Nursing Commons^™

A Multi-Modal Strategy To Activate Pronation For Acute Respiratory Distress Syndrome Patients, Meredith Mccrorie

Doctor of Nursing Practice Projects

Background: Acute Respiratory Distress Syndrome (ARDS) is an acute pulmonary process that compromises the health of patients in the Intensive Care Unit (ICU). ARDS can progress to irreversible fibrosis causing the lungs to become noncompliant, adversely affecting ventilation or gas exchange (Buckley et al., 2019). An ARDS diagnosis accounts for 30-40% mortality rate which is an improvement from 60% in the last two decades. The clinical course of this disease is highlighted by Acute Hypoxic Respiratory Failure (AHRF) evidenced by chest radiographs revealing bilateral dense consolidations. Manual pronation of ARDS patients has shown an increase in alveolar function with end …

Utilizing Multimodal Education To Impact Provider Documentation Of Post-Anesthesia Evaluation In A Rural Hospital, Jennifer Coffman

Doctor of Nursing Practice Projects

Background: Hospital policy, Centers for Medicare and Medicaid Services (CMS), and The Joint Commission (TJC) require a post-anesthesia evaluation to be completed and documented no later than forty-eight hours following surgery or any other procedure requiring anesthesia. This evaluation is required any time general, regional, or monitored anesthesia has been administered to the patient and must be completed by a certified anesthesia provider. One rural hospital facility’s post-anesthesia documentation compliance has declined to 79%, compared to the previous quarter’s report of 95%.

Purpose: The Doctor of Nursing Practice (DNP) project aimed to improve post-anesthesia documentation through a multimodal educational intervention. …

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …

Implementation Of A Diabetes Self-Management Education Program In The Rural Health Care Setting To Improve Glycemic Control In The African American Adult Population, Patricia Jackson

Doctor of Nursing Practice Projects

Background: According to the Center for Disease Control (CDC), Type 2 Diabetes Mellitus (T2DM) is a significant epidemic health problem worldwide. Furthermore, with the generality of T2DM-associated complications increasing, individuals living with chronic diseases must be competent in self-management to prevent long-term complications (CDC, 2021). Therefore, this Project Investigator aims to decrease the reported home glycemic control and improve diabetes self-management education among African American individuals in rural healthcare using the DSMEP tool.

Purpose: The purpose of the DNP project was to implement and assess the Diabetes Self-Management Education Program (DSMEP) effect on African American individuals in the rural health …

Stroke Care: Achieving Recommended Door To Computed Tomography Times In Ambulatory Patients Presenting To The Emergency Department Of A Rural Hospital Through The Application Of American Stroke Association Guidelines, Ricardo Paitz

Doctor of Nursing Practice Projects

Background: Time matters in stroke care, and every second counts because the extent of irreversible neuronal damage increases over time (Saver, 2006). Therefore, the American Stroke Association (ASA) recommends a door to computed tomography time of 20 minutes or less for patients presenting with signs of acute ischemic stroke. This time metric in stroke care is often not met, resulting in the delay of care of patients which translates to poorer outcomes, including death and a decreased quality of life in patients who have suffered an acute ischemic stroke (Kamal, Sheng, et al., 2017).

Purpose: The purpose of this DNP …

Utilization Of Staff Education To Improve The Management Of Aggression And Violence In The Rural Inpatient Psychiatric Setting, Clara Ugwuibe-Ogunseye

Doctor of Nursing Practice Projects

Background: Workplace violence (WPV) is a global concern and an occupational hazard faced by healthcare professionals worldwide. Aggression and violence can result in serious injury to the patient, healthcare professional, other patients, or visitors and cause stress to healthcare workers, and increase work absences (Picot, 2021).

Purpose: This DNP process improvement project aim was to utilize an educational training program on violence risk assessment, therapeutic communication, and verbal de-escalation techniques, to improve the confidence of mental health nursing staff in using early intervention to manage aggressive, violent patients. This education and early intervention reduced rates of aggression and violence escalation, …

Reducing Admissions Of Adult Congestive Heart Failure Patients In The Acute Care Setting, Jamekia Calhoun

Doctor of Nursing Practice Projects

Background: Heart failure (HF) is a clinical diagnosis that affects about 1 to 2% of the population worldwide. Poor education regarding self-care behaviors after discharge has contributed to increased readmissions after acute hospitalization. Hospital readmissions cost is approximately one hundred thousand dollars. This increase in cost has forced the Centers for Medicare and Medicaid Service (CMS) to place penalties on organizations with high readmission rates. The organization may be penalized for increases in readmission rates by decreasing the percentage of the combined total Medicare payments received from the CMS (Centers for Medicare and Medicaid Services [CMS], 2021)

Purpose: …

Implementation And Evaluation Of A Post-Op Coronary Artery Bypass Graft Extubation Checklist To Reduce Prolonged Intubation In The Intensive Care Unit, Melissa Bailey

Doctor of Nursing Practice Projects

Background: Total intubation time of post-op coronary artery bypass graft (CABG) patients is set by the Society of Thoracic Surgeons (STS) guidelines. STS states that post-op CABG patients need to be extubated within twelve hours of end anesthesia time with a recommendation of fewer than six hours. The project site had a total intubation time of greater than seventeen hours before removing the outliers. The current process does not result in a total intubation time of fewer than six hours. Implementation of an extubation checklist was chosen as the intervention for this DNP project.

Purpose: This DNP project aims to …

Physical Activity And Breast Cancer Prevention Among Asian American Women, Jingxi Sheng

Theses and Dissertations

Asian Americans (AsAm) comprise about 7% of the United States population and are the only racial group for whom cancer is the leading cause of death. Breast Cancer (BrCa) is the most commonly diagnosed cancer in this population, with the highest incidence in the age of 45-49 years, which is 30 years younger than for non-Hispanic Whites. The incidence of BrCa has been increasing for over three decades in AsAm.

Physical activity (PA) is a modifiable protective factor for BrCa. Unfortunately, AsAm women have a low PA prevalence of meeting PA recommendations. The increased BrCa risk, younger age at diagnosis, …

Prevalence And Geo-Clinicodemographic Factors Associated With Hepatitis B Vaccination Among Healthcare Workers In Five Developing Countries, Precious Adade Duodu, Ernest Darkwah, Pascal Agbadi, Henry Ofori Duah, Jerry John Nutor

College of Nursing Faculty Research and Publications

Background

There is a four-fold risk for hepatitis B infection among healthcare workers compared to the general population. Due to limited access to diagnosis and treatment of hepatitis B in many resource-constrained settings, there is a real risk that only few healthcare workers with viral hepatitis may get screened or diagnosed and treated. Studies on hepatitis B vaccination among healthcare workers in developing countries are sparse and this bodes ill for intervention and support. The aim of the study was to estimate the prevalence and explored the associated factors that predicted the uptake of the required, full dosage of hepatitis …

Feto-Maternal Outcomes Of Pre-Eclampsia: A Retrospective Study, Linda Varghese, Neenumol Babu, Niya V.C

Manipal Journal of Nursing and Health Sciences

Introduction: Pre-eclampsia is a multisystem multifactorial disease unique to pregnancy with unknown aetiology which is characterized by blood pressure ≥140/90 mmHg after 20 weeks of gestation associated with proteinuria ≥300 mg/24- hour urine specimen. It complicates about 2-10% of pregnancies worldwide. Objectives: To determine the prevalence and evaluate feto-maternal outcomes of pre-eclampsia. Methods: This was a retrospective study conducted at Amrita Institute of Medical Sciences, (AIMS) Kochi from 1 August 2017 to 31 July 2018. This study was done by retrospective analysis of the delivery register (Labour room) and hospital medical records. Results: The prevalence of pre-eclampsia is 2.5% and …

“Into The Lion’S Den”: Covid-19 Experiences Of Black Adults With Sickle Cell Disease, Nadine Matthie, Dora L. Clayton-Jones, Coretta Jenerette

College of Nursing Faculty Research and Publications

Adults living with sickle cell disease are at risk for experiencing severe illness from coronavirus disease 2019 (COVID-19) due to the complexity of their disease. Additionally, self-management and navigating the healthcare system may be challenging during the COVID-19 pandemic. Therefore, we conducted telephone interviews with 25 participants to explore the experiences of Black adults living with sickle cell disease during the early months of the pandemic in the United States. Three overarching themes characterize their experiences: management of sickle cell disease was further complicated by the pandemic, fear of the virus contributed to physical and social isolation, and employment and …

Moral Injury, Nurse Well-Being, And Resilience Among Nurses Practicing During The Covid-19 Pandemic, Joyce J. Fitzpatrick, Grant Pignatiello, Minjin Kim, Jin Jun, Donal P. O'Mathuna, Henry Ofori Duah, Jessica Taibl, Sharon J. Tucker

College of Nursing Faculty Research and Publications

OBJECTIVE

The aim of this study was to determine relationships between moral injury (MI), well-being, and resilience among staff nurses and nurse leaders practicing during the COVID-19 (coronavirus disease 2019) pandemic.

BACKGROUND

Attention to MI among health professionals, including nurses, increased in 2021, particularly related to the pandemic. Few studies examined MI, well-being, and resilience; even fewer provided implications for leadership/management.

METHODS

The sample included 676 RNs practicing in Ohio. The electronic survey included assessments of MI, well-being, and resilience distributed via the Ohio Nurses Association and the schools of nursing alumni Listservs.

RESULTS

There was a significant association between …

‘If The Partner Finds Out, Then There’S Trouble’: Provider Perspectives On Safety Planning And Partner Interference When Offering Hiv Pre-Exposure Prophylaxis (Prep) To Women Experiencing Intimate Partner Violence (Ipv), Noelene K. Jeffers, Jessica L. Zemlak, Lourdes Celius, Tiara C. Willie, Trace Kershaw, Kamila A. Alexander

College of Nursing Faculty Research and Publications

Pre-exposure prophylaxis is an effective women-controlled HIV prevention strategy but women experiencing intimate partner violence fear partners’ interference and subsequent violence could limit its utility. This study explores provider perceptions of safety planning strategies to prevent escalating violence, mitigate partner interference, and promote daily oral PrEP adherence. We conducted interviews (N = 36) with healthcare providers (n = 18) and IPV service providers (n = 18) in Baltimore and New Haven. Using the Contextualized Assessment for Strategic Safety Planning model we organized data into two categories: the appraisal process and strategic safety planning. Themes revealed during …

Debriefing For Meaningful Learning: Implementing A Train-The-Trainer Program For Debriefers, Aimee A. Woda, Jamie Hansen, Kristina Dreifuerst, Brandon Kyle Johnson, Anne Loomis, Nolan Cox, Cynthia Sherraden Bradley

College of Nursing Faculty Research and Publications

Debriefing for Meaningful Learning (DML) is a method of debriefing grounded in the theory of reflection used following a simulation or clinical learning experience to engage participants in an interactive dialogue aimed at examining and evaluating their thinking and decision-making processes. With increasing adoption of DML worldwide, a sustainable training program for nurse educators is needed. Attending conferences and workshops that provide training is challenging for many nurse educators because of time and cost constraints. One promising solution is the train-the-trainer (TTT) model. In this article, the development and implementation of a TTT model of DML debriefer training, adaptable to …

Acquiring, Applying And Retaining Knowledge Through Debriefing For Meaningful Learning, Anne Loomis, Kristina Dreifuerst, Cynthia Sherraden Bradley

College of Nursing Faculty Research and Publications

Abstract

Acquiring, Retaining and Applying Knowledge Through Use of Debriefing for Meaningful Learning (DML).

Background

Developing competence in nursing care is a critical expectation of nursing students. Knowledge acquisition, application and retention are the primary building blocks of competence. DML debriefing offers an opportunity to ensure that students master critical components of nursing they might not otherwise learn and to remove epistemological roadblocks to knowledge development.

Methods

Eighty-two traditional prelicensure baccalaureate nursing students from a single school participated in the study. This quasi-experimental pretest, posttest study explored the impact of the use of Debriefing for Meaningful Learning compared with customary …

Coaching For Childbearing Health: A Theory Synthesis, Jennifer M. Ohlendorf, Lisa Anders

College of Nursing Faculty Research and Publications

This article describes development of a theory to guide nurses promoting perinatal weight self-management behaviors. The Coaching for Childbearing Health (CoaCH) Model was developed through synthesis of the Individual and Family Self-Management Theory with Transitions Theory, following Walker and Avant's process of theory synthesis. Qualitative data were integrated to provide perinatal context. The CoaCH Model is composed of context factors that shape a nurse coaching intervention, supporting patients' self-management efforts. Sustained engagement in weight self-management behaviors will impact the long-term health of both the birthing person and the child. This model is a testable framework for future perinatal health promotion …

An Unbelievable Ordeal: The Experiences Of Adult Survivors Treated With Extracorporeal Membrane Oxygenation, Krista A. Knudson, Marjorie Funk, Nancy S. Redeker, Laura K. Andrews, Robin Whittemore, Abeel A. Mangi, Lois S. Sadler

College of Nursing Faculty Research and Publications

Background: Extracorporeal membrane oxygenation (ECMO) is a rescue treatment option for adult patients with severe cardiac dysfunction or respiratory failure. While short-term patient outcomes, such as in-hospital mortality and complications, have been widely described, little is known about the illness or recovery experience from the perspectives of survivors. Subjective reports of health are important indicators of the full, long-term impact of critical illness and treatment with ECMO on survivors’ lives.

Objective: The objective of this study was to describe the experiences and needs of adults treated with ECMO, from onset of illness symptoms through the process of survivorship.

Methods: This …

A Cross-Sectional Study Of Self-Perceived Educational Needs Of Emergency Nurses In Two Tertiary Hospitals In Nairobi, Kenya, Anthony Ndung’U, Eunice Ndirangu, Ahmed Sarki, Lilian Isiaho

School of Nursing & Midwifery, East Africa

Background: Many low- and middle-income countries lack resources for well-functioning emergency care systems. Emer- gency nurses interact with injured and critically ill patients as the first contact in many health care settings. However, insuffi- cient training limits nurses from providing ideal emergency care. The purpose of this research was to highlight educational needs specific to nurses working in 2 emergency departments in Nairobi, Kenya.

Methods: A descriptive cross-sectional study involving emer- gency units of 2 of the largest referral and teaching hospitals (Aga Khan University Hospital, Nairobi, and Kenyatta National Hospital) in Nairobi, Kenya, was conducted. Data were …

Addressing Factors That Lead To Job Dissatisfaction Among U.S. Hospital Nurses And Poor Health Outcomes In Patients: An Integrative Review, Folayan J. Morehead

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify factors that lead to job dissatisfaction among nurses working in U.S. hospitals and learn how patients experience poorer health outcomes as a result. Many factors including inadequate staffing, workplace bullying, violence, low pay, and hostile working conditions within hospital systems influence nurses’ intent to leave and affect the care quality provided to patients. In turn, the poorer care delivery leads to unsafe working conditions and thus poorer health outcomes in patients. Along with job dissatisfaction, nurses often feel the effects of moral distress and burnout which lessens their resilience. Nurses comprise …

Awareness And Health Promotional Behaviour Regarding Non-Alcoholic Fatty Liver Disease, Tintu Benjamin

Manipal Journal of Nursing and Health Sciences

The study was conducted to assess the awareness and health promotional behaviour regarding non- alcoholic fatty liver disease among female population at risk . Methods: this non- experimental research study was conducted among 149 females under risk of developing Non Alcoholic Fatty Liver Disease. Data collection tools used were a risk assessment checklist, a questionnaire to assess the knowledge and a rating scale to assess the health promotional behaviour. Results: overall awareness regarding Non Alcoholic Fatty Liver Disease among the risk population was average (47.69%).The reported health promotional behaviour regarding Non Alcoholic Fatty Liver Disease was good (67.03%). There is …

Nicotine Dependence Among Housekeeping Staff Of Tertiary Care Centre Of Odisha, India, Nanda Kumar Paniyadi Assistant Professor, Sam Jose Clinical Instructor, Asha P. Shetty Professor- Cum-Principal, Mansi Bajaj Nursing Officer, [email protected], [email protected], [email protected], [email protected]

Manipal Journal of Nursing and Health Sciences

Introduction: Tobacco intake associated with fitness dangers, morbidity, and mortality has been growing. The prevalence of tobacco use and nicotine dependence is very high among housekeeping staff compared to the general population. Nicotine dependence is one of the major public health problems in developing and developed countries. Very few studies are conducted on nicotine dependence among housekeeping staff in hospitals. Objectives: The objectives of the study are: to assess the nicotine dependence among housekeeping staff of AIIMS, Bhubaneswar, and to find the association between nicotine dependence and demographic characteristics such as age, gender, education, job experience, duration of use, age …

Determinants Of Nurse Turnover In Rural Primary Health Centres At Micro, Meso And Macro Levels Within The Health System Of Tamil Nadu, India: A Study Protocol, Ponnambily Chandy Ms, Bart Criel Dr, Lakshmi L Dr

Manipal Journal of Nursing and Health Sciences

Introduction: Nurses play a critical role in delivering patient care services at the grassroots level. But, frequent nurse turnover in rural primary health centres (PHCs) becomes a barrier in achieving health goals in Tamil Nadu (TN), which is the highest populated state in South India. Objective: The study aims to identify the determinants of nurse turnover in rural PHCs and to inform the policy-making at micro, meso, and macro levels within the health system of Tamil Nadu, India. Methods: We will adopt an integrative qualitative design consisting of five phases. In phase 1, we will do a rapid literature review …

Vanishing Twins Syndrome (Vts) - A Case Report, Meena Konsam Ms, Sonia R. B D'Souza Dr, Samir Kumar Praharaj Dr, Shyamala G Dr

Manipal Journal of Nursing and Health Sciences

Vanishing twin’s syndrome refers to the death of one of the co-twin foetus(es) during the early antenatal period. The cause of vanishing twins is unknown and most cases occur with in-vitro fertilization (IVF) conception. Transvaginal ultrasonography helps to detect lost twins during the early trimester. The complications that may arise among neonates born to women with a known history of vanishing twin syndrome are low birth weight and low Apgar score at birth.

A Pilot Study To Determine The Incidence, Type, And Severity Of Non-Routine Events In Neonates Undergoing Gastrostomy Tube Placement, Daniel J France, Emma Schremp, Evan B Rhodes, Jason Slagle, Sarah Moroz, Peter H Grubb, Leon D Hatch, Matthew Shotwell, Amanda Lorinc, Jamie Robinson, Marlee Crankshaw, Timothy Newman, Matthew B Weinger, Martin L Blakely

Faculty, Staff and Student Publications

BACKGROUND: Non-routine events (NRE) are defined as any suboptimal occurrences in a process being measured in the opinion of the reporter and comes from the field of human factors engineering. These typically occur well up-stream of an adverse event and NRE measurement has not been applied to the complex context of neonatal surgery. We sought to apply this novel safety event measurement methodology to neonates in the NICU undergoing gastrostomy tube placement.

METHODS: A prospective pilot study was conducted between November 2016 and August 2020 in the Level IV NICU and the pediatric operating rooms of an urban academic children's …

Reducing Inpatient Falls And Falls With Injury, Constance Leigh Cannon

Electronic Theses and Dissertations

Patient falls are a costly problem for many inpatient hospitals and are exacerbated by poor training of nursing and ancillary staff. The researcher sought to determine if there was a difference in inpatient falls and falls with injury after a hospital facility in the Southwestern United States revised its fall prevention policy, reorganized its fall prevention committee, and provided new interventions for nurses assessing patients for fall risk. In this quantitative, retrospective, comparative project, the researcher reviewed data from 2017–2020 related to the facility’s fall prevention program, including its new interventions and efforts to involve patients in their safety and …

Post-Surgical Emergency After-Hours Calls: Prevalence, Concerns, And Management, Vrisiis Kofina, Drake Lindholm, Abdulkareem Harunani, Andrew R. Dentino, Maharaj Singh, Dimitris N. Tatakis

College of Nursing Faculty Research and Publications

Objective

The purpose of this study was to investigate the prevalence, nature, and management of post-surgical emergency after-hours calls in a dental school setting with predoctoral students, graduate students/residents, and faculty providers.

Methods

A patient chart review (March 2018–February 2020) for post-surgical calls through the emergency after-hours pager system was conducted at the Marquette University School of Dentistry. The total number of surgical procedures, procedure type, the timing of call, operator experience, concern, and recommendation given during the call were documented.

Results

During the review period, 83 calls (from 75 patients) were recorded after 8,487 surgical procedures (1% of procedures). …

Physician Assistant Global Advancement Through The Use Of Medical Relief Organizations, Kara Crafts Pa-C, Sarah Mistrot Pa-C, Mary Henningsgaard Pa-C, Kaley Morris Pa-C, Tamarrah Oliver Pa-C, Kevin Tran Pa-C, Trevor Crafts Md

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Objectives: The physician assistant (PA) model has been adopted by many nations to alleviate health care disparities. The objective of the project is to understand how medical relief organizations are utilizing physician assistants and contributing to the advancement of the career globally.

Methods: A search was conducted to create a list of all U.S. based medical relief organizations. An 18-question online survey was sent to 493 organizations that met inclusion criteria.

Results: Total response rate of the survey was 56.2%. 75.6% of organizations reported using PAs on their medical relief projects, and PAs were used in clinic/hospital/and operative settings.

Conclusions: …

A Qualitative Inquiry On Smokers’ Perceptions Of Smoking Cessation During Covid-19, Sajid Iqbal, Rubina Barolia, Kiran Iftikhar, Pammla Petrucka, Jeniefer Anastasi, Faris Farooq Saeed Khan, Naheed Feroz Ali

School of Nursing & Midwifery

Background: This qualitative exploratory study explores smokers’ perspectives regarding smoking cessation processes amid the COVID-19 pandemic.
Methods: Purposive sampling was employed to conduct semi-structured interviews with cigarette smokers visiting cardiac and pulmonary clinics at a tertiary care hospital in Karachi, Pakistan. Thematic analysis was performed to identify themes from the participants’ responses.
Results: Three themes emerged from the thematic analysis. These were smoking cessation facilitators, smoking cessation barriers, and COVID-19 impacts on smoking cessation. Awareness and education, threat of acquiring health problems, religious beliefs and family or support system behave as smoking cessation facilitators. While, role modeling, associating smoking to …

Hpv Infection And Vaccination: A Question-And-Answer Guide For School Nurses, Mendi England, Karlen E. Luthy, Michael S. Robinson

Student Works

This paper provides school nurses with a quick question-and-answer format guide to common HPV-related questions that are often asked by school aged children's parents.