Nursing Commons^™

The Effectiveness Of Microcurrent Neurofeedback On Depression, Anxiety, Post-Traumatic Stress Disorder, And Quality Of Life, Gloria Duke, Courtney N. Yotter, Beverly Sharifian, Gary Duke, Sandra Petersen

Nursing Faculty Publications and Presentations

Background: The world faces a mental health crisis with elevated rates of depression, anxiety, and post-traumatic stress, leaving a profound impact on daily quality of life (QOL). Current treatments show varying degrees of efficacy and carry burdensome challenges. Evidence exists for use of an innovative neurotechnology to reduce symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD), but the science is lacking for use in the general population. Purposes: The purpose of this pilot study was to explore the effects of microcurrent neurofeedback on depression, anxiety, PTSD symptoms, and QOL in adults. Methodology: This was a one-group, exploratory pilot study …

Shift Change: Minimizing The Covid-19 Nursing Shortage And Decreasing Nursing Burnout, Suzanne R. Baker

MSN Capstone Projects

Burnout and the nursing shortage of the healthcare system is not a new issue for nurses, but the COVID-19 pandemic caused this problem to only get worse (Young, 2021). Most healthcare facilities are severely understaffed. The nursing shortage and symptoms of burnout among nurses working in the Intensive Care Units (ICU) and other high-demand COVID-19 nursing units have been magnified by the COVID-19 pandemic. Inferior working conditions such as increased work times, increased workload, and decreased training in the care of COVID-19 patients magnified nursing burnout and the ongoing nursing shortage (Galanis et al., 2021). Discovering ways to reduce the …

Implementing A Bedside Rounding Tool To Reduce Inpatient Falls, Steven W. Garcia

Master's Projects and Capstones

Problem: Each year, thousands of patients sustain falls while hospitalized, resulting in an increase in serious injuries or death. In a Neuroscience Step Down Unit (NSDU), fall rates in 2022 were higher than the NDNQI benchmark. Despite a thorough fall prevention policy, nurses inconsistently implemented preventative interventions, resulting in increased falls.

Context: The NSDU is a 15-bed inpatient unit providing intermediate-level care for patients with neurological and neurosurgical diagnoses. The unit is part of a 459-bed academic medical center and safety net hospital providing tertiary and quaternary care in southern California.

Interventions: A bedside safety rounds checklist for charge nurses …

Robot Revolution: Impacting Adoption Of The Technology, Cece Noland

MSN Capstone Projects

The author examined the value of robotic guidance platforms in spine surgery, and then implemented an improvement project to positively impact internal (Medtronic employee) adoption of the technology. By promoting adoption, robotics will continue to advance the standard of care for spine surgery patients. This paper is to meet fulfillment of requirements for NURS5382 Capstone.

Assessing The Impact Of Daily Chlorhexidine Baths In Prevention Of Central Line Associated Bloodstream Infections: An Evidence Based Project, Brooke Rea

MSN Capstone Projects

Background: The rates of central line associated bloodstream infections (CLABSI) is a major concern in the healthcare industry. It is imperative that healthcare professionals take every precaution to prevent these life-threatening infections to the already critically ill patient.

Objective: The reason for this paper is to assess the effectiveness of the use of daily chlorhexidine baths in patients with central lines in the prevention of CLABSIs.

Narrative Review: A narrative review of evidence was conducted to assess the effectiveness of daily chlorhexidine bathing in patients with central lines. Twelve studies were moved forward in the project. Each of the twelve …

Pain In The Dying Patient, Shanna Selph

MSN Capstone Projects

This benchmark aims to educate nurses, doctors, and families on the importance of proper pain management in dying patients. The evidence in this benchmark will be appraised to improve practice, improve outcomes, and reduce healthcare costs (Melnyk, 2018). Feelings of being overwhelmed, fatigue, confusion, and guilt can occur in healthcare professionals without the proper knowledge of pain in the dying patient. Health professionals are responsible for ensuring proper care of patients is taken during the most difficult time of their lives to ensure they have the best quality of life through the end of their lives. The question to be …

Implementation Of An Evidence-Base Hospital Acquired Pressure Injury Prevention Program, Brenda Miner

MSN Capstone Projects

Covid-19 hindered many quality improvement projects. As the stressors from the pandemic began to disappear the healthcare industry was struck with new struggles. These new struggles were ensuring quality care was being provided to all patients. The decline in quality care also led to a decline in reimbursement from payor sources, such as Medicare. During the pandemic the healthcare industry was at their most vulnerable state and now that the dust is settling the ramifications of just surviving are staring the industry right in the eyes. Change is difficult, but it is even more difficult following traumatic events such as …

Early Mobilization In Critical Care: A Benchmark Study, Monica Paige Voelkel

MSN Capstone Projects

Critically ill patients often have complex injuries to multiple organ systems creating barriers to mobilization and a decrease in functional status (Bergbower et al., 2020). Early mobilization (EM) in hospitalized patients has shown to improve patient outcomes and decrease length of stay (LOS) (Bergbower et al., 2020). The link between EM and LOS is one that warrants further investigation with the PICOT question: In critically ill patients (P), how does early mobilization (I), compared to standard mobility (C) improve patient outcomes (O) over a three-month period (T)? The purpose of this paper is to discuss the rationale for the benchmark …

Preventing Deep Vein Thrombosis In Surgical Patients, Ariel D. Roberson

MSN Capstone Projects

Deep vein thrombosis (DVT) is a significant medical issue that incurs thrombi formation in the venous system which can result in major medical problems. DVT’s often occur because of complications after orthopedic surgery. Common risks factors for DVT are vein injury, slow blood movement, increase estrogen, and chronic medical illness (Centers for Disease Control and Prevention [CDC], 2018). As many as 900,000 individuals are impacted by DVT each year (CDC, 2020). Consequently, recent estimates show that 60,000 to 100,000 Americans die each year because of DVT. Even more alarming, 10 to 30% of individuals will die of DVT within a …

Safe Staffing, Safe Patients Benchmark Project, Sarah Barton

MSN Capstone Projects

With the most recent pandemic, nurses have been overworked, overwhelmed, and understaffed at dangerous levels. Nurses are leaving full time employment at this facility in droves to seek better wages through traveling. In turn, our patient outcomes have taken a large hit, with an increase in falls, pressure ulcers, and catheter-acquired urinary tract infections, to name a few. This is costly for the hospital, not to mention the damper it puts on the hospital’s vision and goals. With the implementation of a nursing incentive program, the hospital could cut overall spending in half within 2 years with an investment of …

Improving Safety In The Emergency Department: Utilizing Metal Detectors To Mitigate Weapon Possession, Jonathan Garcia

MSN Capstone Projects

Today’s high risk-healthcare environment has prioritized patient safety with great initiatives and, unfortunately, placed staff safety second. However, safety for both groups should be equal priorities. Evidence suggests that Emergency Departments (ED) often care for patients with a history of crime and mental health diagnoses, creating an environment where the threat of violence and weapons is increasingly prevalent compared to other clinical settings. (Erlyana, 2019) Risk mitigation is possible if we consider studies by Malka et al. (2015) and Laidlaw et al. (2017) that indicate the efficacy of metal detectors in accurately identifying concealed weapons. To improve clinician and patient …

Early Mobilization For Adult Mechanically Ventilated Patients, Stephanie Miller

MSN Capstone Projects

Approximately 13 million people worldwide receive treatment in intensive care units (ICUs) annually. Many patients admitted to the intensive care unit require mechanical ventilation for their survival and attempts to mobilize these critically ill patients is frequently restricted for their own safety. It has been suggested that this lack of mobility may have a significant negative impact on the recovery process and lengthen the time of the patient’s overall hospital stay and recovery. Additionally, survivors report significant physical impairments and deconditioning that present obstacles towards their recovery and well-being after prolonged ventilation.

Mandatory Child Abuse And Neglect Reporting Behaviors Among Registered Nurses In New Mexico: A Statewide Comparative Study, Ingrid Ann Wilson

Nursing ETDs

Child abuse and/or neglect (CAN) is a global problem. Although nurses are mandated CAN reporters, a lack of reporting has been an issue. New Mexico (NM) is faced with higher child poverty and CAN-related substance-abuse compared to other U.S. states. This quantitative study aimed to explore factors influencing intended/actual CAN reporting behaviors among NM registered nurses (RN)s, examine relationships of these factors, and compare differences in reporting behaviors between rural and urban locations. A survey to a sample of RNs (N=146) showed factors associated with CAN reporting intended behaviors were work status (r=.21, p < .05), cues to action (r=.20, …

Examining School Nurses' Knowledge And Confidence Related To Their Intention To Screen For And Report Child Sexual Abuse: A Descriptive Cross-Sectional Study, Suzanne Ackers

Electronic Theses and Dissertations

Background: Child sexual abuse (CSA) in a preventable national public health problem that results in adverse health consequences. Research suggests many victims are currently attending school. Screening for early detection of health issues is integral to school nurse (SN) practice but there is little evidence that screening for CSA is occurring in schools despite recommendations that it should be. Lack of confidence and knowledge related to screening for suspected CSA contribute to a SN’s missed opportunity for early intervention.

Purpose: To describe SNs knowledge and self-efficacy associated with screening for and reporting CSA in school settings.

Methods: A descriptive cross-sectional …

“One University’S Covid-19 Pandemic Mitigation Response And Anxiety Construct: A Summative Program Evaluation”, Ann Hodgin

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

The effects of the COVID-19 pandemic continue to ripple through everyday life. In December 2019, an outbreak occurred in China. Subsequently, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus that quickly spread around the globe (Nazario, 2022). As of May 31, 2023, there were 6,938,353 confirmed deaths worldwide from COVID-19 (WHO, 2023).

A needs assessment completed by the University identified that a program evaluation of the university’s COVID-19 response was warranted. Therefore, this program evaluation was conducted to assess the effectiveness of the policies and protocols implemented at a Catholic University in Southwestern Pennsylvania to …

Effectiveness Of A New Graduate Nurse Residency Program: A Program Evaluation, Christine Meyer

Doctor of Nursing Practice (DNP) Manuscripts

Healthcare organizations continue to face challenges in the retention of new graduate registered nurses (NGRNs) within the first year of hire. Accredited nurse residency programs are designed to provide support to NGRNs and help make the transition from student to graduate nurse by developing their knowledge and skills. This project evaluates a nurse residency program at a rural, community hospital. The project aims to analyze both qualitative and quantitative data to evaluate the program outcomes as it relates to nurse retention, turnover, and job satisfaction. The sample includes 94 new graduate registered nurses that were part of the yearlong residency …

Improving Ostomy Patient’S Self-Efficacy And Quality Of Living Through Prehabilitation And Prevention Of Complications Using Telehealth Visits: A Quality Improvement Project, Shabnam Pratik Bagh

Doctor of Nursing Practice (DNP) Manuscripts

Due to the rise in colorectal cancer and diverticular diseases in the United States, approximately 100,000 to 150,000 intestinal stomas (fecal diversions) are created annually. With approximately 80% of readmissions experiencing post-discharge complications (Agri et al., 2020), quality improvement (QI) initiatives to increase ostomy patient’s self-efficacy and quality of living (QOL) are needed. The purpose of this QI project was to enhance the current continuum of care for ostomy patients by adding a Prehabilitation Session prior to surgery followed up with 24-hour Telehealth visits after discharge from the hospital to support their living with an ostomy. The resulting Comprehensive Ostomy …

Evaluating Outcomes Of An Integrated Medical Care Model In An Acute Care Hospital: A Program Evaluation, Erin Flanagan

Doctor of Nursing Practice (DNP) Manuscripts

Background: Increased awareness of disparities for people with co-occurring medical and behavioral health disorders identified a gap in their individualized health care plan. This gap provides opportunities for hospitals and acute care centers to evaluate current care models for this specific patient population. Problem: Hospitals are challenged to meet the growing needs of patients while working to decrease operational costs. Patients with behavioral health disorders also have significantly greater spending for general medical conditions than patients without a behavioral health disorder (Chu et al., 2019). Methods: Hospitals are attempting to address this gap in care through interdisciplinary or collaborative care …

A Program Evaluation Of An Internship Program And Its Effectiveness On Retention During The First Year Of Professional Practice, Jamie Kilpatrick

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: The registered nurse is an essential component of the healthcare team. Successful efforts have occurred worldwide for recruitment to the nursing profession. However, vacancy plagues the nursing profession through turnover, with the new graduate registered nurse remaining the most vulnerable with the highest rate of turnover. This program evaluation will review one organization’s retention project to support the senior nursing student with a paid clinical internship, and additional support through the vulnerable first year of practice within the chosen care setting. Methods: This summative program evaluation will utilize a systems-oriented approach and quasi-experimental methodology with quantitative data …

Implementation Of A Structured Hybrid Training Program To Improve Clinical Skills And Staff Confidence In The Care Of Maternal And Neonatal Patients In The Emergency Department: A Quality Improvement Project, Melissa Hewitt

Doctor of Nursing Practice (DNP) Manuscripts

Caring for a pregnant woman or compromised newborn is often a stressful situation for all healthcare workers regardless of their experience or expertise. This stress is only heightened when the patient presents to a unit that may not be comfortable with the situation such as the Emergency Department (ED). Often units such as the ED do not receive adequate training in caring for maternal and neonatal patients. The infrequency of patient interactions coupled with their lack of knowledge can leave staff with decreased levels of confidence. Various research articles recommend that hospitals provide interdisciplinary team training for high acuity low …

Implementation Of A Nursing Peer Mentorship Program To Improve Nursing Retention And Job Satisfaction In An Acute Care Hospital: A Quality Improvement Project, Rebecca Cassel

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Currently staffing shortages are impacting patients and communities nationwide. This problem has been on the rise since the before the pandemic. COVID-19 has certainly increased the rate of nursing turnover, and vacancy, especially in acute care (Krofft & Stewart, 2021). Many factors contribute to nursing turnover, including nursing satisfaction, interprofessional relationships, and organizational support, and it is apparent that swift and effective action is needed, to ensure that safe, skilled nursing professionals are available to provide the necessary treatment that those seeking healthcare need. Nursing Mentorship programs have been shown to improve retention of nursing staff, …

Mindfulness Meditation To Reduce Nurse Burnout: An Ebp Implementation Project, Lester Denson Jr

MSN Capstone Projects

Hospitals across the United States are suffering from poor staffing (American Nurses Foundation, 2021). A common thread throughout those facilities is that nurses are leaving their jobs due to self-reported burnout, contributing to the staffing shortage and low morale (Shah et al., 2021).

Mindfulness training plays a part in decreasing emotional exhaustion for staff nurses. A reduction of emotional exhaustion has been discovered after the implementation of mindfulness-based intervention programs, with continued improvement after completion of the program (Sarazine et al., 2021; Bianchini & Copeland, 2021). The benefit of this implementation would be a reduction of nurse burnout which ultimately …

Improving Nursing Provision Of Patient Care In High Acuity Medical Units And Fostering Their Wellbeing By Providing Education On End-Of-Life Care And Finding Joy And Meaning In Work: A Quality Improvement Project, Donna Durant

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Palliative care employs a multidisciplinary approach focusing on the quality of life for patients and their families experiencing the complexity of serious illness (Nelson, 2021). Due to shortages of palliative care specialists and a lack of nurse proficiency in caring for people with serious illnesses, integrating a palliative care approach is an ethical obligation for nursing (Parekh de Campos, 2022). Gaps in palliative care and end-of-life education for new nurses coming to the acute care setting in a large tertiary hospital in Southwestern Pennsylvania were identified.

Evidence-based education was delivered by advanced practice providers trained in this content area. …

"Reducing Heart Failure Readmission Rates Through Implementation Of Heart Failure Diuretic", Caley Tatrn, Yvonne Weideman, Venkatraman Srinivasan

Doctor of Nursing Practice (DNP) Manuscripts

Background and significance: heart disease was the number one cause of death in the United States in 2021, with 696, 962 deaths (Leading Causes of Death, 2022). There are about 6.2 million individuals in the U.S. total with heart failure (Kilgore et al., 2017). About one-quarter of patients with heart failure are readmitted within thirty days of discharge, while one-quarter of hospital readmissions are preventable. Between 2010-2017, over seven million patients were admitted for heart failure in the United States. Eighteen percent had a readmission within thirty days and thirty-one percent had a readmission within ninety days (Khan et …

Recognition Of And Response To Obstetric Emergencies: Developing A Virtual Competency-Based Orientation Program, Susan Morrison

Student Scholarly Projects

In order to improve outcomes in the perinatal setting, the development of a Virtual Competency-Based Orientation Program (CBO) toolkit is vital. Two toolkits, namely the Alliance for Innovation on Maternal Health (AIM) and the California Maternal Quality Care Collaborative (CMQCC), have been identified as effective in enhancing perinatal outcomes. AIM is a national initiative focused on improving maternal health outcomes, promoting safer birth practices, and saving lives through the implementation of best practices. CMQCC is a multi-stakeholder organization in California committed to eliminating preventable morbidity, mortality, and racial disparities in maternity care. Both AIM and CMQCC CBO toolkits incorporate research, …

Early Identification Of Postpartum Depression Symptoms During The Antenatal Period Through The Utilization Of The Edinburgh Postnatal Depression Scale, Cherie Didier

Doctor of Nursing Practice Projects

Postpartum depression (PPD) is a prevalent mental health disorder that negatively impacts maternal behavior and infant development. Despite a global incidence of around 12% (Ti & Curtis, 2019), current screening practices are inadequate. The American College of Obstetricians and Gynecologists (ACOG, 2018) recommends universal screening using the Edinburgh Postnatal Depression Scale (EPDS) at least once during pregnancy. However, the project site in an obstetrical clinic currently does not screen during pregnancy. This quantitative quality improvement project in a Memphis, TN, obstetrical clinic used systematic data collection of EPDS scores of pregnant women and analysis to investigate the effectiveness of implementing …

Improving Timeliness Of Nursing Documentation, Anthony S. Morgan

Doctor of Nursing Practice Projects

Nursing documentation is a critical element of the patient's medical record and contains essential information relied upon to create and implement the plan of care. Despite the understood importance of timely documentation, nurses in this community hospital inpatient medical/surgical unit still struggle to complete data entry promptly. This quality improvement project aimed to improve the efficiency and timeliness of nursing documentation in this unit by deploying the EMR on a mobile application as an adjunct to desktop and laptop PC devices. EMR reporting tools were used to collect timestamps of flowsheet documentation observation time and observation entry time. Time in …

Impact Of Anxiety In School Aged Children And Adolescents In Rural Settings, Jasmine Smith

Doctor of Nursing Practice Projects

The widespread prevalence of youth anxiety has a strain on rural communities lacking screening access. The Screen for Child Anxiety Related Emotional Disorders (SCARED) Tool is widely validated to assess anxiety. The project’s purpose analyzed clinician’s adherence to screening youth with a chief complaint of anxiety or as a behavioral referral at Shaw Medical. The principal investigator implemented a SCARED educational protocol which consisted of SCARED handouts, mock training interviews, a post-educational survey, and chart audits. A descriptive research design using a retrospective chart review examined SCARED screenings in 100 youth aged 8-18 listing sociodemographic statuses of gender, race, and …

The African American Dream Deferred: Exploring The Relationship Between The “American Dream” And The Black American Millennial Reality, Simonleigh P. Miller

Seton Hall University Dissertations and Theses (ETDs)

The purpose of this qualitative study is to highlight and bring understanding to the lived experiences of Black American millennials. This study was conducted from the constructivist and critical research paradigms and utilized Reflexive Thematic Analysis methods to analyze qualitative data. The study places specific focus on Black or African American millennials’ associated thoughts and feelings regarding their current reality and positionality within the American context, and its relation to the idealized reality of the American Dream. The influence of the American Dream on the African American millennial reality was explored to gain a better understanding of how, or if …

Rounding With A Purpose: Reducing Falls In Geriatrics Residing In A Community Living Center, Ashley Wesson

Student Scholarly Projects

Practice Problem: Falls among geriatrics continue to be a significant concern for healthcare organizations and one of the costliest healthcare problems attributed to increased morbidity and mortality rates. Falls rates in residential dwellings such as nursing homes and community living centers (CLCs) continue to rise despite fall prevention efforts.

PICOT: The PICOT question that guided this project was In geriatrics, age 65 or older, who reside in the Community Living Center (P), how does one-hour purposeful rounding (I), compared to rounding without structured set time intervals (C), affect fall reduction rates (O), within eight weeks (T)?

Evidence: In fifteen high-quality …