Nursing Commons^™

Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training, Carmen Mclamb

Doctor of Nursing Practice Projects

Achieving peripheral venous access in patients is one of the first steps in most treatment protocols. Delays or even failures to obtain peripheral venous access can delay lifesaving treatments, prolong hospital stays, and affect patient outcomes. Peripheral venous access can be difficult due to chronic disease processes, scarring of valves from frequent cannulation, limitation due to dialysis fistulas, or due to acute conditions such as hypovolemia and hypotension. Studies have found the use of ultrasound-guided techniques can achieve peripheral venous access quickly and prevent the need for more aggressive procedures (Skulec et al., 2020). However, there is a gap between …

Integrating A Community Mental Health Resource Tool In A Rural Emergency Department Setting, Robert Rash

Doctor of Nursing Practice Projects

Providing effective discharge education to patients who are treated in the emergency department setting remains a very important component of a patient’s visit to an emergency department. Literature confirms although there are various governmental regulatory agencies that set forth regulations and guidelines, there remains a need to continually evaluate and critique the discharge education process to best meet the evolving needs of the patients, stakeholders, and community. Universally understood standards include appropriate reading levels and usability of the discharge education being provided. Discharge education can be very simple to complex creating higher demands on nursing staff to ensure they understand …

Studying The Impact Of Hyperlipidemia Monitoring Tools On Referral Rates In Patients Taking Antipsychotics, Jasmyn S. Allen

Doctoral Projects

The purpose of this DNP project is to determine how well an evaluation tool may be used to track hyperlipidemia in patients using antipsychotic medicines who are between the ages of 20 and 50. Elevated lipid contents in the bloodstream, or hyperlipidemia, increase the danger of heart-related illnesses. Antipsychotic drugs, frequently administered for mental health disorders and dyslipidemia, have been connected. The goal is to ascertain whether utilizing an evaluation tool raises the three-month referral rates for hyperlipidemia to primary care (Dayabandara et al., 2017). The foundation of the research is found in several articles collected from different websites. According …

Early Identification Of Barriers To Medication Adherence In The Elderly Population Through The Use Of A Modified Screening Tool, Miranda Joyner, Blake Meranto

Doctoral Projects

Medication nonadherence (MNA) is a major contributor to hospitalizations and accounts for billions of dollars spent every year on health care. Despite medications being prescribed in nearly 75% of healthcare interactions, it is estimated that 33 to 50% of Americans do not take their medications as prescribed, if at all (Bartlett Ellis et al., 2020; Kleinsinger, 2018). The COM-B (Capability, Opportunity, Motivation, Behavior) Model used in this DNP project suggests that an individual must have the capability, opportunity, and motivation to enact a certain behavior, and should any of these areas be lacking, the behavior is unlikely to occur. This …

Effectiveness Of Staff Training On Trauma-Informed Care, Brandy Tramel Williams

Doctoral Projects

The connection between experiencing trauma and the development of substance use disorder is widely recognized. Although trauma is more prevalent among individuals with substance use disorders, healthcare professionals have limited access to training focused on trauma informed care. It is crucial for those working in addiction treatment to receive training and education on trauma informed care to understand the impact of trauma and its association with substance use disorders.

This DNP project's objective was to develop and evaluate an educational presentation for staff emphasizing the importance of trauma-informed care in the context of addiction. The effectiveness of this intervention was …

A Multifaceted Approach Using Implementation Science Methods To Increase Chg Bathing Compliance And Reduce Central Line Associated Blood Stream Infections On A Non-Icu Unit, Emily E. Warwick

VCU Health Nursing

BACKGROUND or RATIONALE:

The Acute Care Surgery unit (ACS) is a General and Progressive level of care post-operative unit at VCU Health system. Between quarter four 2021 and quarter one of 2023, five Central line associated blood stream infections (CLABSIs) occurred. NDNQI data revealed ACS had a higher CLABSI rate per 1,000 patient days than the national average of other similar type units in other magnet hospitals.

STATEMENT OF THE PROBLEM:

A GAP analysis revealed ACS did not achieve the 80% CHG compliance goal set by VCU Health’s Infection Prevention Department in all six quarters that these five CLABSIs occurred. …

The Role Of Body Appreciation And Self-Worth In The Social Support, Self-Management, And Glycemic Control Relationships With Type 2 Diabetes Mellitus Among Adult Arab Omani Women, Samia Alharrasi

Wayne State University Dissertations

Background: Diabetes self-management (DSM) is the mainstay of type 2 diabetes mellitus (T2DM) control. Adhering to self-management tasks is demanding, especially for women living with T2DM. Adult Arab Omani women living with T2DM are highly influenced by their social environment, which might impact women’s body appreciation and self-worth. The literature focused on these psychological determinants of DSM adherence behavior among Omani women living with T2DM is scared. Objective: Therefore, this study aimed to examine the relationship between social support and DSM behavior as mediated by body appreciation and self-worth in adult (≥ 40 years old) Arab Omani women living with …

Postgraduate Residency Program: Pedagogical Strategies In Bridging The Transition From Novice Nurse Practitioner To Confident Primary Care Provider, Kelly Stauter, Katherine Bydalek

CoTL 2023 Research Talks

Advancing the education of new nurse practitioners helps close the gap with the knowledge and core competencies necessary to practice independently and master delivery of quality care across the life span to vulnerable populations. Innovative teaching strategies incorporate the needs of the novice nurse practitioner and are designed to support the inclusive learning environment through educational technology, learner-centered activities, interprofessional partnerships, and local community-based agencies that facilitate active learning. Expanding the didactic and clinical training experience by integrating specialty rotations and simulation immersive events, enhances learning outside of the classroom and equips the postgraduate nurse practitioner with the skills and …

Bundle Up To Improve Cauti, Jennifer Anderson, Valorie Dearmon

DNP Manuscripts

Catheter Associated Urinary Tract Infections (CAUTIs) are a leading cause of healthcare acquired infections. Strong evidence for CAUTI best practices exists, however, the struggle to translate best practice evidence into everyday practice remains a challenge. Catheter associated urinary tract infection rates continue to be a problem despite organizational efforts to implement best practice guidelines; the challenge is to effectively translate and embed best practices into everyday practice. The Centers for Medicare and Medicaid Services (CMS) will no longer reimburse hospitals for expenses associated with hospital acquired CAUTI; moreover, hospitals are subject to penalties for high rates of hospital acquired CAUTIs. …

Why Doesn't She Just Leave? Improving Identification And Response To Victims Of Intimate Partner Violence In The Emergency Room, Elizabeth Berry

Doctor of Nursing Practice Projects

The purpose of this project was to improve identification and response to victims of intimate partner violence (IPV) presenting to the emergency department. Project participants completed a pre-education questionnaire prior to the project leader providing intimate partner violence educational materials and a presentation entitled Recognizing and Responding to Victims of Intimate Partner Violence in the Emergency Room. The project participants then completed a mirrored post-education questionnaire. Evaluation of the project included a comparison of the participant's responses to the mirrored questionnaires. Project participants reported an increase in the:

• recognition of the prevalence of intimate partner violence among their patients, …

Self-Advocacy Training To Support Self-Confidence In Transition To Practice, Debora Shingleton Allder

Doctor of Nursing Practice Projects

Background: The crisis in the competency of newly licensed graduate nurses continues to grow despite the efforts of nursing academia. Transition to practice programs has improved new graduate attrition and narrowed the gap of practice readiness, but much of the responsibility to train graduate nurses falls on nurse preceptors. Many of these preceptors have minimal nursing experience and little to no training in fostering clinical judgment. Furthermore, nurse preceptors must balance providing care for their clients while also guiding novice nurses. They often do not have the time to provide the emotional support, real-time reflection, and timely feedback required to …

Enhancing Emotional Intelligence In Prelicensure Nursing Students, Aimee G. Motley

Doctor of Nursing Practice Projects

Nursing programs are intended to prepare nursing students to become competent nurses, that can make decisions to promote positive patient outcomes. However, studies suggest that as students transition into clinical practice, they are still lacking decision-making skills. Emotional Intelligence (EI) has been suggested to improve communication skills, problem-solving, and resilience. The purpose of this project was to enhance the emotional intelligence of Baccalaureate prelicensure nursing students. The PICOT statement was: Can formal EI training combined with interactive EI training, influence EI awareness, knowledge, and skills of baccalaureate nursing students as evidenced by scoring 77% or higher on an EI posttest …

Stress Management For Healthcare Providers In The Emergency Department During Covid-19 Pandemic, Carrie A. Warns

Theses and Graduate Projects

The challenges healthcare providers face during the COVID-19 pandemic are

unprecedented, leading to work-related stress and burnout symptoms. Stress management for health care providers is crucial during the COVID-19 pandemic. Healthcare providers must find effective modalities during this time. Animal Assist therapy is a stress management modality that evidence-based research has proven to be effective. A comprehensive literature review of the importance of stress reduction for health care providers and the effectiveness of Animal Assist Therapy will help support this project. Jean Watson's human caring theory will serve as a model for this project. The implementation of the scholarly project …

Virtual Reality Pain Intervention For Pediatric Burn Patients, Tanya Ann Hinrichs

Theses and Graduate Projects

Burns can be devasting trauma in the pediatric population, leading to lifelong physical and psychological pain and anxiety. Burn pain management is complicated and undertreated traditionally. The purpose of this scholarly project is to examine the use of virtual reality (VR) for distraction in pediatric patients who have experienced a burn to determine if VR improves pain management during painful procedures. A literature review revealed a gap in pain management in pediatric burn survivors with just traditional pharmacologic analgesia during painful procedures. Leininger’s Culture Care Theory provides a theoretical framework for this project’s purpose to determine if implementing a virtual …

Patient Positioning To Prevent Pressure Injuries, Maria D. Trevis

Theses and Graduate Projects

Skincare is an important intervention to prevent pressure injuries (PIs) during hospitalization. Prolonged pressure on a body part can result in restricted blood flow and oxygen, inadequate nutrition, and varying degrees of tissue damage, ultimately leading to a PI. Patients who have undergone surgery or have limited mobility are particularly vulnerable to developing PIs. The Centers for Medicare and Medicaid Services made a ruling in 2008 that hospitals would not be reimbursed for any hospital-acquired PIs as they are costly and preventable. Unfortunately, there is a knowledge gap in PI prevention due to a shortage of nursing staff, and changes …

Predictors Of Acute Coronary Syndrome Symptom Knowledge, Attitudes, And Beliefs In Adults Without Self-Reported Heart Disease, John R. Blakeman, Marilyn Prasun, Myoungjin Kim

Faculty Publications - Mennonite College of Nursing

Background: The time of symptom onset to the time an individual decides to seek care is the most significant contributor to total treatment delay.

Objectives: To explore predictors of ACS symptom knowledge, attitudes, and beliefs in adults without diagnosed heart disease.

Methods: We used a cross-sectional, descriptive, and correlational design, employing an online survey including the ACS Response Index and the avoidance subscale of the Coping Strategy Indicator. We leveraged social media platforms and a university email list-serv to enroll participants. Stepwise hierarchical linear regressions were used.

Results: We analyzed responses from 981 participants, with a mean age of 35.2 …

Determinants Of Progression Of Gestational Hypertension To Severe Preeclampsia And Eclampsia Among Postnatal Women At Machakos County Referral Hospital, Eunice Mwikali Muia

MSc in Advanced Practice Nursing

Worldwide, maternal morbidity and mortality among pregnant women pose a major challenge which is mainly brought by hypertensive disorders in pregnancy. Progression of gestational hypertension to severe preeclampsia contribute a lot in adverse birth outcomes hence posing a great challenge especially in developing countries. The study seeks to determine the factors leading to progression of gestational hypertension to severe preeclampsia by checking the sociodemographic factors, maternal obstetrical factors, medical factors and adverse birth outcomes. The study used descriptive cross-sectional design, including all mothers who had a diagnosis of gestational hypertension, pre-eclampsia and eclampsia and delivered in Machakos level 5 hospital. …

Therapeutic Gardening And Its Effects On Depressive Symptoms In Dementia Care, Shannon E. Norton

Honors Undergraduate Theses

Aim: To present a literature review of the positive effects and overall reduction of depressive symptoms that an intervention such as therapeutic gardening has on individuals living within memory care facilities.

Background: As most humans age, they often lose abilities or skills that they have had for their entire lives (e.g. driving, grooming, toileting, seeing and/or hearing). By implementing programs that involve therapeutic garden therapy, individuals with dementia who are at greater risk for clinical depressive symptoms may find that this alternative approach improves their symptoms.

Methods: A comprehensive, electronic, literature search in the CINAHL database was completed and included …

Evaluation Of The Violence And Stigmatization Against Children With Disabilities: A Literature Review, Nmesoma Ozougwu

Honors Undergraduate Theses

Violence and Stigmatization against children with disabilities are critical public health issues. Children with disabilities are a vulnerable population as they are exposed to various forms of discrimination and violence globally. The forms of abuse include, but are not limited to, physical, emotional, and sexual abuse. The experiences of Children with disabilities are massively undocumented and there is also a lack of existing literature addressing the issue. The abuse and violence against children with disabilities are also underreported specifically in cultures where this abuse is socially accepted. There are gaps in the literature regarding the condition of children with disabilities …

The Impact Of Student-Led Lactation Education On Self-Efficacy In Clinical Simulation: An Integrative Literature Review, Kaitlyn Flores Yu

Honors Undergraduate Theses

Simulation is a critical component of nursing education. It provides a safe environment to practice and evaluate skills, supplements clinical hours, and removes barriers to a well-rounded education. Nurses are expected to be educators as part of our scope of practice, and simulation can facilitate this. One topic of nursing importance is lactation education, as breastfeeding has been shown to have multiple benefits for both mother and baby. National rates of exclusive breastfeeding for the first 6 months do not currently meet CDC recommendations. The pedagogy known as the Protégé Effect suggests that learning can be improved through teaching. Breastfeeding …

Prevention Of Perineal Tearing During Childbirth: A Literature Review, Victoria Manzo

Honors Undergraduate Theses

Perineal lacerations can be caused by a variety of risk factors such as a large fetal head circumference, birthing positions that place strain on the sacrum, and first-time births. Preventing perineal tears can be challenging for laboring women. Exploring the possible prevention methods to decrease the severity of perineal tearing or preventing it altogether can be beneficial for laboring women's physical and mental health. The primary purpose of this literature review was to examine which interventions are most likely to prevent perineal tearing during childbirth. The secondary purpose was to evaluate natural perineal tears in comparison to surgical incision, or …

Empathy Unfolding: A Complexity Neuroeducation Framework For Tracing The Impact Of Immersive Storytelling And Transformational Learning On Nursing Education, Maria H. Keckler

CGU Theses & Dissertations

Background: Empathy Unfolding is a conceptual framework grounded in complexity theory and neuroeducation principles that emerged during the research process and was used to trace the impact of immersive storytelling and transformational learning on nursing education through multiple lenses and measures. The study addressed the complex and multidimensional problem of declining empathetic concern among nursing students and professionals that disproportionately impacts low-income and culturally/linguistically diverse patient communities. Methods: The mixed-methods design centered around a patient story based on actual events, produced in two-dimensional (2D) video and 180° virtual reality (VR) formats. Second-year nursing students (N=70) were randomly assigned to two …

Informing Youth-Centred Opioid Agonist Treatment: Findings From A Retrospective Chart Review Of Youths’ Characteristics And Patterns Of Opioid Agonist Treatment Engagement In A Novel Integrated Youth Services Program, Kelly Mcinerney, Kristen Marchand, Jennifer Buckley, Chloe Gao, Andrew Kestler, Steve Mathias, Aubree Argyle, Skye Barbic

Nursing Faculty Scholarship

Aim: Youth ages 12–24 account for approximately 20% of overdoses and yet are poorly reached by opioid agonist treatment (OAT), the most widely recommended treatment for opioid use disorder (OUD). This study contributes to understanding this critical gap by describing youths' patterns of OAT engagement at a novel integrated youth-specific OAT program. Methods: A retrospective chart review was carried out on electronic medical records of n = 23 youth with OUD accessing a community-based integrated youth services (IYS) centre. Data abstraction focused on four domains: sociodemographic, social determinants of health, patterns of OAT engagement, and other services utilized. Results: Youths' …

How Essential Oils Help Prevent Against Healthcare Workers’ Burnout, Lauren Casey

Doctor of Nursing Practice Projects

This project set out to see if stress and anxiety (leading to burnout) could be combatted with the use of essential oils (EOs). Burnout is a common concern amongst the medical community and healthcare providers are leaving their jobs and field at unprecedented rates. While EOs have been used for patients, they are rarely used for the healthcare providers’ benefit. Because of that, this project wanted to focus on the employee for a change, which in turn would benefit the patient by having a mentally-present provider and the company by having less turnover. The project consisted of a pre-survey prior …

Combating The Sedentary Lifestyle In A Rural North Carolina Community, Kelsey Toliver Watts

Doctor of Nursing Practice Projects

A rural North Carolina community is experiencing an increase in inactivity, obesity, and comorbidities. The project leader collaborated with the local health department and recreation department to implement community walking events. The events aimed to promote physical activity while providing education to the residents as to why physical activity is important. The project leader used optional pre-walking event and post-walking event surveys to assess activity change and increased knowledge. Out of the 90 attendees, 68% completed the pre-event survey and 14% responded to the post-event survey. This created limited data available for follow-up. All participants who completed the follow-up plan …

Combating Compassion Fatigue In The Emergency Department, Pam Packard

Doctor of Nursing Practice Projects

Combating compassion fatigue in the emergency department is vital to nurses’ well-being. Compassion fatigue is the result of negative physical, emotional, and spiritual strains that often burden nurses. The weight of compassion fatigue is explored throughout this conceptualization of Combating Compassion Fatigue. Two questions were explored: Does compassion fatigue affect compassion satisfaction? If so, is compassion fatigue a precursor to suboptimal compassion satisfaction?

Increasing Future Health Care Providers’ Understanding Of The Complexity Of Endometriosis To Facilitate Early Diagnosis, Christina Alexander

Doctor of Nursing Practice Projects

The DNP project was designed to improve future healthcare providers’ knowledge on the complexity of endometriosis by providing students with a lunch and learn session on endometriosis. The intent of the project implementation was to improve students’ knowledge on endometriosis to facilitate early diagnosis for patients. Improving provider knowledge of evidence-based endometriosis guidelines is imperative to achieve early diagnosis. The educational session provided students with information regarding symptoms, impact of delayed diagnosis, discerning differential diagnoses, associating timing of symptoms, and identifying endometriosis lesions. The impact of the project implementation was measured using pre/post-survey data evaluating overall knowledge, symptoms awareness, “best …

New Leader Mentorship Program Preparing Frontline Nurse Leaders For Success, Melanie S. Smith-Fortney

Walden Dissertations and Doctoral Studies

A new nurse leader often enters their role with minimal training. The absence of a structured orientation leaves new leaders without the advanced knowledge and skills needed to succeed in this complex role, increasing the risk of stress and burnout. This staff education project addressed whether providing the educational framework found within the American Organization for Nurse Leaders (AONL) nurse manager competencies would improve nurses’ knowledge to lead departmental operations and personnel for the new nurse leader. Duchscher’s stages of transition theory focused on the emotional aspects of transitioning into a new role. The AONL Nurse Leader Competency Assessment Tool: …

Educating Oncology Nurses On Identifying And Managing Cancer-Related Distress, Rosemary Vivella Irish

Walden Dissertations and Doctoral Studies

AbstractUp to 50% of patients diagnosed with cancer will experience significant levels of distress. Cancer is related to psychological distress and can negatively impact recovery from surgery, increase treatment side effects, and decrease overall quality of life. The National Comprehensive Cancer Network recommended screening for distress as part of comprehensive cancer care. In the practice setting, there was a need for better assessment of distress in cancer patients. The purpose of this staff education project was to address a gap in practice regarding the lack of knowledge of screening for distress by providing education to oncology nurses on how to …

Education On Protective Measures For Primary Care Staff During Covid Outbreaks, Lenina Ochioza Ukeju Chi-Ukpai

Walden Dissertations and Doctoral Studies

Since the emergence of COVID-19, healthcare workers have been in continuous risk of infection because of the way the disease is transmitted. Hence, the proper use of personal protective equipment (PPE) is important during the pandemic. The aim of this project was to increase healthcare workers’ and patients’ disease protection and prevention. This staff education project assessed the knowledge of proper PPE practice among healthcare workers who were in close contact with COVID-19 patients and provided lectures and practice in proper donning and doffing of PPE. Guided by the Lewin theory of change, the knowledge of the 9 health care …