Nursing Commons^™

Reducing Hapi On A Medical Surgical Telemetry Unit, Emily Nicole Johansen

Master's Projects and Capstones

Abstract

Problem: Hospital-acquired pressure injuries (HAPI) are a global issue that harms patients, prolongs lengths of stay, and increases hospital costs and financial burdens. Because HAPIs are preventable, hospital organizations worldwide are implementing prevention strategies to improve the quality of care and quality of life and decrease costs associated with them.

Context: The 24-bed medical-surgical telemetry unit is one of five adult inpatient units within a Northern California hospital. The patient population includes an increased number of patients who are at risk of HAPI. The unit struggles with HAPI prevention, and the staff is challenged with implementing proper HAPI prevention …

Improving Patient Care Experience By Increasing Medication Communication, Honey Varghese

Master's Projects and Capstones

Background: Patient [DA1] care experiences profoundly impact a hospital's competitiveness and financial viability. Effective communication about medications and their potential side effects is not just a communication strategy but a powerful tool that signifies safe patient care, leads to improved health outcomes, improves medication compliance, and reduces readmissions related to medication side effects and non-compliance.

Problem: Effective communication about medications and their potential side effects is a significant indicator of safe patient care and improved health outcomes. The cardiac telemetry unit of a medical center in Northern California has not met the regional benchmark related to medication communication.

Context: The …

Promoting Awareness In Nurses: Developing Culturally Competent Hair Care Education To Eliminate The Equity Gap For Bipoc Children In Inpatient Settings, Sharlene S. Lansiquot

Doctor of Nursing Practice Projects

Problem

A survey that was administered to staff members on nine units at a pediatric hospital assessing their awareness of hair care for Black, Indigenous, and people of color (BIPOC) indicated a lack of awareness. This impacts the fundamentals of nursing care, which encompasses cultural sensitivity and promoting health equity. In this survey, 12.18% (n=52) of the 427 patients on the nine participating units between December 12, 2023, and January 19, 2024, identified as BIPOC. Although this was the case, the survey sent out on December 12, 2023, to staff members on nine units which included 491 nurses, with 104 …

Medical Assistants Adherence To The Jnc-8 Guidelines In A Primary Care Clinic, Mary Jacob

Doctor of Nursing Practice Projects

Hypertension (HTN) is currently one of the most common diseases that is underdiagnosed and under-treated in the primary care setting. The identified gap in practice is that medical assistants need to gain knowledge of the current JNC-8 HTN guidelines and, therefore, do not apply the JNC-8 guidelines to patient management. This project aimed to educate medical assistants in a primary care clinic on the Joint National Committee 8 (JNC-8) guidelines to improve their HTN management knowledge over four weeks. The social cognitive theory and Kurt Lewin’s change management theory guided the project. The project adopted a quantitative, quasi-experimental design whereby …

Enhancing Discharge Process For Home Iv Milrinone Patients With Advanced Heart Failure, Kaitlyn Bauer

Doctor of Nursing Practice Final Project Abstract

Purpose: Discharge processes for patients with heart failure on home intravenous inotrope support is fraught with barriers and complexities, and causes patients, caregivers, and bedside nurses’ high levels of stress leading to potentially unsafe, complicated discharges. This project aimed to decrease discharge times and improve nurses’ ability to safely and effectively discharge patients.

Background: The project was implemented in a 42-bed advanced heart failure IMU in the Texas Medical Center, where discharge times were longer than hospital standards at over 6 hours.

Methodology: Using elements of the Transition of Care Model, a discharge checklist was created to help staff prepare …

It Was Difficult To Understand The System: Developing A Coordinator Role To Support International Nursing Students- A Qualitative Study, Nick Gibson, Amanda Graf, Tania Beament, Neil Ferguson, Esther Adama, Deborah Kirk, Joyce Muge-Sugutt, Kylie Mccullough

Research outputs 2022 to 2026

International students are an important component of the host country and universities bringing economic, social, and community contributions. International students are the most vulnerable students with challenges related to academic expectations, language proficiency, and socio-cultural integration. This study explores the challenges of international students in a Western Australian School of Nursing and Midwifery. An exploratory questionnaire (n=10), three focus groups (n=15) and a quality improvement survey (n=80) informed this study. Four themes emerged: stress in the first weeks, incorrect and/or late enrolments, lack of guidance and support, and system navigation nightmares. Other issues included: accommodation, culture shock, financial concerns, information …

Increasing Breast Cancer Screening Rates Among Women Ages 40 To 74 In An Urban Safety Net Primary Care Clinic: A Quality Improvement Project, Wilder Pinnock

Doctor of Nursing Practice Scholarly Projects

Background and Problem Description: Breast cancer continues to be the most common and second most lethal form of cancer among women in the U.S. Although there have been improvements in breast cancer screening in the US, major disparities persist. The national breast cancer screening rate for the year 2021 was 75.6%; the rate for the underserved and minority population was 54%. This QI project took place at a Federally Qualified Health Center that provides medical care to medically underserved and vulnerable populations.

Purpose and Aim: This project aimed to increase breast cancer screening at the proposed site to optimize early …

Thoughts From The Frontline - August 2024, Tennessee Center For Nursing Advancement, East Tennessee State University

Thoughts from the Frontline Newsletter

No abstract provided.

A Bundle Of Care For Prevention, Early Recognition, And Treatment Of Hyaluronic Acid Dermal Filler Associated Vascular Occlusion, Genny Sanders

Doctor of Nursing Practice Papers

Background: Hyaluronic acid (HA) dermal fillers, an injectable used for cosmetic use, are gaining popularity, and are expected to continue to do so in the projected future. With the rise in the number of patients seeking these procedures there is a correlated rise is adverse events, including the complication of vascular occlusion. Vascular occlusion has the potential for detrimental outcomes, and clinicians performing these procedures are responsible for educating patients about these risks. As whole, the healthcare community must be prepared.

Purpose: A quality improvement (QI) project was created to help clinicians prepare, prevent, recognize, and treat hyaluronic acid dermal …

Implementation Of An Evidence-Based Intervention To Improve Human Papillomavirus (Hpv) Vaccination Rates Of Children Newly Admitted To A Residential Facility., Krista Danielle Fitzgerald

Doctor of Nursing Practice Papers

Background: The Centers for Disease Control and Prevention (CDC) estimates that more than 42 million Americans are presently infected with the Human Papillomavirus (HPV). The nurse practitioner (NP), who provided primary care to children at the residential facility, reported that only 60-70% of children were consented for HPV vaccination.

Purpose: The purpose of this evidence-based intervention was to have 90% of newly admitted children consented and vaccinated for HPV. The specific aims of this project were to (1) increase staff HPV/HPV vaccine knowledge, (2) implement an updated evidence-based consent form, and (3) increase the HPV consent and vaccination rates.

Methods: …

Smoke Evacuation In The Operating Room, Meghan Holley, Mckenzie Moon

Nurse Residency

In perioperative staff, does mandating the use of smoke evacuation in the surgical setting compared to no smoke evacuation decrease the amount of exposure to toxic byproducts found in surgical plume for each surgical case?

Faculty Attitudes Toward The Preparation Of Baccalaureate Nursing Students For Practice In Hospital And Non-Hospital Settings, Lisa Radley

Dissertations

The ongoing nursing shortage worsened in recent years following the COVID-19 pandemic, has resulted in increasing concerns about future deficits in the nursing workforce. Many nurses are approaching retirement age at a time when the overall demand for healthcare services is expected to increase. Changes in nursing education have been recommended to ensure that the next generation of nurses are willing and prepared to meet the needs of an ageing population. Nursing faculty will have important roles in the education and mentoring of students to prepare them to care for diverse populations in a variety of practice settings. Understanding faculty …

Covid-19 Lockdowns: A Catalyst For Rethinking Assessments In Skill-Based Nursing Courses, Zeenar Salim, Anil Khamis, Shanaz Cassum, Zohra Kurji, Pammla Petrucka

Book Chapters / Conference Papers

No abstract provided.

Global Management Of Serious Bacterial Infections In Young Infants Aged 0 To 59 Days: An Overview Of Systematic Reviews, Karen M. Edmond, Georgia R. Whisson, Derek C. Swe, Natalie A. Strobel

Research outputs 2022 to 2026

BACKGROUND: To inform World Health Organization guidelines for the management of serious bacterial infection (SBI) (suspected or confirmed sepsis, pneumonia, or meningitis) in infants aged 0–59 days. OBJECTIVE: To conduct an “overview of systematic reviews” to: (1) understand which systematic reviews have examined diagnosis and management of SBI in infants aged 0–59 days in the last 5 years; and (2) assess if the reviews examined PICOs (population, intervention, comparator, outcomes) and regimens currently being recommended in low and middle income countries (LMICs) by the World Health Organization. DATA SOURCES: MEDLINE; Embase; Cochrane Library; Epistemonikos; PROSPERO. STUDY SELECTION: Systematic reviews of …

A Survey Of Students’ Experiences Of Returning To Midwifery Studies After Maternity Leave: A Pilot Survey, Liz Mcneill, Elaine Jefford, Michelle Gray, Dianne Bloxsome, Terri Downer, Jessie Johnson-Cash, Lyn Ebert

Research outputs 2022 to 2026

Aim: To identify the barriers and facilitators having an impact on the progression and completion of studies for students who give birth during their midwifery program. Background: Balancing the demands of pregnancy and new motherhood with the rigorous academic requirements of a tertiary-level midwifery program is challenging for students wishing to progress and complete their studies. Understanding the barriers and facilitators students face when resuming midwifery studies following birth can assist universities in providing educational environments that support students in achieving their midwifery education. Design: Social media online Qualtrics survey with closed and open questions. Method: Participants were Australian midwifery …

Delirium Prevention And Management In An Adult Intensive Care Unit Through Evidence-Based Nonpharmacological Interventions: A Scoping Review, Gideon U. Johnson, Amanda Towell-Barnard, Christopher Mclean, Beverley Ewens

Research outputs 2022 to 2026

Objective: To map and review current literature to describe evidence-based nonpharmacological interventions for delirium prevention and management in adult critically ill patients. Introduction: Previous research has demonstrated the efficacy of nonpharmacological interventions for intensive care unit (ICU) delirium; however, the heterogeneity and complexity of these interventions make it challenging to disseminate and integrate into clinical practice. Design: This scoping review follows the Joanna Briggs Institute (JBI) Protocol Guidelines. Data sources: Cumulative Index of Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, PsycINFO, JBI, ProQuest, and Excerpta Medica databases were searched until August 2023. Review methods: Double …

The Lived Experience Of Midwives’ Transitioning From A Clinical Role Into Teaching In Higher Education In One Jurisdiction Of Australia: A Pilot Study, Michelle Gray, Annie De Leo, Melanie Baker, Elaine Jefford

Research outputs 2022 to 2026

Aim: The aim of this pilot study was to explore clinician's experience of transitioning from midwifery clinical practice into university in an academic teaching role within one jurisdiction in Australia. Background: There is a dire shortage of midwifery academics globally. In Australia the shortage is symbiotic with the persistent deficit in the midwifery clinical workforce, which is the predominant recruitment pool for universities. The midwifery workforce cannot be replenished without sufficient academics to provide education. Design: Phenomenology was selected as the most appropriate research approach for the study seeking to illuminate the lived experiences of clinicians as they transition into …

Drawing Blood From A Peripheral Intravenous Cannula And Its Effect On Cannula Dwell Time, Phlebitis, And Bloodstream Infection: A Randomised Controlled Study, Hugh Davies, Alycia Jacob, Lea Aboo, Linda Coventry, Elisabeth Jacob

Research outputs 2022 to 2026

Background: Routine blood sampling can be conducted using venepuncture, inserting a new peripheral intravenous cannula (PIVC), or utilising an existing one. The practice of blood sampling from a cannula requires handling and movement of the cannula bung. It is discouraged due to safety concerns linked to increased risk of phlebitis, infection, or reduced dwell time. Aim: To assess cannula dwell time, the prevalence of phlebitis, and bloodstream infection when using a PIVC compared with venepuncture for blood sampling. Design: A randomised controlled study. Reporting followed CONSORT recommendations. Methods: Adult patients admitted to the emergency department whose health condition required a …

Investigating Nature-Based Mindfulness In Nurse Anesthesia Students: A Pilot Study, Douglas Lovern

Dissertations

Across the country, the mental health crisis continues to rage. Varying degrees of depression, stress, and anxiety are commonly found in college-age students. The COVID-19 pandemic augmented this crisis, but the pandemic is not the sole culprit for the escalation of mental health disorders in the United States. Students across the globe suffer mental health disorders that include depression, anxiety, and stress. Research has shown that graduate students are six times more likely to develop anxiety and depression than the general population. Student registered nurse anesthetists (SRNAs) are vulnerable to mental health disorders. SRNAs enter labor-intensive doctoral programs fraught with …

Collegiality And Job Satisfaction Among Nurse Faculty, Kelsey Phillips

Doctor of Nursing Practice Projects

Nurse faculty turnover has been attributed to low levels of support, low wages, long work hours, uncertainty, and an unpleasant work environment. Leaders must find interventions that will impact the collegiality of nurse faculty, the perceived level of support from leadership, and in result retain their faculty. Purpose: Based on a literature review, this quality improvement project aims to determine if implementing a monthly catered lunch promotes collegiality and improves job satisfaction for nursing faculty in a community college in East Texas. Methods: To determine the impact of monthly catered lunches, a pre-and post-intervention tool [Perceived Organizational Support (POS)] will …

Implementation Of Synchronous And Asynchronous Car-T Education For Emergency Room And Intensive Care Unit Nurses In Non-Oncology Units, Kylie Kuck

Doctor of Nursing Practice Scholarly Projects

Background: Chimeric antigen receptor T cell (CAR-T) therapy is a novel and promising cancer treatment for hematologic malignancies. This treatment is highly regulated by the Food and Drug Administration (FDA) and The Foundation for the Accreditation of Cellular Therapy (FACT) because of the known toxicities associated with treatment.

Local problem: In 2022, FACT published guidelines requiring formal education for both oncology and non-oncology nurses who care for these patients, including emergency room and intensive care unit nurses.

Methods: This quality improvement project provided education to emergency room and intensive care unit care nurses who are caring for CAR-T cell therapy …

Peer Mentorship’S Effect On Nursing Students’ Perceived Stress, Collaboration, And Overall Well-Being, Brooklyn Loxtercamp

DNP Projects

Peer mentorship has proven benefits for undergraduate nursing students, such as improving a sense of belonging and teamwork, improving relationships, helping foster student-directed learning, improving leadership skills, and providing another layer of support for students (Andersen & Watkins, 2018). Because of these notable benefits, this project aimed to extend the work of these researchers to create a sustainable peer mentorship program at one Midwestern nursing program to decrease perceived levels of stress, increase collaboration, and improve students’ overall well-being. Participants (n=58) were recruited from the undergraduate nursing program and consent was obtained. The intervention included a month-by-month toolkit for mentors …

Supporting Nursing Care Transition For Late Preterm Infants From Nicu To The Level 1 Nursery, Megan R. Deans

DNP Projects

Late preterm births are increasing each year due to increasing rates of IVF, multiple births, and advancing maternal age (Visruthan et al., 2015). This group has been traditionally cared for in the NICU, but facilities may consider transitioning this care to the level 1 nursery due to the relative physiologic stability of this population (Visruthan et al., 2015). The transition, without appropriate planning, creates a potential for inconsistencies in caring for the diverse needs of 35.0-35.6 week late preterm infants (LPIs), including variations in education provided to parents and care of the LPI (Visruthan et al., 2015). This project aimed …

Environmental Factors (Rurality, Distribution Of Prescribers, And Altitude) Of People Who Died By Suicide In Montana, 2013- 2022, Anne N. Brown

Electronic Theses and Dissertations

Introduction: Suicide is increasingly prevalent in rural areas across the United States, especially in the western Rocky Mountain states. The connection between suicide and rural residency is not well understood, nor is the relationship between the distribution of prescribers, altitude, and suicide. Purpose: This retrospective quantitative study aimed to describe the characteristics of individuals who died by suicide in Montana and investigate the associations among rurality, distribution of prescribers, altitude, and suicide rate. Methods: Montana suicide mortality data for 2013-22 was used to describe individual characteristics. A second dataset was created for each Zip Code Tabulation Area (ZCTA) level in …

A Quality Improvement Project On The Evaluation Of A Community Gastroenterology Advanced Practice Providers’ Update On The Utilization Of The American College Of Gastroenterology (Acg) Recommendation For Annual Depression Screening In Patients With Inflammatory Bowel Disease, Yolanda Levy Dnp, Fnp-Bc

All Dissertations

Inflammatory bowel disease (IBD) is an autoimmune disease that can result in chronic inflammation in the gastrointestinal tract (Farbod et al., 2021). The two most common types of IBD are called Crohn’s disease and Ulcerative Colitis. There have been several studies that have shown how the psychological disorders, including depression, can be associated with flares of IBD (Farraye et al., 2017). The American College of Gastroenterology (ACG) published clinical practice guidelines in 2017, which recommended gastroenterology (GI) healthcare providers screen for depression in all patients with IBD at least once annually (Farraye et al., 2017). This quality improvement did show …

A Descriptive Study: Aging In Place In The Rural Southeastern United States, Dama G. Cooley

Electronic Theses and Dissertations

Older Americans will soon outnumber children and younger adults. In 2022, there were 58 million older adults. By 2050, older adult numbers will grow to 82 million, and by 2060, 100 million. The National Institute on Aging calls for ongoing research on the impact that a historically large aging population will have on health, well-being, and quality of life. A key concern is how to meet needs while decreasing costs associated with institutional long-term care.

Most of these elders reside in the community and wish to live in their homes throughout their lives, but they will experience an increased need …

Women's Experience Of Cancer Treatment During Covid-19 On The Texas-Mexico Border, Kayla E. Castañeda

Nursing Theses and Dissertations

The COVID-19 pandemic exposed existing racial, ethnic, socioeconomic, geographic, and gender disparities in cancer care and highlighted the need for more research in understudied populations. No studies have elucidated the experience of women living on the Texas-Mexico border receiving cancer treatment during the pandemic. This study explored the lived experience of receiving cancer treatment during the COVID-19 pandemic in 2020 for women living on the Texas-Mexico border and identified participants' self-identified unmet needs while receiving cancer treatment during the COVID-19 pandemic on the Texas-Mexico border. Following IRB approval and informed consent, ten women living on the Texas-Mexico border who received …

Exploring The Relationship Of The Noncognitive Variables Of Grit And Mindset In Baccalaureate Nursing Students And Their Impact On Academic Success, Alecia Hollis

Dissertations

The study aimed to evaluate how the noncognitive variables of grit and mindset could impact the academic success of baccalaureate nursing students. With the present and growing shortage of nurses, attrition within nursing programs is cause for concern. Attrition is a multifaceted problem; however, academic failure is one contributing factor. While cognitive factors, such as the standardized aptitude test (SAT), pre-nursing science GPA, pre-nursing GPA, and standardized entrance exams (Al-Alawi et al., 2020; Chisholm-Burns et al., 2021), have traditionally been used for admission criteria, increasing evidence suggests that noncognitive factors, like grit and mindset, play a crucial role in academic …

Unlocking Icu Barriers: Investigating The Challenges Of Early Progressive Mobility, Leslie S. Bigler

Doctoral Projects

Approximately 800,000 patients in the United States annually are admitted to the Intensive Care Unit (ICU) due to critical illnesses and prolonged immobility contributes to poor patient outcomes. While existing data demonstrates early and progressive mobility helps improve outcomes, adherence remains inconsistent for a variety of reasons such as safety concerns, staffing, and lack of knowledge and confidence of mobilization techniques. This quality improvement project, conducted in a 20-bed Medical Intensive Care Unit, asked staff to identify barriers to adherence to mobility protocols. Nurse managers and clinical educators play a crucial role in addressing these issues using strategies such as …

Quality Improvement Project: Fall Prevention Among Older Adults In Snf Through Staff Education And Hourly Rounding, Reshmi Abraham

Doctor of Nursing Practice Projects

Falls among elderly individuals in Skilled Nursing Facilities (SNF) pose a widespread and significant healthcare challenge, often resulting in severe injuries, reduced quality of life, and increased healthcare expenses. Despite the current efforts to prevent falls, they still occur frequently, underscoring the importance of effective interventions for prevention. This Doctor of Nursing Practice (DNP) project focuses on quality improvement (QI) in healthcare. It aims to reduce fall rates among older adults in SNF by providing staff education and implementing scheduled hourly rounding. This approach aligns with existing research, emphasizing the importance of proactive patient monitoring and improved staff knowledge in …