Nursing Commons^™

Anesthesia Agents And The Risk Of Postoperative Delirium In Adult Non-Cardiac Surgical Patients: An Integrative Review, Narah Latortue

Master of Science in Nursing Final Projects

Introduction: As patients recover from surgery, it has been recognized that anesthetic agents are an external risk factor for the development of acute postoperative delirium. Postoperative delirium (POD) manifests as inattention with changes in perception or cognition, altered levels of consciousness, and changes in motor activity such as agitation or lethargy up to seven days after surgery. POD is linked to increased morbidity and mortality, prolonged hospitalizations and recovery, and persistent cognitive decline.

Purpose: The purpose of this integrative review was to determine which anesthetic agents decrease the risk of postoperative delirium (POD) development in adult non-cardiac surgical patients.

Methods: …

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

Cognitive Test Anxiety, Course Grades, And Course Repetition In Associate Degree Nursing Students, Crystal Elaine Jones

Walden Dissertations and Doctoral Studies

No abstract provided.

Optimizing Sepsis Management Through Enhanced Protocol Compliance In The Emergency Department, Teela Sade Miller-Buford

Master's Projects and Capstones

Abstract

Problem: This quality improvement project aims to enhance early sepsis management and sepsis bundle compliance among Emergency Department nurses to reduce the risk of sepsis-related deaths and hospital length of stays.

Context: A group of students studying to become Clinical Nurse Leaders (CNLs) evaluated Hospital A's Emergency Department (a clinical microsystem) located in the greater Bay Area. This microsystem provides diverse emergency care for patients with various medical conditions and diagnoses. The CNL students concentrated on patients diagnosed with sepsis for their quality improvement project.

Interventions: Although time constraints prevented the implementation of interventions, the CNL students proposed recommendations …

Metformin Plus Insulin For Preexisting Diabetes Or Gestational Diabetes In Early Pregnancy: The Mompod Randomized Clinical Trial, Kim A Boggess, Arielle Valint, Jerrie S Refuerzo, Noelia Zork, Ashley N Battarbee, Kacey Eichelberger, Gladys A Ramos, Gayle Olson, Celeste Durnwald, Mark B Landon, Kjersti M Aagaard, Kedra Wallace, Christina Scifres, Todd Rosen, Wadia Mulla, Amy Valent, Sherri Longo, Laura Young, M Alison Marquis, Sonia Thomas, Ashley Britt, Diane Berry

Faculty, Staff and Student Publications

IMPORTANCE: Insulin is recommended for pregnant persons with preexisting type 2 diabetes or diabetes diagnosed early in pregnancy. The addition of metformin to insulin may improve neonatal outcomes.

OBJECTIVE: To estimate the effect of metformin added to insulin for preexisting type 2 or diabetes diagnosed early in pregnancy on a composite adverse neonatal outcome.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial in 17 US centers enrolled pregnant adults aged 18 to 45 years with preexisting type 2 diabetes or diabetes diagnosed prior to 23 weeks' gestation between April 2019 and November 2021. Each participant was treated with insulin and …

An Educational Intervention To Increase Knowledge And Awareness Of Hypertension Among Nurses, Sylvia Kabba

Walden Dissertations and Doctoral Studies

No abstract provided.

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

The Development And Evaluation Of Nurse-Created Video Modules To Encourage Healthy Behaviors Among Women With Polycystic Ovarian Syndrome (Pcos), Rebecca Akers

Doctoral Projects

Problem Statement: Women with PCOS have a higher prevalence of overweight and obesity, a problem that is directly linked with many of the symptoms and long-term health problems experienced by these individuals. Research studies indicate that lifestyle modifications, including dietary changes and increased physical activity aimed at promoting weight loss, are often the initial approach to treatment, but many women fail to adopt those health-promoting behaviors, which may be due to insufficient teaching and support provided by healthcare professionals.

Purpose: Utilize Pender’s Health Promotion Model to develop and evaluate a set of educational video modules focused on encouraging women with …

Reconceptualizing Complex Post-Traumatic Stress Disorder: An Evolutionary Concept Analysis And Clinical Guide, Jessica Livingston

Doctoral Projects

Conflicting models of how trauma manifests into identifiable symptoms have been a source of controversy and perplexity among practicing mental health clinicians and diagnosticians. Complex post-traumatic stress disorder (CPTSD) is now an internationally recognized diagnosis since its inclusion in the 11^th version of the World Health Organization’s (WHO) International Classification of Diseases (ICD-11) in 2018. The American Psychological Association (APA) does not share this recognition of CPTSD as an individual diagnosis and instead opted to update the diagnostic criteria for PTSD to include DSO and a 4^th category of dissociative features rather than include CPTSD as a separate …

Animal-Assisted Therapy In Mental Illness, Chanae Cypress

MSN Capstone Projects

Mental health disorders are a significant global health concern, with a growing need for alternative therapeutic approaches. Animal-assisted therapy has gained recognition for its potential to improve the emotional and psychological well-being of individuals struggling with these disorders.

This Capstone Benchmark proposed project explores the potential positive impact of animal-assisted therapy (AAT) on patients with mental health disorders during inpatient hospitalization. The project outlines a 4-week intervention program involving 45-60 minutes sessions with dogs, which patients receive 2-3 times per week. For this Capstone Benchmark project, the selected PICOT question is: In patients with mental health disorder (P) how does …

The Impact Of Evidence-Based Diabetes Self-Management Education In A1c Levels In Adults With Type 2 Diabetes, Concepcion Fanous

MSN Capstone Projects

Diabetes Mellitus II is a leading cause of death in the United States, imposing a significant healthcare cost. According to the Centers for Disease Control and Prevention (CDC, 2020), one out of every ten Americans have been diagnosed with diabetes, with 90 to 95% of them having type 2 diabetes (T2d). Effective management T2d is crucial to prevent clinical complications, expensive medical care, and a diminished quality of life. Uncontrolled diabetes can lead to severe medical complications including atherosclerotic cardiac cardiovascular disease, renal disease, and microvascular disease (American Diabetes Association [ADA], 2021). The economic burden of diabetes complications amounted to …

Implementing New Staffing Ratios In The Emergency Room To Improve Nurse And Patient Outcomes, Analicia Solis

MSN Capstone Projects

The significance of appropriate nurse staffing in enhancing patient outcomes and mitigating nurse burnout is well-documented. Inadequate nurse staffing can lead to negative consequences, including burnout, decreased nurse retention, and potential safety risks (Shin et al. 2018; Wynendaele et al. 2019) Research has also established a strong connection between nurse-to-patient ratios, well-being, and job dissatisfaction among nursing staff (Andel et al. 2021; Thompson-Munn et al. 2021).

Given this evidence, there is a compelling rationale for aligning nurse staffing ratios with proposed federal standards to address burnout, improve well-being, and enhance patient outcomes. Implementing these changes necessitates careful planning and assessment. …

Feasibility And Acceptability Of A Loving-Kindness Meditation Among Socio-Economically Diverse Older Adults, Carolyn Streb

Undergraduate Research Symposium Posters

In Psychology one of the first theories we learn is Maslow's Need Triangle. Within this theory we learn that love and belonging is one the basic human needs an individual needs to develop. This continues to be relevant later in age. The lack of compassionate love can result in increase feelings of loneliness and subsequent deterioration of mental health therefore making individuals, specifically older adults, more vulnerable to suicidal behavior. Loneliness is a public health epidemic affecting more the 40% of older adults. Theoretical and empirical evidence implies that human beings can cope with adversity when they possess a repertoire …

The Implementation Of Nurse Practitioner Residency Programs To Increase The Employment Retention Of New Graduates, Roni-Jo Panganiban

Master of Science in Nursing Family Nurse Practitioner

This review explores the effectiveness of Nurse Practitioner (NP) residency programs in addressing role strain, burnout, and retaining new graduates. It emphasizes the factors contributing to NP resignations and proposes formal residency programs to improve job satisfaction and retention rates. Research highlights benefits such as enhanced preparedness, credibility, and better patient care, advocating for increased program accessibility and funding. Additionally, the application of the theory of planned behavior underscores compliance with regulations, evidence-based practice, and environmental influences for patient safety in advanced practice registered nursing. The literature review on NP residency programs draws from six empirical articles, focusing on job …

Evaluation Tools For Undergraduate Nursing Student Performance In Simulated Learning Experiences: A Literature Review, Katie Pettibone

Nursing Masters Papers

Simulated learning experiences (SLEs) are an increasing aspect of clinical experiences in undergraduate nursing programs. Formative student evaluation is a critical component of SLEs as it promotes student growth and demonstrates student learning outcomes. The 2021 International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: Simulation for Student Evaluation of Learning and Performance [INACSL Standards] provide specific guidelines that aim to ensure the best experiences for SLEs participants. With many formative evaluation tools for overall student performance available, it is important that educators utilize evaluation tools that meet the most recent 2021 INACSL Standards.

An integrative …

Surgical Fire Prevention And Management: An Objective Structured Clinical Examination For Nurse Anesthesia, Tate Fazio, Kaleb Killens

Doctoral Projects

Sentinel events in health care are rare events, often corresponding with permanent injury or death. Fires in the operating room (OR) are one type of sentinel event. Although rare due to possible life-threatening injuries to patients and staff, appropriate surgical fire education is critical in nurse anesthesia education, as anesthesia providers play a significant role in surgical fires (Wunder et al., 2020). The development of simulation exercises has the potential for students to experience and become competent in managing high-acuity, low-frequency events, such as surgical fires (Wunder et al., 2020). The Nurse Anesthesia Program (NAP) at The University of Southern …

Health Care Organizations’ Research Capacity And Culture’S Effect On Nurses’ Evidence-Based Practice Implementation, Tamela Marie Fonseca

Walden Dissertations and Doctoral Studies

No abstract provided.

Safe Patient Care Act Advocation, Julia Rhodes

Honors Theses

This paper discusses advocating for the Safe Patient Care Act and how it affects people in society. This topic is very relevant because it affects a vast majority of people including nurses, patients, and the healthcare systems as a whole. Methods used to advocate for this bill include grass roots activism, composing and presenting speeches, scheduling and attending meetings, presenting to different nursing school cohorts, collaborating with the Michigan Nurses Association, and participating in hearings held by the Michigan House of Representatives. Results consisted of positive feedback from representatives and their word to vote for the Safe Patient Care Act. …

Continuity Of Care In The Post-Partum Period, Ashley Quezada

MSN Capstone Projects

Maternal mortality rates in the United States have been a growing concern over the past decade, with rates continuing to climb as recent studies have been published. The total maternal mortality rate in the United States in 2018 was 17.4 and has increased to 32.9 as of 2021, while other developed countries continue to decline (Hoyert, 2023). The maternal mortality rate is the number of deaths per 100,000 live births. More than 50% of pregnancy-related deaths in the United States occur after delivery, in the post-partum period (Melillo, 2020). The purpose of this report is to not only bring light …

Online Relational Database For Department Of Nursing: An Evidence-Based Practice Project, Denise L. Rismeyer

Doctoral Dissertations and Projects

Departmental nursing leaders and their support staff manage large amounts of data in their daily work and have reported inefficiencies, manual labor, and dissatisfaction with previous electronic tools. Cognitive overload occurs when the amount of data exceeds the brain’s ability to process it and leads to negative consequences such as errors, burnout, anxiety, and poor productivity. Use of technology aligns with nurse leader competencies for business skills and principles along with utilizing evidence-based data for goal setting and decision-making. An online relational database (ORD) allows multiple users at one time, web-based access, ability to hold a large capacity of data …

Leadership Style And Nursing Retention, Brenae J. Reason

MSN Capstone Projects

Nursing is the heart of healthcare, for decades we have been the drivers of innovation and have contributed to so many advancements in the profession. Even with nursing being a sincere passion amongst many nurses, there is an alarming trend of nurses who are faced with burnout (Brusie, C., n.d.). It has been reported that 1 in 5 nurses left their position in one particular health system (Andreyeva et al., 2023). It is also noted that turnover can be costly for organizations (Zuniga et al., 2019). While there are a multitude of reasons nurses could be leaving their companies, one …

The Effectiveness Of Implementing Nurse-Driven Mobility Protocol To Reduce Los, Delirium And Ventilator Days, Sajani Abraham

Doctor of Nursing Practice Final Project Abstract

The effectiveness of implementing a nurse-driven mobility protocol to reduce LOS, ventilator days, and delirium

PURPOSE

The purpose of this scholarly project was to implement the effectiveness of a nurse- led mobility program in enhancing patient ambulation rates, thereby reducing the length of stay, delirium, and ventilator days in an intermediate care unit.

BACKGROUND

The project was implemented in an 18 bed IMU in the academic center in the Texas Medical Center, Houston, Texas.

METHODOLOGY

The project utilizes AHRQ nurse-driven mobility protocols to enhance patient mobility. The staff were educated on the use of the tool prior to implementation and …

Scaffolded Simulation In Psychiatric Mental Health Nursing Education, Lori Bobo, Stacy Mikel, Yolanda Chandler, Hungwei Tseng

Higher Learning Research Communications

Objectives: The purpose of this study was to investigate the impacts of using scaffolded clinical simulations on nursing students’ confidence in clinical reasoning, clinical judgment, and critical thinking skills. Next, we also attempted to gain insights into students’ perceptions of the benefits of scaffolded clinical simulations.

Method: We used a mixed-methods research design to investigate the impacts of using scaffolded clinical simulations on 133 second-semester baccalaureate nursing students’ confidence in clinical reasoning, clinical judgment, and critical thinking skills.

Results: Findings from this study indicate that students who perceived the benefits of scaffolded simulation activities (i.e., peer observations, debriefings, and self-reflections) …

Predicting Factors Of Health-Related Quality Of Life Among End-Stage Renal Disease Patients Receiving Hemodialysis At A Tertiary Level Hospital In Nepal., Jyoti Gahatraj, Poolsuk Janepanish Visudtibhan, Tiraporn Junda, Nipaporn Butsing

Journal of Health Research

Background: End-stage renal disease (ESRD) puts tremendous burdens upon affected patients and their support persons in Nepal. The health-related quality of life (HRQoL) among Nepalese persons with hemodialysis-dependent ESRD is not well understood. This study aimed to examine HRQoL and its predicting factors among persons undergoing hemodialysis in Nepal.

Methods: A purposive sampling was applied to recruit 106 persons with ESRD receiving hemodialysis at a tertiary hospital in Nepal between October and December 2021. The structured questionnaires included personal information, the World Health Organization Quality of Life instruments (WHOQOL-BREF), the fatigue assessment scale (FAS), the Hamilton depression rating scale (HDRS), …

Healthcare Access Among Low-Income Latinx Communities: A Culturally Sensitive And Intersectional Approach, Gabriela Meza

Nursing | Student Research Posters

Various factors, including immigration status, language barriers, age, and socioeconomic status, influence healthcare service utilization among the Latinx population. This study seeks to assess whether culturally sensitive care addressing intersectional factors enhances health access and outcomes in low-income Latinx communities (Purpose). The research proposes a longitudinal quasi-experimental study involving 400 Latinx participants aged 18 and above in low-income urban Los Angeles neighborhoods. A control group of 200 participants and an intervention group of 200 will be established, with the latter receiving culturally sensitive interventions when seeking care during the study. A pre-study survey will collect demographic information, health history, healthcare …

5th Annual Occupational Therapy Program Research Conference, Kelly L. Taylor Ms, Otr/L, Cbis

Student Scholarship & Creative Works

Occupational Therapy Program RESEARCH CONFERENCE

5TH OT COHORT | CLASS OF 2024

OT Program Student Presentations Graduate Students from the Class of 2024

Moral Distress As A Predictive Variable Of Perceived Job Retention In Senior Nursing Students, Rebekah L. Barber

Honors College Theses

New Bachelor of Science in Nursing (BSN) graduate nurses are leaving careers within inpatient healthcare facilities presumably because of moral distress related to the anticipated workload of registered nurses (RN). BSN curriculums are responsible for providing practical education through clinical instruction; however, many students experience inconsistencies in best practice recommendations. The inconsistencies predominantly originate between didactic nursing instruction and clinical learning within inpatient healthcare facilities. Using a cross-sectional descriptive research design, this thesis utilized the validated Moral Distress Scale-Revised (MDS-R), a 21-item instrument that assesses the frequency and intensity of moral distress experienced by healthcare workers. Student responses to the …

A Credentialing Protocol Education To Enhance Nurse Float Pool Competency, Dalton J. Skipper

Walden Dissertations and Doctoral Studies

No abstract provided.

Utilizing Mock Code Simulation To Enhance Nurses’ Confidence A Benchmark Project, Denecia Mark

MSN Capstone Projects

Each year, about 292,000 adult patients in the United States have an in-hospital cardiac arrest (IHCA), with substantial variance in their rate of survival (Merchant et al., 2020). Graduate nurses must be knowledgeable and prepared to respond to codes. Mock Codes or simulation-based teaching will allow nurses to practice skills, expand their knowledge, and gain self-confidence in a secure and controlled setting with no risk to patients, reducing nurses' anxiety. CPR certification is currently updated every two years, and research has shown that learned skills begin to deteriorate after three months. As a result, if simulated codes are introduced skills …

Prevention Of Medical Device-Related Pressure Injuries: A Quality Improvement Project, Monika Grzelczak

DNP Projects

Significance and Background: Hospital-acquired pressure injuries (HAPI) continued to rise, costing the healthcare system about $ 11 billion annually. Medical device-related pressure injuries (MDRPI) account for about 10% of HAPI. They are also noted to be on the rise, especially in the Intensive Care Units (ICU), where multiple medical devices are placed on patients for monitoring and treatment. An intervention to reverse those unfavorable trends is needed. Evidence supports poster education to improve rates of MDRPI.

Purpose: This quality improvement project was conducted to eliminate incidents of MDRPI in the ICU and improve nurses’ perception of the importance of preventing …