Nursing Commons^™

Challenges To Coordination Of Care In The Diabetic Homeless Population, Melissa K. Smith

Doctoral Dissertations & Projects

Abstract

Diabetes mellitus (DM) significantly impacts the lives of Americans and the healthcare industry. Clinicians and patients utilize significant time, effort, and resources to combat the challenges faced. Homeless patients have additional burdens not experienced by those of housed individuals. A Midwest homeless shelter recognized the ongoing unmet needs for primary care and behavioral health services for their clinic patients. It was postulated that implementing a streamlined referral process to primary care services, enabling patients to be seen same day or next day, would increase utilization of services by this population. To increase the probability of patients presenting for their …

Hepatitis C Virus Screening Strategies To Improve Early Identification And Treatment: ​ A Scoping Review​, Megan Elizabeth Lyons, Rn, Bsn, Ccrn, Thomas Tyler Bennett, Rn, Bsn, Ccrn, Felicia Ann Gray-Hamilton, Rn, Bsn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Hepatitis C virus (HCV) is the most common bloodborne infection in the United States (Ludden et al., 2022). Sadly, over half of the individuals living with chronic HCV are unaware of their condition (Halket et al., 2022). Due to rising numbers, HCV screening guidelines have been updated to recommend that every adult be screened at least once (Patel et al, 2021). Despite these guidelines, screening rates remain low. This scoping review aims to examine current research on HCV screening and strategies to improve early diagnosis and treatment.

Methods

This review began with a literature search using CINAHL and PubMed …

Development Of An Advanced Practice Provider Diagnostic Clinic Within An Oncology Practice, Abigail Jean Voss

Masters Projects

Background: The process of diagnosing cancer and the time to treatment can influence a patient’s experience with diagnosis of cancer at a later stage being associated with poorer cancer outcomes and decreased quality of life post-treatment. With increasingly complex oncologic imaging and pathology findings, effective interventions for early diagnosis of cancer requires a cohesive approach including referral, diagnosis, staging, and treatment phases. Objectives: The aim of this article is to outline the program development efforts initiated to apply current literature findings and organizational assessment to create a program development toolkit and business plan for an Advanced Practice Provider …

Early Progressive Mobility In The Micu: A Qi Project, Kenneth Johnson

DNP Projects

Abstract

Background: Immobility causes grave harm to ICU patients. There is not a body system that bedrest does not affect negatively. The MICU has an early mobility protocol; however, patients are often left in bed, PT/OT is underutilized, and nurses are unfamiliar with the current early mobility protocol.

Methods: The Plan Do Study Act quality improvement method was used for this project which ran from September 1 to November 30, 2022, and involved the MICU RN staff. This QI project evaluated the current early mobility protocol, assessed barriers, determined the nurse’s perceptions, and offered recommendations for sustainability.

Intervention: The project …

Implementation Of Purposeful Hourly Rounding To Decrease Fall Rates, Dannette Kizy

Student Scholarly Projects

Practice Problem: Patient falls can lead to an increased length of stay and potentially reduce the quality of life. In addition to serious injury, the patient and the hospital have a significant financial burden. PICOT: On a medical-surgical unit, does incorporating purposeful hourly rounding in the patient care routine compared to no purposeful rounding decrease patient fall rates over eight weeks?

Evidence: Of the 35 articles related to fall prevention and PHR, a final selection of eight articles met the criteria and were of high quality and evidence levels.

Intervention: PHR was implemented to decrease falls over …

Development Of Guidelines For Early Implementation Of Regional Anesthesia In United States Personnel With Peripheral Injuries, Matthew Baker

Doctor of Nursing Practice Scholarly Projects

Dating back to 3200 BC, military personnel routinely experience peripheral extremity wounds during combat. Traditionally, military anesthesia providers utilized general anesthesia and opioids to treat acute pain in the combat setting. Opioids can cause adverse effects such as respiratory depression, delirium, hemodynamic instability, nausea & vomiting, and addiction, which causes delays in care and requires more resources. Regional anesthesia is gaining favor during military operations due to its safety profile and effectiveness in controlling acute pain. Regional anesthesia is safer and more effective than opioids in the trauma/combat setting. Guidelines were provided based on current evidence in the literature and …

The Implementation Of A Nurse Residency Program, Jessica Conrad

MSN Capstone Projects

Implementing a nurse residency program in a hospital can be a successful plan to improve nurse retention and the quality of patient care. Nurse residency programs allow new graduate nurses to transition into professional practice and gain skills for safe and effective care. Components of the programs include preceptorship, educational seminars, shadowing days, and support from preceptors, educators, and other leadership members. The program also may provide benefits to hospitals, including improved patient outcomes, nurse job satisfaction, and decreased costs associated with reduced turnover. Successful implementation needs leadership, collaboration, and communication among all stakeholders, including the staff nurses, preceptors, educators, …

The Introduction Of A Family Advisory Council In A Neonatal Icu, Jennifer Streelman

MSN Capstone Projects

Having a baby can be a beautiful thing, but sometimes it’s not all sunshine and roses. Birth sometimes does not go smoothly, and sometimes it happens way too soon. The babies that need help at birth all end up in the neonatal ICU requiring differing levels of care. This is never what anyone plans, and therefore can cause lots of stress to new parents trying to navigate not only being new parents, but suddenly thrust into a world of medical uncertainty. Creating an environment that focuses on family centered care is vital to healthy role transition. The presence of a …

Impact Of Teamstepps On Team Performance In An Oral And Maxillofacial Surgery Practice, Katherine E. Lee

DNP Projects

Effective communication and teamwork skills among oral and maxillofacial surgery (OMS) teams are essential for quality and safe patient care. As some in the profession assert that the team model for delivering anesthesia care is integral to their history of safety, the model continues to be scrutinized by professional groups whose members seek to limit oral surgeons’ ability to provide anesthesia services in the office setting. This quality improvement project assessed how introducing the TeamSTEPPS Office-Based Care (OBC) program in an OMS clinic impacted team dynamics. The impact of TeamSTEPPS OBC training on attitudes and perceptions of teamwork was evaluated …

Exploring Hapi Incidence In Patients Admitted Through The Ed: A Quality Improvement Initiative, Alexa L. Tietgens

DNP Projects

Each year in the U.S., pressure injuries, or PIs, are responsible for more than 60,000 patient deaths and billions of dollars’ worth of treatment costs. Research shows that roughly 95% of all PIs are preventable by following evidence-based practice guidelines which include early identification of patients at risk, frequent skin assessments, and implementation of prevention strategies. However, the ED environment creates unique risks for PI development due to the routine use of hard surfaces (i.e., stretchers, backboards, exam tables) and frequent hospital overcrowding. Although nurses play a pivotal role in PI prevention, frequent staffing shortages, high patient acuity levels, and …

Developing A Pediatric Weight Management Program In Primary Care, Alyssa Bosse

Masters Theses/Capstone Projects

The practicum was completed at Central Ohio Primary Care Physicians (COPC), a large group of physician owned primary care practices. COPC would like to start a program for pediatric weight management utilizing their three pediatric Registered Dietitian Nutritionists (RDNs). The first step was collecting data to see any improvements that are needed from the current nutrition program. The second step was reviewing the literature on pediatric weight management to ensure the new program is evidenced-based. All steps were evaluated by COPC leadership and collaborated with internal company resources.

Peer-Supervision Of Nursing Professionals: A Shield Against Burnout, Kyle Gamache, Sarah Gamache, Joseph Robillard

Journal of Wellness

Introduction: Burnout is a major risk in healthcare professions and is a significant contributor to the current nursing shortage. Strategies to combat burnout of healthcare professionals are in desperate need. The purpose of this project is to introduce the clinical peer supervision model as a method to alleviate burnout in nursing professionals.

Approach: Eight nurses from in-patient settings participated in a peer-supervision support group, modeled after existing European nursing and mental health provider-support protocols. To assess the effect of this intervention, qualitative data analysis was conducted on the transcripts of session and the results described. All participants reported statistically high …

Perceptions Of Preparedness Among New Graduate Nurses: Traditional Curriculum Versus Concept-Based Curriculum, Ashley A. Wheeler, Steven Busby, David Phillippi, Tammy Legge

DNP Projects

Concept-based curriculum (CBC) is a newer trend in nursing education curriculum aimed at preparing new graduates to enter the workforce as generalist nurses better suited to care for a more medically complex population. Using CBC, students are introduced to concepts in order to build conceptual understandings as they engage in knowledge and skill learning, as opposed to a traditional nursing curriculum that is taught in sections grouped by patient population and medical complexity. At a nursing school housed within a private university in the southeast, the traditional nursing curriculum was replaced with CBC in 2016. To better understand the preparedness …

Staff Education To Increase Confidence In Caring For Lgbtqi Cancer Patients: A Quality Improvement Initiative, Clara C. Beaver

Masters Projects

This project was to provide education to promote a welcoming environment, increase staff knowledge, and confidence in caring for LGBTQI cancer patients. Methods: An educational session was provided to increase staff competence and knowledge about LGBTQI cancer patient uniqueness. A pre- and post-test was administered to measure staff knowledge, comfort in discussing with coworkers, and confidence in caring for LGBTQI patients. Results: After the session, there was a 42% increase in staff responses to the importance of knowing about a patient’s sexual orientation when providing care, 58% increase in knowledge about cancer issues related to LGBTQI population, and 39% increase …

Leadership, Policy Development And Emr Utilization In At Services At Heidelberg University, Matallyn Overmyer

Masters Theses/Capstone Projects

The practicum is being completed with Heidelberg University AT Services. I started January 2023 and plan to finish April 2023. I am working directly with Tyson Depinet, Coordinator of AT Services, to learn more about roles and responsibilities of a collegiate head athletic trainer. Emphasized areas of focus: - EMR Administrative Utilization - Policy Development - Leadership & Managemen

Job Satisfaction And Burnout In Nursing, Tasha M. Tovar

MSN Capstone Projects

Job satisfaction, or lack thereof, can directly lead to burnout. Nursing is known globally as a high-stress career, thus leading to an increased level of burnout. Job burnout is among the most important occupational disorders and phenomena which have received great attention in the recent century (Nabizadeh et al., 2020). Multiple studies have proven that subtle, low-cost interventions can decrease the burnout experienced by nurses, leading to reduced turnover rates and an increase in the quality of patient care. Higher quality of care leads to improvement in patient satisfaction scores and also to increased reimbursement rates (Jun et al., 2021). …

Improving Adherence To Annual Diabetes Guidelines In Rural Primary Care, Ashley Barney

Masters Projects

Background: The American Diabetes Association (ADA) (2022) identifies comorbidity risk assessments and treatment planning as key health maintenance components for diabetic patients. However, many providers do not adhere to the recommended national guidelines (Brenner et al., 2020).

Objectives: At a rural primary care clinic, the effectiveness of implementing a checklist was evaluated to improve provider adherence to the annual diabetes guidelines set by the ADA.

Methods: A quality improvement project was initiated and guided by the Lean Six Sigma framework. The checklist was implemented to assess if providers adhered to the recommended annual diabetes guidelines. The project …

Structural Foundations Of Potassium Selectivity In Channelrhodopsins, Sukyeong Lee, Sang Bum Lee, Nuri Sung, Wendy W Xu, Changsoo Chang, Hyun-Eui Kim, Andre Catic, Francis T F Tsai

Faculty, Staff and Student Publications

Mitochondria are critical to cellular and organismal health. To prevent damage, mitochondria have evolved protein quality control machines to survey and maintain the mitochondrial proteome. SKD3, also known as CLPB, is a ring-forming, ATP-fueled protein disaggregase essential for preserving mitochondrial integrity and structure. SKD3 deficiency causes 3-methylglutaconic aciduria type VII (MGCA7) and early death in infants, while mutations in the ATPase domain impair protein disaggregation with the observed loss-of-function correlating with disease severity. How mutations in the non-catalytic N-domain cause disease is unknown. Here, we show that the disease-associated N-domain mutation, Y272C, forms an intramolecular disulfide bond with Cys267 and …

Improving Diabetes Management For School Health Workers Using A Live, Virtual Training Course, Bonnie Mccann-Crosby, Lisa Setchfield, Yvonne Barham, Dawn Espinosa, Jennifer Bailey, Beth Pali, Amanda Garey, Sarah Lyons, Rona Sonabend

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: Type 1 diabetes is one of the most common chronic diseases in childhood. Optimal school nurse and staff education is critical to creating a safe learning environment and influencing long term outcomes of students with type 1 diabetes. The purpose of this project was to develop a virtual continuing education diabetes management course for school health workers to improve their knowledge of diabetes management and evaluate the effectiveness of the learning platform.

Methods: A total of 199 participants completed the live, virtual continuing education course. Participants completed a pre and post-test to assess improvements in the key learning objectives …

Covid-19 Vaccination: A Study Of College Students’ Perceptions Regarding Inoculation Post-Covid Infection, Analisa Harter, Wilma Matti

Honors College Theses

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), known as Covid-19, was first identified in China and proclaimed a pandemic in March 2020 by the World Health Organization (WHO). Covid-19 is a virus transmitted via respiratory droplets and becomes airborne when a person who carries the virus coughs, sneezes, or breathes out droplets, and the virus enters a susceptible host. Since the pandemic outbreak, three vaccines have been approved by the Food and Drug Administration (FDA). Despite FDA approval, many Americans are hesitant to receive Covid-19 vaccinations. The perceived severity of SARS-CoV-2 and the perceived safety of the vaccine appear to …

Commitment To Collaboration: Development Of A School Nursing Collaboration Instrument, Jodi S. Bullard

Nursing Theses and Dissertations

Registered nurses (RNs) have an ethical responsibility to collaborate, thereby promoting the scope of nursing practice and working to positively influence health outcomes. This responsibility encompasses RNs employed as school nurses (SNs). Examples of SN collaboration with campus, school district, and community health partners exist. However, SNs’ commitment to collaboration in these relationships has not been examined.

Chapter 2, “COVID-19: Planning and Postpandemic Partnerships,” explores surges in school nursing partnerships that occur during healthcare emergencies. The significance of partnering with SNs in the school, school district, and community setting is discussed. The need to develop school nursing partnerships that extend …

Enhanced Discharge Preparation To Decrease Discharge Delays: A Quality Improvement Project, Angela Graham

Graduate Theses, Dissertations, and Capstones

Increased length of stay (LOS) is a focus in hospitals as it has implications for decreased quality of care, increased cost of care, and results in care delays for other patients (Rojas-Garcia et al., 2018). LOS is a measure of a hospital’s efficiency and throughput, which is the process of admitting, treating, and discharging patients. Micallef et al. (2020) found a longer LOS can occur from having extra days due to inefficiency in delivering care or from delays in discharge once the patient no longer needs acute care. The longer a patient stays in the hospital, the greater the risk …

Improving Safety & Quality Outcomes In A Rural Emergency Department With Clinical Practice Guidelines For Nurses, Kaylee Eckert

Undergraduate Publications

The most beneficial way of implementing evidence-based practice in nursing is through clinical practice guidelines, according to numerous research studies and meta-analysis. At the Centra Southside Community Emergency Department, there is a lack of evidence-based clinical practice guidelines for nurses to use as aids in the critical judgment nursing process. The goal of this research is to create clinical practice guidelines that are relevant for the clinical environment, practical for everyday use, easily accessible, and cohesive with current standards of care in the Southside Emergency Department. This goal will be met through surveys of the daily staff nurses and nursing …

Exploring Digital Interventions To Facilitate Coping And Discomfort For Nurses Experiencing The Menopause In The Workplace: An International Qualitative Study, Camille Cronin, Gemma Bidwell, Janene Carey, Sara Donevant Phd, Rn, Ccrn, Kerri-Ann Hughes, Marja Kaunonen, Jette Marcussen, Rhonda Wilson

Publications

INTRODUCTION: The global nursing workforce is predominantly female, with a large proportion working in the 45-55 age group. Menopause is a transition for all women, and; therefore needs recognition as it can impact work performance and consequently staff turnover. BACKGROUND: Women will go through the menopause, but not all women are affected. The menopause transition presents a range of signs and symptoms both physical and psychological which can impact the quality of life and individuals' work/life balance. The nursing workforce is predominantly women that will work through the menopause transition. OBJECTIVES: The study explored perspectives on digital health interventions as …

Hand Hygiene’S Impact On Patient Safety And Teammate Morale, Amanda Ortiz

MSN Student Capstones

No abstract provided.

Formal Unit-Based Shared Governance To Improve Nurse Engagement, Tracey A Larsen

Student Scholarly Projects

Practice Problem: Nurse engagement is a key driver of nurse satisfaction and nursing retention. Shared governance is an evidence-based practice proven to increase nurse engagement through shared decision-making and results in higher work satisfaction.

PICOT: The PICOT question that guided this project was (P) in an ambulatory nursing clinic (I) what is the effect of a shared governance unit-based committee (C) compared to current practice (O) on nurse engagement (T) over 10 weeks?

Evidence: An exhaustive literature search resulted in 61 peer-reviewed articles. Eleven studies were included after filtering for duplicates and keywords and evaluating for strength and quality …

The Effects Of Carbohydrate Counting On Hemoglobin A1c Levels In Adult Diabetics, Dillon Moore

Anna Vaughn School of Nursing Doctor of Nursing Practice (DNP) Projects

Diabetes is one of the most prevalent disease processes in the world. Approximately 537 million people have diabetes (International Diabetes Federation, 2021). Hemoglobin A1C levels are used to monitor overall blood glucose control in three-month increments. If the hemoglobin A1C can be lowered, the person should achieve better blood glucose control. Since carbohydrates are the main contributor to blood glucose, this project’s goal is to determine if carbohydrate counting via Cornerstones4Care Meal Planning and Carb Counting booklet (Cornerstones4Care, 2021) (Appendix A) will help diabetics achieve a lower hemoglobin A1C. Data were collected from a retrospective chart review during a five-year …

Blood Pressure Management In The Outpatient Setting, Kattie Efird

MSN Student Capstones

No abstract provided.

Extended Outreach Process: Heart Failure Care Management Program, Amy Crofts

MSN Student Capstones

No abstract provided.

Fall Reduction In Skilled Nursing Facilities, Amanda Lewis

MSN Student Capstones

No abstract provided.