Nursing Commons^™

Evaluation Of An Australian Neurological Nurse-Led Model Of Postdischarge Care, Judith Dianne Pugh, Kathleen Mccoy, Merrilee Needham, Leanne Jiang, Margaret Giles, Elizabeth Mckinnon, Kym Heine

Research outputs 2014 to 2021

Neurological disorders are a leading cause of disease burden worldwide, placing a heavy demand on health systems. This study evaluated the impacts and cost savings of a community-based nursing service providing supported discharge for neurological patients deemed high-risk for unplanned emergency department presentations and/or hospital readmissions. It focused on adult patients with stroke, epilepsy, migraine/headache or functional neurological disorders discharged from a Western Australian tertiary hospital. An observational design was used comprising prospective enrolment of patients receiving nurse-led supported discharge and follow-up (Neurocare), 21 August 2018 to 6 December 2019 (N = 81), and hospital administrative data, 1 February …

Depression, Gerardo Serrano

Nursing Student Class Projects (Formerly MSN)

Depression is a common illness worldwide, with an estimated 3.8% of he population affected, including 5.0% among adults and 5.7% among adults older than 60 years (Schomerus et at., 019). Approximately 280 million people in the world have depression (Schomerus et at., 2019). Depression is different from usual mood fluctuations nd short-lived emotional responses to challenges in everyday life. Especially hen recurrent and with moderate or severe intensity, depression may become serious health condition. It can cause he affected person to suffer greatly and unction poorly at work, at school and in he family. At its worst, depression can lead …

Chronic Obstructive Pulmonary Disease Pathophysiology, Alex Thompson

Nursing Student Class Projects (Formerly MSN)

This poster presentation overviews the pathophysiologic process and accompanying disease characteristics associated with Chronic Obstructive Pulmonary Disease (COPD). COPD is a leading cause of mortality worldwide. Studies suggest that its incidence will only increase in the future. COPD risk factors include smoking tobacco, environmental chemical/pollution irritants, and genetic predisposition. Smoking is the most common cause of COPD, and cessation can improve patient outcomes drastically. This chronic obstructive pulmonary disease overview discusses the importance of knowledge of COPD, signs, symptoms, pathophysiology, peri-operative management, treatments, and prevention.

Acute Kidney Injury, Chelsey Benner

Nursing Student Class Projects (Formerly MSN)

Acute kidney injury (AKI) is a common complication of surgical procedures and can lead to increased morbidity and mortality. AKI can be described by a sudden decline in kidney function, evidenced by elevation of serum creatinine, elevated blood urea nitrogen levels, and a decreased glomerular filtration rate (McCance & Huether, 2018, p. 1360). Optimal perioperative management and recognition of patients at high risk for AKI is important in preventing the development of acute kidney injury.

Myasthenia Gravis, Rebecca Wheeler

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG), a neuromuscular and autoimmune disorder, is not completely understood by clinicians and scientists. The primary cause is thought to be anti-Acetylcholine receptor antibodies that attack the neuromuscular junction, causing destruction of post-synaptic junctional folds and blockade of the receptor. This causes frequent weakness and fatigability of voluntary muscles, making activities of daily living difficult for those living with MG. Although it is not an incredibly prevalent disease, the incidence is increasing in the United States due to better testing and diagnosis. Treatments are available, including cholinesterase inhibitors that raise the concentration of Acetylcholine at the neuromuscular junction …

Anesthetic Considerations For Patients With Aortic Stenosis, Owen Diehl

Nursing Student Class Projects (Formerly MSN)

Aortic Stenosis places surgical patients at greater risk for adverse events during surgery. Due to the pathological process of Aortic Stenosis, the left ventricle must generate high systolic pressures to ensure adequate cardiac output. These increased pressures result in left ventricular hypertrophy, placing the patient at greater risk for myocardial ischemia. For induction of anesthesia, it is imperative to maintain hemodynamic stability as this is where problems arise. Five research articles were reviewed to determine how to administer anesthesia to these patients safely. Additional sources were gathered for a background on the pathophysiology of aortic stenosis. The research articles reviewed …

Malignant Hyperthermia, Luther Nyirenda

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is a rare, life-threatening, and rapidly progressing disorder of the skeletal muscle tissue. It can be induced with the use of neuromuscular blocking agents and inhaled anesthetics which are frequently used by anesthesia providers. The pathophysiology of MH involves an uncontrolled release of free calcium from the ryanodine receptor that is found in the sarcoplasmic reticulum leading to a hypermetabolic state. MH has hereditary significance due to mutation of the ryanodine receptor, thus genetic testing and MH contracture biopsy should be performed to assess susceptibility. Signs and symptoms present as tachycardia. labile blood pressure, hyperthermia, elevated carbon …

Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason

Innovations in Health Sciences Education Journal

Due to workforce demands, new undergraduate nurses are hired directly into fast-paced units and are expected to manage complex patients with rapidly changing conditions and respond to time-sensitive situations. It is important for nurse educators to prepare undergraduate nurses for transition into clinical practice upon graduation. Simulation has been a valuable tool to provide experiential learning and promote clinical decision-making. The next iteration of improving clinical simulation as an experiential learning modality for nursing students is Immersive Virtual Reality (IVR): a realistic, immersive simulation in a 3-dimensional environment that is experienced by body movements and hand controllers. IVR can incorporate …

Perioperative Management Of The Patient With Obesity, Trevor Mack

Nursing Student Class Projects (Formerly MSN)

Abstract

Obesity has become a problem worldwide during the past few decades. The prevalence of obesity worldwide has led to an increase in the number of obese surgical patients to whom perioperative care needs to be delivered. Hence, surgeons and nurse anesthetists will care for an increasing number of obese patients in the foreseeable future and should be prepared to provide optimal management for these individuals. This poster considers preparing for and managing the obese surgical patient by explaining underlying pathophysiology, implications of nursing care, perioperative considerations, diagnosis, and various treatments. This review provides updated evidence regarding perioperative management for …

Evaluating Burnout, Secondary Traumatic Stress, And Sleep Disturbances In Healthcare Professionals During A Global Pandemic, Laura K. Miller, Sarah Pehlke

Journal of Wellness

Introduction: For healthcare workers, the COVID-19 pandemic resulted in increased workload, work related stress and patient acuity potentially leading to burnout, secondary traumatic stress (STS), and sleep disruptions. This study aims to assess the prevalence of burnout and STS symptoms, as well as sleep disturbances among healthcare personnel working in the United States during the pandemic.

Methods: Healthcare workers from all disciplines and settings in the United States completed a cross-sectional survey about work and personal characteristics from January 20-March 1, 2021. Participants reported on symptoms of burnout, STS, and sleep disruptions.

Results: A total of 360 participants in the …

Malignant Hyperthermia, Christina Bensley

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia

Christina Bensley

Department of Nursing, Otterbein University

NURS 6810: Advanced Pathophysiology for the Advanced Practice Nurse

Dr. Batross and Dr. Bhatnagar

August 5th, 2022

Abstract

Malignant Hyperthermia (MH) is a rare genetic mutation of the skeletal muscle that induces a hypermetabolic response when patients are exposed to volatile inhaled anesthetics or depolarizing neuromuscular blockers (Weant & Gregory, 2021). The first case of MH was identified in 1960, with an estimated mortality rate of 70-80% without appropriate treatment (Hopkins et al., 2021). Perioperative care providers must be able to identify triggering agents, recognize presenting signs and symptoms, and know …

Professional Development In Nursing Starting At The Bedside: An Evidence-Based Study, Annette Joyce Carlisle-Spotts

Graduate Theses, Dissertations, and Capstones

Frontline nurses are faced with a host of responsibilities requiring clinical skills to care for complex, and often, chronically ill patients. Nurses need leadership skills to communicate effectively with the interdisciplinary and multidisciplinary teams they are increasingly required to work alongside. The Institute of Medicine’s recommendation is to prepare bedside nurses with the advanced skills needed to collaborate with others to revolutionize healthcare (Institute of Medicine, 2010). With more than four million nurses in the United States serving a variety of patients and families and levels of need; the urgency for gaining advanced skills has never been greater. We also …

Reducing Falls Related To Toileting, Brian Locastro

Student Scholarly Projects

Practice Problem: The practice problem for the medical-surgical unit is a high rate of falls associated with toileting activities, despite universal fall precautions for all patients. The current fall rate is an average rate of 4 falls per 1,000 patient days.

PICOT: The PICOT question that guided this project was: Among adult patients in the inpatient medical-surgical unit (P), what is the effect of adding a toileting care plan (I) to the current practice of universal fall precautions (C) to reduce the severity and incidence of falls (O) within an 8-week period (T)?

Evidence: Nine high-quality articles supported a toileting …

Medication Administration Errors: Actions, Barriers And Preventions, Alyssa Slone

University Honors Program

Nurses play a huge role in the medication administration process. Medication administration errors have been around for a while and keep increasing in number. Communication amongst healthcare professionals helps prevent medication errors from happening. Communication increases the knowledge that patients have about their care to reduce any adverse errors that could occur. Medication administration programs, like MedEye and IndentRx, help prevent medication errors. A way to familiarize nurses with medication is to start implementing the administration process in the nursing program curriculum. There are different influential factors that can result in medication errors. The similar packaging of the medications alongside …

Implementation Evaluation Of A Leadership Development Intervention For Improved Family Experience In A Private Paediatric Care Hospital, Pakistan, Muneera A. Rasheed, Ayesha Hussain, Amin Hashwani, Johannes T. Kedzierski, Babar S. Hasan

Department of Paediatrics and Child Health

Background: A study from a tertiary care center in Pakistan demonstrated that a leadership development intervention led to improved family experience of care outcomes. The objective of the current paper is to assess the implementation of this intervention and identify barriers and facilitators to inform sustainability and scalability.
Methods: A working group designed the intervention using a theory-of-change model to strengthen leadership development to achieve greater employee engagement. The interventions included: i) purpose and vision through purpose-driven leadership skills trainings; ii) engaging managers via on-the-job mentorship programme for managers, iii) employee voice i.e., facilitation of upward communication to hear the …

The Effect Of Transfer Of Care Protocol On The Rehospitalization Rates In Psychiatric Patients, Fernando Guillen Msn, Cnp, Pmhnp-Bc

Student Scholarly Projects

Practice Problem: The problem involved the transition of psychiatric care from long psychiatric hospitalizations to community-based psychiatric treatment which has developed into shorter inpatient psychiatric hospitalizations, which in turn has developed into a significantly higher number of individuals being readmitted within one year of inpatient discharge.

PICOT: In adult patients undergoing inpatient acute psychiatric care (P), how does the use of a transfer of care protocol (I), compared to current transfer of care practice (C), affect the rate of readmission within 30 days for inpatient acute psychiatric care (O), in 10 weeks?

Evidence: The evidence from an extensive literature review …

Exploration Of Vaccination Attitudes Among Parents And Caregivers In A Rural Appalachian Health Clinic, Radwa Omar, Karen Hande, Natasha Mcclure

Journal of Appalachian Health

At a rural Appalachian health clinic in Kentucky, 20% of patients under 18 years were not up to date with the CDC-recommended immunization schedule. Reasons parents or caregivers chose to delay or refuse their child’s immunizations were explored using the Caregiver Vaccination Attitude Scale. High levels of trust in the healthcare provider and self-reported vaccine knowledge highlight opportunities for rural healthcare providers to apply evidence-based communication strategies to address vaccine hesitancy and promote the safety and health of the entire community.

Factors Influencing Utilisation Of Services Provided By Community Midwives And Their Non-Retention In District Thatta, Pakistan: A Qualitative Study Protocol, Bakhtawar M Hanif Khowaja, Anam Shahil Feroz, Sarah Saleem

Department of Obstetrics & Gynaecology

Introduction: Drawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to provide skilled birth attendance to pregnant women living in rural areas. Despite a large investment in CMW programme, the availability of community midwives in rural areas following their training is a constant struggle. The concerns related to the training, support and acceptability of community midwives need to be studied in order to identify gaps in the provision of skilled maternal and newborn healthcare. Therefore, this study aims to explore …

The Best Practice For Colon Cancer Screening Recommendations By Primary Healthcare Providers: An Integrative Review, Anna Lynn Viens

Doctoral Dissertations and Projects

Colorectal cancer screening is an important step toward reducing the mortality rate of this disease. Screening rates will improve with the utilization of trusted health care provider recommendations for patients. The purpose for a review of literature on best practices for colon cancer screening recommendations by providers is to increase the number of effective conversations between primary care providers and their patients around colorectal cancer, and, ultimately, to facilitate more provider screening recommendations for patients. This topic is important for reducing the burden of colon cancer. Providers would benefit from education and decision aids to assist with the colon cancer …

The Effect Of Trauma-Informed Care Education On Improving Knowledge And Confidence Of Clinicians Caring For Women In A Labor And Delivery Setting, Claire Annaliese Wycoff

Doctoral Dissertations and Projects

The birthing process can be profoundly emotionally, mentally, and physically strenuous for women. Many women feel a loss of sense of control during their labor and birth experience. While trauma during the birthing process can happen to anyone, women with a history of sexual trauma are more likely to experience retraumatization during birth. Health care workers have the ability to exacerbate the patient’s trauma or promote healing through the care they provide. The lack of provider and nurse education in trauma-informed care is related to women’s experiences of secondary trauma during labor and childbirth and can cause prolonged complications for …

Analyzing The Relationship Between Non-Pharmacologic Interventions And Pregnancy-Induced Hypertension: An Integrative Review, Karen Ann Ellis

Doctoral Dissertations and Projects

Maternal and fetal health outcomes are threatened due to pregnancy-induced hypertension, which complicates nearly 6%–10% of pregnancies worldwide. This disease carries a high risk of maternal and fetal morbidity and mortality. Medications are commonly used to reduce blood pressure and physical consequences related to high blood pressure. However, the use of medications does not resolve the disease as there is no pharmacological cure. Current evidence demonstrates the detrimental long-term effects of pregnancy-induced hypertension and the increased risk of future cardiac disease. Close surveillance and effective treatment during pregnancy is needed to prevent serious complications. The aim of this integrative review …

The Importance Of Education In The Management Of Diabetes, Taylor Nicole Henry

Doctoral Dissertations and Projects

Type 2 diabetes continues to affect millions of people every day across the United States. Uncontrolled blood sugars pose a risk to individuals’ overall health by causing microvascular and macrovascular changes and ultimately lead to an earlier mortality. One’s blood sugar levels can be checked at any time, but an individual’s hemoglobin (hgb) A1c is a three-month average that allows the diabetic to have an overview on how they are managing their diabetes. Appropriate nutrition and having someone hold the diabetic accountable have proven to limit these risks by lowering the patient’s hgb A1c. Providers and staff need to do …

Implementation Of A Flash Therapy Technique Pilot Program To Evaluate Well-Being In Bedside Nurses Caring For Patients With Covid-19, Rachel Faye Lakes

Doctoral Dissertations and Projects

The nursing shortage is no longer a crisis but an epidemic and it is being exacerbated by burnout and compassion fatigue. This burnout and compassion fatigue are stemming from a loss of resilience and inability to cope. The COVID-19 pandemic has further intensified these issues. A safe, efficient, and effective intervention is needed to help improve well-being and resiliency among healthcare workers. The purpose of this project was to implement a flash therapy technique pilot program to evaluate resiliency and well-being of healthcare professionals caring for patients with COVID-19. A pilot program consisting of two flash therapy sessions was implemented …

Revising An Order Set To Standardize The Workflow For The Outpatient Intravenous Diuretic Therapy Clinic In The Cardiac Cath Lab Holding Area, Mackenzie Trent Rasnake

Doctoral Dissertations and Projects

Heart failure (HF) is the leading cause of hospital admissions and readmissions. This produces costly hospital bills and detrimental effects on healthcare systems (Babar et al., 2020). It has been shown that intravenous (IV) diuretic therapy in the outpatient setting will reduce HF-related hospital readmissions (Abougergi et al., 2021). Outpatient IV diuretic therapy clinics are crucial for this reason. Revising an order set for the outpatient IV diuretic therapy clinic in the Cardiac Cath Lab holding area will reduce patient length of stay, improve nurse-provider communication, and increase patient and nurse satisfaction. Utilizing the Secure Chat feature within the electronic …

Walking To Improve Outcomes In Patients With Type Ii Diabetes, Kelley Leigh Sanders

Doctoral Dissertations and Projects

Walking is a simple, feasible, and effective exercise modality in which providers can instruct patients as a component of type II diabetic treatment plans. Many patients are overwhelmed when given instructions to exercise and therefore never begin. Lack of exercise contributes to poor glycemic control and adverse outcomes. Also, gym memberships can be expensive resulting in patients forgoing exercise altogether. The purpose of this DNP scholarly project was to conduct research outcomes which may enlighten providers to prescribe exercise interventions by providing evidence walking 45 minutes three times a week can improve glycemic control among type II diabetic patients. Also, …

The Effectiveness Of A Chart Audit And Education Intervention To Improve Rts Referral Rates And Confidence In Emergency Nurses Delivering Care To Patients Experiencing Perinatal Loss, Rachel Kathleen Tillas

Doctoral Dissertations and Projects

Perinatal loss is a significant event in a woman’s life that can have both physical and psychological impacts. Women with perinatal loss often seek care in emergency settings. Research shows that nurses working in emergency settings lack confidence in caring for this patient population, and women who seek care for perinatal loss in the emergency department are dissatisfied with their care. Resolve through sharing (RTS) is an evidence-based approach to bereavement care that offers resources and training to organizations and healthcare professionals. RTS can help bridge the education gap among emergency nurses caring for patients experiencing perinatal loss, be used …

Performance Of Machine Learning Classifiers In Classifying Stunting Among Under-Five Children In Zambia, Obvious Nchimunya Chilyabanyama, Roma Chilengi, Roma Chilengi, Michelo Simuyandi, Caroline C. Chisenga, Masuzyo Chirwa, Kalongo Hamusonde, Rakesh Kumar Saroj, Najeeha Talat Iqbal, Innocent Ngaruye

Department of Paediatrics and Child Health

Stunting is a global public health issue. We sought to train and evaluate machine learning (ML) classification algorithms on the Zambia Demographic Health Survey (ZDHS) dataset to predict stunting among children under the age of five in Zambia. We applied Logistic regression (LR), Random Forest (RF), SV classification (SVC), XG Boost (XgB) and Naïve Bayes (NB) algorithms to predict the probability of stunting among children under five years of age, on the 2018 ZDHS dataset. We calibrated predicted probabilities and plotted the calibration curves to compare model performance. We computed accuracy, recall, precision and F1 for each machine learning algorithm. …

Supporting Children Impacted By Parental Addiction: A Toolkit For Kinship Caregivers, Nicole Mueller, Jaimee Kudrle

Nursing DNP Projects

Kinship caregiving has become increasingly common in the United States, specifically due to parental substance use disorder. These kinship caregivers (KC) have unique needs that are largely unmet. Often, there is no comprehensive resource for KCs specific to their community. KC’s greatest needs are financial, legal, and mental health assistance, as well as educational information about care of children for the kinship caregivers. The objective of this project was to develop a KC resource toolkit to meet priority needs within the community. The project design utilized an EBP framework and followed a community-based participatory research approach. Project leads worked with …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …