Nursing Commons^™

Implementation Of Scripted Debriefings Following Neonatal Delivery Room Resuscitations., Kimberly M. Knott

Doctor of Nursing Practice Papers

Abstract

Background: The functioning of neonatal delivery teams can be affected by technical and non-technical skills of individual team members. The team in this project was challenged by varying knowledge and skill levels and did not have a standardized process for debriefing resuscitation events. The literature shows that debriefings can aid in improving knowledge, skills, teamwork, and communication of resuscitation teams.

Purpose: The purpose of this quality improvement project was to implement a scripted, post-resuscitation debriefing with the neonatal delivery team to improve non-technical skills of the resuscitation team and identify challenges to providing optimal care.

Method: Scripted, …

Revising An Order Set To Standardize The Workflow For The Outpatient Intravenous Diuretic Therapy Clinic In The Cardiac Cath Lab Holding Area, Mackenzie Trent Rasnake

Doctoral Dissertations and Projects

Heart failure (HF) is the leading cause of hospital admissions and readmissions. This produces costly hospital bills and detrimental effects on healthcare systems (Babar et al., 2020). It has been shown that intravenous (IV) diuretic therapy in the outpatient setting will reduce HF-related hospital readmissions (Abougergi et al., 2021). Outpatient IV diuretic therapy clinics are crucial for this reason. Revising an order set for the outpatient IV diuretic therapy clinic in the Cardiac Cath Lab holding area will reduce patient length of stay, improve nurse-provider communication, and increase patient and nurse satisfaction. Utilizing the Secure Chat feature within the electronic …

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …

Implementing A Standardized Nursing Communication Tool To Improve Inpatient Nursing Communication, Ashley D. Nator

Dissertations

Implementing a Standardized Nursing Communication Tool to Improve Inpatient Nursing Communication

Ashley D. Nator

B.S. Nursing, University of Missouri-St. Louis, 2018

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice with an emphasis in Family Nurse Practitioner

August 2022

Advisory Committee

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C

Chairperson

Sarah Jackson, DNP, APRN, FNP-C

Amy Terbrock, MSN, PCCN, SCRN, RN

Copyright, Ashley D. Nator, 2021

Original: 08/2021 Revised: 09/2021, 10/2021, 04/2022

Abstract

Problem: Patient handovers occur among nurses more than 4,000 times …

Improving Confidence And Job Satisfaction In Emergency Nurses Through Teamstepps., Anna Moore

Doctor of Nursing Practice Papers

Problem Statement: New-graduate nurses (NGNs) are experiencing job dissatisfaction related to low communication confidence leading to high turnover rates and avoidance behaviors.

Purpose: To improve communication confidence and job satisfaction in NGNs through a nurse-led education session on emergency department (ED) communication techniques.

Methods: One online class lasting ~60 minutes was provided to educate NGNs on standardized emergency communication techniques. A pre-test post-test design was used with evaluations occurring before the education, immediately after, and 30 days later.

Results: Descriptive statistics were used to analyze the sample makeup. The Wilcoxon signed-rank test was used to calculate significant changes in communication …

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 …

Civility And Communication Interventions To Improve Patient Outcomes, Lane Denney

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Communication in health care is vital for the successful care of patients and their outcomes while they are hospitalized. Healthcare workers are responsible for communicating patient information whether it is between change of shifts or reporting to a patient’s provider. It is important that this information is communicated effectively. This review evaluates how nurses communicate in shift- report and how this affects patient outcomes and civility between nursing units and teams. Overall, bedside shift reports promoted the best patient outcomes and increased teamwork on hospital units.

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

The Use Of Standardized Patients To Improve Communication Skills: A Benchmark Study, Baylee A. Azbell

MSN Capstone Projects

Effective communication is an important skill set for all nurses to withhold. In the medical field, poor communication skills have been associated with negative patient outcomes, increase in patient dissatisfaction and complaints, faulty treatment adherence, inadequate patient education, malpractice claims and poor patient and healthcare team relationships (Lin et al., 2013). Communication is a learned skill and needs to be taught from the very beginning of nursing school. Nursing schools need to be proactive and prepare their nursing students in promoting clear communication skills to ensure patient safety and satisfaction in care. This issue led to the benchmark project that …

Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport

Senior Honors Theses

The average emergency room patient is not receiving the compassionate nurse-patient communication that patients experience on other hospital floors. Fewer positive nurse-patient interactions prompt patients to state that they feel uncomforted and dissatisfied on hospital exit surveys, inciting hospital management to investigate how to reverse this trend to retain their federal funding. Emergency room nurses cite multiple barriers inherent in their work environment that prevent them from building rapport with their patients, including a layout not conducive to private conversations, strict time constraints, and a fluctuating workload. Working for a prolonged period under these conditions is driving many nurses to …

Strategies To Improve Communication In Healthcare: An Integrative Review, Tracy Lynn Macdonald

Doctoral Dissertations and Projects

The purpose of this integrative review is to research, analyze, critique, and synthesize current literature to determine current practice of communication within healthcare. Communication errors continue to have a negative impact on patient outcomes, so this literature review will consider current strategies to improve communication, and thus improve patient outcomes. Several themes were identified as strategies to improve communication. Although there is abundant research on the topic of communication in healthcare, there is still a need for further adoption and implementation of various communication strategies, as well as a need for further evaluation to determine if these strategies do improve …

Impact Of Emotional Intelligence On Interprofessional Teamwork, Interprofessional Communication, And Interprofessional Leadership, Kathleen M. Cox

Nursing Theses and Dissertations

Objective: The purpose of this body of work was to explore relationships among emotional intelligence (EI) and interprofessional (IP) competency domains to enhance IP team dynamics and communication.

Background: Decentralization of healthcare delivery may hinder effective handoffs creating opportunity for miscommunication of vital information and subsequent medical errors. Fostering effective communication is paramount for IP teams; however, differing communication styles can promote misunderstanding and conflict. Behavioral aspects of team dynamics and communication that comprise EI may be a solution but are rarely addressed in educational and safety programs.

Methods: Included in this portfolio are three manuscripts that help elucidate …

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 …

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 …

Reduction Of Order-To-Scan Times To Increase Patient Throughput And Improve Patient Outcomes: A Quality Improvement Project, Jason Harrington

Master's Theses and Capstones

Background: Throughput is a key metric for both the emergency department and the hospital system. Diagnostic tests, such as CT scans, can lead to a large delay in patient throughput which can negatively impact patient satisfaction and patient outcomes. Finding ways to reduce delays in CT scan acquisition can positively impact patient satisfaction and patient outcomes.

Aim: The specific aim of this quality improvement project was to decrease the amount of time it takes to complete abdominal CT scans with IV contrast once ordered from 61 minutes to below 35 minutes by July 1^st, 2022

Methods: Plan was …

Huddle Implementation In The Perioperative Setting, Tina Thomas

DNP Projects

Background: Communication is essential for safe and effective patient care. In the perioperative setting, information sharing is critical to care coordination. Lack of communication between caregivers can lead to medical errors. Evidence shows that huddles lead to increased communication, satisfaction, and engagement between team members resulting in better patient outcomes. Huddles are short, less than 10-minute gatherings that focus on the daily schedule, identify potential obstacles, explain unique needs, and discuss preceding day issues.

Objectives: This project aimed to evaluate the effectiveness of huddles on employee satisfaction, engagement, and communication of healthcare workers while also determining if huddles were …

Cyberbullying In Middle School Students: An Intervention Using An Educational Mobile Application For Caregivers: A Pilot Study, Gregory C. Claxton

Journal of the Georgia Public Health Association

Cyberbullying among middle school students is a growing problem that is shown to affect psychological development in middle school youth which can result in self-harm and suicide. Evidence suggests more frequent communication between children and their caregivers is a protective factor against cyberbullying. The KnowBullying app is designed to increase caregiver and student communication to prevent bullying. This study examines the effectiveness of the KnowBullying app regarding enhanced caregiver and child communication and cyberbullying experience reduction in middle school students. Five students and nine caregivers were given surveys before and after the caregivers downloaded and used the KnowBullying app. The …

An Educational Program To Enhance Knowledge And Communication For Nursing Staff Who Care For Dementia Patients, Behnaz Mohammadi

Walden Dissertations and Doctoral Studies

AbstractDementia is a progressive chronic disease that requires skilled nursing care. Staff at a skilled nursing facility were not using best practices to prevent and manage the psychological and behavioral symptoms of dementia. The purpose of this DNP project was to implement a dementia care education to address this gap in knowledge. The question for the evidence-based educational project was whether the program increased knowledge, promoted positive attitudes, and increased confidence in dementia care staff. A 5-hour workshop was presented in person, twice in two weeks. The person-centered care model served as a framework for the project. Nursing staff (N …

Identification, Treatment, And Management Of Patients With Suicidal Ideation On The Medical-Surgical Unit For Nurses, Renea Crawford

Walden Dissertations and Doctoral Studies

Suicide and suicidal ideations are among the leading causes of death in the United States. The Joint Commission identifies inpatient suicide as a sentinel event that should never happen. Nurses working on the medical/surgical (M/S) unit in a hospital located in the midwestern region of the United States voiced their concern that they were not prepared to recognize the signs that may indicate an escalating emotional situation in patients with suicidal ideation; in addition, there were no guidelines in the hospital to use as a resource. The purpose of this project was to determine whether an evidence-based (EB) clinical practice …

Situation-Background-Assessment-Recommendation During Hand-Off In A Mental Health Nursing Unit, Renel Ramos

Walden Dissertations and Doctoral Studies

AbstractCommunication failures, especially inadequate hand-off communication, in U.S. hospitals has accounted for 30% of malpractice claims, resulting in 1,744 deaths over 5 years. This prompted the Joint Commission to recommend utilizing standardized communication tools to reduce the number of medical errors related to miscommunication. The Situation-Background-Assessment-Recommendation (SBAR) Communication Tool has been used to improve the effectiveness of communication among health care providers. The partner organization noted failures to communicate patient-care-related information between psychiatric mental health nurses (PMHN) during hand-off, given the absence of standardized communication. This project aimed to develop a program to educate PMHNs on the SBAR Communication Tool. …

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …

Nurse Manager Communication Associated With Staff Nurse Satisfaction Or Retention, Svetlana Periut

Master of Science in Nursing Final Projects

Background: Nursing communication is a significant part of a nurse's job, especially when communicating with their patients, patient's families, and the healthcare team. Communication is the center of attention of many studies, and the way nurse leaders relate massages can influence an organization’s outcomes, including nurse satisfaction and retention. This integrative review aims to analyze communication styles, behaviors, and instruments used by hospital unit nurse managers to increase staff nurse satisfaction and retention.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis were used in the literature search and review. The Johns Hopkins Evidence-Based Practice Model and Guidelines were …

A Good Life: Palliative Care In The World Of Dementia, Nicola Farmer

Journal of Interdisciplinary Graduate Research

Objective: The World Health Organization (2019) reports that dementia is the seventh leading cause of death with an estimated 50 million people worldwide with this disease. In the United States out of one and a half million Medicare patients on hospice in 2016, only 18% had dementia (The National Hospice and Palliative Care Organization, 2017). McAteer and Wellbery (2013) identified that while referrals to services seem to be on the rise, many are not made until the patient is close to death in the last weeks of an illness. The purpose of this project was to review the literature to …

Complete (Communication Plan Early Through End Of Life): Development Of A Research Program To Diminish Suffering For Children At End Of Life, Verna L. Hendricks-Ferguson, Amy R. Newman, Katharine E. Brock, Joan E. Haase, Jennifer L. Raybin, Shermini Saini, Karen M. Moody

College of Nursing Faculty Research and Publications

While overall survival has improved significantly for children with cancer over the past 75 years, cancer remains the leading cause of death from disease among children and adolescents. Further, despite the many advances in medical and nursing care, children with cancer still experience significant physical and emotional suffering over the course of their illness, especially at the end of life (EOL). Children endure significant rates of high-intensity medical interventions (e.g., intubation, intensive care unit admission) at the EOL despite many parents, adolescents, and young adult patients identifying home as their preferred location of death. Hospice care has the potential to …

Burnout In The Nursing Profession: Extant Knowledge And Future Directions For Research And Practice, Sara Labelle

Nursing Communication

Burnout is a psychological state resulting from prolonged psychological or emotional job stress, and is a culmination of three factors: emotional exhaustion, depersonalization, and reduced personal accomplishment. Due to the nature of the “people-work” they must constantly perform, along with a highly stressful and unpredictable work environment, nurses have alarmingly high rates of burnout among members of their profession. Given the importance of research on burnout to understanding the context-specific stressors and challenges of nursing, this review offers a synthesis of research published in the last decade in both nursing and communication journals, with an emphasis on discussing opportunities for …

Burnout In The Nursing Profession: Extant Knowledge And Future Directions For Research And Practice, Sara Labelle

Communication Faculty Articles and Research

Burnout is a psychological state resulting from prolonged psychological or emotional job stress, and is a culmination of three factors: emotional exhaustion, depersonalization, and reduced personal accomplishment. Due to the nature of the “people-work” they must constantly perform, along with a highly stressful and unpredictable work environment, nurses have alarmingly high rates of burnout among members of their profession. Given the importance of research on burnout to understanding the context-specific stressors and challenges of nursing, this review offers a synthesis of research published in the last decade in both nursing and communication journals, with an emphasis on discussing opportunities for …

By Utilizing Technology Can Nursing Students Gain More Confidence And Decrease Anxiety When Communicating With Chronically Ill Patients About Their Sexual Relationship?, Sheri Rickman Patrick, Alice Butzlaff

Faculty Research, Scholarly, and Creative Activity

Introduction
Effective communication is an essential part of nursing care. Nurses need to effectively communicate with patients, families, providers and staff. The purpose of this study was to show how the use of technology (i.e., video conferencing on an electronic device) could assist nursing students to gain more confidence and reduce anxiety when discussing difficult topics such as sexual intimacy.
Methods
Pre-licensure nursing students were recruited to participate as part of regular class activities. A pre- and post-survey asking about their confidence and anxiety in communicating with patients was completed; then subjects were randomly placed into groups of 4 to …

Language Abilities In Children Born To Mothers Diagnosed With Diabetes: A Systematic Review And Meta-Analysis, Diana Arabiat, Mohammad Al Jabery, Mark Jenkins, Vivien Kemp, Lisa Whitehead, Gary Adams

Research outputs 2014 to 2021

Background:

This meta-analysis reviewed and synthesized the available evidence on the association between intrauterine exposure to maternal diabetes and language abilities in children.

MEDLINE/PubMed, EMBASE, PsycINFO, Proquest Dissertations and Theses Global, and Google Scholar databases were searched through December 2020. Studies were systematically searched, and effect sizes were calculated using random effects models.

Results:

Twelve studies were identified for inclusion in this review, however, only 10 were included in the meta-analysis. Sample size ranged from 9 to 115 participants in the diabetes group and 28 to 8192 in the control and aged around 3 years. The pooled results of the …

Closing Communication Gaps For Unplanned Surgical Patients: One Pre-Op Checklist At A Time, Seda L. Vash

Master's Projects and Capstones

Problem: Unplanned, inpatient surgical patients were experiencing poor outcomes and dissatisfaction with their overall care. This surgical patient population also lacked communication from their healthcare teams with regard to plans of care throughout their hospital stays.

Context: This was a quality improvement project for the unplanned, inpatient surgical patient population in the Central Valley of California. Approximately 13% of this hospital’s surgical patients required post-surgical care in the inpatient units. These patients, according to unfavorable HCAHPS scores, experienced unsatisfying care and insufficient communication from their healthcare teams, including physicians and nurses.

Intervention: This project implemented an Add-On Communication Tool for …