Nursing Commons^™

Improving Emergency Department Nurses Communication Self-Efficacy With Underrepresented Populations Through Cultural Humility Training, Nikki L. Graham

Doctor of Nursing Practice Projects

Problem Description: The chasm of health inequality for underrepresented populations in the United States is growing, despite advances in healthcare and increased life expectancy. Disparities span the age and healthcare continuum for underrepresented populations, with increased mortality and morbidity rates in nearly every category. Non-white residents in Cook County face the same challenges. Historical lack of trust creates a reluctance to seek healthcare among Black populations, but when they do, they are disproportionately dissatisfied with their care, receive less aggressive treatment, and report higher levels of uncontrolled pain. Nurses, as the largest body of healthcare professionals, are uniquely positioned …

Improving The Culture Of Patient And Family-Centered Partnerships: A Quality Improvement Project, Nicole S. Ardres

Doctor of Nursing Practice Projects

Problem Description: In 2020, the coronavirus (COVID-19) impacted the world, changing the landscape of the nursing profession. The pandemic changed societal norms to reduce transmission and death rates by instituting social distancing requirements, stay-at-home policies, and mask mandates. Hospitals enacted crisis standards of care, changed orientation and training practices, and restricted family visitation policies. In addition, nursing programs temporarily halted in-person clinical training experiences and transitioned to online learning. These were challenging times to enter the nursing profession. The pandemic worsened the nursing shortage, contributing to burnout, turnover, and increased use of agency or travel nurses, resulting in a loss …

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 …

Utilization Of Staff Education To Improve The Management Of Aggression And Violence In The Rural Inpatient Psychiatric Setting, Clara Ugwuibe-Ogunseye

Doctor of Nursing Practice Projects

Background: Workplace violence (WPV) is a global concern and an occupational hazard faced by healthcare professionals worldwide. Aggression and violence can result in serious injury to the patient, healthcare professional, other patients, or visitors and cause stress to healthcare workers, and increase work absences (Picot, 2021).

Purpose: This DNP process improvement project aim was to utilize an educational training program on violence risk assessment, therapeutic communication, and verbal de-escalation techniques, to improve the confidence of mental health nursing staff in using early intervention to manage aggressive, violent patients. This education and early intervention reduced rates of aggression and violence escalation, …

Improving Healthcare Team Communication With Limited English Proficiency Families In The Nicu, Ivonne Mandell

Doctor of Nursing Practice Projects

Language barriers are common in healthcare settings, creating disparities in care between individuals with limited English proficiency and those with English proficiency. In the NICU setting, professional medical interpreters have been shown to improve parent/staff communication and increase parent satisfaction by allowing parents to ask questions and form trusting relationships with staff. Solid parent-provider communication can result in better health outcomes by increasing parental empowerment and participation in their child’s care. Despite the acknowledged advantages of using professional interpreters in healthcare settings, they are frequently under-utilized, even when readily available. The purpose of this project was to improve communication with …

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 …

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 …

Crna To Cvicu Rn: Implementation Of A Standardized Patient Handoff Checklist For Post-Surgical Heart Patients, Ashley Mcgrath

Doctor of Nursing Practice Projects

Patient handoffs occur when the information and responsibility of the patient is transferred from one health professional to another. Ineffective communication during the critical postoperative phase of the transfer of care (TOC) has been associated with extended hospital stays, increased healthcare costs and patient dissatisfaction. In 2007, the Joint Commission National Patient Safety Goals proclaimed the importance of a standardized handoff process for effective handoffs. The purpose of this quality improvement doctoral project was to assess if the utilization of a standardized TOC checklist from the operating room to the cardiac intensive care unit (CVICU) for post-heart patients improved communication …

Improving Patient And Provider Engagement By Utilizing Ask Me 3®, Joseph G. Smith, Msn, Arnp, Fnp Bc

Doctor of Nursing Practice Projects

Background: Patient and provider engagement in healthcare has an impact on health outcomes.

Purpose: To study the implementation of the Ask Me 3 (AM3) tool, a tool that encourages patients to ask three questions about their health to their care provider. The aim of the project is to explore the level of patient and provider engagement by patients` reports of their perception of engagement with their provider and in understanding their diagnosis.

Methods: The setting was a small urban family practice in the Pacific Northwest. Every patient that checked in for their appointment, excluding pediatric and younger than 18 years …

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. …

Standardized Patient Handoff Tool, Matthew Marten

Doctor of Nursing Practice Projects

Patient handoffs are defined as the transmission of information and accountability between teams and individuals. These handoffs can be periods of increased risk for the patient and increased errors among anesthesia providers and PACU nurses (Segall et al., 2012). The Joint Commission recommends healthcare providers improve patient handoff as a national goal (Robins & Dai, 2015). The purpose of this nursing doctoral project was to determine if using a standardized patient handoff tool could improve communication and satisfaction between anesthesiologists, CRNAs, and PACU nurses. A review of the current literature supported the need for a standardized patient handoff tool for …

Effects Of Transitional Care Management On Hospital Readmissions, Samantha Dunkirk

Doctor of Nursing Practice Projects

Primary care providers are challenged to identify strategies to decrease hospital readmissions. Transitional care management (TCM) services can improve communication and allow primary care providers (PCP) an opportunity to meet with patients just after discharge to assess needs and prevent readmissions. A TCM protocol was evaluated at a large Midwestern clinic to determine if communication improved and readmissions decreased. The protocol consisted of notifying the PCP upon admission and discharge to the hospital, communicating with the patient or family within 48 hours of discharge, and facilitating a follow up visit with the primary care provider within 14 days of hospital …