Nursing Commons^™

Decreasing Re-Intubation Rates In Mechanically Ventilated Adult Patients: A Scoping Review, Anne J. Shearin Bsn, Rn, Wesley Gray Bsn, Rn, Philip Habegger Msn, Aprn, Fnp-C, Evan Gregory Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Donna Lynch-Smith Dnp, Aprn, Acnp-Bc, Ne-Bc, Cnl

Doctor of Nursing Practice Projects

Decreasing Re-Intubation Rates in Mechanically Ventilated Adult Patients: A Scoping Review

Purpose/Background

Critically ill patients often require mechanical ventilation to support respiratory function. Prolonging mechanical ventilation can increase adverse outcomes. Weaning patients from the ventilator as soon as clinically appropriate can decrease adverse outcomes. The decision to wean mechanical ventilation lacks a standardized approach. This scoping review will evaluate the literature about the effectiveness of a standardized weaning protocol in decreasing the number of reintubations within 72 hours of extubation.

Methods

We conducted a literature search on PubMed, CINAHL, Scopus, and Medline between November 2020 and November 2023 using key …

Cognitive Behavioral Therapy To Prevent Nurse Burnout In Sub-Saharan Africa, Anna C. Johnson

MSN Capstone Projects

Overall, burnout prevention has been shown to foster nurse resilience, ability to cope with stressors, teamwork, and improving the personal value of “doing good” and “being good”; the effects have been shown to last between 6 months and one year. The current evidence is strong enough to recommend a change to current nursing practice via annual Cognitive Behavioral Therapy (CBT) trainings to strengthen nurse resilience.

This researcher proposes to implement a CBT-based burnout prevention program in Ghana’s capital of Accra in sub-Saharan West Africa. There is ample evidence that African nurses face many of the same burnout issues that nurses …

A Survey Of Nurse Preceptor Preferences Regarding Training Topics: A Descriptive Study, Janice Yao Valadez

Doctoral Projects

Background: The nurse preceptor role can be as challenging and demanding as it is critical in the context of nursing shortages and burnout. The improvement of nurse preceptor training, based on preferences expressed by the nurses fulfilling this role, therefore represents a potentially important part of the solution to these problems.

Methods: A modified version of the +RN Learning Needs Assessment tool was administered to 24 nurse preceptors who precepted in the nurse residency program on two campuses of a not-for-profit Western US hospital, regarding their preferences for topics to be covered in preceptor training, as well as the sequence …

Adaptive Leadership: Nurse Executives Building Organizational Adaptive Capacity During Times Of Crisis, Challenge, And Change, Kristian Poitier

Dissertations

Purpose: The purpose of this exploratory phenomenological study was to identify and describe the strategies used by nurse executives in acute care hospitals to build an adaptive capacity based on the five key characteristics of adaptive leadership identified by Heifetz et al. (2009).

Methodology: This qualitative phenomenological study identified and described the perceived impact of adaptive leadership on building an organization’s adaptive capacity as perceived by nurse executives in acute care hospitals, for-profit and not-for-profit, with the title of chief nursing officer (CNO) or chief nurse executive (CNE) in Southeast, West, and North Florida. The researcher was part of a …

A Multimodal Intervention To Aid In Smoking Cessation, Lauren Druzbicki

Evidence-Based Practice Project Reports

The Centers for Disease Control and Prevention (CDC; 2023a) notes there are 28.3 million smokers in the United States. In Indiana alone, nearly 29% of adults currently use tobacco, with 19% of the total being cigarette smokers (Indiana Department of Health, 2022). The purpose of this evidence-based practice (EBP) project was to implement a multi-modal intervention to aid in smoking cessation in adults aged 18 and older who are cigarette smokers. The intervention included physician/nurse advise using the ask, advise, refer (AAR) model, the SmokefreeTXT program, and FDA approved smoking cessation medications. The project took place at a primary care …

Factors Associated With Anaemia Among Pregnant Women In Rwanda: An Analysis Of The Rwanda Demographic And Health Survey Of 2020, Lilian Nuwabaine, Joseph Kawuki, Livingstone Kamoga, Quraish Sserwanja, Ghislaine Gatasi, Linet M Mutisya, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background: Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda.

Methods: Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26).

Results: Of the 435 pregnant …

Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes Bsn, Rn, Ashley Lynch Bsn, Rn, Scott Jamison Bsn, Rn, Mary Joiner Bsn, Rn, Gray Seymour Bsn, Rn, Dwayne Accardo Dnp, Aprn, Crna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C

Doctor of Nursing Practice Projects

Purpose/Background

The induction of anesthesia using hypnotic sedatives, such as etomidate and midazolam, is common practice. Etomidate and midazolam are commonly employed in the induction of anesthesia in the septic patient population, each with its unique advantages and drawbacks. This scoping review aims to synthesize evidence on the effects of anesthetic induction with etomidate versus midazolam in adult septic patients, focusing on the incidence of mortality and associated adverse effects during hospitalization. The purpose is to establish a standard of care for anesthetic induction in this population.

Methods

A literature review was conducted from September 2022 to March 2023 utilizing …

Impact Of Fall Education To Oncology Staff On Oncology Patient Fall Rates, Danni Sloane

Articles, Abstracts, and Reports

Significance & Background

Falls and fall-related injuries impact patients' health outcomes and are the most commonly reported adverse event in hospitals. Patient falls also affect reimbursement rates and can increase length of stay by about 6.3 days and increase undue patient harm. An increase of patients falls on the medical and surgical oncology acute care units have caused undue physical harm, increased moral distress, mental fatigue, and burnout in nurses; as well as placing financial burdens on the healthcare system. Implementing fall education and interventions aligns with national patient safety goals, is a top-priority project, is in alignment with the …

Evidence-Based Strategy To Engage And Retain Patients In Treatment For Opioid Use Disorder: A Contingency Management Plan, Olubukola Juliet Akinyele

Doctoral Dissertations and Projects

Opioid use disorder (OUD) is a significant public health problem in the United States that requires immediate and effective interventions to treat. The medication-assisted treatment approach has proven to be effective, but a significant number of individuals suffering from OUD do not seek treatment or are unable to stay in treatment due to several factors. Contingency Management (CM) is an intervention that has proven to be a promising strategy for patients suffering from OUD. The sole aim of this scholarly project was to determine the effectiveness of CM through a literature review of relevant articles and implement the result into …

Procedural Oxygen Mask Use For Inpatient Bariatric Endoscopy: A Scoping Review, Makinlee Meadows, Marion Millette, Brittany Morgan, Lauren Pegrim, William Collier Phillips, Dwayne Accardo Dnp, Crna, Faana, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Hypoxia is a severe adverse event that is often associated with sedated endoscopy procedures, and bariatric patients have a significantly higher risk for complications related to oxygenation during sedation due to pathophysiological changes to the respiratory system. This scoping review compares the rate of hypoxemic events with the use of a binasal cannula versus a procedural oxygen mask during inpatient endoscopic procedures in patients aged 19-64 with a BMI greater than 40.

Methods

The scoping review includes control trials with and without randomization, case-control/cohort studies, systematic reviews, and qualitative/descriptive studies. With limited research regarding the PICOT, extending the age …

Educational Campaign: Using Exercise To Prevent Postpartum Depression, Ruth Platt

MSN Capstone Projects

Postpartum depression is one of the most common medical ailments surrounding childbirth. It affects up to 20% of postpartum women and has detrimental effects not only on the mother but her infant and family as well (Navas et al., 2021). Currently, the medical community takes a reactive approach to postpartum depression by screening and treating cases of postpartum depression as they occur. An evidence-based search of peer-reviewed articles found that exercise in the perinatal period had a positive effect on maternal mental health and decreased postpartum depression scores. This is especially true for women who have a history of depression …

Reducing Central Line Infections In Pediatric Critical Care Patients, Callie Lazarine

MSN Capstone Projects

The purpose of this project is to show how early identification of patients who are at high risk for developing central line infections has an impact on infection rates, and how prevention strategies directed towards that patient population could lead to positive patient outcomes and a decrease in central line-associated bloodstream infections (CLABSI). Central line infections are a major hospital-acquired condition within hospital settings. In pediatric critical care areas, central venous catheters are inevitable due to complex diagnoses, patient size, and small vessels. However, CLABSIs have a massive impact on pediatric patients increasing mortality from 4% to 37%, prolonged hospital …

Improving Fall Rates And Satisfaction Through Implementation Of Bedside Shift Report Protocol., Olive Atsafack Tieumo

Doctor of Nursing Practice Final Project Abstract

PURPOSE

Implementing BSR Protocol to improve patient fall rates and satisfaction in an adult medical surgical unit in Texas aims to decrease the patient fall rates by 10%, increase patient satisfaction rates by 7%, and improve the completion of nursing BSR and fall checklists by 10% with the implementation of a standardized BSR tool and a fall TIPS checklist within 16 weeks.

BACKGROUND

High fall-risk patients are found on the unit, and about 86.1% of inpatient falls occur at the bedside. The average unit fall rates exceed the target of 2.3 and HCAHPS scores stay below 65%. Inconsistencies in shift …

Effectiveness Of Virtual Reality In Anesthesia Machine Education, Heather Milder, Rachel Geisendorfer

Doctor of Nursing Practice Projects

The anesthesia machine is an essential part of anesthesia practice, as it connects the patient to the provider and provides a constant stream of vital information. Therefore, the Certified Registered Nurse Anesthetist (CRNA) should be trained to utilize and troubleshoot the anesthesia machine to deliver high-quality patient care. Education about the anesthesia machine begins with Student Registered Nurse Anesthetists (SRNAs) through various learning opportunities. Immersive virtual reality simulation has emerged as a potential educational aid to engage active learners. This project aimed to determine the effectiveness of utilizing the immersive virtual reality simulator SIMVANA for first-year Southern Illinois University Edwardsville …

Emr Templates For Age-Appropriate Well-Child Pediatric Visits, Alison Drerup, Kelsey Piper

Doctor of Nursing Practice Projects

The world of pediatric medicine is continually evolving. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) regularly update guidelines to have the most current information available to providers and their patients. The overwhelming majority of primary care offices have transitioned to electronic medical records (EMRs) for charting purposes. Templates included in EMRs ease the workflow and documentation process for providers. In the primary care setting, templates include essential information discussed at well-child visits, such as developmental milestones, vaccination schedules, and anticipatory guidance. The project’s purpose was to update the age-specific well-child templates at …

Student Veterans’ Transition To Nursing Education: Barriers And Facilitators, Bruce P. Hunter, Steven Busby Dr., Jeannie Giese Dr., David Phillippi Dr.

DNP Projects

Student Veterans’ Transition to Nursing Education: Barriers and Facilitators

Abstract

The transition for student veterans from military service to higher education can be a challenging endeavor, especially for those pursuing an education in nursing. While the experiences and perspectives of each student veteran is unique, their successful integration into an academic environment can be influenced by a complex array of barriers and facilitators. This mixed-methods study aims to explore the themes and concepts that can be found in the transition experiences of student veterans in nursing education, with a focus on identifying the barriers they face and the facilitators that …

Promoting Mental Health And Well-Being Among Undergraduate Nursing Students: A Practice Guideline, Armen Mailyan

DNP Projects

Poor mental health and well-being among undergraduate nursing students negatively affects social dynamics, communication, decision making, and stress management, thus compromising the quality of healthcare delivery and patient care outcomes. It is imperative that nursing programs support students to develop positive self-care, resilience, and mental health skills while in school to foster their well-being, enhance their academic success, and to promote high-quality, patient-centered care in their future practice. The purpose of this Doctor of Nurse Practice (DNP) project was to develop a mental health and well-being practice guideline with a comprehensive set of evidence-based interventions for academic nursing programs to …

The Predictive Relationship Between Pre-Nursing Boot Camp Participation And Successful Completion Of The First Semester And Retention In An Associate Degree Nursing Program, Misty Beth Stine

Doctoral Dissertations and Projects

First semester students in undergraduate nursing programs are at the highest risk for attrition, so retention of these students is a priority concern. The purpose of this non-experimental correlational predictive quantitative study was to investigate whether participation in a pre-nursing student boot camp is predictive of successful completion of the first semester and retention at an Associate Degree Nursing program at a community college in the rural Southwestern United States. Data was retrospectively obtained from archival student records for all first semester nursing students accepted into the ADN program from 2018-2022. Sample size was N = 227. The chi-square test …

Use Of Acupuncture As A Complementary Therapy For The Treatment Of Chronic Pain In The Veteran Population To Improve Outcomes: An Integrative Review, Tabitha T. Smithers

Doctoral Dissertations and Projects

Clinical care in patient management is progressive and should change as evidence-based practice research is available. Veterans’ experiences with pain related to their service-related injuries are unique. This pain can limit their ability to function in society successfully. Many of the patients continue to experience uncontrolled pain, as well as side effects from medications that have been prescribed. This integrative review focused on the use of acupuncture as a complementary therapy to improve pain and quality of life in the Veteran population. The review analyzes systematic reviews, randomized control trials, and additional levels of evidence from scholarly articles supporting the …

Embracing Technology To Optimize Patient Repositioning, Michelle Gideon

Doctoral Dissertations and Projects

An evidence-based quality improvement approach was used for this project. The aim of the project was to examine the effect of the use of a patient monitoring system on the rate of change in pre-existing pressure injuries; for those that spend time in the intensive care unit (ICU). A patient monitoring system can provide real-time feedback on the frequency and angle of a patient’s repositioning. Additionally, the project looked at the ability of such a system to generate reports on staff compliance with patient repositioning. Data were collected for 8 weeks prior to implementation and 8 weeks after implementation of …

An Exploration Of The Lived Experience Of Novice Adjunct Nursing Faculty As They Transition From Clinical Expert To Novice Educator, Angelique Tolentino-Martin

Doctoral Dissertations and Projects

This transcendental phenomenological study aimed to describe and understand the lived experiences of novice adjunct nursing faculty teaching in the United States in undergraduate nursing programs as they transition from clinical practice to academia. The theories that guided this study are Meleis’ transition theory and Schoening’s nurse educator transition model which provide a framework for the transition experiences for novice adjunct nursing faculty. The central research question is: What are the lived experiences of novice undergraduate adjunct nursing faculty transitioning from clinical expert to novice nurse faculty? Purposive sampling and snowball sampling were used to recruit participants who were novice …

Defining Best Practices And Validation For Curriculum Mapping, Hannah Smith, Jesse Chittams

College of Nursing Faculty Papers & Presentations

The alignment of curriculum content with standards is a quality improvement measure used to identify gaps or overlaps in academic content. Curriculum mapping results, while commonly used, are rarely reported. Undergraduate faculty mapped 11 courses in a single timepoint using a web-based curriculum mapping tool. Quantitative results were calculated and compared to defined client needs categories. A validation analysis was performed by mapping one course in triplicate. Faculty feedback following the exercise was obtained by online survey. Three client needs categories were determined to be marginally out of range in the initial analysis of the quantitative mapping data. The curriculum …

Prognostic Values Of Serum Lactate-To-Bicarbonate Ratio And Lactate For Predicting 28-Day In-Hospital Mortality In Children With Dengue Shock Syndrome, Thanh Nguyen Tat, Nhu Vo Hoang-Thien, Dat Nguyen Tat, Phuc Hoang Nguyen, Lien Thi Ho, Duong Hung Doan, Dung Tuan Phan, Yen Nguyen-Hoang Duong, Truc Huynh Nguyen, Tuyet Kim Nguyen, Ha Thi-Thu Dinh, Thuy Thi-Diem Dinh, Anh Thi-Mai Pham, Viet Do Chau, Tung Huu Trinh, Luan Vo Thanh

Faculty, Staff and Student Publications

This study aimed to assess the clinical utility of blood lactate-to-bicarbonate (L/B) ratio, as a prognostic factor for 28-day in-hospital mortality in children with dengue shock syndrome (DSS), admitted to the pediatric intensive care unit (PICU). This single-center retrospective study was conducted at a tertiary children hospital in southern Vietnam from 2013 to mid-2022. Prognostic models for DSS mortality were developed, using a predefined set of covariates in the first 24 hours of PICU admission. Area under the curves (AUCs), multivariable logistic and Least Absolute Shrinkage and Selection Operator (LASSO) regressions, bootstrapping and calibration slope were performed. A total of …

Preyemary Care Optical Coherence Tomography: Increasing Adherence To Retinopathy Screening, Henry Junior Peña

Doctoral Dissertations & Projects

Background: Diabetic retinopathy (DR) is a leading cause of preventable blindness in working age adults in the United States. Nonadherence to screening recommendations persists due to significant barriers. Early detection is crucial to mitigate economic burdens and improve patient outcomes. This quality improvement project aimed to increase DR screening access for patients with diabetes at an urban Midwest safety net clinic by implementing an optical coherence tomography (OCT) screening program. Methods: A 12-week, cross-sectional study design using convenience sampling to recruit adult diabetic patients, type-1, or type-2, at a Midwest primary care clinic. Intervention involved retinal imaging scans of participants …

Prevalence And Prevention Of Pressure Injuries In Residents Over The Age Of 65, Bao Vo, Trista Theimer, Joe Nordstrom

Celebrating Scholarship and Creativity Day (2018-)

Pressure injuries are an ongoing problem for people over the age of 65 who have chronic comorbid conditions. Many interventions have been implemented to decrease pressure injuries. Pressure injuries cause pain and can lead to medical issues including sepsis and death. The cost of pressure injuries is high due to the medical complications that result from the pressure injury. Client repositioning is an extremely important intervention to prevent pressure injuries. Risk assessment is also important in order to identify clients at risk to support early interventions. This quality improvement project focused on educating staff and implementing best practices to prevent …

Flow Of Communication Between Interdisciplinary Team Members In Long-Term Care, Danielle Anderson, Ellie Anez, Isabella Gillman, Annabelle Handt, Anne Koslowski, Ella Madson

Celebrating Scholarship and Creativity Day (2018-)

Communication is an essential tool for maintaining quality care in any health care setting, including long-term care. Interdisciplinary communication is also essential in providing and coordinating care that addresses resident needs. Lack of communication can lead to safety concerns for residents and staff, decreased care proficiency, ineffective care plans, and decreased staff satisfaction. Upon review of the surveys among staff at the long-term care facility, it was identified that nursing and housekeeping staff highlighted the admission process to be an area that they would like to see improvement in. Room changes and discharges were areas that were reported to need …

A Benchmark Project On Early Mobility In The Intensive Care Unit, Millicent Odhiambo

MSN Capstone Projects

Introducing early mobility interventions in the Intensive Care Unit (ICU) is a crucial measure to improve patient outcomes and optimize care delivery in the critical care setting. The objective of this project is to tackle the difficulties caused by extended periods of immobility in the Intensive Care Unit (ICU), with the aim of diminishing complications, shortening the duration of ICU stays, and enhancing the functional recovery of patients.

"Salir Adelante": Improving The Quality Of School Entrance Physicals For Immigrant Minors, Jennifer Sternberg, Elizabeth Morse

DNP Projects

The purpose of this QI project was to improve the delivery of school physicals in the setting of an -friendly non-profit safety-net clinic by creating a patient-centered clinical pathway to improve focused screening and referrals for newly arrived migrant children and their families by routinely assessing and addressing behavioral health care (BH) and social determinants of health needs (SDoH).

Using QI methodology and Donabedian’s Structure Process Outcomes framework, the project team implemented a clinical pathway that included an immigration-focused history of present illness, systematic behavioral health (BH), and social determinants of health (SDoH) screenings embedded within an electronic health record …

The Effectiveness Of Dexmedetomidine As An Adjunct In Spinal Anesthesia For Pain Relief In Cesarean Patients: A Scoping Review, Tyler Polanco Bsn, Rn, William Riley Bsn, Rn, Michelle Russell Bsn, Rn, Christina Samson Bsn, Rn, Bria Sharp Bsn, Rn, Dwayne Accardo Dnp, Ccrna, Faana

Doctor of Nursing Practice Projects

No abstract provided.

Depression Screening In Type 2 Diabetes In Adolescent 12-18 Year Olds, Mykyla Coleman Bsn,Rn, Chelsea Conlee Bsn,Rn, Carol Gracia Msn, Aprn, Fnp-Bc, Emily Jennewine Msn, Aprn, Cpnp-Pc, Ibclc, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background

Although more commonly diagnosed in adults, type 2 diabetes is increasingly diagnosed in pediatric populations in the United States. Research suggests a correlation between depression and type 2 diabetes, however, a gap in research exists regarding depression and type 2 diabetes among pediatrics, specifically adolescents. This scoping review aims to address this gap by assessing the impact of depression screening on glycemic control in this specific population.

Purpose

The goal of the review is to contribute to the development of effective strategies for depressing screening in adolescents with type 2 diabetes, with the expectation this may positively impact glycemic …