Nursing Commons^™

Implementing Adverse Childhood Experiences (Ace) In A Youth Regional Treatment Center, Laruen Russell-Smith

Virtual Presentations

The purpose of this study was to investigate Adverse Childhood Experiences (ACE) awareness among staff working with a population known to have high ACE scores. The intended purpose was to evaluate staff understanding of ACEs and their impact on patient satisfaction scores.

Virtual Osce Solutions For Nurse Practitioner Students During Covid, Lori Prewitt Moore, Shannon Harris

Virtual Presentations

This presentation discusses the Objective Structured Clinical Examinations (OSCE) utilized for evaluating the clinical skills of graduating nursing students. The OSCE method assesses clinical competency in a structured manner with an emphasis on objectivity. The framework involves multiple stations where students rotate and perform designated tasks for assessment in healthcare disciplines.

Improving Mental Wellness In Clinical Staff: Using Respite Rooms And Mindfulness Strategies In Ambulatory Care Settings, Whitney Hodges Shanley

Doctor of Nursing Practice Projects

Background: Diminished physical and mental wellness of clinical staff leads to poor patient health outcomes and high turnover rates. Providing designated quiet spaces to practice mindfulness can be beneficial to the overall health of healthcare workers, thus, improving compassion fatigue, job satisfaction, and retention of clinical staff.

Aim: This project implemented a respite room in an ambulatory care practice to improve clinical staff’s self-reported ratings of compassion fatigue, compassion satisfaction, and intent to leave their job.

Methods: This quality improvement project used a pre- and post-test design to compare clinical staff ratings of compassion fatigue (burnout and secondary traumatic stress), …

Depression Screening In Hematology/ Oncology Outpatient Clinic, Nikki Marshall Msn, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Oncology patients have multiple factors that can lead to depression, such as treatments, end-of-life decisions, stressors from home, pain, financial responsibilities, and transportation needs. If depression goes unaddressed, it can diminish the quality of life in oncology patients.

Objectives: (1) The purpose of this evidence-based practice (EBP) project is to improve Hematology/ Oncology (HEM/ONC) patient quality, with improved screening (PHQ-9 screening tool) and identification as well as referral for adult patients (18 and older). (2) Assess the knowledge, perception of depression, and confidence level of utilizing the PHQ-9 screening tool in the hem/onc outpatient clinic staff. (3) To increase …

The Oncology Clinical Trial Nurse Complex Design And Role Comprehension Training Evaluation Project, Pamela Herena Msn, Rn, Ocn

Doctor of Nursing Practice Projects

Background: The oncology Clinical Trial Nurse (CTN) plays a significant role in conducting clinical trials; however, the role comes with many challenges. These difficulties are related to the expanding landscape, advances in cancer research, complex trial designs, and the lack of role definition leading to role confusion and limited role comprehension.

Aims/Objectives: The project’s purpose was to develop a training program specific to complex clinical trial design, cancer disease overview and the oncology clinical trial nurse role. The aim focuses on the evaluation of the program by clinical trial research leaders.

Methods: A non-probability convenience snowball sampling method was used …

Deriving A Model For Predicting Hospital Falls, Aubreylynne Porras, Kim Nicole Rossillo, Elizabeth Winokur, Jose Ramirez, Angela Leano

Articles, Abstracts, and Reports

Background: In the United States 700,000 to 1,000,000 people fall in the hospital annually, 1/3 result in injury. One single fall averages $14,000, resulting in an increase in hospital length of stay and burden on hospital budget. In St. Joseph Hospital of Orange, from calendar year 2019 to 2020, there was an increase in falls from 178 to 185 falls, despite the use of a telesitter. At time of data collection, 12 telesitter cameras were initiated after a fall. An investigation was deemed necessary to determine the cause of the increase and the factors related to patient falls.

Purpose: The …

Impact Of Opioid-Free Anesthesia Versus Opioid-Based Anesthesia On Time To Extubation: A Scoping Review, Mary K. Connor Rn, Bsn, Srna, Dexter Browning Rn, Bsn, Srna, Ariel Clark Rn, Bsn, Srna, Erica B. Gates Rn, Bsn, Srna, Madison T. Mccaskill Rn, Bsn, Srna, Dwayne L. Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Opioids during surgery have been clinically proven to lengthen the time between intubation and post-op extubation. Increased time to extubation is associated with negative patient outcomes. This scoping review aims to evaluate the use of ketamine with opioid free analgesia (OFA) versus traditional opioid usage and its outcomes on extubation times.

Methods

From September 2021 to November 2021, we conducted a literature search using the University of Tennessee Health Science Center’s (UTHSC) online library. Through the PubMed, CINAHL, Medline, and Cochrane databases, we identified seventy-one articles that matched our criteria. Of those articles, we selected twenty-five to undergo rapid …

Driving Toward A Culture Of “Zero Cautis”, M Bowe, E Bowen, S Carlton, L Dyjur, P Harmon, J Harrod, L Jackson

Articles, Abstracts, and Reports

No abstract provided.

Orientation Materials: Impact Of Transitioning From Paper To An Electronic Format, Megan Bowles, Abby Lust, Teresa Rangel, Tobi Bryan

Articles, Abstracts, and Reports

Background:

In one region including 4 hospitals, acute care nurses historically met with professional development practitioners (PDP) and received binders containing printed, specialty-specific policies and a competency checklist (required to be signed and returned to the nurse leader) upon new hire or transfer. Creating physical orientation packets is costly, time-consuming, and restricts the ability to share appropriate orientation materials in the event of a PDP sick call. Real-time communication between the orientee, preceptor, PDP, and nurse leader regarding status of the competency checklist cannot occur with a physical binder. Providing electronic onboarding materials is a potential solution.



Purpose:

To describe …

Creation And Implementation Of A Trauma-Informed Care Safety Tool In An Inpatient Mental Health Unit, Katie Rhea, Jeremy Williams, Teresa Rangel

Articles, Abstracts, and Reports

No abstract provided.

Throughput Without Barriers, Laura Longacre

Articles, Abstracts, and Reports

No abstract provided.

Implementation Of A Patient Satisfaction Survey At A Free Community Clinic: A Quality Improvement Project, Nora O'Sullivan

DNP Projects

Background: The uninsured, underinsured, and underserved populations in the US are impacted by health disparities and have unique experiences with healthcare. Yet, settings which serve these populations – the “safety net”- are not adequately supported to gather patient experience data. In Connecticut, Fairfield County has a higher percentage of uninsured people than the overall state. Additionally, this population has demonstrated higher frequency of emergency department utilization than the overall population. Therefore, processes to measure the barriers to accessing quality care and patient experience and satisfaction with care are needed in safety net clinics to promote elimination of health disparities and …

Covid-19 Lockdown: Impact On College Students’ Lives, Wendy C. Birmingham, Lori L. Wadsworth, Jane H. Lassetter

Faculty Publications

Objective: In light of COVID-19, leaders issued stay-at-home orders, including closure of higher-education schools. Most students left campus, likely impacting their employment and social network. Leaders are making decisions about opening universities and modality of instruction. Understanding students' psychological, physiological, academic, and financial responses to the shut-down and reopening of campuses can help leaders make informed decisions. Participants: 654 students from a large western university enrolled during the pandemic shutdown. Methods: Students were invited via email to complete an online survey. Results: Students reported stress, depression, loneliness, lack of motivation, difficulty focusing on schoolwork, restless sleep, appetite changes, job loss …

Implementing Team Birth To Improve Patient Satisfaction On An Ldrp (Team Birthsingleroom ) Unit, Deanna Higgins, Alyson Willard, Teresa Rangel

Articles, Abstracts, and Reports

No abstract provided.

Dnp Final Report: Conquering Rn Turnover: Implementing Flexible Scheduling To Improve Job Satisfaction, Camille Y. Parsee

DNP Final Reports

Nurse turnover is a complex problem for the nursing profession, especially in the behavioral health setting, where turnover rates are higher than the overall RN national average. The consequences of high nurse turnover include increased health costs, low-quality patient care, and staffing constraints. The association between nurse turnover and job satisfaction is profound because of their reciprocal relationship; therefore, implementing an intervention to help mitigate nurse dissatisfaction is essential to overcoming nurse turnover. Flexible scheduling is an intervention that gives nurses independence with their schedule which improves work-life balance and promotes nurse retention (Wright, 2017). The following PICOT question was …

Dnp Final Report: Medication Adherence: Evidence-Based Interventions For Parkinson's Disease, Amanda George

DNP Final Reports

Parkinson's disease (PD) is a challenging, progressive neurodegenerative process projected to affect greater than one million patients in the United States over the next decade. Pharmacological interventions are the hallmark of treatment and are used for symptom management; there is no cure for this lifelong disease. Once-daily preparations are typically inadequate as a sole treatment or contraindicated related to comorbid or drug-induced psychiatric symptoms or behaviors. In addition, multiple medications and a variety of dosing times have an increasingly negative effect on medication adherence. The literature contains many resources to measure and understand what medication non-adherence is, who is at …

Use Of A Worksite Physical Activity To Improve Subjective Daytime Sleepiness Among Night Shift Healthcare Workers: A Quality Improvement Project, Marthe Sooh Nkongo

DNP Projects

Background and Significance: Shift work including work schedules beyond the typical "nine-to-five," causes the disruption of sleep-wake behaviors (Healy et al., 2021). The circadian misalignment is a potential pathway for the development of metabolic diseases, excessive daytime sleepiness, sleep deprivation, and declines in alertness and performance among night shift workers (James et al., 2017; McHugh et al., 2020; Parry et al., 2018). Emerging evidence suggests that physical activity synchronizes the sleep-wake cycles (Healy et al., 2021).

Purpose: This quality improvement project (QI) aimed to improve night-shift nurses ‘subjective daytime sleepiness by incorporating a 4-week worksite walking activity during working hours. …

Implementation Of A Daily Central Line Maintenance Audit Form In An Outpatient Infusion Center: A Quality Improvement Project, Sarah E. Christiana

DNP Projects

Significance and Background: Best evidence supports central venous access device (CVAD) dressing changes occur every 7 days or sooner, if indicated. At a community hospital in New England, patients receive outpatient antimicrobial therapy via CVADs. It is vital that nurses adequately maintain CVAD dressings according to evidence-based protocols to reduce the risk of central line-associated bloodstream infection (CLABSI). CLABSIs, associated with increased morbidity, mortality, and health care costs, are largely preventable through proper CVAD maintenance. At the project site, a review identified that dressing changes were frequently changed beyond the 7-day parameter. Documentation and surveillance processes were identified as opportunities …

Fitness Assessments Of Women With Polycystic Ovary Syndrome: A Prospective Process Feasibility Study, Pamela J. Wright, Cynthia F. Corbett Phd, Rn, Faan, Robin M. Dawson Phd, Rn, Cpnp-Pc, Michael D. Wirth Msph, Phd, Face, Bernardine M. Pinto Phd, Fapa, Fsbm, Fabmr

Publications

Background: Fitness is a marker of physiological and mental health. The purpose of this pilot study was to assess the feasibility of processes to recruit women with polycystic ovary syndrome (PCOS) during the Covid pandemic and collect their health and fitness data. Additionally, the data was used to explore possible associations between anthropometrics, PCOS biomarkers, health-related quality-of-life (HRQoL), and depressive symptoms with that of fitness and self-reported physical activity levels among women with PCOS. Methods: A convenience sample of women with PCOS (n = 15) were recruited via flyers and the snowball method. Participants completed surveys, anthropometrics, a dual energy …

The Impact Of A Human Trafficking Educational Module On Nurse Practitioner Students Awareness, Knowledge, And Confidence In Responding To Human Trafficking, Casey Elliott

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Aim: The purpose of this study was to determine if a human trafficking education module increased master level nursing students’ awareness, knowledge, and confidence in responding to human trafficking (HT) victims. Background: HT in the United States and worldwide is a growing problem. Millions of men, women, and children are victims of HT each year. Victims of human trafficking are often vulnerable due to several factors, including emotional problems, social instability, and economic difficulties. Studies have found up to 88% of victims of HT are seen by a healthcare provider during their captivity. Improving the awareness, knowledge, and confidence of …

Firefighter: 24/48 Versus 48/96; Sleep, Strain, And Recovery, Amy Sprague

Honors Theses

Firefighters provide important safety services for a 24-hour society. Sleep is very important to the human body. Without sleep a person can experience both short- and long-term side effects. These side effects not only put the sleep deprived person in danger but can also put the public in danger as well. There are many different shift schedules that fire departments can run on. While on duty firefighters must be ready to respond to any emergency call, they receive no matter the time. This can impact the amount of sleep they get while on duty. The current study used biometric straps …

Impact Of An Evidence-Based Order Set On Pneumonia Length Of Stay, Troy Wayne Spires

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Among adult patients admitted with pneumonia, what is the effect of Computerized Provider Order Entry (CPOE) sets for pneumonia, as compared to usual practice, on the length of stay over three months.

Purpose: The project aimed to determine if inpatient LOS related to pneumonia could be impacted by utilizing appropriately completed computerized physician order entry (CPOE). The current pneumonia order set was evaluated and updated to reflect the latest evidence-based standards of care. Pneumonia order sets with evidence-based practice treatment algorithms was the intervention focus as they have been shown to impact the length of stays …

Reducing Falls Among Adult Psychiatric Inpatients Using K-Cards With The Epi, Epfrat Factors, And Nursing Judgment, Katelyn Dunn

Doctor of Nursing Practice Scholarly Projects

In the United States, the highest rates of falls are in the psychiatric inpatient population. Fall reduction was as an organizational goal of the project site, a 352-bed hospital in the Southeastern United States. The Epic Predictive Index (EPI), an automated fall risk assessment tool, had recently been adopted. This project evaluated the impact of an enhanced fall reduction strategy involving the use of Kamishibai Cards (K-Cards), which are a compliance reminder for healthcare staff, to support additional evidence-based identification of fall risk among adults receiving inpatient psychiatric care at the facility. The use of K-Cards with each patient’s current …

Trauma And Resiliency, Madelyn Ferguson

Honors Projects

Life is a series of events, some overwhelmingly positive and others devastatingly negative. Because of the inevitability of adversity, one must learn to adapt to negative circumstances. However, people react to trauma in different ways with some seeking to take their own lives and others finding a healthy outlet. What causes such a difference in our reactions to trauma? Is it simply the power of thought or is there a genetic component? What can I do to build my own resilience and promote the resilience of others around me? The purpose of this paper is to explore the relationship between …

Implementation Of An Activity Protocol In The Acute Care Setting: A Quality Improvement Project, Crystal M. Ryan

DNP Projects

Background: Physical activity following cardiothoracic surgery can help decrease post-operative complications, expedite functional recovery, improve overall well-being, shorten hospital length of stay (LOS), and reduce morbidity and mortality (Miwa et al., 2017). Of these patients, 58% developed complications after cardiac surgery; of these complications, 31% were pulmonary, 16% were of cardiac in nature, and 14% were neurological (Yayla, 2018).

Purpose: This quality improvement project aims to implement an evidence-based protocol for evaluating the correlation between physical activity in uncomplicated post-operative coronary artery bypass and length of stay.

Methods: The Plan-Do-Study-Act (PDSA) tool from the Institute for Healthcare Improvement (IHI) guided …

Sunscreen Is Not Just For White People: Church-Based Sunscreen Education For Black Women, Lauren Mitchell

DNP Projects

Significance and Background: African American women are an undeserved population in healthcare, particularly regarding skin cancer prevention. The lack of education and misinformation surrounding skin cancer has resulted in general mistrust of the healthcare system amongst African Americans. Proper education on sunscreen use and skin cancer screening is essential to prevent late diagnosis of skin cancer and to promote prevention efforts.

Purpose: This quality improvement project utilized evidence-based practice to provide education on the proper use of sunscreen and skin cancer screening to African American women in a faith-based setting in Southern Connecticut.

Methods: A pre-survey was conducted to assess …

Evaluating The Efficacy Of Medication-Assisted Treatment For First Episode Psychosis: A Scoping Review, Chanel Thomas Msn, Aprn, Fnp-Bc, Rn-Bc, Alexandra Wittenberg Bsn, Rn-Bc, Anttrenika Anderson Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that individuals with substance use disorder (SUD) receive medicated-assisted treatment (MAT), as a complete approach to substance use treatment (SAMHSA, 2019). However, treatment measures using combination treatment for SUD in individuals experiencing first episode psychosis (FEP) are seldom used. This scoping review assesses the efficacy of MAT in conjunction with antipsychotics compared to the use of antipsychotic monotherapy for FEP individuals on hospital readmission rates.

Methods

The authors conducted a literature review utilizing PubMed, EBSCO, Elsevier, Google Scholar, PsychINFO, and Medline from August 2020 to November 2022. Key phrases …

The Jackson/Cubbin Skin Risk Assessment Tool: Implementing An Evidence-Based Practice Change Initiative In The Intensive Care Unit, Andrew Riddle Msn, Rn, Npd-Bc, Ccrn-K

Doctor of Nursing Practice Projects

Background: Pressure injuries in acute care patients cause thousands of deaths and billions of losses annually. The Braden Scale has been an American standard of pressure injury risk assessment yet demonstrates poor predictability in the Intensive Care Unit (ICU) population. Recent evidence indicates that the Jackson/Cubbin Scale performs similarly or superiorly to the standard.

Purpose: To compare the Jackson/Cubbin Scale to the Braden Scale in assessing ICU patients’ risk for pressure injuries and resulting nursing interventions. Methods: Using a pretest-posttest and comparative design, trained nurses in two ICUs applied both Jackson/Cubbin Scale and Braden Scale to assess patients’ risks twice …

Impact Of An Automated Text And Phone Call Post-Discharge Follow-Up Program On Patient Satisfaction Scores And 30-Day Hospital Readmission Among Adult Patients, Michael Clarke

Doctor of Nursing Practice Projects

Background: The Center for Medicare & Medicare (CMS) withholds reimbursement from hospitals that fail to meet established benchmarks for the rate of 30-day hospital readmission and patient satisfaction.

Objective: This project aimed to improve patient satisfaction scores and decrease 30-day hospital readmissions among adult patients at the project hospital by implementing an automated phone call and text message post-discharge follow-up program.

Methods: This quality improvement project utilized a Plan-Do-Study-Act (PDSA) method. Program participants’ 30-day readmission data and patient satisfaction scores were collected and analyzed throughout the 90-day project and up to 30 days after the project ended. Program participants received …

Roadmap To Reduce Barriers To Medical Aid In Dying For Rural Coloradans: A Health Policy Analysis And Advocacy Campaign, Ashley D. Fry Msn, Apn, Agacnp-Bc, Achpn

Doctor of Nursing Practice Projects

Background: Medical aid in dying (MAID) is a process by which a terminally ill adult with a prognosis of six months or less can request prescription medications to end their life. Colorado’s End-of-Life Options Act requires that two physicians participate in the process to certify terminal illness and prescribe medications. Nearly all rural and frontier counties face shortages of medical professionals. These conditions challenge rural residents who want to access MAID. Advanced practice registered nurses and physician assistants can address gaps in rural and frontier counties; on average, they outnumber physicians in these communities.

Aims: The aims of this health …