Nursing Commons^™

Children In Psychiatric Crises, Elizabeth Mcgarvey, Gabriella Demeo, Jasmine Clark, Carrie Ribbing, Paige Hameister, Sally Hannafon

Nursing Research and EBP Day 2024

Mental illness in children is on the rise and more children are becoming psychiatric boarders while awaiting treatment. Many hospitals lack a separate area to board children in psychiatric crisis who can’t be discharged to home which means that children are housed in the same unit as adult psychiatric patients. This EBP project sought to identify best practices for children experiencing a mental health crisis, but a more thorough review of the literature as well as an evidence synthesis needs to be completed before practice recommendations can be identified.

Decreasing Workplace Violence In Ambulatory Care, Jeanene Case, Christine Cook, Nicole Gemme, Rebecca Hass, Taylor Mikiewicz, Lynn Paladino, Erin Parkinson, Maydelin Reve Padilla, Amanda Thongsirimonghoun, Carolyn Vojtush

Nursing Research and EBP Day 2024

Workplace violence is recognized as a significant public health issue. Staff in ambulatory settings are at high risk for experiencing violence from patients or clinic visitors. Exposure to workplace violence may put staff at risk for depression, chronic fatigue, or poor job satisfaction. Developing a safety plan that incorporates organizational policy, staff training, environmental changes and debriefing may help reduce the risk of workplace violence.

Centralized Triage: Working Together To Improve Patient Safety, Quality And Satisfaction - A Focus On Improving Average Speed To Answer, Maria Larner, Tammy Palamitia, Nora Closser, Heather Waske

Nursing Research and EBP Day 2024

The speed in which triage calls are answered affects patient access to care. After addressing workflows and barriers through huddles and team meetings, this quality improvement project adjusted staff schedules, partnered with Access Coordinators, and utilized the Genesys team to streamline calls and monitor call volume, quality and safety.

Results from these initiatives substantially reduced the average speed to answer for both inbound and outbound queues. The team will continue to monitor the data and capture trends in volume to ensure we sustain the gains.

Improving Incidence Of Hospital Acquired Pressure Injuries, Dena Chapman, Melissa Combs, Heather Lewis, Amanda Spamer, Gracie Young, Hope Van Duyne, Brandon Sproul, Sarah Stripp, Bethany Surline

Nursing Research and EBP Day 2024

Pressure injuries remain a huge concern in both the acute and long term care settings worldwide. It is estimated that nearly 2.5 million people are affected each year by a pressure injury. They contribute to higher costs for care, decrease patient’s quality of life and can increase morbidity and mortality.

This project implemented the use of rounding by both skin care champions and nurse residents for high risk patients, while leadership utilized huddles to reinforce appropriate interventions. Turning and positioning every two hours was endorsed as was daily bathing for patients at high risk for developing pressure injuries.

Family Presence During Resuscitation Efforts, Gabrielle Gavin, Marissa Pecora, Gabrielle Narvaez, Kalpana Rai, Matthew Mendolera, Leanne Coon, Bailey Oldham, Olivia Pino

Nursing Research and EBP Day 2024

Family presence during resuscitation enables family members to be present during the resuscitation efforts of a loved one. The focus of this process is to provide support to the patient and their family, while also providing transparency and trust in the medical process and personnel.

The purpose of this project was to identify the impact on family members of witnessing life saving measures on their loved one.

Roadmap To Address Nursing Recruitment And Retention In Ambulatory Care, Susan Madison, Tiffany Smith

Nursing Research and EBP Day 2024

As hospital stays shorten, ambulatory care must expand to meet the increased patient acuity and need for care. Ambulatory care is the entry point for care delivery and the initiator of disease management and wellness (Ulrich, 2019). The ambulatory care system of Rochester Regional Health includes 400 registered nurses, and 600 licensed practical nurses with a nursing turnover rate of 18.75%.

By leveraging technology and innovation in program development, ambulatory-specific programs have been implemented to target nursing staff recruitment and retention, resulting in a 4% decrease in ambulatory nurse turnover rates.

Nurses Busting Burnout: How Self Care Programs Support Nurse Well-Being, Lenard Fernandez, Marguerite Loughrey, Andrea Cooley, Ashley Dilimone, Mariah Luce, Gabriella Rindell

Nursing Research and EBP Day 2024

Nurses working in acute care suffer from high levels of stress, burnout and turnover. Our question: For acute care nurses, what is the effect of self-care program versus no program on moral resilience? A literature review was conducted and results showed that when education on group-based wellness practices was provided, there was increased job satisfaction, moral resilience, and problem solving ability. There were decreases in feelings of burnout, and improved work/life balance. Some studies demonstrated an increase in patient satisfaction. Within Rochester Regional Health, it may not be too difficult to implement group based programs and coaching services.

12-Hour Shifts: Heaven Or Hell?, Amy Bontrager, Mary Caprio, Lakysha Grant, Seth Kibler, Savanah Wirth, Sarah Reynolds

Nursing Research and EBP Day 2024

In many hospital settings, the 12-hour shift is the standard. While it may be better for continuity of patient care, many studies have looked at the effect it has on nurses as well as patient safety. This project identified themes in the literature and while it couldn’t see a precise path forward, flexible scheduling may be looming just over the horizon.

Nurse Navigation Supports Implementation Of Guideline Based Care, Michelle Ferguson, Uzma Iqbal, Alyssa Pino

Nursing Research and EBP Day 2024

The European Society of Cardiology has developed guidelines aimed at identifying and mitigating risk for cardio-oncology events in oncology patients. Cardiovascular risk factors, cancer type and therapeutic regimen present unique treatment considerations requiring individualized risk assessment. Use of a nurse navigator to initiate triage with pre-visit testing and to coordinate care with the provider ensures patients receive timely treatment.

State Of Science Literature Review: The Effect Nutrition Has On Wound Healing, Alicia M. Grandy

Nursing Research and EBP Day 2024

Objectives:

• State the steps necessary to conduct a comprehensive review of the literature
• Utilize available resources/tools when conducting a literature search

The Effect Of Interruptions In Surgical Counts, Jaidin Degraw, Brooke Gisel

Nursing Research and EBP Day 2024

Retained surgical items can lead to patient frustration and prolonged hospital stays. They remain the top reason for reoperation despite the tools that are used to maintain accurate counts. Minimizing disruptions and distractions in the operating room may be one way to assist circulating nurses in obtaining correct and consistent counts.

Flexible Work Schedules To Promote Leader Wellbeing Ambulatory Care Nursing Leadership, Elizabeth Carreira, Rebecca Hall, Rebecca Dellafave

Nursing Research and EBP Day 2024

Nursing leaders in ambulatory care may experience high levels of work-related stress and dissatisfaction with the number of hours they were working, and this dissatisfaction may result in higher turnover among nursing leadership.

The purpose of this evidence-based practice project was to develop a flexible scheduling option for nursing leaders practicing in ambulatory care at Rochester Regional Health to promote leader wellbeing and role satisfaction.

Results indicated that leadership satisfaction with their role and the amount of time spent working with nursing staff increased. Perceptions of work-life balance improved as did their interprofessional relationships. A decrease in the average number …

Morale Wednesday, Sadie Bonetti, Christen Ballard, Desiree Dixon, Casey Legros, Danielle Pickney, Meghan Camp, Alyson Harp, Jonathan Ferrer, Catie Wood, Melissa Combs, Heather Lewis, Dena Chapman

Nursing Research and EBP Day 2024

Many factors lead to low nurse satisfaction and poor morale. Some of the factors identified in the literature include organizational culture, burnout, staff shortages, and lack of leadership support. Nurses who are not satisfied at work may become less engaged and may be more likely to leave the organization

This project implemented manager rounding, break buddies, staff snack sharing and encouraged intentional recognition of peers.

Teaching Sbirt To Nurses In A Mental Health Setting For Improved Assessment And Management Of Patients With Substance Use Disorders, Kifle Gashie Jikamo

Walden Dissertations and Doctoral Studies

Addressing the knowledge gap is essential in nursing practice, as RNs are the first point of contact for patients in mental health settings where substance use significantly influences overall health and recovery. This Doctor of Nursing Practice project focused on the need for staff education in an inpatient mental health unit regarding the assessment and triage of patients with substance use disorders (SUDs). The guiding question for this project was: “In nurses working within an inpatient mental health setting, does the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) training improve knowledge in assessing, managing, and providing care …

Patient Engagement And Co-Creation In Healthcare Services: A Scoping Review, Thiruppavai Sundaramurthi, Smita Mathews, Ella Bermudez, Satish M. Mahajan

Patient Experience Journal

Objective: The objective of this review was to find literature related to the concepts of patient engagement and co-creation in healthcare services and identify models and/or frameworks that combined these concepts. Methods: We developed the eligibility criteria using the Population-Concept-Context framework applicable to studies with population of patients exploring the concepts of engagement and co-creation in the context of healthcare services. The search was conducted in PubMed, CINAHL, Cochrane, APA PsycINFO, and Ovid MEDLINE. We searched for articles in English with no search limitations on publication dates. Reviewers screened abstracts and full texts to identify articles for data …

An Exploratory Qualitative Study Of Perinatal Experiences In An Acute Setting During Early Phases Of The Covid-19 Pandemic, Sharon Hoosein, Pamela Winchester, Stephanie Babinski, Naomi Smith, Payalben Bhavsar, Susan Law

Patient Experience Journal

The COVID-19 pandemic was highly disruptive for people delivering babies in-hospital and for obstetrical healthcare professionals. The purpose of this study was to explore the experiences of people with or without COVID-19 giving birth in a community-based hospital to provide patient insight to obstetrical care providers regarding the services/policies used during the pandemic. Nine interviews were conducted with participants within six months of giving birth in-hospital – four who tested positive for COVID-19 and five who tested negative. Seven themes were identified in the analysis: conflicting emotions; experiences of COVID-related protocols; altered experiences of pregnancy and birth; other aspects of …

Interactive Educational Program For Purposeful Leader Rounding, Gina Lupi

Walden Dissertations and Doctoral Studies

This education project was to introduce nurse managers to the evidence-based practice of daily purposeful leader rounding on all staff in this acute care facility. The need for practice change was evidenced by low all employee survey and the Survey of Healthcare Experience of Patients (SHEP) results; low retention rates throughout the inpatients units; and an increase of patient safety events in fiscal year 2023. Leadership rounding is an evidence-based practice that increases staff retention by supporting and engaging staff. The purpose of the interactive education was to increase the knowledge and self-confidence of the participants to assist in hardwiring …

Executive Summary: Staff Education Project Staff Education On Early Screening For Diabetes Among Young Black Adults, Frantz Jacob

Walden Dissertations and Doctoral Studies

There are healthcare disparities associated with Type 2 diabetes management in youths, and the condition disproportionately affects racial/ethnic minorities. The gap in practice at the practice site was inconsistent integration of diabetes screening and prevention strategies. The purpose of this project was to develop, implement, and evaluate a staff education program on early screening and prevention of Type 2 diabetes in the young Black community. The practice-focused question centered on whether healthcare staff demonstrated increased knowledge about early screening and prevention for Type 2 diabetes in the young black community. The project occurred at a large family practice clinic in …

Their Stories, Our Testimony: A Narrative Inquiry Into The Remote Teaching Experiences Of Community College Clinical Nurse Educators During The Covid-19 Pandemic, Catherine E. Fenner

Doctor of Education Program Dissertations

This narrative inquiry explored the lived experiences of clinical nurse educators who taught at community colleges during the COVID-19 global pandemic, contributing to the growing body of literature about what nurses endured during the pandemic. The pandemic and the ensuing havoc it caused occurred when the profession faced significant staffing shortages. In the early months of 2020, when the virus was spreading rapidly, many states issued stay-at-home orders requiring nursing programs to pivot to remote learning platforms. Teaching hands-on skills, communication techniques, and time management strategies through virtual and remote pedagogy was a time of confusion for nurse educators, who …

Clinical Practice Guideline For Evidence-Based Patient Appointment Reminders, Rohan Matthews

Walden Dissertations and Doctoral Studies

Clinical practice guidelines (CPGs) are health care interventions used for best care outcomes. With this CPG project, I addressed a practice gap regarding the lack of a systematic approach to patient appointment reminders that resulted in disruption to patient health maintenance in an outpatient community clinic setting. Community and population health are improved with preventative care, wellness, and appropriate health maintenance measures. The practice-focused question central to this CPG was: Will a guideline on patient reminders designed to reduce the frequency of missed appointments in a clinic setting, be approved by a panel of clinical experts for future implementation? The …

Effectiveness Of Clinical Reasoning Reflection Prompts To Develop Clinical Judgment In Prelicensure Nursing Students: A Quasi-Experimental Study, Tiffany Condren

Doctoral Dissertations and Projects

The development of clinical judgment is an important topic in nursing education, and various teaching strategies have been proposed to improve this skill among nursing students and new graduate nurses. However, the effectiveness of these strategies is not well-researched. One promising approach is using higher-order questions to guide and develop the thought patterns of clinical reasoning. One suggested teaching strategy is using clinical reasoning reflection prompts based on Tanner’s Clinical Judgment Model. This study aimed to evaluate the efficacy of using clinical reasoning reflection prompts in the patient care setting to develop clinical judgment among 35 pre-licensure nursing students within …

Decreasing The No-Show Rate In A Mental Health Clinic., Aina Oyibo

Walden Dissertations and Doctoral Studies

The identified practice problem of high no-show rates within a mental health clinic setting creates immense challenges to patient care continuity and clinic efficiency. This issue, in the context of nursing practice, needs resolution for improved patient outcomes and the best possible utilization of clinic resources. The practice-focused question to guide this doctoral project is: Will staff education on the importance of consistent appointment reminders improve knowledge? This project's intervention in staff education concerning the importance of consistent appointment reminders focuses on telephone reminders. A literature search used CINAHL, MEDLINE, PubMed, Google Scholar, and textbooks. All the articles were peer-reviewed …

Quality Of Newborn Care And Associated Factors: An Analysis Of The 2022 Kenya Demographic And Health Survey, John Baptist Asiimwe, Earnest Amwiine, Angella Namulema, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Shamim Nabidda, Imelda Namagembe, Lilian Nuwabaine

School of Nursing & Midwifery, East Africa

Kenya one of the African countries has pledged to reduce neonatal death as per the 2030 World Health Organization target. Providing high-quality newborn care is critical in minimizing neonatal mortality. This study aimed to determine the factors that influence the quality of newborn care in Kenya. Secondary data from 11,863 participants of the 2022 Kenya Demographic and Health Survey (KDHS) were analyzed. The participants were chosen using two-stage stratified sampling. The quality of newborn care was operationalized as receiving all components of newborn care after childbirth, as reported by the mother. Using SPSS (version 29), univariate and multivariable logistic regression …

Staff Education On Service Recovery For New Nurse Leaders, Cara Conley

Walden Dissertations and Doctoral Studies

The goal of this staff education project is to improve nurse leaders’ ability to execute service recovery strategies in a hospital setting. The identified practice problem was the lack of structured education for nurse leaders on service recovery, which impacts their effectiveness in managing patient dissatisfaction, potentially leading to compromised patient safety and organizational performance. The practice-focused question was: In nurse leaders, does the implementation of a service recovery education course significantly improve their knowledge on how to perform service recovery? The purpose of the project was to create and implement a structured education course for nurse leaders with 0–5 …

Evidence-Based Project To Improve Staff’S Knowledge And Attitude Toward Electroconvulsive Therapy, Nicole A. Marshall

Doctoral Dissertations and Projects

Electroconvulsive therapy (ECT) is a safe and effective treatment for depression, bipolar disorder, schizophrenia, catatonia, schizoaffective disorder, and neuroleptic malignant syndrome. Barriers to the use of ECT are misinformation and stigma among healthcare workers and limited access to the treatment. The clinical question for this scholarly project was, “In adult psychiatry and operating room staff at a multisystem hospital located in the mid-Atlantic region of the United States, improve knowledge and attitudes toward ECT?” After a brief educational PowerPoint presentation on ECT with the adult psychiatry and operating room staff, staff knowledge rose from 66% to 72% within the QuAKE …

Improving Student's Hands-On Clinical Experience Through Staff Development, Courtney Eileen Bailey

Doctoral Dissertations and Projects

Precepting students in clinical practice is a widely accepted practice for nursing education. Preceptors are nursing staff on the units working on the days the students come to practice clinical skills. These preceptors typically have minimal to no training in precepting, making them expert clinicians but novice educators. This situation can lead to a lack of knowledge of how to guide students in hands-on clinical skills during the student’s time at clinical. This lack of hands-on skills creates a poor clinical perception for the student and reduces their preparedness for practice. The purpose of this quantitative, quasi-experimental, pretest-posttest, within-subjects design …

Early Mobility And Delirium Prevention For Intensive Care Unit Patients At Kingman Regional Medical Center, Lyndsey R. Lehman Ms, Otr/L

Masters Projects

Over five million patients are admitted to the intensive care unit (ICU) annually in the United States, with 50-70% of those developing debilitating physical, cognitive, and mental health issues. Occupational therapy (OT) is a holistic profession that provides evidence-based interventions to improve ICU patients’ function and participation in daily occupations by addressing early mobility and delirium. A needs assessment performed for the Kingman Regional Medical Center (KRMC) ICU revealed a lack of knowledge about early mobility and delirium prevention among nursing staff, underutilization and limited understanding of OT services, and KRMC-specific barriers impacting patient care. This author designed and implemented …

Streamlining The Discharge Process On The Telemetry Units To Improve Overall Hospital Throughput, Michelle Corder

Walden Dissertations and Doctoral Studies

This evidence-based staff education project was implemented to address the problem of ineffective discharge processes and delayed discharges within the hospital setting that leads to poor patient flow impacting overall hospital throughput. There was an overall lack of knowledge by registered nurses (RNs) on effectively implementing changes that affect a standardized discharge process that could help improve patient flow and hospital throughput. This staff educational project aimed to improve the staff nurses’ knowledge of the standardized discharge process and its impact on hospital throughput. The practice-focused question that guided this project was as follows: “What is the impact of a …

Evaluating The Impact Of Semiglutide On Weight Loss In Overweight Adults, Justina 0. Umweni-Oyiboke

Walden Dissertations and Doctoral Studies

Obesity is a pressing health issue. By 2030, it is estimated that nearly half of all adults in the United States will be obese. This trend has serious consequences for both physical and mental health. Obese individuals face an increased risk of conditions like cardiovascular disease, type 2 diabetes, fatty liver disease, osteoarthritis, and even depression. In this Doctor of Nursing Practice Project, I evaluated the effectiveness of a quality improvement (QI) initiative at the project site that addressed the practice problem of inadequate weight loss management caused by relying solely on diet and exercise as treatment strategies. The QI …

Best Practice Toolkit For Nursing Staff Caring For Ventilated Patients, Erin Belisle

Student Scholarly Projects

Practice Problem: Best practice tool kits are used to guide better outcomes for ventilated patients and staff members. Many reasons can contribute to requiring a patient to be on mechanical ventilation, but the most common reasons are a trauma event and infection.

PICOT: The PICOT question that guided this project was: In critical care staff such as nurses, respiratory therapists (RT), and critical care providers caring for mechanically ventilated patients (P), what is the effect of implementing a best practice coordination toolkit (I) compared to standard care procedures (C) on the adherence to best practices by critical care providers (O)? …