Nursing Commons^™

Recognizing The Unique Health Care Needs Of Pregnant Female Afghan Refugees, Catherine Mcelroy

Liberty University Research Week

Undergraduate

Theoretical Proposal

Morality Of Restraint Use In Medicine: A Literature Review And Ethical Application, Gracyn Wagner

Liberty University Research Week

Undergraduate

Theoretical Proposal

Improving Cultural Competence In The Nurse To Reduce Adverse Patient Events, Anna Ponder, Julia Booker

Liberty University Research Week

Undergraduate

Theoretical Proposal

The Priority Patient In Maternal/Fetal Conflict, Eden Alley

Liberty University Research Week

Undergraduate

Theoretical Proposal

Communication Techniques For Nursing Students, Karlee Coddens

Honors Theses

This thesis will discuss the effects nursing preceptors have on nursing students' clinical experience. This thesis will explore multiple factors that negatively impact nursing student’s communication with their preceptors. It has been found that clinical experiences are extremely important for the future of nursing students. However, there is often a communication barrier between nursing students and their preceptors. This barrier can lead to negative outcomes for new nurses entering the field. Strained communication can also create dangerous situations for patients. Students who fear harsh comments or vertical violence may be reluctant to disclose the limitations of their knowledge. We completed …

Dnp Final Report: An Evidence-Based Initiative To Reduce Risk Of Ventilator-Associated Events, Bailey Dee Burge

DNP Final Reports

Ventilator-associated events have been considered an outcome metric for quality patient care. Ventilator-associated events are associated with unnecessary medical expenses. These events are multifactorial, yet bedside nurses can help decrease this nosocomial infection through proper oral care. A PICOT question was constructed to search the evidence systematically. The systematic literature search evidence was appraised to provide recommendations for the bundle of care process regarding ventilator-associated event prevention, specifically oral care. The body of evidence was comprised of five articles reporting statically significant outcomes. The evidence-based oral care protocol was implemented for a quarter of a year in patients with mechanical …

Dnp Final Report: Decreasing Stress & Anxiety In Nursing Students: A Mindfulness-Based Program Intervention, Jennifer L. Cole

DNP Final Reports

Nursing students experience increased stress and anxiety due to the rigorous requirements of nursing school. Students often feel pressure to perform in a competitive environment that stretches them mentally and physically to learn extensive didactic material while simultaneously performing competently in clinical settings. Without effective methods to address self-care, students may experience the ramifications of unresolved stress. The practice question guiding the project was: In undergraduate Level II nursing students (P), does implementing a Mindfulness Based Program (MBP) (I), compared to not implementing a MBP (C), affect stress, anxiety, and mindfulness (O) during a semester (T)? Based on systematic review …

Type 2 Diabetes Treatment Plan, Kylie N. Laird

MSN Capstone Projects

Diabetes affects more than 34 million Americans, with approximately 90-95 percent of them having type 2 diabetes. Diabetes is primarily managed by the patient with assistance from their healthcare team (Centers for Disease Control and Prevention, 2021). Diabetes is a costly disease that affects individuals, healthcare systems, economies, and entire societies globally. Based on the knowledge, lifestyle interventions have shown to be effective in the management of type 2 diabetes (Garcia, 2020), a more holistic approach to disease management was pursued. Garcia (2020) conducted a study in which lifestyle intervention data for treatment of diabetes was compared to pharmaceutical management …

Postpartum Education On Maternal Morbidity And Mortality, Ashley Veasley

MSN Capstone Projects

Postpartum education, or lack thereof, is the most overlooked cause of maternal morbidity and mortality. The lack of thorough postpartum education with patient understanding is often the reason warning signs are overlooked as normal and seeking care is delayed, or not pursued at all. This narrative review aims to find research to enhance awareness of maternal morbidity/mortality and improve patient outcomes through education, including ways to intervene beforehand. The literature review began in August 2021, suitable peer-reviewed studies were retrieved from CINAHL, Cochrane, and PubMed databases. Evidence from the reviewed studies found supporting evidence indicating insufficient postpartum education related to …

Importance In Decreasing Blood Culture Contaminations, Jannery Valdelamar

MSN Capstone Projects

Blood culture collection was a skill introduced while in nursing school. We are all human and make mistakes, and sometimes errors are made. Blood culture contamination happens. It happens even more in hectic departments like Emergency Department and Intense Care Unit. The American Society for Microbiology and Clinical Laboratory Standard have recommended that the %3 should be the overall rate for blood contamination rate (Center for Disease Control, 2023). In the current facility that I am in, blood culture contamination is an enormous issue. The facility rate is 9.3%, the Emergency Department was 11.3%, and the Phlebotomy was 5.2%. Multiple …

Learn, Reflect, Practice, Discuss: A Professional Development Pilot For Clinical Nurse Educators, Jessica Savage, Linda Wofford Dr., David Phillippi Dr.

DNP Projects

Abstract

AIM: The aim of this project was to assess the effect of a professional development pilot on the self-efficacy among clinical nurse educators toward evaluation and assessment of students in the clinical setting.

BACKGROUND: Nursing schools employ clinical nurse faculty with varied levels of experience and formal education in teaching. Positive student outcomes are dependent on the competency of their nursing faculty, yet best practices to train and support the professional growth of clinical faculty have not yet been identified.

METHOD: A multi-modal professional development pilot including online-learning modules, self-reflection, practice-learning, and peer-mentoring components was designed and implemented with …

Teach-Back Education In Heart Failure Patients Benchmark Study, Bethany N. Johnson

MSN Capstone Projects

Heart failure exasperation is one of the most common causes of hospital readmission in the United States (Breathett et al., 2018). It is estimated that greater than half of all heart failure patients will be readmitted to the hospital within six months of discharge (Caluya, 2021). Additionally, one in four individuals with heart failure are readmitted within thirty days of discharge (Rahmani et al., 2020). This data shows a large area of improvement for hospitals in order to improve patient outcomes. Due to the lack of standardized discharge teaching, heart failure patients are often admitted to the hospital for the …

Individual Characteristics That Promote Or Prevent Psychological Safety And Error Reporting In Healthcare: A Systematic Review., Dawn M. Wawersik, Emile R. Boutin, Teresa Gore, Janice C. Palaganas

HPD Articles

BACKGROUND: Healthcare errors continue to be a safety issue and an economic burden that causes death, increased length of stays, and emotional trauma to families and the person who commits the error.  Speaking up and error reporting within a safety culture can reduce the incidence of error; however, this is complex and multifaceted.

AIM: This systematic review investigates individual characteristics that support or prevent speaking up behaviors when adverse events occur.  This study further explores how organizational interventions designed to promote error reporting correlate to individual characteristics and perceptions of psychological safety.  .

METHODS: A systematic review of peer-reviewed articles …

Making Breastfeeding Easier With Clinician Support, Katherine Laney

MSN Capstone Projects

This benchmark project provides a template for how to implement clinician support and education in an organization with obstetric and pediatric clinics and a hospital based on the PICOT: In first-time breastfeeding mothers (P), how does clinician driven support and education during the perinatal period (I) compared to no clinician assistance (C) affect the rate of continued breastfeeding (O) within the first 3 months postpartum (T). Research demonstrates that increased clinician support and education provided to the mothers during the perinatal period increases breastfeeding rates and self-efficacy. The project would initially last for approximately 12 weeks and follow women from …

Combination Thromboembolism Prevention Prophylaxis, Karma Davis

MSN Capstone Projects

Venous thromboembolism (VTE) is a leading cause of preventable hospital death in the United States (Centers for Disease Control and Prevention, 2022). The correct selection of VTE prophylaxis in hospitalized patients is critical in stopping increased length of stays, incurring extra costs, and preventing deaths. Currently, the single modality of pneumatic compression sleeves (ICD) are often utilized for inpatient deep vein thrombosis prevention. ICDs are an easy, quick way for physicians to meet the requirement for VTE prevention in both general medical patients and those in the critical care unit. However, patients may remove or refuse this type of prevention …

Diabetes Education Benchmark Study, Caitlyn A. Wildey

MSN Capstone Projects

Diabetes mellitus is a disease that happens when the body does not produce enough insulin or does not respond to insulin. Type two diabetes happens when there isn’t enough insulin produced in the body, when there is resistance to the action of insulin in the body, or when the body does not use the insulin produced properly (Type 2 Diabetes, n.d.). Type two diabetes is important because of the increasing incidence of the disease and the complications that come if not managed. Some of the complications associated with type two diabetes include heart disease, kidney disease, neuropathy, retinopathy, and diabetic …

Technology-Mediated Diabetes Prevention Program (Dpp) Benchmark Project, Devon Senical

MSN Capstone Projects

This benchmark project intends to broaden access to the Diabetes Prevention Program (DPP) by offering technology-mediated content at the primary care level because the Primary Care Physician (PCP) predominantly diagnoses prediabetes due to the recommendation by The U.S. Preventive Services Task Force (USPSTF) that nonpregnant overweight or obese adults aged 35 to 70 be screened for prediabetes and type 2 diabetes (Davidson et al., 2021). Thus, the primary care setting is the first opportunity to impact the conversion from prediabetes to type 2 diabetes. Of the 84 million people in the United States (U.S.) with prediabetes, they are estimated to …

Benchmark Study: Impact Of Electronic Health Records Vs. Paper-Based Records, Erin Emmerich

MSN Capstone Projects

Medical documentation is an essential part of healthcare and conducted at the highest standard; documentation ensures the delivery of safe and high-quality healthcare services (Noureldin et al., 2014). Performance Improvement team reports the same poor outcomes each quarter that may be a result of the paper-based documentation system. These outcomes include patient safety, patient satisfaction and cost-effectiveness. This narrative review’s purpose is to determine whether the implementation of an electronic health record (EHR) system could improve outcomes. Evidence-based guidelines for the implementation of an EHR need special consideration to have a successful transition. Further studies may need to be reviewed …

Targeted Temperature Management Following Cardiac Arrest, Kylie Carimi

MSN Capstone Projects

Cardiac arrest is often associated with the death of brain tissue resulting from the lack of oxygen supply caused by the interruption of blood circulation. For this reason, good neurological outcome following cardiac arrest is difficult to achieve. Targeted temperature management, formerly known as therapeutic hypothermia, is the maintenance of specific body temperature parameters after the return of spontaneous circulation (ROSC) following cardiac arrest (Donnino et al., 2015). The goal of therapy is to improve neurological status and facilitate healing by reducing the metabolic requirement of the brain. (Saigal et al., 2015). Therefore, the question arose, in adult patients who …

Strategies For Preventing Surgical Site Infections, Dorathy Anderson

MSN Capstone Projects

Post-surgical site infection has continued to remain a significant public health concern. Amid the prominent hospital-acquired infection, surgical site infections contributed to a considerable rate of death, severe morbidity, increased cost of therapy, disability, prolonged hospital stay, higher insurance payment, complications in patient healing, an increase in healthcare cost as well as treatment expenses (Allaf & Navyashree, 2022). Although seemingly relatively low in occurrence, about 10% of the infections are related to healthcare-associated infections. (Allaf & Navyashree, 2022). Knee reconstructive procedures are most common among older patients, who have a higher risk of developing complications.

The current practice of scrubbing …

Importance And Impact Of Diabetes Education On People With Diabetes, Nicole R. Glasco

MSN Capstone Projects

This paper aims to explain the significance and importance of why it is essential to offer patients with diabetes standardized education regarding their diabetes.

Evidence Based Change To Improve Outcomes In Cardiac Patients, Amy L. Callahan

MSN Capstone Projects

According to the Centers for Disease Control and Prevention, “heart disease is the leading cause of death in the United States” (CDC, 2022). Modern healthcare has made numerous advances in changing the prevalence of heart disease and has shifted resources to promoting prevention. When a patient requires admission to an acute care facility for heart disease exacerbation, the focus is more of treating the acute process and how to manage the condition moving forward.

Although there have been a substantial number of resources that have been allocated to prevention in the primary care and outpatient setting, there is a need …

Palliative Care In The Neonatal Population, Raegan Miller

MSN Capstone Projects

In more than 90% of cases of neonate deaths, terminal comfort care was provided in a Neonatal Intensive Care Unit (NICU) (Soni et al., 2011). Palliative care teams are increasing, but not enough organizations have embraced the need for better palliative care guidelines. Nor do many organizations know when, how, or if palliative care should even be introduced. These events lead to comfort care measures being underutilized in the NICU for most newborn infants with life-limiting and life-threatening conditions. Neonatal palliative care is discussed more than in years past, but little research has been dedicated to how early palliative care …

Standards Of Care In Surgical Site Prevention Benchmark Study, Jasmine Taylor

MSN Capstone Projects

In depth synthesis of studies supporting efficacy of alcohol-based rubs in prevention of surgical site infections.

Peer Support Buddy System To Reduce Nurse Burnout Benchmark Study, Ebony Jones

MSN Capstone Projects

This paper is a Benchmark project to introduce the use of a Buddy System program as peer support for acute care nurses, in the attempt to reduce nurse burnout.

Women's Stories Of Reaching A Diagnosis Of Endometriosis: A Qualitative Study, Susan C. Debolt

DNP Projects

Endometriosis is a chronic gynecological condition affecting 10% of reproductive-aged women worldwide. Women with endometriosis often experience a decreased quality of life compared to women without endometriosis. The average time to diagnosis is greater than six years for adult women and greater than 11 years for adolescents. Yet, there is little research investigating the pre-diagnostic experiences of women with endometriosis. This study aims to inform healthcare providers of patients' pre-diagnostic experiences of endometriosis in an effort to improve patient care. Using one-on-one, semi-structured online interviews and a qualitative design, this study explored six women's pre-diagnostic experiences of endometriosis. The main …

Culturally Sensitive Emergency Care For Sexual And Gender Minority Youth, Kaysi Goodall

DNP Projects

There is substantial evidence of disparities in access to healthcare and health outcomes affecting sexual and gender minority youth (SGMY). However, evidence of SGMY cultural sensitivity training for pediatric emergency health professionals is limited. This quality improvement research project in an urban pediatric emergency department (PED) used a cross-sectional, pre-test post-test design to improve health professionals’ knowledge, attitudinal awareness, and clinical preparedness in caring for this population. It was informed by the Institute for Healthcare Improvement’s Model for Improvement and completed in four Plan-Do-Study-Act (PDSA) cycles. Evidence-based pedagogical strategies were utilized for a 60-minute staff training session, including introducing foundational …

Exploring Factors Influencing Nursing Engagement In 4ms Initiatives On An Inpatient Older Adult Unit, Sarah Nelson

DNP Projects

Background: The older adult population is growing, and these individuals often have health challenges that require complex nursing care. On an older adult unit in Tennessee, a 4Ms (What Matters, Medication, Mentation, and Mobility) Age-Friendly care initiative was implemented to improve care and outcomes. Early data showed inconsistent nursing engagement with 4Ms initiatives and qualitative data on engagement factors was needed to increase nursing support and improve patient outcomes. Purpose: Therefore, this scholarly project explored factors influencing nursing staff engagement with the 4Ms initiative on an older adult unit. Methods: Nurses and …

Sepsis Work-Up And Treatment Interdisciplinary Approach, Alyssa M. Hughes

MSN Capstone Projects

Sepsis affects millions of Americans annually. Oncology patients are at greater risk for infection which in turn makes them higher risk for sepsis. In order to address sepsis bundle compliance a interdisciplinary team with distinct roles can be created out of current staffing with the end goal to provide better patient outcomes. The interdisciplinary teams involved include: nursing, pharmacy, physicians, lab technicians, and patient care technicians. Mobilizing all of these people and giving an assigned role along with early notification with the goal to improve compliance to sepsis bundles to 90% a month among all patients diagnosed with sepsis.

Mitigating Fatigue In The Triage Process: A Creative Solution To Shorter Shifts, Rebecca J. Arismendi

MSN Capstone Projects

Triage is a critical assessment process performed by a registered nurse by which Emergency Rooms (ERs) sort patients who present for a medical evaluation. With ER visits increasing, pressure on staff to move patients through the department is often palpable. Whether a patient decides to walk in, or come in by ambulance, the first person to assess the patient is the triage nurse. They determine the appropriate level of care needed for the presenting complaint.

After a review of literature, it was found that fatigue is correlated with shift length in triage with the highest level of fatigue being at …