Nursing Commons^™

Beyond Involuntary Movements: A Case Of Diabetic Striatopathy Complicated By Cardiac Arrest, Deepa M

Manipal Journal of Nursing and Health Sciences

Abstract

Diabetic striatopathy (DS) is a rare neurological manifestation of poorly controlled diabetes mellitus, typically characterized by hemichorea–hemiballismus and distinctive basal ganglia abnormalities on neuroimaging. We report the case of a 57-year-old woman with type 2 diabetes mellitus who presented with generalized choreiform and ballistic movements and subsequently developed an in-hospital cardiac arrest. Diagnostic evaluation revealed uncontrolled hyperglycemia (random blood glucose 243 mg/dL; HbA1c 8.3%) without ketosis, with neuroimaging findings consistent with DS. The patient was initially managed in the casualty department and subsequently admitted to a neuro stepdown intensive care unit, where she remained for 10 days. Comprehensive medical, …

Enhancing Engagement In Cardiovascular Risk-Reducing Behaviors Through Motivational Text Messaging (Mtm) In An Underserved Population Of Memphis, Tennessee, Lindsey H. Dao

DNP Projects

Enhancing Engagement in Cardiovascular Risk-Reducing Behaviors Through Motivational Text Messaging (MTM) in an Underserved Population of Memphis, Tennessee

Functional And Traditional Medical Management Of Endometriosis: An Integrative Review, Madison G. Daniels

Senior Honors Theses

Endometriosis, a progressive disease that affects many women worldwide, has been managed primarily through hormonal medication, pain management and surgical intervention. However, there is a growing desire among women to use more natural and holistic methods to control the progression of this disease as well as effectively manage the severe symptoms that accompany it. This integrative review examines the efficacy of functional management as compared to traditional medical management. The pathophysiology of each treatment method and provide statistical evidence as to its efficacy. The progression of the disease, symptom management, and related side effects are all taken into consideration in …

Post-Traumatic Stress Disorder Among Critical Care Nurses Caring For Covid-19 Patients, Marwa Abdo

Nursing

Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, with a substantial number of severe cases requiring admission to isolated intensive care units (ICUs). This unprecedented situation exposed critical care nurses (CCNs) to a highly stressful traumatic environment, placing them at increased risk for developing post-traumatic stress disorder (PTSD). Early identification and intervention for PTSD are crucial to mitigate the negative consequences for nurses' well-being, job performance, and overall quality of life. Aim: This study aimed to assess post-traumatic stress disorder among CCNs caring for COVID-19 patients. Method: A descriptive cross-sectional design with a convenience sample of 109 CCNs …

Delayed Newborn Bathing To Increase Breastfeeding, Nadia Martino, Amanda Bace, Carrie Moneysmith, Mary Brooks, Shelly Wu, Wala Safi

Nurse Residency Posters

Facilitator: Ellie Barte, RN

Reducing Falls In Hospitalized Adults With The Use Of Bed Alarms, Tracy Hock Bsn,Rn, Marzane Hawthorne Rn, Prabesh Acharya Bsn,Rn, Megan Kuck Bsn,Rn, Jonna Hicks Bsn,Rn

Nurse Residency Posters

Facilitator: Megan Sowder

Grant Medical Center

Occupation-Based Activities For Neuroatypical Adults In Inpatient Settings, Kim Miller, Angelina Mills, Latasha Sheets

Nurse Residency Posters

Facilitators: Melissa Harper and Donita Warren

OhioHealth O-Bleness Hospital

Promoting A Culture Of Well-Being On A Nursing Unit, Jayla Campbell Rn, Jessica Detty Rn, Rebekah Krider Rn, Abby Winegardner Rn

Nurse Residency Posters

Facilitator: Ellen Villalobos

OhioHealth Berger Hospital

Implementation Of The Novel Nurse Intuition Patient Deterioration Scale To Assess For A Correlation Among Nurse Intuition And Patients Returning To The Intensive Care Unit, Janie L. Walsh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Adult hospitalized medical and surgical patients at an academic medical center are being transferred out of the Intensive Care Unit (ICU) to the step-down floor and having rapid response calls in less than 48 hours after the transfer. Nurse intuition is not a consideration in the decision to transfer a patient. Physiological variables such as Modified Early Warning Scores (MEWS) and vital signs are relied on heavily as indicators for escalation or de-escalation of care. There is evidence supporting the use of acknowledging nurse intuition to better predict a patient’s readiness for transitions of care.

Purpose: To evaluate the …

Closing Racial And Ethnic Disparity Gaps In Pediatric Asthma Follow Up Care - A Quality Improvement Initiative, Ayodele Ayeko

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Closing racial and ethnic disparity gaps in pediatric asthma follow up care - A quality improvement initiative

Ayodele Ayeko

Introduction/Background: Inadequate management of asthma significantly contributes to poor asthma control, poor quality of life (QOL), and high hospitalization rates among pediatric patients. The Global Initiative for Asthma (GINA) guidelines offer recommendations designed to enhance asthma control and improve the quality of life for those affected (2015), including recommendations for close follow up care. At WVU Medicine Children’s Hospital (WVUMCH), insufficient asthma control has been associated with lower clinic follow-up rates and an increase in hospitalization. Although educational initiatives …

Implementation Of An Evidenced Based Enteral Nutrition Protocol For Mechanically Ventilated Patients: A Quality Improvement Initiative, Hannah R. Nuzum

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementation of an Evidenced Based Enteral Nutrition Protocol for Mechanically Ventilated Patients: A Quality Improvement Initiative.

Hannah Nuzum

Background: Mechanically ventilated patients require supplemental nutrition as an important factor for their overall recovery. Malnutrition in hospitalized patients is reported as high as 35% (Ikram et al., 2022).

Purpose: Lack of an enteral nutrition (EN) protocol has contributed to variability in initiation of EN for post-intubated mechanically ventilated patients.

Intervention: The project interventions are threefold: the development of an EN protocol, EN initiated within 24 to 28 hours for post-intubation patients, and staff understands that EN should be initiated within …

Implementing Noninvasive Capnography Monitoring To Enhance Early Recognition Of Postoperative Respiratory Decline In High-Risk Patients: A Quality Improvement Project, Trevor A. Messenger

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementing Noninvasive Capnography Monitoring to Enhance Early Recognition of Postoperative Respiratory Decline in High-Risk Patients: A Quality Improvement Initiative

Trevor Messenger

Background: Those suffering from chronic respiratory disease, obstructive sleep apnea (OSA), obesity, and other serious comorbidities are at an increased risk of respiratory decline after receiving general anesthesia. Respiratory decline leads to adverse outcomes, including increased hospital length of stay, intensive care unit (ICU) admissions, morbidity, and mortality.

Purpose: To improve the safety of postoperative patients at risk for OSA, and to reduce adverse events and airway interventions by enhancing the monitoring capabilities of bedside clinicians with waveform …

Keep It Quiet: A Quality Improvement Initiative To Reduce Noise In The Operating Room During Anesthesia Induction, Ghislaine Fasseu Kameni

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: Excessive noise during the critical phase of anesthesia induction in operating rooms (OR) can significantly impact anesthesia providers' ability to focus, potentially compromising patient safety and quality of care.

Objectives: This project aimed to reduce anesthesia providers' perception of distraction caused by noise during induction by implementing educational interventions and visual cues. The objectives included educating anesthesia and surgical staff on the impact of noise, introducing visual reminders to minimize distractions, and evaluating the effectiveness of these strategies through survey data collection.

Methods: A quality improvement initiative was conducted in the OR department of a nearby hospital. Certified registered …

Does Education On Aseptic Non-Touch Technique Affect Nurse Knowledge On Aseptic Technique When Placing Ultrasound Guided Peripheral Intravenous Lines? A Quality Improvement Initiative, Hannah G. Keyser

Graduate Theses, Dissertations, and Problem Reports (ETD)

This Doctor of Nursing Practice (DNP) project attempted to increase nurse’s knowledge of aseptic technique when placing USG-PIVs in hospitalized adult patients after educational training on the Aseptic Non-Touch Technique Clinical Practice Framework (ANTT CPF). Implementation of the ANTT CPF in the cardiovascular intensive care unit (CVICU) at Ruby Memorial Hospital, as a didactic educational session for nurses already trained to place ultrasound-guided peripheral intravenous lines, was utilized for this DNP project. Pre- and post-surveys were employed to determine changes in knowledge scores as well as feelings of comfort and knowledge related to the CPF. Results remained stable for survey …

A New Electronic Handoff Tool To Facilitate Patient Transfer From The Or To Sicu: A Quality Improvement Initiative, Kaylan Jean Kerrigan

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Transfer of care is a vulnerable time for patients. Continuity of care depends on good communication from the transferring team to the receiving team. Communication failures contribute to frustration among medical staff and poor patient outcomes. Purpose: The purose of this project was to improve handoff communication and satisfaction between the anesthesia team in the operating room (OR) and the receiving surgical intensive care unit (SICU) nurses. Intervention: A new electronic handoff tool was developed for the Epic electronic health record (EHR) to provide SICU nurses with patient information (name, age, allergies), procedure and diagnosis, intubation status, reversal status, …

Improving Timely Palliative Care Consultation In The Micu: A Nurse-Driven Quality Improvement Initiative, Sandy Louise Gray

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Improving Timely Palliative Care Consultation in the MICU: A Nurse-Driven Quality Improvement Initiative

Sandy L Gray

Background: Early palliative care in intensive care units improves outcomes and reduces costs, yet referrals are often delayed. At J.W. Ruby Memorial Hospital’s medical intensive care unit (MICU), baseline median time to consultation was 112 hours (mean=246), exceeding recommended benchmarks and highlighting the need for a standardized process.

Purpose: This quality improvement project evaluated a nurse-driven screening tool to improve timeliness and consistency of palliative care consultations in the MICU.

Intervention: The tool was embedded in the electronic health record (EHR) …

Still Faces, Different Places: An Assessment Of The Literature On The Face-To-Face Still Face Procedure For Cultural Congruence, Merilyn Arikkat, Leslie B. Lantz, Patricia Kinser

Undergraduate Research Posters

Cultural understanding is a factor that impacts reliability of research results for observational studies. It is important to include participants of minority groups in research, as many people of color face disproportionate challenges in terms of healthcare access and resources. Within the context of mother-infant attachment, a technique known as the Face-to-Face Still Face procedure can be utilized to observe attachment styles and the bond between a parent and their infant. In order to combat subjectivity within the coding process for this Face-to-Face Still Face procedure, cultural congruence between the participants being observed in the study and the coding researchers …

A Quality Improvement Project To Assess The Impact Of A Patient Acuity Tool On Nurse Satisfaction In Equitable Patient Assignments In Nurse Workload And Perceived Quality Care Provided, Claire Alexandra Rodgers

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Traditional nursing staffing models used to create patient-care assignments do not account for patient acuity. As patient acuity increases, nurse workload increases. When patient-care assignments do not account for acuity, nurses are unable to provide quality care to patients. Utilizing a patient acuity tool (PAT) has been shown to improve nurse satisfaction and equity in assignments while also enhancing the ability for nurses to provide quality care.

Purpose: The project aims to assess the impact of a PAT to improve nurse satisfaction in equitable patient assignments based on nurse workload and perception of quality of care provided to patients …

An Evidence-Based Practice Initiative To Improve Blood Pressure Control, Teresa D. Hines

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: High blood pressure (HBP) is a significant public health concern. It affects millions of adults in the United States (US) and half of the adult population in the Appalachia regions. High blood pressure is a known risk factor for cardiovascular disease (CVD), which is the leading cause of morbidity and mortality Appalachia. Complications associated with high blood pressure result in substantial economic burdens for patients and their families, healthcare systems, and national economies. High blood pressure is a significant health issue in West Virginia (WV), with an estimated 602,000 people suffering from HBP.

Purpose: The purpose of this …

Accessing Facility Electronic Health Record For Payer Utilization Review Review, Betsey Denton

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this project was to improve the prior authorization process for payer, provider, and patients by reducing the number of medical necessity denials, peer-to-peer calls, appeals, and increasing payer and provider satisfaction.

BACKGROUND A literature review indicated opportunities for improvement in prior authorization processes. Medical necessity denials are issued by payer if clinical documentation is not available for review. Implementation setting was a large academic medical center. Studied populations included patients who are members of a large Medicaid HMO health plan, payer utilization review registered nurses (RN), and hospital utilization review staff. METHODOLOGY Payer RNs began utilizing …

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

To Be Soft Again: A Phenomenological Study Of Uncertainty And Resilience In Childbearing During The Covid-19 Pandemic, Marcianna Nosek

Nursing and Health Professions Faculty Research and Publications

Background:

During the COVID-19 pandemic, uncertainty was exacerbated in experiences of pregnancy and childbirth as people navigated through uncharted territory. Building resilience may be one effective way to cope. However, for those who carry a heavier burden in upholding others, a societal expectation of “toughness” and the ability to endure may lead to an appearance of resilience, while on the inside, well-being may be compromised.

Objectives:

This study is part of a larger phenomenological study that explored the broad research question: What is the lived experience of childbearing during the COVID-19 pandemic? Specific themes of uncertainty and resilience are reported …

Application Of Root Cause Analysis For Fall Prevention: A Quality Improvement Initiative For Older Adults In A Skilled Nursing And Long-Term Care Facility, Terrence Ranjo

Doctoral Projects

Falls in older adults are common and often have severe outcomes. They are the leading cause of fatal and non-fatal injuries among people aged 65 and older and continue to increase. Half of residents in nursing facilities fall annually, and one in every ten falls will lead to a severe injury. Federal regulations like the Centers for Medicare and Medicaid Services require long-term care (LTC) facilities to incorporate quality assurance performance improvement initiatives to address identified quality concerns in LTC facilities. Root cause analysis (RCA) can help clinicians identify several root causes of falls and guide clinicians in developing personalized …

Exploring Gaps In Hiv Prevention: Hiv Pre-Exposure Prophylaxis Awareness, Attitudes, Utilization, Coverage, Hiv Testing And Risk Perception Among Sub-Saharan African College Students In The United States, Ikenna Obasi Odii

All ETDs from UAB

This dissertation focuses on increasing HIV awareness and contributing to efforts at reducing new HIV infections among Sub-Saharan African (SSA) college students. It begins with an introductory chapter one and ends in the concluding chapter five. Chapter two presents a systematic review identifying key gaps in HIV Pre-Exposure Prophylaxis (PrEP) knowledge, attitudes, and utilization among Black college students in the United States (U.S). The review synthesizes findings from four studies, revealing that a third of participants demonstrated adequate PrEP knowledge, while PrEP utilization remained under-utilized at three percent. Key barriers to PrEP uptake included fear, low self-perceived HIV risk, infrequent …

Everyday Decision-Making Involvement Among Hispanic & Latinx Dementia Caregivers And Its Associations With Daily Anxiety And Daily Depressive Symptoms, Abigail Poe

All ETDs from UAB

Background: Hispanic and Latinx (H&L) caregivers of individuals living with Alzheimer’s disease and related dementias (ADRD) experience elevated caregiving burden and poorer mental health outcomes compared to caregivers from other racial and ethnic groups. Limited research has examined H&L caregivers’ involvement in everyday decision-making for persons living with dementia (PLWD), particularly how this involvement may relate to daily mental health symptoms such as anxiety and depression. Purpose: This study examined baseline decision-making involvement (DMI), its associations with individual-level factors, and its relationship with daily anxiety and depressive symptoms in H&L ADRD caregivers. Methods: A secondary analysis was conducted using data …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Determining Space Requirements For Small And Sick Newborns And Their Mothers In Health Facilities: A Systematic Review, Natalie Strobel, Georgia Whisson, Derek Swe, Rajesh Mehta, Amy Budrikis, Karen Edmond

Research outputs 2022 to 2026

Background There are currently no World Health Organization and United Nations Children Fund benchmarks or ‘norms’ for scaling up small and sick newborn (SSN) service delivery in health facilities in low- and middle-income countries (LMICs). Specifically, there is limited evidence on optimal bed space requirements in SSN units such as special care nurseries and neonatal intensive care units (NICUs). Through this systematic review, we aimed to gather evidence on the optimal space requirements needed for SSNs and their mothers in health facilities, particularly at level 2 district hospitals. Methods We included simulation, experimental, and observational studies, as well as guidelines …

Determinants Of Short Interpregnancy Intervals In High-Income Countries: A Systematic Review, J. Dunne, D. Foo, J. Jancey, G. Pereira, B. Kefale, D. G. Belay, G. Dhamrait, A. T. Gebremedhin, K. B. Mruts, S. D. Nyadanu, A. Roy, G. A. Tessema

Research outputs 2022 to 2026

Short interpregnancy intervals (IPIs) of <6–18 months are associated with adverse maternal and child outcomes. This study aimed to identify the individual, relationship, community, and societal factors that influence short IPIs in high-income countries. A comprehensive search was undertaken in CINAHL Plus, Ovid/EMBASE, Ovid/MEDLINE, Ovid/PsycINFO, ProQuest, PubMed, Scopus, Web of Science, and Google Scholar for articles published in English from 1st January 1990 to 26th October 2023. Studies were included if they reported an effect estimate of at least one determinant of pregnancy spacing in a high-income country. The quality of the included studies was assessed using the Johanna Briggs Institute Critical Appraisal Tool and Cochrane Risk Assessment Tool. Multi-level factors at the individual, relationship, community, and societal level were systematically identified through the socio-ecological model. This study is registered with PROSPERO (CRD42020176311). Of 2005 unique articles, 220 were identified for full-text review, and 55 met the inclusion criteria representing a total of 27,103,055 women from 13 high-income countries. All the included studies were deemed to be of moderate to high quality. Most of the studies reported determinants of short IPI at the individual level, with non-use of contraception the most common reported factor. Peer influence was a factor at the relationship level, and access to health care and reproductive services were impactful at the community and societal levels, respectively. Future research and efforts should support the development and implementation of policies and practices that support optimum pregnancy spacing from a comprehensive socio-ecological position.

Estimating The Number Of Hospital Beds For The Care Of Sick And Small Newborns: An Evidence-Based Systematic Approach, Bireshwar Sinha, Mohan Kumar, Deena Thomas, Natalie Strobel, Gagan Gupta, Karen Edmond, M. Jeeva Sankar

Research outputs 2022 to 2026

Background Current recommendations for neonatal bed requirements are largely assumption-based rather than data-driven. We aimed to estimate the number of beds per 1000 live births needed for the care of small and sick newborns. Methods We first extracted data from studies published between 2018 and May 2023. Then, due to considerable heterogeneity in the data, we performed a meta-analysis using a random effects model to estimate the number of neonatal admissions and the length of stay. We divided the total patient days (admission rate multiplied by the length of stay) by 365 to estimate the annual number of beds per …

Integration Of Virtual Simulation Within A Nursing Curriculum: A Mixed Methods Study, Martina Costello, Hugh Davies, Fiona Williams, Michelle Gay, Jennifer Jennings, Joyce Muge-Sugutt, Olivia Gallagher

Research outputs 2022 to 2026

Background: Virtual simulation is a valuable learning tool for health professionals to facilitate knowledge, skills, and confidence. Simulation-based learning in Nursing has increased with advances in digital technologies, embedding diverse virtual modalities. The integration of virtual simulations requires careful consideration of pedagogical approaches and implementation strategies. The vSim® for Nursing platform was integrated into the curriculum of an undergraduate nursing program at an Australian university to enhance clinical learning experiences. Aim: To evaluate the implementation of the vSim® for Nursing learning platform within the second-year curriculum. Methods: A mixed-methods cross-sectional survey design was used, guided by Kirkpatrick's training evaluation model. …