Nursing Commons^™

Implementation Of Daily Multidisciplinary Rounding Audits Of Adherence To An Indwelling Catheter Protocol Impact On Catheter-Associated Urinary Tract Infections, Jacqueline April Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Catheter-associated urinary tract infections (CAUTIs) among critical care patients negatively impact the trajectory of the patient’s hospitalization through increased mortality, morbidity, length of stay, and cost. To combat this, hospitals have implemented bundles in compliance with evidence-based practice models to reduce CAUTIs. Purpose: Determine if implementing a daily multidisciplinary rounding audit of established CAUTI prevention protocol decreases the occurrence of CAUTIs in critical care patients with indwelling urinary catheters. Methods: Participants in this quality improvement project included critical care nurses and providers participating in daily multidisciplinary rounds on all critical care patients with indwelling urinary catheters admitted to …

Design And Implementation Of A Community-Based Mother-To-Mother Peer Support Programme For The Follow-Up Of Low Birthweight Infants In Rural Western Kenya, Jemma Wright, Florence Achieng, Linda Tindi, Manasi Patil, Mwanamvua Boga, Mary Kimani, Hellen Barsosio, Dan Juma, Helen Nabwera, Laura Kiige

Obstetrics and Gynaecology, East Africa

Background: Globally, low birthweight (LBW) infants (

Methods: Key informant interviews were conducted with 10 mothers of neonates (infants days) from two rural communities in western Kenya. These data informed the identification of key characteristics required for mother-to-mother peer supporters (peer mothers) following up LBW infants post discharge. Forty potential peer mothers were invited to attend a 5-day training programme that focused on three main themes: supportive care using appropriate communication, identification of severe illness, and recommended care strategies for LBW infants. Sixteen peer mothers were mentored to conduct seven community follow-up visits to each mother-LBW infant pair with fifteen …

Care Labour Shortage Needs A Cure, Not More Band-Aids, Yasmin Y. Ortiga

Asian Management Insights

Retaining care workers will become more difficult for Asia’s ageing economies.

Editorial - Summer 2023, Edwin Van Teijlingen, Rafat Jan, Kiran Mubeen, Abeer Musaddique

Journal of Asian Midwives (JAM)

No abstract provided.

Labor Companionship: A Concept Of Doula Care: A Commentary Paper, Arisha Amin, Rabab Vadivala

Journal of Asian Midwives (JAM)

A labor companion is a person who offers consistent individualized support to laboring women. Doula care is defined as the care which an individual provides of physical, social, and emotional support during pregnancy, labor, birth, and the postnatal period (1). Doulas help women ease their anxiety, and pain and address their concerns with comfort, care, and respect. Doulas help in cherishing a mother and child bonding helps in initiate breastfeeding and provide an emotional bond throughout the birthing time. It helps in reducing cesarean sections, and high-risk pregnancies and minimizes infant and maternal mortalities. The purpose of the study is …

Bangladesh To Take Over The Training Of Midwifery Educators: A Commentary Paper, Kerstin Erlandsson, Ulrika Byrskog, Catrin Borneskog Sinclair, Christina Pedersen

Journal of Asian Midwives (JAM)

While Bangladesh has made gains in maternal health provisions, there are still gaps and unmet need for services. Bangladesh has trained over 7 000 midwives, and many more midwifery educators are needed to serve the country’s population of 140 million with midwifery services. In April 2016 the first nursing faculty teaching midwifery students at nursing institutes across Bangladesh were enrolled in a blended online and onsite master’s programme with the Dalarna University, Sweden. The programme content focused the subject sexual, reproductive and perinatal health and was the first of its kind in Asia. The graduating faculty members were expected to …

Is It Safe To Have Sexual Intercourse During Pregnancy? A Commentary Paper, Misbah Zafar, Mehreen Aslam

Journal of Asian Midwives (JAM)

Sexuality is an expression of love, care, and intimacy between couples but pregnancy, and the early postnatal period can have a significant impact on sexual health. Numerous physiological and psychological changes take place during pregnancy^[1]. These changes may have a deep influence on the sexual lives of married couples in a variety of ways. ^[2]

The degree of sexual health awareness, myths, rituals, and beliefs about sexual activity during pregnancy are some of the contributing factors which promote or hinders the sexual relationships during pregnancy ^[3]. The most common fear related …

Strengthening Midwifery Response: Implementing Updated Who Guidelines In Birthing Centers In Northern Pakistan, Rafat Jan, Marina Baig, Sadia Karimi, Farzana Yameen, Kiran Mubeen, Arusa Lakhani

Journal of Asian Midwives (JAM)

No abstract provided.

A Step To Improve Maternal Health In Mountain Region Of Pakistan, Rafat Jan, Farzana Yameen, Marina Baig, Sadia Karimi, Kiran Mubeen, Arusa Lakhani

Journal of Asian Midwives (JAM)

No abstract provided.

Father’S Role In Family Planning: A Case Study, Inara Muhammad Karim

Journal of Asian Midwives (JAM)

When a married couple decides the optimum time to start a family, how many children they want, how long they want to wait between kids, and the type of contraception they want to use it is called family planning. In Asian countries like Pakistan, men are decision makers inside the families and dominantly take decisions about contraception, prevention of sexually transmitted diseases (STI), finance distribution for antenatal care, childbirth, and nutrition requirements during pregnancy. Financial status, misconception, myths, and lack of knowledge about the use of contraception are a few factors apart from religion and culture which influence the father’s …

A Peculiar Case Of Dengue Hemorrhagic Fever: A Case Report Of Radical Outcomes: A Case Study, Neelam Ubaid-Ur-Raheem

Journal of Asian Midwives (JAM)

Dengue is the arthropod-borne flavivirus infection, its severity increases during pregnancy, and results in worst maternofetal outcomes, which is an alarming issue. Dengue fever (DF) is the most common cause for preterm delivery and abortion. Dengue-related thrombocytopenia increases the risk of bleeding during pregnancy and delivery and can also leads to high maternal mortality rates. Globally 3.9 billion people are at risk of dengue fever, especially in Asia.
This case study focuses on a 22-years old pregnant woman from Pakistan without known co-morbidities. She presented in an emergency department with high fever, nausea, vomiting, and bleeding gum. She was positive …

Harvesting Health: Indigenous Mothers’ Resilience In The Face Of Climate Change And Maternal Nutrition Challenges In Rural Bajaur, Pakistan: A Study Protocol, Ihsan Ullah, Rafat Jan, Dilshad Begum, Kiran Mubeen, Laila Amir Ali Lalji

Journal of Asian Midwives (JAM)

No abstract provided.

Work-Related Stress Among Midwives In Central Uganda. A Key Comparison Between Rural-Urban And Private-Public Midwives: A Cross-Sectional Study, Diana Mbatudde, Ahmed Sarki, Ofra Halperin, Ekaete Asuquo, Grace Edward

Journal of Asian Midwives (JAM)

Background: Midwives in Uganda face challenges that predispose them to vulnerability and traumatic work-related stress which may impact the provision of quality midwifery care and the well-being of midwives. This study aimed at exploring the prevalence and sources of work-related stress and comparing the differences in the experiences of stress among rural or urban midwives and private or public midwives in health facilities in central Uganda.
Methods: A descriptive cross-sectional study design was utilized. The 57-item Expanded Nursing Stress Scale (ENSS) was used to collect data from 208 midwives working in urban and rural (both public and private) health facilities …

International Day Of Midwives: Honoring Midwives' Dedication And Zeal In Gilgit Baltistan, Pakistan, Arusa Lakhani, Rafat Jan, Sadia Karimi, Mehreen Aslam

Journal of Asian Midwives (JAM)

No abstract provided.

Improving Initial Lactic Acid Compliance Of Suspected Septic Adults In A Rural Emergency Department, Nataleigh Jones

Doctor of Nursing Practice Projects

Background: Sepsis remains one of the leading causes of death in hospital settings. The doctor of nursing practice (DNP) project demonstrated areas that the hospital is doing satisfactorily with compliance and many areas for improvement within the organization regarding sepsis compliance. The DNP project demonstrated the effectiveness of the sepsis best practice advisory (BPA) tool in increasing sepsis bundle compliance in the emergency department (ED).

Purpose: The purpose of this DNP project is to help aid in the early recognition of sepsis and improve initial lactic acid compliance in a local emergency department. Many tools help with the early recognition …

Reducing The Incidence Of Opioid-Induced Unintended Advanced Sedation And Respiratory Depression In Hospitalized Patients, Angel Elliott

Doctor of Nursing Practice Projects

Background: Opioids are commonly administered to hospitalized patients to treat acute pain and can cause serious adverse events such as unintended advanced sedation and respiratory depression, also known as opioid-induced respiratory depression (OIRD). Post-surgical patients are at increased risk of unintended advanced sedation and respiratory depression due to anesthesia and pre-and post-opioid administration. They have a greater risk because they have less monitoring than those in the intensive care unit because their care teams, typically nurses, have higher staff-to-patient ratios. The use of enhanced interventions, such as the use of sedation evaluation tools, can decrease the risk of OIRD.

Purpose: …

Use Of Evidence-Based Telehealth To Reduce Complications In Adults With Type 2 Diabetes In A Rural Health Facility, Joni Kelley

Doctor of Nursing Practice Projects

Background: Formal education for type 2 diabetes mellitus (T2DM) patients is essential, especially in rural areas where diabetes is approximately 17% higher than in urban areas (Bolin & Ferdinand, 2018). In 2019, diabetes was listed as the direct cause of 1.5 million deaths, and 48% of all deaths due to diabetes occurred before 70 years (American Diabetes Association, 2021). According to the American Diabetes Association (2021), approximately 550,149 people in Alabama, or 14.1% of adults, have been diagnosed with diabetes. An additional 119,000 people in Alabama have diabetes but are unaware, significantly increasing their risk of complications (American Diabetes Association, …

Implementation Of A Perinatal Depression Screening Protocol, Michele Fuller

Doctor of Nursing Practice Projects

Background: Perinatal depression (PD), leading to suicide, ranked as a high cause of maternal mortality and was found to affect one out of 7 women in 2018, according to the American College of Obstetrics and Gynecology (ACOG) (2018). PD screening at the start of pregnancy care aims to achieve early referral to behavioral health resources (ACOG, 2018).

Purpose: The purpose of the Doctor of Nursing Practice (DNP) project was to implement an evidenced-based PD screening protocol by presenting the Edinburgh Postpartum Depression Scale (EPDS) to each initial prenatal visit patient (IPV).

Methods: Qualitative pre-data was collected, followed by qualitative post-data …

Implementing An Evidence-Based Pressure Injury Bundle To Reduce Acquired Pressure Injuries In A Long-Term Care Facility, Latecia Rhoden

Doctor of Nursing Practice Projects

Background: Pressure injuries in the United States affect between 1-3 million people. Of the percentage of patients affected by pressure injuries, a range from 2% to 28% of those patients are in long-term care facilities. In Alabama, the pressure injury rate in long-term care facilities ranges from 2.3% to 18.4%. According to this long-term care facility's November 2022 quality improvement report, the acquired pressure rate rose from 2.2% to 8.3% in a year. A total of nineteen newly acquired pressure injuries were reported. Eleven of the nineteen pressure injuries occurred in the long-term stay unit, accounting for almost 58% of …

Utilizing A Multidisciplinary Team Approach To Opioid Stewardship At An Interventional Pain Clinic, Georgemarie Garber

Doctor of Nursing Practice Projects

Background: The opioid epidemic is a preventable health threat that is a recognized national problem by the Centers for Medicare and Medicaid Services (CMS) and Health and Human Services (HHS). The evidence-based Opioid Stewardship (OS) toolkit is essential in the opioid epidemic because it supports identifying patients at risk for opioid aberrancy. However, at the Interventional Pain Management Clinic (IPMC), a chart review on the completion rates of the OS toolkit components for new patients admitted in June 2022 revealed that providers were not consistently completing components of the OS toolkit such as Opioid Risk Tool (ORT), the Morphine …

Implementation Of A Postpartum Depression Screening Protocol, Samantha Abercrombie

Doctor of Nursing Practice Projects

Background: Postpartum depression (PPD) is a major depressive disorder that can occur after having a baby and anytime during the first year postpartum (Centers for Disease Control and Prevention [CDC], 2021). Symptoms of PPD may include anger, crying more than usual, withdrawing from family, inability to bond with the baby, feelings of anxiousness, or thoughts of the mother harming herself or the baby. PPD can yield many challenges and hinder daily living activities. Recent research by the CDC (2021) estimates that 1 in 8 women experience manifestations of PPD. Findings also suggest that 1 in 5 women were not …

Implementation Of A Patient Care Specialist Role To Enhance The Patient Experience In A Pediatric Emergency Department, Jillian Brodeur

Doctor of Nursing Practice Projects

Background: Patient-centered care (PCC) has been an emerging trend in healthcare for the past two decades (Walsh et al., 2022). PCC and the patient experience have become essential measures of the quality of care provided and are linked to reimbursement dollars and improved patient outcomes (Rapport et al., 2019).

Purpose: The purpose of the Doctor of Nursing Practice (DNP) project was to improve the patient experience in the Emergency Department (ED) of a metropolitan hospital. The DNP project focused on the benefit of a patient advocate in the ED to improve the patient experience. The project sought to improve …

Reducing The Incidence Of Hospital Acquired Pressure Injuries With An Interprofessional Collaboration Using Range Of Motion Exercises, Angela Johnson

Doctor of Nursing Practice Projects

Background: Hospital - Acquired Pressure Injuries (HAPIs) are an enormous problem for healthcare institutions and patients. HAPIs are painful, can lead to additional infections, increase the length of stay, and even cause death. Hospitals around the country are experiencing increases in the number of HAPIs. This project was implemented in a medical-surgical unit of a local urban hospital in the southeastern United States. The medical-surgical unit reported an increase in the number of HAPIs that exceeded the national average of 3%.

Purpose: The purpose of this quality improvement project was to apply an interprofessional approach to reduce HAPIs using a …

Improving Influenza Vaccination Rates In A Primary Care Clinic: A Quality Improvement Crusade, Janet Lowe

Doctor of Nursing Practice Projects

Background: Research consistently shows that influenza vaccines prevent medical appointments, treatments, and disabilities. In the United States (U.S.), 25-49 million individuals contracted influenza from October 2022 through January 2023. However, despite a greater community consciousness regarding viral contagions and the improved availability of vaccinations through primary care settings, ambulatory clinics, and local pharmacies, adults in the U.S. continue to miss the national influenza vaccination goals of 70%.

Purpose: This Doctor of Nursing Practice (DNP) project aimed to boost influenza immunization rates and comprehension of vaccination benefits among patients in a primary care setting during the influenza season. The DNP student …

Improving Door-To-Balloon Times In Adult Patients With St-Elevation Myocardial Infarction By Utilizing A Stemi-Rn, Amanda Hunter

Doctor of Nursing Practice Projects

Background: Heart disease is the leading cause of death in Alabama. The national estimated annual incidence of myocardial infarction (MI) is 605,000 new and 200,000 recurrent attacks, of which approximately 170,000 are silent (Tsao et al., 2022). Roughly every 40 seconds, an American will have an MI (Tsao et al., 2022). An ST-elevation myocardial infarction (STEMI) occurs when one or more of the coronary arteries supplying the heart with blood occlude, leading to myocardial injury (Akbar et al., 2021). Clinical practice guidelines for STEMI recommend Door to Balloon (D2B) intervention in 90 minutes or less (O'Gara et al., 2013), while …

Utilization Of A Simulation Electronic Documentation Model For Healthcare Providers To Reduce Documentation Errors In A Hospital Setting, Icy Moton-Hale

Doctor of Nursing Practice Projects

Background: Electronic health records (EHRs) are commonly used within healthcare systems across the United States. Although EHRs were developed to provide safe delivery of care, poor documentation quality remains a problem. Poor HER documentation can negatively affect many patients’ health outcomes.

Purpose: The purpose of the DNP project was to determine the degree to which using a simulated electronic documentation model to train nurses in an acute care unit would decrease documentation errors and missed care and decrease missed opportunities for patient education in EHRs.

Methods: The theoretical framework was underpinned by the Donabedian model, positing that factors associated with …

Establishing A Routine Process Of Medication Reconciliation In A Rural Primary Care Clinic To Address Unnecessary Polypharmacy In Patients 65 And Older, Jessica Kirkwood-Harp

Doctor of Nursing Practice Projects

Background: Medication safety by reducing the proportion of older adults who use inappropriate medications is a Healthy People 2030 goal (Office of Disease Prevention and Health Promotion, n.d.(a)). The research for this proposal supported an established medication reconciliation (MR) to reduce errors and adverse drug events (ADEs). Consistent MR is essential for patient safety and positive patient outcomes in rural outpatient primary care clinics, as these patients possess multiple comorbidities.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project (QIP) established a routine MR process within a rural primary care clinic with reduced unnecessary polypharmacy and decreased risk of …

Promoting Wellness With Medical-Surgical Nurses In An Urban Medical Center Through Mindfulness-Based Stress Reduction, Shemeka Leonard

Doctor of Nursing Practice Projects

Background: Due to their position on the forefront lines of the healthcare system, nurses are more likely to experience stress at work. Job-related stress can cause increased anxiety, emotional turmoil, depression, and other mental issues. Nurses commonly deal with elevated distress due to workload demands such as passing medication, checking for errors, ensuring patient safety, and charting—mindfulness-based stress reduction (MBSR) is a useful means of reducing psychological distress.

Purpose: The DNP project objectives were to reduce stress, encourage well-being, and show how effective an MBSR program works in a hospital setting. The aim is to reduce stress/improve wellness.

Methods …

Improving Early Sepsis Recognition And Treatment By Utilizing The Surviving Sepsis Campaign In Emergency Department Patients, Rebecca Smith

Doctor of Nursing Practice Projects

Background: Sepsis is a physical reaction to infection that can cause bodily injury, organ deterioration, and death (Sepsis Alliance, 2022). Early sepsis identification and intervention requires staff engagement in quick recognition and implementation of care (Jorgensen, 2019). Septic patients require prompt initiation of intravenous fluids, hemodynamic observation, and appropriate laboratory testing (Evans & Rhodes, 2021). Rapid detection of sepsis can prevent patients from progressing to severe sepsis and septic shock, increasing the risk of mortality (Jorgensen, 2019). As a result of the high mortality rates and complications associated with this health disparity, evidenced-based care bundles were developed to improve care …

Using The 2as And R Method To Encourage Referral To Smoking Cessation Counseling In An Urban Pulmonary Clinic, Jennifer Holloway

Doctor of Nursing Practice Projects

Background: Smoking is a habit of millions of Americans despite the associated preventable health issues and death that it produces. Smoking cessation programs, particularly those using pharmacotherapy, are effective in increasing smoking cessation rates. However, smoking cessation programs remain underutilized.

Purpose: The purpose of the DNP project is to educate providers on using the 2As and R (ask, advise, and refer) of smoking cessation to assess a patient’s readiness to quit and refer to smoking cessation counseling. For providers working in an urban pulmonary clinic, does education regarding the use of the 2As and R method as a standardized intervention …