Nursing Commons^™

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Increasing Annual Depression Screening For Adults In A Primary Care Setting, Sandy Zachery, Sheryl Winn, Flor Culpa-Bondal

Graduate Research Showcase

Increasing Annual Depression Screening for Adults in a Primary Care Setting

Background:

Depression is a mental illness that's common worldwide, which can cause an individual to function poorly in society and can progress to suicide. Because of several barriers, patients in a primary care environment are not being seen or treated for depression. Even though the U.S. Preventive Services Task Force (USPSTF) recommends that all adults in primary care receive annual depression screening that delivers effective treatment with the correct diagnosis and accurate follow-up, patients are still not being screened for depression.

Purpose:.

This project aims to improve …

Developing And Implementing A Sexually Transmitted Disease Screening Program To Decrease Chlamydia Cases On A College Campus, Amanda C. Harris

All Capstone Projects

Introduction: Sexually active college students were experiencing a high incidence, spread, and reinfection of the sexually transmitted Disease (STD) chlamydia on a university campus.
Purpose: To determine if implementing of a quality improvement program on campus utilizing a holistic approach would help decrease chlamydia cases. This program focused on fast-track STD screening, increasing knowledge about STDs, and addressing mental health issues.
Methods & Study Design: This was a descriptive/quasi-experimental design. Participants utilized the fast-track STD screening and completed surveys. Descriptive statistics and frequency tables were used to summarize survey responses for 1) the pre-and post-sexually transmitted disease (STD) education survey, …

Student Academic Success System, Brandi Castle

Doctor of Nursing Practice Projects

This project aimed to enhance academic success and retention rates in a practical nursing program through the implementation of a Student Academic Success System (SASS), utilizing evidence-based teaching strategies. A quality improvement design using both the Iowa Model of Evidence-Based Practice and the Plan, Do, Study, Act (PDSA) framework was guided by Kolb’s Model. Nurse faculty saw a need for increased student retention among practical nursing students; the student then proposed a plan, translated evidence, created a pre- and post-survey, and carried out SASS with the use of trained nurse faculty coaches. The goal of the project was to reduce …

Measuring Attitude Change In Nursing Students After Completion Of A First Nations Peoples’ Health Unit: Embedding A Validated Tool In Learning And Assessment Practices, Kylie Mccullough, Angela Genoni, Melanie Murray, Darren Garvey, Linda Coventry

Research outputs 2022 to 2026

The health inequities experienced by Aboriginal and Torres Strait Islander peoples, rooted in the historical and ongoing negative impacts of colonisation and disrupted traditional lifestyles, sees higher rates of illness and hospitalisations, increased morbidity and higher premature death rates than other Australians. Nurses represent the majority of Australia’s health workforce and nursing students must have knowledge to provide culturally safe care to Australia’s Aboriginal and Torres Strait Islander peoples. An Aboriginal and Torres Strait Islander Peoples’ Health and Wellbeing unit was developed and introduced into an undergraduate nursing curriculum. This project aimed to determine the effectiveness of the unit content …

Out-Of-Hospital Birth Training, Experience And Confidence Of Australian Rural Volunteer Ambulance Officers, Michella G. Hill, Belinda Flanagan, Sara Hansen, Luke Hopper, Brennen Mills

Research outputs 2022 to 2026

Introduction: Unplanned out-of-hospital births represent less outs have a high risk of life-threatening complications, which are than 1% of ambulance requests for assistance. However, these call- particularly complex in rural or remote settings with limited accessibility to specialist care support. Many community hospitals Four themes emerged from analysis: (1) Lack of education and no longer provide obstetrics care, so birth parents must travel to exposure to birth resulted in low confidence. Most participants larger regional or metropolitan hospitals for assistance. Increased reported significant anxiety attending obstetric call-outs, and travel time may increase the risk of unplanned out-of-hospital explained under-utilisation of …

Self-Efficacy And Home Dialysis: An Integrative Review, Nicola A. D'Souza, Ma'en Zaid Abu-Qamar, Lisa Whitehead

Research outputs 2022 to 2026

Background: Enhancing patient confidence in their ability (self-efficacy) is vital to ensure people are equipped to maintain home dialysis protocols. Bandura's social cognitive theory provided a framework for understanding the role of self-efficacy in patients managing home dialysis. Objectives: To identify self-reported levels of self-efficacy, the measurements used to assess self-efficacy and the effectiveness of interventions to enhance self-efficacy in patients undergoing home dialysis. Design: An integrative review approach was employed using Whittemore and Knafl's methodology. Methods: A comprehensive search was conducted to identify literature on self-efficacy in patients managing home dialysis. Searches were conducted in CINAHL, MEDLINE, Embase and …

White Lies And Safety Nets: The Perceptions Of Nurses On The Use Of Early Warning Systems And The Development Of Higher-Order Thinking Skills, Deb Massey, Tracy Flenady, Amy Louise Byrne, Justine Connor, Danielle Le Lagadec

Research outputs 2022 to 2026

Background: Algorithmic tools such as early warning systems (EWSs) have been embedded into clinical practice globally to facilitate the early recognition of patient deterioration and to guide the escalation of care. Concerns have been raised that the mandated use of these EWS tools may impact the development of nurses' higher-order thinking. However, the relationship between EWS tools and the development of higher-order thinking is poorly understood.

Objectives: This paper provides the qualitative results of a larger study that sought to explore the impact of EWS tools on the development of nurses' higher-order thinking. The objective of this component of the …

Nurses’ Attitude Toward Trauma-Informed Care In Critical Care Units: A Cross-Sectional Study, Hashem Alkotaifan, Raghad H. Abdelkader, Mohammad N. Alshloul, Shaher H. Hamaeh, Mohammed S. Albashtawy, Nazzal M. Alshloul, Doha M. Alshloul

Research outputs 2022 to 2026

Objective: Trauma-informed care (TIC) is an innovative concept that recognizes the lasting impact of psychological trauma. Critical care nurses’ attitude toward TIC plays an essential role in assessing, monitoring, and addressing trauma experienced by patients. This study aimed to describe critical care nurses’ attitudes toward TIC in critical care units at Jordanian military hospitals. Methods: This descriptive-analytical cross-sectional study was performed on 315 critical care nurses at seven military hospitals (two from the north, three from the center, and two from the south) in 2022. The data collection tool was the Attitudes Related to Trauma-Informed Care-35 (ARTIC-35) scale. Multi-stage sampling …

The Gender Pay Gap In The Australian Nursing Workforce: A Retrospective Observational Study, Gemma Doleman, Christine Duffield, Ian W. Li

Research outputs 2022 to 2026

Aim: To explore the gender pay gap among the Australian nursing workforce and identify reasons for such a gap. Background: Gender discrimination exists in nursing, with men having a higher rate of pay and a faster rate of career progression, irrespective of experience and qualifications. In addition, men are shown to have a greater representation in leadership roles compared to the proportion of men in the profession. Methods: The study uses a retrospective, observational survey design of graduate nurses from all Australian universities. Findings: The gender wage gap was around 4% at six months after graduation, increasing to 13% at …

How Do Professional Connections And Relationships Impact Midwives’ Well-Being And Career Sustainability? A Grounded Theory Study Protocol, Lynnelle Moran, Sara Bayes, Kim Foster

Research outputs 2022 to 2026

Significant attrition and projected workforce shortages within the midwifery profession are global issues. Extensive research has identified that high levels of workplace adversity, chronic stress, and increasing rates of vicarious trauma and moral injury experienced by midwives, underpin this situation. Researchers have explored midwives’ intention to stay in the midwifery workforce and identified ways to support students’ transition to professional practice. Supportive collegial relationships have been reported to be protective for new and early career midwives’ well-being and resilience. However, there is a gap in knowledge and understanding of the impact and significance of professional connections and relationships for midwives …

Physical Health Of People With Mental Illness: A Snapshot Of Consumer Engagement In The Provision Of Care In Primary Care., Irene Ngune, Dianne Wynaden, Karen Heslop

Research outputs 2022 to 2026

Primary care is crucial to the health of people with mental illness. However, there is limited information on their reported engagement in this setting. This study surveyed 100 people with mental illness who had a general practitioner or a general practitioner and a case manager from a tertiary mental health service to determine their engagement level with their GP and what interventions they received to manage their health. Forty-four per cent had their psychotropic medications primarily prescribed by their GP, and 58% reported visiting their GP for physical health problems. Ninety-four point nine percent of participants aged 50 years and …

Cross-Sectional Survey Of Staff And Family Perspectives On The Use Of Cctv In Australian Residential Aged Care, Davina Porock, Caroline Vafeas, Mandy Towell-Barnard, Laura Emery, Gemma Doleman, Janine Alan

Research outputs 2022 to 2026

Objective: To describe staff and family members' opinions about closed-circuit television (CCTV) in communal and private areas of residential aged care facilities (RACF), and to investigate how this relates to perceptions of care quality. Methods: A cross-sectional survey was developed to capture perceptions of CCTV's influence on care quality, and acceptable locations for CCTV placement. Data were recorded as ordinal-scale and open responses. Non-parametric tests of association were conducted. Results: The survey was completed by 81 staff and 74 family members. Both staff and family were satisfied with care quality and safety, irrespective of CCTV use. More family members were …

It Takes It Out Of The Textbook: Benefits Of And Barriers To Expert By Experience Involvement In Pre-Registration Mental Health Nursing Education, Brenda Happell, Sarah Gordon, John Hurley, Kim Foster, Mike Hazelton, Richard Lakeman, Lorna Moxham, Terri Warner

Research outputs 2022 to 2026

What Is Known on the Subject?: Service user involvement in mental health nursing education is beneficial in terms of attitudinal change to reduce stigma, clinical skill development and enhancing understandings of recovery-oriented practice. Service users as experts by experience have not been embedded within pre-registration nursing programs. Consequently, they remain limited in number, ad hoc and frequently tokenistic. Nurse academics responsible for the design and delivery of pre-registration mental health nursing curricula have a potentially important role in facilitating expert by experience involvement in mental health nursing education. What this Paper Adds to Existing Knowledge: Nurse academics teaching mental health …

Nursing/Midwifery Students' Perceptions Of Caring Pedagogy And Online Learning During The Covid-19 Pandemic, Rikki Jones, Debra Jackson, Kylie Rice, Murray Fisher, Pauline Callega, Martin Hopkins, Caryn West, Pauletta Irwin, Shirley Mcgough, Lauretta Luck, Felicity Walker, Nicola Whiteing, Kim Usher

Research outputs 2022 to 2026

Aim: This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce. Design: Mixed methods. Methods: A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students’ experience of learning during the COVID-19 pandemic. Results: There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning …

Preparing For End Of Life In A New Country: A Grounded Theory Study On African Migrants Living In Australia, Gertrude Gondwe Phiri

Theses: Doctorates and Masters

African migration to Australia has grown in the past 20 to 25 years with many migrants staying permanently. This has led to migrants dying away from their birthplaces where family is responsible for end-of-life care planning for the individual. Although migrating to Australia is considered a great achievement, many migrants also experienced challenges. Previous studies have explored the barriers faced by migrants in relation to end-of-life care but have not addressed the cause of those challenges. This constructivist grounded theory study examines how migrants from three African countries, Malawi, Zambia, and Zimbabwe (MZZ) prepare for end-of-life in Australia. The study …

Hidden And Unacknowledged: The Mental Health And Psychosocial Interventions Delivered By School Nurses In Western Australia, Anita Moyes, Shirley Mcgough, Dianne Wynaden

Research outputs 2022 to 2026

Schools are an important setting for the early identification, assessment and intervention of mental health problems in children and young people. Internationally, many nurses work in schools, but the role of this group with young people experiencing mental health problems has had only limited investigation. This study explored the activities school nurses undertook with young people experiencing mental health problems in Australia. Reporting was guided by the COREQ checklist. Thirty-one nurses participated in a semi-structured interview. Data were analysed using the constant comparative method of analysis as developed by Glaser and Strauss (1967). The findings identified that nurses working in …

Study Protocol For A Stepped-Wedge Cluster (Nested) Randomized Controlled Trial Of Antenatal Colostrum Expression (Ace) Instruction In First-Time Mothers: The Ace Study, Cassandra Cuffe, Roslyn Giglia, Matthew N. Cooper, Julie Hill, Desiree Silva, Anita M. Moorhead, Valerie Verhasselt, Joshua R. Lewis, Deborah Ireson, Jill R. Demirci, Talea Cotte, Kathryn Webb, Frances Patey, Therese A. O’Sullivan

Research outputs 2022 to 2026

Background: Although many mothers initiate breastfeeding, supplementation with human-milk substitutes (formula) during the birth hospitalization is common and has been associated with early breastfeeding cessation. Colostrum hand expressed in the last few weeks before birth, known as antenatal colostrum expression (ACE), can be used instead of human-milk substitutes. However, evidence is lacking on the efficacy of ACE on breastfeeding outcomes and in non-diabetic mothers. Methods and Planned Analysis: This multicenter stepped-wedge cluster (nested) randomized controlled trial aims to recruit 945 nulliparous pregnant individuals. The trial is conducted in two phases. During Phase 1, control group participants are under standard care. …

Staff Perceptions On The Effectiveness Of Grip-S, A New Approach To Clinical Supervision Incorporating Safewards: An Interpretive Phenomenological Analysis, Jennifer Hamilton, Amanda Cole, Richard Bostwick, Irene Ngune

Research outputs 2022 to 2026

This study explored the impact of an innovative approach to clinical supervision for mental health nurses which integrates Safewards, named Group Reflective integrated Practice with Safewards–GRiP-S. Qualitative data was collected through 10 individual semi-structured interviews with nursing staff who had participated within the clinical supervision approach. Interviews provided insights into the nursing staff’s perception and experience of the clinical supervision approach. Through interpretive phenomenological analysis six themes emerged (i) illuminating embodied practice of Safewards, (ii) building confidence through empowering connections, (iii) creating a culture of positive change, (iv) identifying internal motivation for and external barriers to supervision engagement, (v) navigating …

Does Intrauterine Exposure To Diabetes Impact Mental And Motor Skills? A Meta-Analysis Of The Bayley Scales Of Infant Development, Diana Arabiat, Mahammad Al Jabery, Lisa Whitehead

Research outputs 2022 to 2026

Background: Attempts to conduct meta-analyses of the association between child development and diabetes have been limited by the wide range of tools and definitions of developmental outcomes used in the literature. We aim to meta-analyze a widely used measure of child development, the Bayley Scales of Infant Development, with respect to exposure to diabetes and developmental scores. Methods: PsycINFO, MEDLINE/PubMed, EMBASE, Emcare, and Google Scholar databases were searched. Two independent reviewers screened, extracted, and quality-appraised the studies using JBI SUMARI software. Forest plots were created with the standardized mean difference using the random-effects model, and heterogeneity was assessed using I2. …

Environmental Sustainability, Healthcare Workers And Healthcare Students: A Literature Review Of Attitudes And Learning Approaches, Pamela R. Mccauley, Kavita Mathur, Reza Kamali Miab, Nina Cohen, Kedena Henriques-Thompson, Jyo Gopinath

Health Professions Education

Purpose: Today, increased attention has been placed on the healthcare industry and its workers in the wake of the global COVID-19 pandemic. Increases in facemask production, personal protective equipment, and the number of patients admitted into hospitals have resulted in a sharp rise in medical waste and environmental concerns. This has led to a greater interest by the research community to study the type of training and education that healthcare workers and students receive which could facilitate the implementation of sustainability activities during their work.

Design/Methodology: We have conducted a literature review (2010 to 2024) on healthcare worker …

The Impact Of Mandated Use Early Warning System Tools On The Development Of Nurses' Higher-Order Thinking: A Systematic Review, Tracy Flenady, Justine Connor, Amy Louise Byrne, Deb Massey, Marie Danielle Le Lagadec

Research outputs 2022 to 2026

Aim: Ascertain the impact of mandated use of early warning systems (EWSs) on the development of registered nurses' higher-order thinking. Design: A systematic literature review was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist (Page et al., 2021). Data Sources: CINAHL, Medline, Embase, PyscInfo. Review Methods: Eligible articles were quality appraised using the MMAT tool. Data extraction was conducted independently by four reviewers. Three investigators thematically analysed the data. Results: Our review found that EWSs can support or suppress the development of nurses' higher-order thinking. EWS supports the development of higher-order thinking in two …

Physical Restraint In Older People: A Statement From The Early Career Network Of The International Psychogeriatric Association, Mustafa Atee, Claire V. Burley, Victor A. Ojo, Agboola J. Adigun, Hayoung Lee, Daniel J. Hoyle, Olufisayo Elugbadebo, Tomas Leon

Research outputs 2022 to 2026

The International Psychogeriatric Association (IPA) has expressed significant concerns over the use of physical restraints in older people across diverse aged care settings. Following an extensive analysis of the available literature, the IPA's Early Career Network (ECN) has formulated a collection of evidence-based recommendations aimed at guiding the use of physical restraints within various care contexts and demographic groups. Physical restraints not only infringe upon human rights but also raise significant safety concerns that adversely impact the physical, psychological, social, and functional well-being of older adults. Furthermore, their effectiveness in geriatric settings remains inadequate. Given these considerations, the IPA and …

Impact Of An End-Of-Life Simulation On Nurses’ Attitudes, Self-Confidence, And Communication Skills, Amanda Scofield

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: New graduate nurses (NGNs) often lack exposure to end-of-life (EOL) care. Simulation experiences offer a safe place for learning and reflection. Implementation of an EOL simulation has the potential to increase NGNs attitudes, selfconfidence, and communication skills.
Methods: Forty-one NGNs in a nurse residency program participated in an EOL simulation. Attitudes toward EOL, self-confidence regarding EOL care, and EOL communication were evaluated using a pretest posttest format.
Results: Following the simulation, mean self-confidence scores increased, however the increase was not statistically significant (p = 0.53). Mean scores increased for 1 of 2 categories related to attitude toward EOL, however …

Implementation Of A Non-Pharmacological Cognitive Stimulation Therapeutic Activities Protocol As A Delirium Prevention Method For Adults, Jada Hieb

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background/Purpose: Delirium is a complex clinical syndrome comprising a constellation of symptoms, including acute onset, inattention, altered level of consciousness, and disorganized thinking or cognitive dysfunction. Delirium is a common complication often unrecognized, expensive, and preventable. This project's focus was further exploring non-pharmacological delirium prevention strategies (NDPS).
Methods: A NDPS program using a therapeutic activity book (TAB) was implemented in a Midwestern acute care hospital measuring the impact on the number of positive delirium screens, the number of delirium diagnoses, and hospital length of stay (LOS).
Results: A causative relationship or association between the TAB and outcomes could not be …

Improving Preventive Care Tasks In Adults Aged 50 And Older With Pre- Visit Planning In Primary Care: Review Of Literature, Destinee Rice

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Introduction: Primary care providers are seeing an increased number of elderly patients with several chronic health issues. The time required to address multiple chronic health issues during an appointment impedes timely completion of preventive care tasks. Previsit planning can aid in closing this gap in preventative care by having all necessary information prepared before a patient’s visit.
Evidence Summary: A literature search was conducted in Cumulative Index to Nursing and Allied Health Literature and PubMed using subject headings and MeSH terms. The search was refined to include articles within the last 10 years. Articles were further narrowed down by their …

Implementing The Teach-Back Method On Pessary Utilization In A Urogynecology Clinic, Marissa Eich

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The effectiveness of pessary patient education using the teach-back method and improving nurse confidence and conviction related to pessary use are essential in improving patient outcomes.
/="/">Local Problem: The current limitations in pessary education stem from constraints in nurse availability and workload distribution.
/="/">Methods: The quality improvement initiative involved conducting surveys to evaluate nurse confidence using surveys adapted from the Agency for Healthcare Research and Quality toolkit before the nurse education session, 1 month into the intervention, and at 3 months, when the implementation period ended. These surveys assessed the effectiveness of the teach-back method.
/="/">Intervention: …

Reduction Of Pressure Injury Development In Long-Term Care Residents Using A Pressure Injury Prevention Plan And Communication Alerts, Joseph Osazee

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Accurate communication of changes in residents' skin condition and the provision of appropriate intervention in long-term care is key to ensuring patient safety and well-being through the prevention of pressure injury (PI) development. Effective use of a PI prevention plan and communication tools by certified nursing assistants (CNAs) and nurses can help in this regard.
/="/">Methodology: Thirty-three nursing staff attended an initial I -hour education session on how to identify changes in skin conditions and report them using the as needed (PRN) skin check tool or custom alert tool and implement interventions to prevent PI progression. The Pieper-Zulkowski …

Impact Of Evidence-Based Interventions On Nurse Burnout Among Ambulatory Care Nurses, Haley M. Lupher

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The physical and emotional demands of the nursing profession often cause increased stress and burnout in nurses. If burnout is not addressed, the negative consequences of burnout are perpetuated by one another. Evidence-based interventions, such as meditation, yoga, and physical activity can help reduce nurse burnout.
Local Problem: This project was completed at an ambulatory dermatology clinic that sees approximately 300 patients a day. In recent years, this department has noticed increased nurse turnover and low nurse morale.
Methods: A convenience sample from approximately 30 nurses was utilized. Burnout was measured using the Maslach Burnout Inventory for Medical Personnel …

Nurses' Knowledge, Confidence, And Compliance With An Ambulatory Surgery Discharge Checklist, Heather Van Marion

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Preventable errors in healthcare are fueling the growth of patient safety cultures. Checklists have been found to increase discharge accuracy and efficiency and detection of patient safety concerns before discharge.
Local Problem: Oversight errors can be traced back to poor communication or outdated workflows. Ad hoc communication and knowledge of physician preferences are no longer sufficient for ensuring complete discharge instructions. Methods & Interventions: A discharge checklist was developed and implemented in an ambulatory surgery department to ensure discharge instructions were complete and accurate. Nurses completed a pre and 3-month post-checklist questionnaire assessing their knowledge and confidence in the …