Nursing Commons^™

Improving Effective Communication In Telephone Triage Nursing Practice: A Quality Improvement Project, Joanne Firlit

MSN Student Capstones

No abstract provided.

A Structured Life Review Intervention To Improve Life Satisfaction In Home Health Service Patients: A Feasibility Study, Leah Graf

University Scholar Projects

Two million older adults in the U.S. suffer with depression. Adults who live with the difficulties of depression concurrently experience dissatisfaction with life. Life review is a systematic recollection of past events. Dr. Robert Butler postulated that, as the elderly and those with terminal illness approach the end of their lives, there is a resurgence of life experiences in the conscience (1963). A successful life review conducted by an active listener assists the individual to process unresolved conflicts and attain ego-integrity in the final stage of life. Home health services have become an increasingly accepted option for managing chronic illnesses …

Hypertension, Bethany Stemen

Masters Theses/Capstone Projects

Hypertension is dangerous and known as the silent killer. It can be managed with proper healthy life choices.

Comparing Student Satisfaction In High- And Low-Fidelity Simulation Experiences, Bailey Kuhlman

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to compare student satisfaction in high- and low-fidelity simulation experiences. The project took place at the Pittsburg State University Irene Ransom Bradley School of Nursing. Participants included 79 pre-licensure Fundamentals of Nursing students in their first semester of nursing school. Implementation took place in the Fall of 2022. Students underwent either a high- or low-fidelity patient simulation experience related to pneumonia. Upon completion of the scenario students were asked to voluntarily participate in a satisfaction questionnaire. The questionnaire was composed of 27 closed-ended questions. There was a statistically significant difference with higher satisfaction scores …

The Need For Sharps Boxes To Be Offered In The Hospital Setting For People Who Use Substances: Removing Sharps Boxes Puts All Of Us At Risk., Cheryl Forchuk, Michael Silverman, Abraham Rudnick, Jonathan Serrato, Brenna Schmitt, Leanne Scott

Nursing Publications

INTRODUCTION: Substance use can occur in the hospital setting among people with substance use disorder, including intravenous use. However, the provision of sharps boxes is not typically offered in Canadian hospitals. This study set out to explore the current issues due to the lack of harm reduction in the hospital setting.

METHOD: Thirty-one health care professionals participated in virtual one-to-one interviews and focus groups regarding harm reduction in hospital. The issue of sharps box removal was highlighted as a concern. A secondary ethnographic thematic analysis explored this theme in more detail. A scoping review of the literature observed additional considerations. …

Implementation Of A Code Lobby Surge And The Impact On Left Without Being Seen Rates, Nicole Plouffe

Student Scholarly Projects

Practice Problem: Crowding of emergency departments contribute to higher-than-average left without being seen (LWBS) rates. LWBS patients pose risks to the hospital as well as to one’s own health.

PICOT: The PICOT question that guided this project was in a pediatric emergency department (P), does implementation of a “Code Lobby Surge” (I), compared to standard care (C), decrease left without being seen rates (O) within eight weeks (T)?

Evidence: Surge interventions and decreasing the visual of crowding have shown to decrease LWBS rates.

Intervention: “Code Lobby Surge” was implemented to decrease LWBS rates and improve throughput within the …

The Importance Of Educating Adolescent Mothers In The Postpartum Period, Sydney Price, Madelyn Travis, Reagan Schwable

Scholars Week

Due to the lack of policy or procedure for individualized education for adolescent mothers, we concluded that a educational checklist in the charting system would be the most effective way to properly educate young mothers during this confusing stage in their life. Specific education helps to improve perceived quality of care, safety/wellbeing in the young mother and newborn, and reducing the risks of complications such as postpartum depression or issues with pregnancy later on. In summary, ensuring that teenage mothers are fully educated before discharge will provide for better mother and baby outcomes.

The Benefits Of Family Presence During Resuscitation, Abigail Harris, Payton Hale, Audrey Jeziorski

Scholars Week

The research provided analyzes the benefits and fears concerning Family Presence During Resuscitation (FPDR) as a standard practice in healthcare facilities. Evidence is available that FPDR supports increased familial satisfaction and psychological outcomes as well as benefits to the patient and healthcare team involved in resuscitation efforts, however this practice is not consistently implemented in healthcare facilities. Three main studies were analyzed throughout this research in order to determine the causation of inconsistent and absent policies regarding FPDR. The analysis of these studies determined that there is a lack of guidelines, education, and policies resulting in absence of family members …

Using Specially Designed Software To Create A Simulation Space Design Assignment, Desiree A. Díaz, Mindi Anderson, Kathleen Bastedo, Corey Peterson

FDLA Journal

A college of nursing at a large southern university created a completely online graduate degree and online certificate related to healthcare simulation. In the organizational and operations simulation course, a paper/pencil assignment course was replaced with the use of an innovative online specialty software, i.e., widget, which allowed students the opportunity to design to scale a simulation space. The collaborative team of nursing and university technology and learning faculty jointly designed and created the widget. The purpose of this study was to describe the assignment and widget development and then to discuss the study to determine the usability and student …

Outpatient Intravenous Antibiotics, Audrey Crews

MSN Capstone Projects

This paper discusses the use of outpatient intravenous antibiotics in comparison to inpatient intravenous antibiotics. Hospital admission rates, cost of care for patients and facilities, length of stay, patient experience, and patient outcomes are compared and evaluated with treatment to determine the efficacy of use.

Effects Of An Evidence-Based Practice Bundle Project On Nurse Empowerment, Kevin Jay Inman

Graduate Theses, Dissertations, and Capstones

The project determined the effect of an Evidence-Based Practice bundle program on nurses’ perception of empowerment. The EBP bundle included 7 interventions implemented simultaneously throughout a small community hospital. There was a significant increase in nurses’ perception of empowerment (p<.001), EBP beliefs (p<.001), and use of EBP (p<.001) after the implementation of an EBP bundle.

Implementation Of A Hospital-Wide Surge Plan To Reduce Emergency Department Length Of Stay, Laura Massey

Student Scholarly Projects

Practice Problem: Suboptimal patient flow throughout the hospital has resulted in an increased length of stay (LOS) for emergency department patients and the potential for adverse events.

PICOT: In admitted and discharged emergency room patients (P), how does a hospital-wide surge plan (I) compared to current throughput plan (C) affect the length of stay (O) within 8 weeks?

Evidence: The literature evidence reviewed supported the implementation of a hospital-wide surge plan approach positively impacts the emergency room length of stay and patient outcomes.

Intervention: The primary intervention for this project was the implementation of a hospital-wide surge policy. Targeted …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, Kara Marie Roman, Aaron Mestemaker

Masters Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Creating A Culturally Adaptable Comprehensive Sexuality Education Teacher's Manual, Stephanie Carteciano

Student Works

Purpose: The purpose of this project was to create a culturally adaptable comprehensive sexual education teacher’s manual by (a) standardizing content using The United Nations Educational, Scientific and Cultural Organization’s (UNESCO) 2018 International Technical Guidance on Sexuality Education (CSE), (b) providing evidence-based CSE pedagogy in the form of classroom activities, and (c) including adaptable teaching methods to fit diverse cultural contexts.

Development: The manual lessons were derived from UNESCO’s 2018 International Technical Guidance on Sexuality Education, and the pedagogy followed Anderson and Krathwohl’s revision of Bloom’s Taxonomy. Health information was obtained from various medical and university resources. We surveyed eight …

Prepare For The Flare: Preparing Georgia Southern College Of Nursing Students On How To Properly Assess And Educate Patients With Atopic Dermatitis, Charlotte V. Moore

Honors College Theses

Atopic dermatitis is a skin disorder commonly known as eczema. This autoimmune disease is common and can appear on multiple parts of the body as dry, itchy skin. This thesis will discuss research on educational programs presented to nursing students in a Bachelor’s of Science nursing program on how to recognize atopic dermatitis and its triggers and be able to properly educate future patients about it. Nurse-led education is beneficial in reducing disease severity and improving quality of life by enhancing self-management, adherence and patient/guardian engagement. Are nursing students aware of the signs and symptoms of the disease, and do …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, An Evidence-Based Intervention, Kara M. Roman, Aaron Mestemaker

Masters Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Clabsi Prevention Methods, Noah Heine, Talon Cockrel

Scholars Week

Infection and the risk thereof is one of the major concerns regarding patient outcomes in the health care facility. One of the interventions with the highest causes of infection is the use of central lines. These lines provide necessary venous access for medication administration but can cause infections called CLABSI or Central Line Acquired Bacterial Infection. The purpose of our article was to research CLABSI prevention methods and provide a new policy using these safe effective methods. These new methods include the use of stat locks for central line securement, using antimicrobial lines, and flushing/locking the central line with a …

Clinical Decision Support System For Standardization Of Disease-Specific Education, Paul Nava

Student Scholarly Projects

The evidence-based, contextually relevant, disease-specific health education materials aim to provide strategies for improvement in health literacy, disease management comprehension, and medication adherence. The health education materials address difficulties many adults experience in understanding health information. The health education system must remain a contextually relevant, patient-specific reference for standardizing disease-specific education according to the patient's mental capability (Fereidouni et al., 2019). Nurse-driven education material system addresses equity, diversity, and inclusion, tailored for all literacy degrees.

Clinical decision-making is a complicated process influenced by a highly variable process that exponentially increases error rates, selection, or exclusion, unintended or not, by presenting …

Strategies To Prevent Clostridioides Difficile Infections In Acute-Care Hospitals: 2022 Update, Larry K Kociolek, Dale N Gerding, Ruth Carrico, Philip Carling, Curtis J Donskey, Ghinwa Dumyati, David T Kuhar, Vivian G Loo, Lisa L Maragakis, Monika Pogorzelska-Maziarz, Thomas J Sandora, David J Weber, Deborah Yokoe, Erik R Dubberke

College of Nursing Faculty Papers & Presentations

No abstract provided.

Sterile Tubing Changes To Prevent Clabsis In The Nicu, Rachel Janson, Megan Meyer

Nursing Posters

Purpose Statement:

NICU patients have a decreased risk of CLABSI infections when two-person sterile central line changes are implemented into central line maintenance bundles compared to bundles that only use one-person clean line change techniques.

Background:

Neonates admitted to the neonatal care intensive care unit (NICU) often require the placement of central lines for the administration of medications, fluids, parental nutrition, and hemodynamic monitoring. Despite their many advantages, central lines can lead to serious infections, known as cental line associated bloodstream infections (CLABSI). These infections are not related to an infection from another site and develop within forty-eight hours of …

In-Patient Smoking Cessation – A Quality Improvement Project, Shannon Harris, Lori P. Moore, Tochie Lofton, Aphry Olafsen, Robert Percy

Poster Presentations

This project aimed to demonstrate that in-patient smoking cessation education would prepare the patient for a serious attempt to quit smoking. Thus, this project explored in-patient smoking-cessation strategies to mitigate smoking-related hospitalizations.

In Adult Patients Aged 18 And Over, What Is The Effect Of Telemedicine, As Compared To Traditional Office Visits, On Missed Appointment Rates, Tavaris Brooks, Shannon Harris, Kristen Currie

Poster Presentations

During the COVID-19 pandemic public health officials sought out different options to limit the spread of the disease and continue providing the much-needed care that patients deserved. Telemedicine became one of the leading initiatives to assist in caring for patients while limiting potential exposures. Prior to the pandemic telemedicine was primarily utilized in the psychology and neurology settings. The lost of life during the pandemic was unimaginable additionally, many healthcare entities begin to suffer from lack of protective supplies. Due to the unknown and newly implemented stay at home mandates made throughout the country many people became fearful of COVID-19 …

Plethysmography Variation Index (Pvi) Utility In Guiding Goal-Directed Fluid Therapy During Major Abdominal Surgery, Ricky Malo

Nurse Anesthesia Student Capstones

When considering intra-operative MAP maintenance, preload is a significant driving factor of stroke volume and therefore cardiac output. In major abdominal surgeries, large fluid shifts are common and accurate fluid resuscitation is extremely important to maintain hemodynamic stability and promote optimal patient outcomes. Invasive methods of measuring fluid status range from esophageal doppler derived flow time (FTc) and arterial line-derived metrics such as stroke volume variation (SVV) and pulse pressure variation (PPV). However, invasive means are not always warranted for every surgical procedure or patient and there is a higher potential risk for complication. Plethysmography Variation Index (PVI) has been …

Perioperative Pain Management In Morbidly Obese Patients Undergoing Bariatric Surgery, Jean-Louis Luther

Nurse Anesthesia Student Capstones

Patients with morbid obesity are a growing patient population. These patients present a unique set of challenges in healthcare management. These unique challenges have been a long-standing concern to anesthesia providers in appropriately managing postoperative pain with opioids. Multimodal analgesia strategies have been adopted by many providers to minimize opioid-related side effects that are highly desirable in bariatric surgical procedures. The literature reviewed for this manuscript highlights the challenges this population presents to anesthesia providers, as well as conclusively supports alternative approaches utilizing multimodal pain management.

Impact Of Intrathecal Morphine On Patient Outcomes In Major Abdominal Surgery, Tori E. Howe

Nurse Anesthesia Student Capstones

Colorectal enhanced recovery after surgery (ERAS) guidelines for patients undergoing major abdominal surgeries have started to include intrathecal morphine (ITM) as part of the protocol to improve patient outcomes. There is interest amongst other abdominal surgical disciplines in expanding the use of ITM. When used as a single bolus, ITM has shown to have an intravenous (IV) opioid sparing effect postoperatively, as well as improved pain scores for up to 24 hours (Koning et al., 2020). However, ITM coincides with unique considerations and side effects. There is a dose-dependent concern of ITM causing respiratory depression postoperatively that necessitates additional monitoring …

Perioperative Methadone Use And Postoperative Pain Control In Adult Patients Undergoing Elective Spinal Fusion Surgery, Amelia Haney

Nurse Anesthesia Student Capstones

Patients undergoing elective spinal fusion surgeries often experience moderate to severe postoperative pain (Murphy et al., 2017). The use of perioperative methadone has been suggested as an effective adjunct for patients to reduce postoperative pain, decrease opioid use, and improve patient satisfaction (Murphy et al., 2017). Traditional opioid management of orthopedic spine surgeries include intermittent injections or patient-controlled analgesia devices. These approaches may cause fluctuating levels of opioids or require patient education and cooperation to be effective (Murphy & Szokol, 2019). Methadone has a much longer elimination half-life when compared to other opioids, and therefore may provide patients with a …

Benefits Of Ketamine Versus Propofol In Acute Traumatic Brain Injuries With Elevated Intracranial Pressure, Marissa Diloreto

Nurse Anesthesia Student Capstones

Ketamine is a widely used medication that can be administered for the delivery of anesthesia as well as analgesia while supporting hemodynamics. A commonly taught concept based on early research is that ketamine should not be administered to those with acute brain injuries. Early research had stated that ketamine can cause a dangerous increase in intracranial pressure (ICP) and thus a decrease in cerebral perfusion and oxygenation in those with traumatic brain injuries (TBI) (Takeshita et al., 1972). More recent research has shown that ketamine may be efficacious for patients with TBIs and can decrease ICP (Dengler et al., 2022). …

The Role Of Intraoperative Esmolol Vs Ketamine In Laparoscopic Cholecystectomy, Rebekah Bitar

Nurse Anesthesia Student Capstones

As the understanding of opioid dependence mechanisms and origins in the adult population continues to evolve in the United States, so does the pursuit of alternative avenues for analgesia. Many opioid substance-use disorder patients can trace the origins of their dependence to routine prescription and administration of opioids during surgical procedures (Bohringer et al., 2020). One such procedure where opioids are frequently utilized for intraoperative and postoperative analgesia is laparoscopic cholecystectomy. Incidence of gall bladder disease is closely related to obesity (Hines & Marschall, 2018). Gallstone disease continues to be a common and costly health problem affecting 10 to 20% …

Improving Pediatric Medical Nurses’ Confidence In Caring For Pediatric Mental Health Patients: A Pilot Project Large Academic Pediatric Health System In The Pacific Northwest, Lauren Kalember

Doctor of Nursing Practice Projects

Problem Description

Pediatric mental and behavioral health care needs continue to increase across the nation. Approximately ten percent of pediatric hospitalizations are for a primary mental or behavioral health condition (Canvara & Johnson, 2020). With the increase in hospitalizations for mental health (MH) needs, pediatric psychiatric units are at capacity, and MH patients are admitted to pediatric general medical/surgical units for care. Most of the nurses that work on these units have not received pediatric mental health education outside of nursing school curricula and report a lack of confidence in their ability to care for pediatric MH patients. With the …

An Inpatient Fall Prevention Program Evaluation Using The Context, Input, Process And Product Model, Brittany Harker

Doctor of Nursing Practice Projects

Background/Context: Falls remain a substantial risk for patients and is reported that 1,000,000 patients fall each year and one-third result in injury to the patient.

Problem/Purpose: To evaluate the implementation of a fall prevention toolkit to determine if standards of care were followed and outcomes were met using the Context, Input, Process, and Product model.

Outcomes/Results: Fall risk assessment was occurring on admission (n=33) with opportunity for reassessment throughout stay. Required post-fall documentation was not completed per policy. 26% of staff responded to the feedback survey. The facility’s fall rate target was not met but reducing the …