hospital in Los Angeles County experienced a 50% compliance rate in patient barcode scanning prior to blood glucose POCT which affected the delivery of care.

PICOT: The PICOT question that guided this project was: Among emergency room nursing staff (P), how does the implementation of audit and feedback (I), when compared to random observations (C) improve compliance of patient identification with barcode scanning before performing blood glucose check (O) within ten weeks (T)? Evidence: …

Adolescents With Depression Capstone Benchmark Project, Myeshia Salter

MSN Capstone Projects

This change project promotes the inclusion of adolescent involvement within the informed consenting process for recommended treatment plans for symptoms of depression. This project proposal will include the adolescent throughout the development of the treatment plan to promote compliance. The incorporation of this plan will encourage autonomy in the adolescent and aid with developing a plan that the adolescent agrees with. The current process does not include the adolescents' desires or opinions, which results in poor efficacy of the treatment plan, thus exacerbating the symptoms of depression.

Polypharmacy Teaching In The Acute Setting, Brandy Marie Duncan

MSN Capstone Projects

Within stable economic societies, polypharmacy has become a phenomenon that can be more harmful, although medications prescribed are with good intentions. Education is integral to nursing responsibilities; it is an intervention tool to help patients affected by polypharmacy. The interest in polypharmacy stems from witnessing the lack of patient education within the acute setting, and the lack poses a greater risk for adverse drug events (ADEs). The healthcare industry’s responsibility is to help alleviate the adverse effects that polypharmacy causes, such as falls, adverse drug reactions, hospitalizations, mortality, and cognitive mental (Fried, 2014).

A new performance improvement project (PI) will …

A "Collaborative" Approach To Improving Nurse Turnover, Tiffany M. Nawabi

Master's Projects and Capstones

Problem: A cardiovascular unit is experiencing an increase in RN turnover and decreased NDNQI RN to RN interaction scores.

Context: Several recent studies demonstrate that a collaborative environment of well-being and enhanced RN communication can improve nurse retention rates (Alsufyani et al., 2021), as well as increase job satisfaction (Ylitörmänen et al., 2019).

Interventions: Nursing-led collaborative sessions were launched, consisting of the unit’s clinical nurses, the management team, and interprofessionals. The collaborative meetings provide a forum for the nurses to express their concerns, collaborate, and develop meaningful solutions.

Measures: The first measure is the Human Resource’s nursing retention report, with …

Optimization Of Postoperative Length Of Stay, Sadia Imran

Master's Projects and Capstones

Abstract

Problem: The increased patient postoperative length of stay (LOS) is impacting the throughput of the operating room and resulting in prolonged wait time for new post-anesthesia care unit (PACU) admissions from the operating room. The baseline data indicated that average LOS of laparoscopic cholecystectomy patients after surgery was 153 minutes, which is longer than the regional 90-minute standard.

Context: To deliver more efficient care, the healthcare team determined that improving LOS for laparoscopic cholecystectomy patients would increase patient care experience, improve department efficiency, and decrease healthcare cost (Health Catalyst, 2018).

Intervention: The microsystem adopted the continuous improvement methodology to …

Clinical Simulation Training To Increase Medical Surgical New Graduate Registered Nurse (Ngrn) Confidence And Competence When Caring For Deteriorating Patients: A Quality Improvement Project, Tammy Schwaab

Doctor of Nursing Practice (DNP) Manuscripts

Problem: Patient harm from preventable cardiac arrest continues despite implementation of Rapid Response Teams (RRT) in the hospital setting. Medical surgical NGRNs lack adequate practice experience to prepare themselves with the competency skills necessary to manage high acuity patients in a complex healthcare environment. An awareness of a lack of readiness for practice leads to low NGRN self-confidence. Deficiencies in NGRN self-confidence and clinical competence lead to an inability to recognize and respond to patient complications with subsequent ineffective use of the RRT. Failure to Rescue (FTR) is one of the top three medical errors committed by NGRNs. Current evidence …

Establishment Of Unit Based Council Using A Shared Governance Toolkit, Viji George

Student Scholarly Projects

Practice Problem: Shared governance (SG) is an organizational structure that provides healthcare professionals control over their professional practice. Lack of a unit-based council (UBC) was noted as a problem disrupting the shared decision-making and problem-solving approach.

PICOT: In an adult acute care unit lacking a UBC structure (P), what is the effect of the implementation of a SG toolkit (I) compared to no SG toolkit (C) on the establishment of a SG UBC within a period of 10-weeks (T)?

Evidence: The literature evidence suggest that SG enables nurses to engage as a partner with nursing leaders within …

Malignant Hyperthermia, Jessica Joos

Nursing Student Class Projects (Formerly MSN)

Being a proficient anesthesia provider requires vigilantly monitoring for any complications that may arise during the anesthetic period. Malignant Hyperthermia (MH) is one such complication. Succinylcholine, a neuromuscular blocking agent, and volatile anesthetic gases can initiate an MH reaction. In MH, ryanodine receptors are stimulated to release excess calcium, which causes muscle hypermetabolism. This process causes the patient to develop highly elevated temperatures, hypoxia, hypercarbia, and muscle rigidity. Left untreated, MH can be fatal. Treatment requires discontinuation of the triggering agent, administering dantrolene, providing 100% oxygen, and managing complications such as acidosis, hyperkalemia, and arrhythmias. MH is a manageable complication …

Hellp Syndrome: Hemolysis, Elevated Liver Enzymes, Low Platelets, Kimberly Roman

Nursing Student Class Projects (Formerly MSN)

The research provided was to understand a rare, life-threatening condition that occurs in pregnant women or recently postpartum women. The topic searched was HELLP Syndrome, an acronym for Hemolysis, Elevated Liver Enzymes, and Low Platelets. This syndrome is named this due to the underlying conditions in women who experience this disorder. Women can recover from HELLP Syndrome if detected early and treated appropriately, but symptoms are vague and difficult to diagnose. The best way to understand and detect this disorder is by promoting awareness and understanding the mechanisms and treatment involved. A search was conducted about the topic through research …

Diabetes Mellitus Type 2, Jyoti Adhikari

Nursing Student Class Projects (Formerly MSN)

Diabetes Mellitus is a metabolic disorder that affects millions of people. The trend continues to be upward. Youth and children are not exempt from this. It is a chronic metabolic disorder characterized by persistent hyperglycemia. Causes are impaired insulin secretion, resistance to the peripheral action of insulin, or both. There are three types of diabetes: type 1, type 2, and gestational. Type 2 DM accounts for around 90% of all cases of DM. In type 2 DM, the body's response to insulin diminishes causing insulin resistance. It is commonly seen in people older than 45 years old but increasingly seen …

Hashimoto Thyroiditis, Ojaswi Bhattarai

Nursing Student Class Projects (Formerly MSN)

Hashimoto's thyroiditis (HT) is a type of autoimmune disease marked by thyroid-specific autoantibodies, which cause immune cells and antibodies to attack and kill thyroid cells. As a result, the body's mechanisms slow down, resulting in fatigue, coldness, weight gain, dry skin, and hair loss, among other symptoms. Although the exact cause of HT is unknown, it is thought to be caused by a combination of genetics, environment, physical activity, immunology, dietary intake, and epigenesis. High serum antibody concentrations against one or more thyroid antigens, as well as widespread lymphocytic infiltration of the thyroid, are clinical manifestations. Typically, HT is treated …

Lipopolysaccharide-Induced Interferon Response Networks At Birth Are Predictive Of Severe Viral Lower Respiratory Infections In The First Year Of Life, James F. Read, Michael Serralha, Danny Mok, Barbara J. Holt, Mark Cruickshank, Yuliya V. Karpievitch, David I. Broadhurst, Peter D. Sly, Deborah H. Strickland, Stacey N. Reinke, Patrick G. Holt, Anthony Bosco

Research outputs 2022 to 2026

Appropriate innate immune function is essential to limit pathogenesis and severity of severe lower respiratory infections (sLRI) during infancy, a leading cause of hospitalization and risk factor for subsequent asthma in this age group. Employing a systems biology approach to analysis of multi-omic profiles generated from a high-risk cohort (n = 50), we found that the intensity of activation of an LPS-induced interferon gene network at birth was predictive of sLRI risk in infancy (AUC = 0.724). Connectivity patterns within this network were stronger among susceptible individuals, and a systems biology approach identified IRF1 as a putative master regulator of …

An Overlooked Problem: A Qualitative Meta-Synthesis From Experience Of Men With Diabetic Erectile Dysfunction, Junjira Seesawang, Pulawit Thongtaeng

Journal of Health Research

Background: ED is negatively associated with men’s sexual function capacity, emotional, intimate relationship and particularly psychological well-being. The purpose of this study was to synthesize qualitative findings which explain the experiences of men with diabetes who have erectile dysfunction.

Method: A meta-synthesis was performed. A search for qualitative studies published in English from 2010 to 2020 was conducted using PubMed, CINAHL, PsycInfo, and Science Direct databases. The main key words included: experience, men/male patient, erectile dysfunction, diabetes, diabetic erectile dysfunction, and qualitative research. Inductive and interpretative technique was used to analyze and synthesize findings from qualitative studies and reviewed by …

Relationship Between Preventive Health Behavior, Optimistic Bias, Hypochondria, And Mass Psychology In Relation To The Coronavirus Pandemic Among Young Adults In Korea, Dong-Suk Lee, Hyun-Ju Koo, Seung-Ok Choi, Ji-In Kim, Yeon Sook Kim

Nursing Faculty Publications

The great challenge to global public health caused by the coronavirus pandemic has lasted for two years in Korea. However, Korean young adults seem less compliant with preventive health behaviors than older adults. This study aims to explore the relationship between risk perception variables of optimistic bias, hypochondriasis, and mass psychology, and preventive health behavior in relation to the coronavirus pandemic through a cross-sectional online survey. The participants are 91 Korean young adults aged 19–30. The results show that mass psychology has a positive relationship with preventive health behavior, whereas optimistic bias and hypochondriasis do not. In detail, people with …

Quantification Of Obstetric Hemorrhage, Alma Garcia

Student Scholarly Projects

Practice Problem: The practice problem identified involved the inconsistent measurement of blood loss during the postpartum period due to the standard practice of estimating blood loss. Estimates are subjective measures that can have variable results based on interpretation and thus provide minimal meaningful data.

PICOT: The question that guided this project was structured in the following PICOT format. In postpartum women (P), how does the implementation of quantitative blood loss measurements (I), compared to estimated blood loss measurement (C), affect the early identification of severe hemorrhage (O), during the recovery period (T)?

Evidence: Obstetric hemorrhage is a preventable event that …

Influence Of Cultural Competency Program On Bias In A Community Volunteer Program, Melodie L. Anderson

Student Scholarly Projects

Practice Problem: Individuals may express hesitancy in volunteering in community health programs that directly interface with persons experiencing poverty due to poverty biases. Failure to understand the issues and needs of those experiencing poverty may factor into disparities and inequities along the social determinants of health, leading to poorer population health, well-being, and quality of life.

PICOT: The PICOT question that guided this project was in volunteers (mentors) of community health programs (P) how does a cultural competency program (I) compare to the standardized training program(C) influence bias (0) over 8 weeks (T)?

Evidence: An evidence review indicated …

Caring For The Caregiver During Covid-19 Suspended Visitation, Melissa D. Rouse, Lorie K. Shoemaker, Priscilla Kyle, Chris Tenold, Whitney Anthony, Jordan White

Patient Experience Journal

During the 4th surge of COVID-19, August to November 2021, visitation was suspended in a hospital system in North Georgia. The Compassionate Connections Call Center (CCCC) was created to alleviate staff stress and to manage calls and communication. The goal of the initiative was to reduce interruptions to patient care caused by the increased number of calls to the clinical units by patients, families, loved ones and personal caregivers. The CCCC managed all incoming calls and communicated with the patient’s primary nurse through a coordinated process which limited interruptions. By caring for the caregiver, the aim was to improve the …