Nursing Commons^™

Implementation Of Staff Education To Standardize Use Of Positions During The First Stage Of Labor, Kelsey Jo Koch

Master's Projects and Capstones

The aim of this project was to assess whether supplemental education on labor positioning for Labor and Delivery nurses would increase the nurses’ confidence in utilizing patient positioning to promote fetal descent and progress labor. Previous research suggests that upright, mobile positions during the first stage of labor have various benefits, including reduced cesarean rates, shorter lengths of labor, and less epidural usage. However, a major barrier to maximizing these benefits is a gap in knowledge among Labor and Delivery nurses, resulting in inconsistent use of various positions. This improvement project addresses this problem at a large community hospital in …

Standardizing Handoff Report In A Medsurg Telemetry Floor, Brandon Tyler Thompson

Master's Projects and Capstones

Problem: Hospital A’s 9^th floor telemetry units lacked a standardized method of handoff and required investigation. Current practices were evaluated, and an intervention was designed based on weak communication areas. Context: Using a 5 P’s assessment the key stakeholders included unit nurses, the nursing director, nurse educators, and unit nurse managers, and the patients were medsurg telemetry patients. The process included handoff in care and the pattern evaluated was methods of reporting with the purpose of providing high quality evidence-based patient centered care. A SWOT analysis revealed strong teamwork, interdisciplinary collaboration, and proficiency in health record technologies as strengths …

Nurse-Led Education On Oral Chemotherapy Medications, Carmen Lucia Glick Alonso

Master's Projects and Capstones

Problem: Breast cancer is one of the leading causes of cancer death among women in the United States. Annually, around 264,000 breast cancer cases are diagnosed in women and 2,400 in men (Centers for Disease Control and Prevention, 2022). According to the American Cancer Society, the risk of a woman in the United States being diagnosed with breast cancer in their life is around 13% (2022).

Context: Along with a cancer diagnosis comes the need to introduce patient education about new oral chemotherapy treatments. As a treatment team member, the oncology nurse plays a vital role in this …

Decreasing Hospital Acquired Pneumonia In Adult Patients By Patient Care Technicians: Education With A Focus On Oral Care And Tooth Brushing, Amanda Nicole Lee

Master's Projects and Capstones

Hospital acquired pneumonia’s (HAPs) are unfortunate and preventable events quality improvement efforts should focus on. At a Northern California Hospital, there was an unmet HAP rate goal of 2.3 (20 out of 8795 patients) against a target goal of 2. This increase in HAP rates, both non-ventilated and ventilated was a call to action to reduce HAP to the target goal. The quality improvement project specifically aimed to reduce HAP rates on medical-surgical units through an ultra-brief refresher on the hospital validated and endorsed ROUTE bundle. The education focused on oral care completed by the patient care technicians (PCT’s). The …

Reducing Hospital-Acquired Pneumonia By Educating Patient Care Technicians On Route Bundle Care Measures, Munroop K. Thiara

Master's Projects and Capstones

Hospital-acquired pneumonia (HAP) is an infection of the lungs that can lead to severe and sometimes fatal outcomes. HAP can be prevented by oral care interventions, but without proper patient care, treatment can be very expensive. Evidence-proven HAP preventative measures such as the ROUTE bundle and increased patient mobility can significantly lower the risk of pneumonia as well as prevent additional hospital costs. Hospital X is a private nonprofit health care organization in the urban suburbs of a large Northern California city with a current HAP rate of 2.3 and with targeted goals of 2.0. By creating a project that …

Improving Nursing Staff Knowledge For Management Of Geriatric Patients With Confusion In The Emergency Department, Kareem G. Carter

Master's Projects and Capstones

Problem: Staff knowledge of effective management of confusion in geriatric patients (>65yo) may be limited and inconsistent with the current goal of establishing a geriatric-friendly Emergency Department (ED) Model of Care. Suboptimal management of this patient population can result in prolonged ED stays, which increases the cost to the hospital and the patient (Han & Wilber, 2013).

Context: An Emergency Department at a large Bay Area urban hospital hopes to obtain Geriatric Emergency Department Accreditation (GEDA) through the American College of Emergency Physicians (ACEP).

Interventions: Create a simplified checklist for nursing staff using mnemonic devices to …

Esp In Nursing: Building Communicative Competence For Internationally-Educated Nurses, Sami Vuong

Master's Projects and Capstones

The nursing shortage in the United States has been an ongoing issue due to nursing burnout and retirement. Together with the COVID-19 pandemic, it has further exhausted the healthcare system’s resources and healthcare providers. In order to sustain the healthcare system in society, a large number of internationally educated nurses (IENs) have been transferred to work in the United States. As a result of different nursing practices, cultures, and communication styles, many IENs experience language and cultural barriers at work. Difficulty in communication influences the quality of patient care provided, which can lead to negative health outcomes for patients and …

Sepsis Inservice And Video At An Urban Hospital In California, Angela T. Ho

Master's Projects and Capstones

The emergency department at an urban hospital in California was performing below institutional goals related to sepsis protocols over the past few months. This intervention was targeted at nurses and was composed of a PowerPoint in-service on compliance to SEP-1 protocols and follow-along video on using the correct sepsis order set and documentation in the electronic health record (EHR). Goals included increased compliance to the SEP-1 protocol and documentation, (2) reduced time between the onset of symptoms, recognition, and intervention, (3) decline in sepsis rates and mortality rates, and (4) lower cost of care. Data was collected from the EHR …

Improving Safe Handling And Administration Of Usp<800> Hazardous Drugs Within The Medical-Surgical Unit, Pavlo Karaputa

Master's Projects and Capstones

Nurses comprise the largest proportion of healthcare providers who make contact with Hazardous Drugs (HDs) during multiple types of clinical activities and have a risk of exposure. Hazardous drugs (HDs) are a class of pharmaceuticals that pose serious health risks to individuals who handle them, including organ toxicity, reproductive and developmental defects, infertility, miscarriage, genetic toxicity, cancer, and even death. This project was implemented in a hospital system within Northern California, on two units that serve medical-surgical, oncology, geriatric, and transplant patients. The Medical Surgical microsystem at this hospital comprises a small group of professionals such as registered nurses (RNs), …

Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard

Master's Projects and Capstones

The COVID-19 pandemic has profoundly impacted the Adult Day Services program and Adult Day programs across the country. As the Adult Day Services program transitions to an in-person format, goals within the organization include developing appropriate programming, increasing group size, and keeping clients entertained. The framework guiding this quality improvement project is Montessori-Based Dementia Programming ® (MBDP). This project aims to increase client engagement, decrease client anxiety, and decrease staff workload. This will be measured by a self-developed staff workload survey, the Menorah-Park Engagement, and the Affect rating scale. Implementation of MBDP at the Adult Day Center did not meet …

Formal Caregiver Burden Among Nursing Assistants In Nursing Homes: A Mixed Methods Study, Rachel Kunkle

Theses & Dissertations

Formal caregivers are the direct care workforce in nursing homes that aid residents. Providing care to residents is hazardous and demanding, as highlighted during the pandemic. Caregiver burden affects formal caregivers; however, is interchanged with caregiver stress and caregiver burnout. The overall purpose of this dissertation was to describe formal caregiver burden among nursing assistants who provide direct care to residents in nursing homes. This was first accomplished by conducting a concept analysis of formal caregiver burden in nursing homes. Next, an integrative review of the literature was performed to assess formal caregiver burden in nursing homes and available psychometric …

Frailty Determination And Responsiveness In Left Ventricular Assist Devices, Sarah Schroeder

Theses & Dissertations

Frailty, the state of being vulnerable with susceptibility to decreased age-related physical reserve, is found in 56-79% of adults with end-stage HF receiving durable left ventricular assist device (dLVAD) therapy. Frailty increases risk of adverse events, including increased mortality in the dLVAD population, but less is known about depression, quality of life (QOL), cognition and frailty responsiveness. Therefore, we aimed to describe and compare frailty (5-Meter Walk Test, 5MWT), depression (Patient Health Questionnaire-9, PHQ-9), quality of life (EQ5D Visual Analog Scale, EQ-5D VAS) and cognition (Trailmaking B) from pre- to 12-months post-dLVAD We also compared demographics, clinical characteristics, and post-dLVAD …

Sunsetting Excessive Chest X-Rays In An Intensive Care Unit: A Quality Improvement Project, Cassandra Sweet

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

In the cardiovascular service line at an academic medical center in the southeastern United States, obtaining daily chest x-rays still occurred despite evidence that it is unnecessary and possibly even harmful. This quality improvement project was implemented in a 24-bed Cardiovascular Intensive Care Unit and 20-bed acute care unit, together considered to be the cardiac service line. Using the implementation framework of the Model for Improvement and Plan/Do/Study/Act, a guideline that outlines appropriate times to obtain a chest x-ray based on the American College of Radiology’s appropriateness criteria was created. Daily chest x-rays were eliminated and replaced with an on-demand …

Medication Reconciliation Policy Analysis: A Collaborative Project With The Principal Hospital In Cayman Islands Health System, Bethany Landes

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Medication errors, readmissions, and chronic disease management complications are modifiable healthcare problems. Standardized Medication Reconciliation (Med Rec) policies can impact healthcare organizations' patient safety by reducing these medication errors, decreasing readmission rates, enhance the management of chronic disease while also offering fiscal stewardship for healthcare systems. Medication management standardized policies are an expectation of systems aiming to gain Joint Commission (JC) accreditation. The principal hospital of the Cayman Islands does not have a medication reconciliation policy. Using The Eightfold Path to More Effective Problem Solving, multiple policy options that offer evidence-based recommendations were reviewed for consideration of a standardized Med …

Developing Influential Nurse Leaders: Utilizing Strengths And Styles Assessments To Create Individualized, Intentional Coaching, Linda Shepherd

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

Background: A north-central Virginia university and a hospital in the British West Indies (BWI) entered a collaborative agreement in 2020. Growing competitive environments heightened awareness and urgency in creating expansively competent, influential nurse leaders in the BWI. Without formalized data to quantify or validate nurse manager strengths, leadership style, or competencies, an assessment of these items and an evidence-based coaching intervention were performed.

Methods: The population for this evidence-based (EB) practice project was 20 inpatient nurse leaders. The Multifactor Leadership Questionnaire (MLQ) and the Clifton Strength Finders Assessment (CSF) for Managers were deployed as pre-intervention assessment tools. …

Nurses Addressing The Knowledge Gap In Advance Care Planning, Stephanie Winkel, Elaine B. Harwood

International Journal of Faith Community Nursing

Background: Advance care planning allows people autonomy about values and preferences related to care at the EOL. Engaging in advance care planning enables one to consider decisions about medical treatment at the EOL and informing significant others, including health care providers, about preferences (National Institute on Aging [NIA], 2018).

Methods: In this QI project, the intervention will be a one-time ZOOM^® meeting between nurse leaders and participating church members. The nurse leader will present the 5 Wishes curriculum and lead a question-and-answer portion at the end of the ZOOM^® meeting. Participants will be asked to complete a short …

Program Evaluation Of Faith Community Nursing Cardiovascular Education Intervention, Jennifer Cummings

International Journal of Faith Community Nursing

Abstract

Background: Cardiovascular disease is the leading cause of death in the United States. Many cardiovascular risk factors are modifiable. Community engagement by Faith Community Nurses in church settings can help patients reduce risk.

Problem/Purpose: Faith Community Nurses at a Philadelphia church identified a need for cardiovascular lifestyle risk modification education and planned this as the inaugural topic of its new health outreach program. The project purpose was to evaluate effectiveness of the program in increasing knowledge of cardiovascular risk modification, increasing level of readiness to make self-identified lifestyle changes, and to evaluate the program format as a potential model …

Advance Care Planning In Faith Communities: A Quality Improvement Project, Lorie Hacker, Jan Gaddis, Jessica Grimm, Catherine Chung

International Journal of Faith Community Nursing

This quality improvement project examined the impact of providing an advance care planning training tool to faith community nurses in the community setting on advance care planning knowledge, self-efficacy, and implementation of advance care planning outreach and advance directive completion. The pre- and post-intervention frequencies measure and paired-t test survey design resulted in clinically significant improvements in knowledge, and self-efficacy of advance care planning among faith community nurses. A fifty-fold increase was seen in advance care planning outreach activities among the group from pre- to post-intervention. The limitations of the project included small sample size and short implementation timing. However, …

Technology For Faith Community Nursing Practice, Katrina Goodrich

International Journal of Faith Community Nursing

Technology is an ever-expanding tool that can be utilized by Faith Community Nurses to enhance their practice. Technology offers options for organizing and promoting services, collaborating with others on an international level, education of both the Faith Community Nurse and their clientele, and multiple instruments for tracking and managing wellness plans.

Mental Health Benefits Of Physical Activity In Older Adults, Adrian Kurt Zitzmann

Master of Science in Nursing Family Nurse Practitioner

Physical activity is the fountain of youth, strengthening both the physical body as well as the mind, leading to better emotional stability and a general sense of well-being. The population over age 65 is nearing retirement age and are transitioning from a high paced work and family life to a slower and less active “empty nest” lifestyle. Among adults over age 65, will implementing an exercise program for 30 minutes per day increase mental well-being? The benefits of physical activity will be supported by gathering a group of older adults ages 65 and up from a local retirement community to …

Impact Of Pcts In The Prevention Of Hap Through A Route Bundle With An Emphasis On Oral Care And Positioning The Patient Out Of Bed And In A Chair, Melissa Ray

Master's Projects and Capstones

Background: Hospital Acquired Pneumonia (HAP) is a leading cause of most hospital-acquired infections among surgery patients who are hospitalized and bed-bound for more than 48hrs. The occurrence of HAP is associated with increased hospital stays and cost of care. However, its occurrence can be reduced by oral care. In this regard, this project aimed to decrease the incidence of HAP on the 3^rd, 4^th, 6^th, and 7^th floors on the Medical Surgical and ICU units of the Northern California Hospital.

Methods: To achieve the aim above, the project utilized methods namely …

Health Status And Preventive Health Services Among Reproductive-Aged Women In Treatment For Opioid Use Disorder, Vanessa Short, Dennis J. Hand, Lauren Pyfer, Hanna Steiger, Meghan Gannon, Gregory A. Jaffe, Diane J. Abatemarco

College of Nursing Faculty Papers & Presentations

OBJECTIVE: To assess the utilization of preventive health services and the prevalence of chronic health conditions among a cohort of women in treatment for opioid use disorder (OUD).

METHODS: Ninety-seven women who were receiving treatment for OUD from a single urban treatment program completed a self-administered anonymous online questionnaire that asked about demographics, health, receipt of preventive health services, and utilization of health care. Descriptive statistics were used to describe data.

RESULTS: More than one-third of respondents reported that their health was fair or poor, whereas one-quarter were very concerned with their health. Most participants (59%) reported at least one …

Improving Nursing Shift Handoff Reports: A Quality Improvement Project, Nathan Mm Secrest

Master's Projects and Capstones

Nursing shift-to-shift handoff report can greatly impact a patient’s quality of care. According to the Joint Commission, “an estimated 80 percent of serious medical errors involve miscommunication between caregivers when patients are transferred or handed-off” (Inadequate handoff communication, 2017). In total, this quality improvement (QI) project worked with three hospital inpatient units on three different floors in an urban California (CA) city. Each unit and even shifts within each unit varied, leading to the conclusion that interventions should be trialed by units with the most buy-in, then adjusted to the unique needs of each unit. For our main intervention we …

Home Health Workplace Safety During The Covid-19 Pandemic: A Cross-Sectional Descriptive Analysis Of Home Health Agencies In Arkansas, Kelly M. Neal Taylor

ATU Theses and Dissertations 2021 - Present

Abstract

Workplace safety is a continual concern for home healthcare workers that provide medical care in a patient’s home environment. Healthcare workers, such as registered nurses, licensed practical nurses, and nursing aides, make up the largest group of home care providers. Before the COVID-19 Pandemic, home healthcare providers had to navigate job safety issues related to clutter in the home, unsanitary conditions, pest infestations, fumes, pets, and aggressive family members (Gershon et al., 2008). The pandemic brought about additional safety concerns, such as the implementation of isolation policies and limited supplies of personal protective equipment, to name a few. This …

The Mediating Effect Of Caregiving Relationship Quality On The Association Between Caregiving Stressors And Mental Health Problems Among Older Spousal Caregivers, Fei Wang, Elliane Irani

Faculty Scholarship

Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect =.14, p =.016). Moreover, role overload was positively associated with caregiver mental health problems, …

Interprofessional Education Lab Manual And Workbook, Geraldine Terry

Open Textbooks

This laboratory manual was designed to educate and develop integrated healthcare practices essential in delivering person-centered care. Participants will develop their ability to distinguish the role of their own profession and other healthcare professionals collaborating in the care coordination and case management of patients. The content and team-oriented activities in this manual provide guidance on advancing leadership and communication principles necessary for effective interprofessional communication and team collaboration. The well-researched material is tailored to build on the strengths of participants, while also identifying and encouraging areas for improvement.

Topics And Sentiment Surrounding Vaping On Twitter And Reddit During The 2019 E-Cigarette And Vaping Use-Associated Lung Injury Outbreak: Comparative Study, Dezhi Wu, Erin Kasson, Avineet Kumar Singh, Yang Ren, Nina Kaiser, Ming Huang, Patricia A. Cavazos-Rehg

Publications

BACKGROUND: Vaping or e-cigarette use has become dramatically more popular in the United States in recent years. e-Cigarette and vaping use-associated lung injury (EVALI) cases caused an increase in hospitalizations and deaths in 2019, and many instances were later linked to unregulated products. Previous literature has leveraged social media data for surveillance of health topics. Individuals are willing to share mental health experiences and other personal stories on social media platforms where they feel a sense of community, reduced stigma, and empowerment. OBJECTIVE: This study aimed to compare vaping-related content on 2 popular social media platforms (ie, Twitter and Reddit) …

Association Of Fabry Disease With Hearing Loss, Tinnitus, And Sudden Hearing Loss: A Nationwide Population-Based Study, Yen-Fu Cheng, Sudha Xirasagar Mbbs., Ph.D., Chin-Shyan Chen, Dau-Ming Niu, Herng-Ching Lin

Publications

Hearing loss and the related otologic manifestations are receiving increased scrutiny as significant causes of morbidity in Fabry disease. However, the relative risks of auditory deficits among patients with Fabry disease relative to the general population without a diagnosis of Fabry disease have not been studied. This study aims to explore the associations between Fabry disease and hearing-related manifestations using a nationwide population-based dataset. We identified study patients for this cross-sectional study from the 2015−2017 claims databases of the Taiwan Longitudinal Health Insurance Database 2005. We first identified 2312 patients aged over 20 years with a diagnosis of Fabry disease. …

Creating Rural Nurse Retention Strategies For Nursing Administrators, Susan Lesser

Doctoral Projects

Rural area nurse retention has been referred to as a crisis for decades; this crisis has been exacerbated by several factors including the COVID-19 pandemic, resources being directed towards larger hospitals, the inability to recruit and retain healthcare providers to rural areas, and the aging workforce (Rossetter, 2020). The researcher in this Doctor of Nursing Practice (DNP) Project investigated the elements that encourage rural nurse retention and sought to develop retention strategies that are rooted in the literature and anchored in the concerns of rural nurses. Retention strategy recommendations were drawn from results from the Revised Casey Fink Nurse Retention …

Estimulación Cognitiva Y De La Actividad Fisica En La Persona Mayor - Una Experiencia Desde La Práctica, Maria Victoria Rojas Martinez, Adriana Hernandez Bustos, Blanca Gregoria Melo Melo

Ciencias de la Salud

El trabajar con la persona mayor que presenta limitación física o mental, lleva a la aparición de grandes retos para el estudiante y futuro profesional de enfermería, más aún cuando el campo de acción es el hogar, porque el cuidado será compartido entre la persona, el cuidador o grupo familiar, dentro de su propio espacio, por lo tanto, se convierte en una intervención individual con el uso de recursos propios y generalmente con la participación directa del cuidador o acompañante. Para el cuidado en el hogar el autocuidado es base fundamental para el cumplimiento de metas en la salud de …