Nursing Commons^™

Improving Handoff Communication In The Emergency Department, Amy Shepherd

Doctor of Nursing Practice Projects

Ineffective handoff communication has been recognized for years as a practice issue and is the most frequently reported cause of sentinel events in U.S. hospitals (Dufault et al., 2010) and responsible, at least in part, for 30% of all malpractice claims (Fucik, 2019). The development of standardized tools has been identified as a key component to improving handover practice. For this project, a standardized SBAR tool was modified for a local emergency department. The intervention was a process change in the emergency department to utilize an SBAR tool during handoff reports. The project was implemented by educating staff on the …

Standardized Daily Family Updates To Improve Patient Satisfaction Scores On A Pulmonary Medical Progressive Care Unit, Quentin Butterfield

Doctor of Nursing Practice Projects

Communication remains one of the most challenging aspects of healthcare. COVID-19 added another layer of communication breakdown in the form of visitor restrictions that limited or removed visitation for hospital-positive patients. Guided by the principles of Jean Watson’s theory of human caring, a literature review was performed to determine best practice evidence related to improvements in communication.

A daily family update form was drafted to guide the nurses of a pulmonary medical progressive care unit in providing standardized daily family updates to improve communication through consistency of information shared. Patients identified family members they would like to receive daily updates …

Improving Communication Skills Of New Graduate Nurses: Using Sbar Format, Meredith Lyanne Parker

Master of Science in Nursing Theses and Projects

New graduate nurses face many challenges as they transition to professional practice (Mongale et al., 2018). Support from transition to practice (TTP) programs can have a tremendous impact on the success of a new graduate nurse and improve retention rates (Silvestre, 2017). Research identifies a gap in new graduate knowledge of communication skills (Song & McCreary, 2020). Education on improving communication using a standard format can impact patient outcomes and improve provider confidence (Marshall et al., 2008). Research also links provider confidence and proficiency to improved outcomes (Owens & Keller, 2018). Benner’s Novice to Expert Theory provides a theoretical foundation …

Trauma Admission Guidelines For Elderly Isolated Orthopedic Injuries, Jessica Lauren Hamrick-Welchel

Master of Science in Nursing Theses and Projects

A rise in complications at a southeastern level one trauma center had the trauma department and performance improvement personnel looking for a cause and a solution. It was determined through data mining that the patient population that was driving certain complication cohorts above acceptable levels was the injured elderly patient admitted by the non-surgical hospitalist group. Patients admitted by this group commonly sustained a single injury, mostly hip fractures. Elderly patients are admitted by this group in efforts of successfully managing the many co-morbidities these patients typically possess with co-management by the orthopedic group to manage the injury. A meeting …

A Multi-Client Simulation To Improve Communication, Prioritization, And Clinical Judgment Among Nursing Students, Adam K. Combs

Doctor of Nursing Practice Projects

Background: Hospital administrators have noted a lack of clinical judgment in novice nurses, which can result in negative client outcomes. This paper describes the implementation of a multi-client simulation experience with the purpose of determining if the experience improved communication, prioritization, and clinical judgment.

Method: A descriptive, pretest postest study, using the National League for Nursing (NLN) Jeffries Simulation Theory, examined the perceived competence of 37 senior level Associate Degree Nursing students.

Intervention: The participants rated their perceived competence on the Perceived Competence Scale and were scored on the ISBAR Interprofessional Communication Rubric (IICR) and the Lasater Clinical Judgment Rubric …

Reducing Nurses' Communication Anxiety During End Of Life Care, Susan Dunbar Wolfrom

Master of Science in Nursing Theses and Projects

End of life (EOL) conversations are meaningful discussions pertaining to the patient’s disease trajectory, symptom management, and the patient’s goals at end of life. End of life care discussions have been associated with many benefits for the patient including: decreased healthcare costs, less aggressive treatments at EOL, and a good death. These sensitive discussions must occur over the course of several interactions or spontaneously in the moment in order to support the patient during delicate moments. This makes the nurse the prime candidate to help facilitate and harbor these discussions. However, barriers to communication exist, leading to the omission of …

Communication Within The Perioperative Department, Leah Quinn

Master of Science in Nursing Theses and Projects

No abstract provided

Implementing Safeplan: A Communication Template For Emergency Nurses Caring For Psychiatric Patients, Michele Leigh Rudisill

Doctor of Nursing Practice Projects

This DNP Project explored the impact of introducing a communication template for emergency department (ED) nurses to use during handoff when caring for psychiatric patients. This need was identified as ED nurses are now caring for psychiatric patients for longer periods of time in the ED setting, sometimes weeks to months, due to limited inpatient mental health resources and resources in the community. ED nurses’ perceptions were surveyed and the need for a standardized, yet flexible communication template was identified. The literature was reviewed, and no such template was identified specific to ED nurses caring for the psychiatric patient population. …

Improving Nurse-Patient Communication Using The Teach-Back Method, Sheila Revis Smallwood

Nursing Theses and Capstone Projects

Effective nursing communication considers health literacy, the person’s ability to understand and make health decisions based on the information given. Health professionals often overestimate the health literacy of patients, thereby affecting patient outcomes. In a hospital environment, patients rate the ability of the nurse to explain things in a way patients understand by completing the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) after discharge. The HCAHPS results are converted to a score which is used in a formula to determine hospital reimbursement; the lower the score, the lower the reimbursement. The purpose of this project was to improve …

Improving Therapeutic Relationships Among Psychiatric Nursing Staff And Adolescent Patients, Carla Kay Cozart

Nursing Theses and Capstone Projects

This Doctor of Nursing Practice Project examined the effect of an evidence-based staff development education program on the attitudes and knowledge levels of nursing staff regarding the mentally ill adolescent patient population, for which they provide treatment and supervision. A convenience sample of 61 nursing staff members participated in the Improving Therapeutic Relationships among Psychiatric Nursing Staff and Patients project, with 74% of the available sample completing all project surveys. Descriptive statistics were used to compare the scores for the responses of participants to the Community Attitudes toward Mentally Ill (CAMI) pre and post-surveys. Concepts scored by this survey included: …

Improving Nurse-To-Nurse Handover Through Implementation Of Standardized Sbar, Russell Coleman

Nursing Theses and Capstone Projects

In today’s health care environment, nurses are faced with caring for an increased number of patients with more complex issues. In caring for these complex patients, communication among nurses becomes an essential piece of patient care. Handover provides nurses the opportunity to share patient information to achieve positive patient outcomes. When poor patient outcomes became linked to poor communication during handover, recommendations for a standardized handover form emerged. Situation, Background, Assessment, and Recommendations (SBAR) is an example of a standardized handover form which provides structure to the handover process and decreases gaps in patient information. The aim of this descriptive …

Patient Safety In The Ambulatory Oncology Environment: A Teamstepps® Journey, Tammi Phelps Hick

Nursing Theses and Capstone Projects

Problem: Children have reported that pain and anxiety were the most difficult part of hospitalization, and under treatment of pain and anxiety can have short and long term effects on health outcomes. Most healthcare professionals recognize a link between emotional health and physical health, but this may be especially true for pediatric patients who may not be able to marshal adequate coping skills due to their developmental age. Providing age appropriate alternatives, such as distraction therapy, may result in less invasive treatments for pediatric patients. Distraction therapy is an effective non-pharmacological intervention that is often under-utilized in the acute care …

Nurse-Physician Collaboration And Satisfaction, Fatima Brewton

Nursing Theses and Capstone Projects

The purpose of the study was to examine the effects of interdisciplinary rounds (IDR) on a neurology medical-surgical inpatient unit. Existing research shows that IDR improves nurse-physician relationships and satisfaction and improves patient outcomes. Using the Collaboration and Satisfaction about Care Decisions (CSACD) tool developed by Baggs, nurse-physician collaboration and satisfaction was measured pre and post implementation of interdisciplinary rounds. Twenty-one nurses and five physicians participated in the study which included education sessions, a two week trial of IDR, and a pre and post survey. Nurses and physicians in this sample perceived a significant increase in collaboration (X = 5.6563, …