Nursing Commons^™

Nurses' Perceptions Regarding Supportive Care In The Neonatal Intensive Care Unit, Brandi D. Garrett

Nursing Theses and Dissertations

NICU nurses are the primary supporters of NICU families and their infants, making it vital that nurses understand the impact of a NICU visit on families and how to improve the parental experience. The complex challenges begin at the NICU admission, where families are left bewildered and unprepared for the uncertainty that lies ahead. During the NICU stay, nurses support families by providing encouragement and empowerment as they navigate their new role as NICU parents. In addition, NICU nurses are advocates for supportive initiatives to help NICU families cope with challenges such as being away from their infant and better …

Electronic Health Records: Using Polarity Thinking To Explore The Relationship Between Technology And Nursing Practice, Debra Winckler

Nursing Theses and Dissertations

Building a robust information technology infrastructure has been recognized as integral in addressing national concerns about patient safety, healthcare quality, and healthcare costs. Federal efforts to promote the nationwide adoption and integration of electronic health records (EHRs) include the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which provided over $27 billion in federal incentives to healthcare organizations and providers to incorporate EHRs into healthcare practices. Medicare and Medicaid Electronic Health Record Incentive Programs, initiated in 2011, were enacted to expand EHR functionality, encourage EHR system upgrades, and establish nationwide use of certified EHR technology. Subsequently, …

Evaluation Of The Feasibility Of A Midwifery Educator Continuous Professional Development (Cpd) Programme In Kenya And Nigeria: A Mixed Methods Study, Duncan Shikuku, Hauwa Mohammed, Lydia Mwanzia, Alice Ladur, Peter Nandikove, Eunice Ndirangu, Alphonce Uyara, Catherine Waigwe, Lucy Nyaga, Issak Bashir

School of Nursing & Midwifery, East Africa

Background Midwifery education is under-invested in developing countries with limited opportunities for midwifery educators to improve/maintain their core professional competencies. To improve the quality of midwifery education and capacity for educators to update their competencies, a blended midwifery educator-specific continuous professional development (CPD) programme was designed with key stakeholders. This study evaluated the feasibility of this programme in Kenya and Nigeria.

Methods This was a mixed methods intervention study using a concurrent nested design. 120 randomly selected midwifery educators from 81 pre-service training institutions were recruited. Educators completed four self-directed online learning (SDL) modules and three-day practical training of the …

Utilization Of The Reproductive Justice Framework In Contraceptive Counseling With Black And African American Women: A Comparison Of Patient Satisfaction And Provider Knowledge, Simranjeet K. Tagore

Doctoral Projects

Current practice in contraceptive counseling is characterized by great variation in both content and implementation. The literature indicates that African American women desire contraceptive counseling based in respect, trust, and equity. Conducted over 8 weeks, this quality improvement project compared satisfaction in African American and Black patients receiving contraceptive counseling by a provider trained in the Reproductive Justice Framework (RJF) versus those receiving contraceptive counseling by a provider not trained in the Reproductive Justice Framework. This project also evaluated the effects of Reproductive Justice Framework training on clinician knowledge. Inclusion criteria for the patients included identifying as Black and/or African …

Male Infertility: A Retrospective Review Of Laboratory Charts At A Tertiary Teaching Hospital In Nairobi City County, Festus Mulakoli, Doris Machaki, Abednego Ongeso, Maureen Akolo, Ruth Wagathu

School of Nursing & Midwifery, East Africa

Background: Globally, approximately 50 million couples experience one form of infertility, and 10 million cases of subfertility have been reported in sub-Saharan Africa. Infertility is characterized by a lack of clinical conception among couples who live together for more than one year with regular coitus, without the use of contraception. Factors related to fertility vary by sex and geographical region. These factors include age, lifestyle, infectious diseases, and genetic disorders. In African culture, children are considered a simple inheritance and a measure of masculinity, so efforts are needed to address the growing problem of male infertility in this context. …

Unlocking How To Escape Standard Education Platforms: A Prospective Controlled Trial Comparing Traditional Teaching Methods To The Use Of Escape Rooms For Nursing Education, Michael Defrancisco, Amanda Bennett, Victoria English, Meaghan Anderson

Costas T. Lambrew Research Retreat 2024

Introduction: During the pandemic, nurse educators identified gaps in engagement, attendance, and participation among nursing staff in professional development and continuing education. Nurses reported a gap in confidence in practice regarding nurse sensitive indicators: Catheter Associated Urinary Tract Infection (CAUTI), Central Line Associated Blood Stream Infections (CLABSI), falls, and Hospital Acquired Pressure Injuries (HAPI).

Implementing A Two-Nurse Indwelling Urinary Catheter Insertion Process With A Checklist To Decrease Catheter-Associated Urinary Tract Infections In The Intensive Care Unit, Alexa Austin

Doctor of Nursing Practice Final Project Abstract

Implementing a Two-Nurse Indwelling Urinary Catheter Insertion Process with a Checklist to Decrease Catheter-Associated Urinary Tract Infections in the Intensive Care Unit

PURPOSE The purpose of this quality improvement project was to decrease CAUTI rates within the Intensive Care Unit (ICU) by implementing a two-nurse indwelling urinary catheter (IUC) insertion process utilizing the Agency for Healthcare Research and Quality (AHRQ) IUC evidence-based checklist.

BACKGROUND The project was implemented in a 52-bed Medical-Surgical ICU of a large academic specialty hospital in the Southwestern United States of America (USA). At the project site, there was an increase in CAUTI rates above the …

Improving Patient Safety By Reducing The Use Of Restraint And Seclusion Through De-Escalation In An Inpatient Psychiatric Unit, Ndidiamaka Okafor

Doctor of Nursing Practice Final Project Abstract

Improving Patient Safety by Reducing the Use of Restraint and Seclusion through De-escalation in an Inpatient Psychiatric Unit

PURPOSE:

The purpose of this quality improvement project is to improve safety among adolescent patients ages 13 – 17 on an inpatient psychiatric unit through improved staff de-escalation techniques as evidenced by a decrease in the use of restraint and seclusion combined by 23% from 65% to 50% within 3 months. A secondary aim is that staff will provide self-reported improvement in confidence.

BACKGROUND:

Aggression from adolescents admitted to the inpatient psychiatric unit is one challenge nursing staff face when providing care. …

The Power Of Empowerment: What Happens When We Include Patients In Nutritional Decision-Making, Katarina Konstantino Bsn, Julia Vaughan Bsn, Jennifer Hillyard Bsn

Nurse Residency

In hospitalized patients, how do personalized meal selections impact patient satisfaction and overall quality of life during hospital stays?

Evaluation Of An Emergency Department Provider Information Update On The Initiation Of Suboxone With A Community Treatment Program Referral For Opioid Overdose And Opioid Use Disorder, Carmen Brewington

All Dissertations

Over 21 million people in the United States (U.S.) require substance use disorder (SUD) treatment; yet less than 4 million people receive treatment (Bressan & Kening, 2023). According to Thomas et al. (2022), opioid overdose deaths are increasing, and improving access to evidence-based treatment is critical. Hospital emergency departments (EDs) play a lifesaving in the emergency treatment of opioid overdoses; but can also serve as gateways to opioid treatment by healthcare providers for opioid addictions (Reuter et al., 2022). Mortality, after an ED visit for opioid overdose, is high (Thomas et al., 2022). Community resources are limited, thus making it …

Trends In Racial/Ethnic Disparities In Postpartum Hospital Readmissions In California From 1997 To 2018, Curisa M. Tucker Phd, Rn, Chen Ma, Mahasin S. Mujahid, Alexander J. Butwick, Anna I. Girsen, Ronald S. Gibbs, Suzan L. Carmichael

Publications

BACKGROUND: Postpartum readmission is an important indicator of postpartum morbidity. The likelihood of postpartum readmission is highest for Black individuals. However, it is unclear whether the likelihood of postpartum readmission has changed over time according to race/ethnicity. Little is also known about the factors that contribute to these trends. OBJECTIVE: This study aimed to: (1) examine trends in postpartum readmission by race/ethnicity, (2) examine if prenatal or clinical factors explain the trends, and (3) investigate if racial/ethnic disparities changed over time. STUDY DESIGN: We examined trends in postpartum readmission, defined as hospitalization within 42 days after birth hospitalization discharge, using …

A 5-Year Longitudinal Structural Equation Model Of Social Isolation And Probable Major Depression Among Participants With Spinal Cord Injury, Chao Li, Susan Newman Phd, Rn, Crrn, Faan, Jillian M. Clark, James S. Krause

Publications

OBJECTIVE: To develop longitudinal structural models of social isolation and probable major depression (PMD) over a 5-year interval among participants with spinal cord injury (SCI). DESIGN: Longitudinal structural equation modeling of self-report assessments collected during two follow-ups (2013 as Time 1, 2018 as Time 2) of a 45-year multicohort longitudinal study. Participants (n = 557) were identified from a specialty hospital in the Southeastern United States and two Midwestern hospitals and were initially enrolled in 1973-1974, 1984-1985, 1993-1994, or 2003-2004. PMD symptomology was measured by the Patient Health Questionnaire-9 (PHQ-9) and was defined by PHQ-9 scores ≥ 10. Social isolation …

Mentorship Program Including Alumni, Nicole Brainin

Doctor of Nursing Practice Projects

The landscape of advanced education in nurse anesthesia presents considerable challenges for Student Registered Nurse Anesthetists (SRNAs), accentuated by demanding clinical hours and the transition from experienced ICU nursing to novice learners. This study explores the implementation of alumni mentorship within Nurse Anesthesia Programs (NAPs) to alleviate these stressors. An initial survey gauged alumni interest in mentorship roles, while a follow-up survey assessed the program's impact on student satisfaction and communication. Findings suggest that engagement and communication frequencies are lower than optimal, while alumni mentorship is perceived positively. Recommendations for enhancing the program include diversified communication channels, structured interactions, and …

Qualitative Vs. Quantitative Train Of Four, Caleb Culbreath

Doctor of Nursing Practice Projects

The growing body of evidence linking residual neuromuscular blockade (NMB) to postoperative complications has underscored the need to integrate quantitative neuromuscular monitoring techniques into anesthesia practice. This study, conducted at a tertiary care center in southern Illinois, investigates the gap between current clinical practices and the latest evidence advocating for objective monitoring. The study utilized a non-experimental pretest-posttest design to evaluate an educational intervention's effectiveness in increasing anesthesia providers' knowledge of quantitative neuromuscular monitoring techniques and enhancing their awareness of the incidence and clinical implications of postoperative residual neuromuscular blockade. Analysis of the pretest and post-test responses revealed significant improvements …

Educating Srnas On Barriers And Facilitators Of Clinical Learning, Mesud Dedic, Richard Heuermann

Doctor of Nursing Practice Projects

A national survey of 143 Student Registered Nurse Anesthetists (SRNAs) conducted by Clancy and Bruinius (2022) revealed that factors impeding effective SRNA clinical education include unstable preceptorship, hostile environments, limited autonomy, and heavy didactic burdens. Clancy and Bruinius (2022) also found that facilitators of SRNA clinical education include rapport with preceptors, effective feedback, strong clinical site orientation, and beginning of day discussions. This project aimed to enhance second-year SRNAs' clinical success by mitigating these evidence-based barriers and employing these evidence-based facilitators by developing a presentation for SRNAs and assessing its effectiveness through a pre-implementation survey and post-implementation survey. The literature …

Emotional Intelligence And Srna Success Utilizing A Sim Experience, Melody Gassoway, Kaleigh Peters

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) face many challenges in meeting the rigorous demands of their doctoral-level training. Research demonstrates that high levels of emotional intelligence (EI) contribute to SRNAs’ academic and clinical success and improve patient safety and quality of care. Simulation is emerging as an educational tool to enhance the EI skills of students training in highly stressful professions and demonstrates promising benefits for SRNAs, such as improved decision-making, critical thinking, self-awareness, and self-regulation (Moriber & Beauvais, 2017; Dix et al., 2021). This doctoral project aimed to determine the efficacy of a high-fidelity simulation for strengthening the EI skills …

Development Of High-Fidelity Simulations For Srnas: Airway Fire And Venous Air Embolism, Ashlyn Russo, Brooke Skaggs

Doctor of Nursing Practice Projects

Student registered nurse anesthetists (SRNAs) must swiftly recognize and treat high-risk, low-incidence complications in a high-stress environment. Most SRNAs do not experience high mortality or rare emergencies throughout their training. This project involves developing and implementing two high-fidelity simulations for airway fire and venous air embolism (VAE) to help SRNAs improve their skills in a safe learning environment. Objectives for this project include examining current evidenced-based literature to determine the efficacy of high-fidelity simulation on the SRNA’s knowledge and performance post-simulation, determining the incidence, pathophysiology, and treatments for airway fires and VAE, creating two high-fidelity simulation scenarios, and integrating the …

Educating Anesthesia Providers On The Physiological Effects And Anesthesia Implications Of Cannabis, Carmel Loud

Doctor of Nursing Practice Projects

In the U.S., currently 37 states have legalized cannabis for medicinal use prescribed by qualified medical professionals (National Conference of State Legislatures [NCSL], 2022). In 2012, the legalization of recreational cannabis began; as of 2022, 19 states have legalized the recreational use of marijuana (NCSL, 2022). This project aimed to optimize care for patients using cannabis by increasing anesthesia provider knowledge about cannabis. The project's aim was accomplished through a thorough review of the current medical literature and implementation of education to anesthesia providers about the physiological effects and anesthesia implications of cannabis. Thirteen CRNAs took a pre- and post-quiz …

Application Of Ultrasound For Difficult Vascular Access In Obstetric Patients, Carly Mccleland

Doctor of Nursing Practice Projects

This project aimed to create a three-tiered educational program to introduce the benefits of ultrasound application for peripheral IV placement in obstetrical patients. The main goals of this project were to increase successful first-attempt IV placement in obstetric patients who may be difficult to obtain IV access on. The first tier of education consisted of presenting findings from the literature review as an educational PowerPoint to all project stakeholders. The second tier of education included stakeholders practicing using the ultrasound for PIV placement on mannequin arms. The third tier, which is still on going, included implementation of the first two …

Best Practice In Airway Management Of The Neonatal Population, Brittaney Montcalm

Doctor of Nursing Practice Projects

The historical idea that uncuffed endotracheal tubes (ETT) are the best method for pediatric airway management is being challenged in today’s current anesthetic practice. Whether to use a cuffed or uncuffed ETT in the neonatal population remains controversial. This project involved a comprehensive literature review of best-practice recommendations for neonatal airway management, focusing on the use of uncuffed versus cuffed ETTs. Literature review findings were presented as an educational PowerPoint presentation, and a quick reference guide for pediatric airway management was developed. A post-implementation questionnaire was administered to determine the effectiveness of the presentation and its perceived application in clinical …

Anesthetic Management Of The Parturient With Increased Intracranial Pressure Disorders, Madeline Olson

Doctor of Nursing Practice Projects

The parturient experiences various physiologic changes that contribute to the potential for increased intracranial pressure (ICP). Patients with preexisting neurologic conditions such as Chiari Malformation I, pseudotumor cerebri, and mass occupying lesions are at significant risk of increased ICP. A literature review was conducted to determine the safest labor anesthesia options for the parturient with increased intracranial pressure. After the literature review, a PowerPoint presentation and reference guide were given to a group of anesthesia providers at a central Illinois hospital that discussed the evidence-based recommendations. A voluntary survey was completed after the presentation to assess an improvement in knowledge …

Local Anesthetic Systemic Toxicity: Last Protocol Development, Implementation, And Evaluation For Healthcare Providers, Rachel Vaughn

Doctor of Nursing Practice Projects

LAST is an uncommon but deadly complication of local anesthetic administration. Healthcare facilities benefit from protocol implementation to help streamline best evidence-based practice. The American Society of Regional Anesthesia and Pain Medicine warrants a LAST emergency protocol for any healthcare facility practicing regional anesthesia. Healthcare personnel encountering patients at risk for LAST must understand the symptoms and treatment of LAST to improve response time and patient outcomes. The project implemented a LAST protocol at a rural hospital in Southern Illinois in July 2023. The investigator held an educational service to discuss the new LAST protocol and implementation. The educational service …

Discharge Lounge Utilization, Jessica Goneh, Areo Comonal

Doctor of Nursing Practice Projects

Efficient hospital throughput is crucial for maintaining quality patient care and managing healthcare resources effectively. This project examines the relationship between hospital throughput, measured by discharge lounge utilization, and the National Emergency Department Overcrowding Scale (NEDOCS) score. A mixed-methods approach was employed, combining quantitative analysis of discharge lounge utilization data with qualitative assessment of staff perceptions and operational challenges. The project was conducted over nine months in a large urban hospital. Results indicate a significant correlation between discharge lounge utilization rates and NEDOCS scores, suggesting that higher levels of discharge lounge utilization are associated with NEDOCS score improvement. Furthermore, qualitative …

Procedural Sedation Training: Competency Verification Through Simulation, Christine Hawknuff

Doctor of Nursing Practice Projects

A 450-bed tertiary hospital in Central Illinois lacked a standardized process for competency verification for procedural sedation care by registered nurses (RNs). Despite recommendations by many organizations, there are no consistent or standardized guidelines for verifying competency in nursing care of the procedural sedation. This project implemented a Procedural Sedation Training Course which comprised an in-person prelearning lecture, a group simulation learning experience, and an individual verification of competency through simulation.

Fifty-six RNs completed the Procedural Sedation Training Course and demonstrated competency through simulation, and 24 of these RNs completed a procedural sedation within the eight-month pilot period. Qualitative and …

Increasing Ob/Gyn Clinic Nursing Staff Knowledge And Comfort Level In Providing Breastfeeding Education, Nancy Moore

Doctor of Nursing Practice Projects

There are well known benefits of breastfeeding for both mother and child, yet the educational support from providers during prenatal visits is not consistent or well-documented. An educational presentation discussing guidelines of breastfeeding education, common breastfeeding problems and barriers to breastfeeding was developed and presented to a “Baby Friendly” hospital-based OB/GYN clinic staff at an urban St. Louis hospital. The goal was to increase staff knowledge and comfort providing education and resources surrounding breastfeeding to be used to increase discussion of breastfeeding during prenatal and postpartum visits. Evaluation of pre and posttest data showed an increase in knowledge regarding managing …

Education For Healthcare Professionals On Protocol For Prostate Cancer Screenings On Inmates, Heather Ackerman, Randi Janae Ballard

Doctor of Nursing Practice Projects

Cancer is the leading cause of death for incarcerated individuals, prostate cancer awareness and screening guidelines are essential areas of focus for healthcare professionals (Puglisi et al., 2021). Prostate cancer screenings recommend that males between the age of 55-69 be informed of evidence-based guidelines and offered these screenings as a part of routine health maintenance (USPSTF, 2018). In 2019, the Illinois Department of Corrections (IDOC) was ordered to follow these guidelines for incarcerated individuals (Raba, 2021). As of 2021, the IDOC had yet to implement these screenings for incarcerated individuals within the state facilities. Two separate one-hour educational sessions regarding …

Pneumococcal And Influenza Vaccine Co-Administration In The Incarcerated Population, Kaitlyn Stroh

Doctor of Nursing Practice Projects

Background/Significance: Streptococcus pneumoniae is responsible for 20-60% of U.S. bacterial pneumonia cases and has a mortality rate of 10-30%. Invasive pneumococcal disease (IPD) occurs when streptococcus pneumoniae invades otherwise sterile sites. Adherence to immunization guidelines is 60-70% effective at preventing IPD. Co-administration of pneumococcal and influenza vaccines has shown promise at increasing uptake of the pneumococcal vaccine and enhancing immunological response. Population/Setting: A state-run Department of Corrections (DOC) clinic system serving just over 30,000 individuals was the site for this project. Incarcerated individuals present an increased risk of contracting pneumococcal disease due to close living quarters. Other risk factors such …

Implementation Of Menstrual Cycle And Fertility Awareness Education For Community Healthcare Providers Serving Guatemalan Women, Alissa Struble

Doctor of Nursing Practice Projects

Research indicates that lack of reproductive knowledge, literacy & academic attrition, lack of educator support, poverty, religion, gender inequality, and decreased access to electronic devices contribute to high numbers of teenage pregnancies in Guatemala. Educating United States (U.S.) healthcare providers and Guatemalan volunteers/workers about fertility awareness using Standard Days Method® (SDM) and CycleBeads® has the potential to empower young Guatemalan women and encourage them to make independent, informed reproductive decisions. In December 2023, a quality improvement project was implemented in a Guatemalan rural health clinic. Likert scale questionnaires were utilized to assess knowledge and comfort levels regarding fertility awareness. Analysis …

Dnp Final Report: Increasing Rapid Response Activations, Carlton J. Rojas Jr

DNP Final Reports

In 2008, facilities were encouraged to develop an emergency response system. A system in which nurses could activate a team of specialists directed to the bedside of a patient with a deteriorating condition. Despite this initiative, nurses and hospital staff have failed to recognize deterioration and correctly activate a rapid response. The clinical problem: Nurses are failing to recognize patient deterioration and activate a rapid response. The practice question was, what will increase rapid response activations? This DNP Project focused on increasing the identification of patient deterioration and activation of the rapid response team. A systematic review of the literature, …

Psychiatric Mental Health Nurse Practitioner Perceptions Of How Providing Patient Care During The Covid-19 Pandemic Affected Their Own Mental Health, Linda Cabage

Electronic Theses and Dissertations

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to …