Nursing Commons^™

Valley Fever: Education For Primary Care Providers And Allied Health Care Professionals, Michelle Elizabeth Bergen

Doctor of Nursing Practice (DNP) Projects

Valley Fever: Educating Primary Care Providers and Allied Healthcare Professionals

Abstract

Problem: Coccidioidomycosis (cocci), informally Valley Fever (VF), infects the lungs with the fungal spore coccidioides. It is prevalent in areas where soil disturbance occurs. Currently, there are no related educational or standardized guidelines exist for primary care providers (PCPs) in California’s Central Valley, where VF is highly endemic (Centers for Disease Control and Prevention, 2018).

Context: A Doctor of Nursing Practice project educational program for PCPs and allied healthcare workers (AHWs) at the Adventist Health Central Valley Network (AHCVN) clinics. The project aimed to educate PCPs to …

A Systems Approach To Increase The Icu Nursing Workforce During A Pandemic, Jennifer Mendenhall

Master's Projects and Capstones

A Systems Approach to Increase the ICU Nursing Workforce During a Pandemic

Abstract

In early March 2020 an intensive care unit (ICU) patient died of COVID-19 in an integrated healthcare system hospital in Northern California. Data from China and the CDC indicated that more healthcare members would require intensive care and could overwhelm the 21 acute care hospital macrosystem. A microsystem pilot program to upskill peri-anesthesia care unit (PACU) RNs to care for ICU patients was initiated. Concurrently the upskill pilot program was reviewed by macrosystem nursing leadership. Over a three-week period, the program was standardized, disseminated and implemented across …

Diabetes Education In The Emergency Department: Decreasing Repeat Visits And Admissions, Keith Hatfield

MSN Capstone Projects

Parkland Memorial Hospital (PMH) has many patients with diabetes under its care (Parkland Health & Hospital System, 2019a). Lewis et al. (2015) found that most patients with diabetes seeking care in a large urban ED lacked the basic diabetes survival knowledge needed to stay healthy. Poor diabetes control leads to complications and illness, which leads to repeat ED visits and inpatient admissions. A further literature review supported providing patients with additional diabetes education to reduce admissions.

This project will train the ED Registered Nurses (RN) to provide additional diabetes education at discharge and provide the patient with educational materials to …

Medication Error Prevention Strategies, Shana L. Brown

MSN Capstone Projects

The fundamental purpose of every healthcare organization is to enhance patient quality of life through the provision of superior healthcare to produce the best patient outcomes. In the pre-hospital practice setting of helicopter emergency medical service (HEMS) the desire of system leaders and medical staff is to be primarily patient-centered, focused on the safety and wellbeing of patients while at the same time managing the business finances and budget of the organization. Maintaining a healthy environment with safe patient practices is the responsibility of organization administrators, physicians, nurses, paramedics, and all healthcare providers.

One of the primary duties that healthcare …

Early Screening Of Postpartum Depression, Mary Ramirez

MSN Capstone Projects

Postpartum depression (PPD) is the most common pregnancy-related complication affecting over half-million mothers each year in the United States and only 50% of these women seek treatment or even receive a mental health evaluation (American College of Obstetrics and Gynecology, 2015; Horowitz & Goodman, 2004). Failure to detect or diagnose PPD can have serious consequences for both mom and baby. Nurses play a key role in discharge teaching and education, which puts them in the perfect position to ensure that adequate referrals are coordinated and to stress the importance of follow-up care to new mothers (Logsdon et al., 2018). Current …

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

Nurses' Attitudes Toward Physician-Assisted Suicide, Cheyenne Star Lowrey-Lagrone

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Physician-assisted suicide, or PAS, is end-of-life option in which patients self-administer physician-prescribed lethal medication to end their life. Nurses' own interpretations and understandings of the legalities, ethical dilemmas, and factors that influence their attitudes can be analyzed to determine the nurses’ role in the support or opposition of the practice. Although nurses do not have an active role in PAS, they play a pivotal role in patient advocacy and education. This paper analyzes the factors that contribute to nurses’ attitudes toward the practice, along with the benefits of education of this topic going forth.

Achieving An Inclusive Nursing Culture: Developing A Model For Diversity And Inclusion Education, Amber K. Charleville

Theses and Graduate Projects

The creation of an inclusive environment is essential in health care. Therefore, this paper describes the development of an educational project to achieve a more inclusive nursing culture with registered nurse case managers at a large Midwest teaching hospital. This project sets forth the goal of establishing and discussing diversity and inclusion education by proposing a model with reflection, learning, and growth as self- sustaining practices in an ongoing cycle of praxis with Chinn and Kramer’s emancipatory knowing. Over the course of a year, monthly modules will be taught by a facilitator who will encourage discussion and reflection on various …

Cardiac Resuscitation Training: An Integrative Literature Review, Dominick Pahl

Nursing Masters Papers

Despite highly trained healthcare professionals being readily available to respond to In-Hospital Cardiac Arrest (IHCA), a patient experiencing an IHCA often remains a devastating event for the patient. Each year in America, 13.5% of all deaths result from sudden cardiac arrest. Even with healthcare professionals certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS), the survival rates following an IHCA are not inspiring. The median survival rate to hospital discharge of an adult experiencing IHCA is 26.4% and 49.5% for the pediatric population. Despite a continued focus on improving CPR quality from the American Heart Association (AHA), …

Ppe Compliance And Knowledge Among Healthcare Staff, Beatrice Hagert, Nicole Krummel

Nursing DNP Projects

Abstract

Problem: One of the most important steps in infection prevention is the use of personal protective equipment (PPE) to protect patients and staff from infectious agents; yet, research indicates that PPE compliance remains suboptimal in many healthcare institutions.

Purpose: To identify the effect of a multidisciplinary education campaign on PPE compliance and knowledge among healthcare workers (HCWs) on a rehabilitation unit of a large, midwestern teaching hospital.

Methods: This project utilized pre-intervention observational audits and a survey to determine baseline PPE compliance and knowledge on the piloted units. A post-intervention survey was sent to HCW to assess for a …

Redesigning Nursing Education To Build Healthier Communities: An Innovative Cross-Sector Collaboration., Beth Ann Swan, Peggy Hilden, Nikki West, Garrett Chan, Kathryn Shaffer, Judith G Berg, Mary Dickow, Deloras Jones

College of Nursing Faculty Papers & Presentations

Today's health care environment requires registered nurses to be prepared for an array of practice settings, providing care outside the hospital and directly in the community. There is increasing focus on wellness, prevention, access to care, and mental health services for an aging and more diverse population. To improve alignment of education with increasingly complex needs, donor-advised funding supported four prelicensure nursing schools to transform their curricula. Selected schools were guided through a curriculum redesign process emphasizing community and continuum of care. This innovation was consistent with meeting challenges to realize the Institute of Medicine's 2011 Future of Nursing recommendations.

Improving Care Experience Of Total Joint Home Recovery Patients Through Nursing Education, Earvin Ledi

Master's Projects and Capstones

Problem: At a Northern California hospital (NCH), there is a current effort to ensure the perioperative patients are satisfied with their care. These patients receive the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey after surgery. The scores regarding discharge process and patient knowledge over the last five quarters have fluctuated between the 10th percentile and the 36th percentile. NCH relies on patient satisfaction scores to better serve their members.

Context: NCH understands the higher the scores, the more members they will retain and the higher the overall income. Based on the low OAS …

Pediatric Bullying Education In Arkansas Baccalaureate Nursing Programs, Jasmine Jackson

McNair Scholars Research

Over the years, there has been an ever-increasing spotlight on the issue of bullying among adolescents. Nurses are another adult-figure, in addition to parents and teachers, that can help identify and address bullying if educated properly. The purpose of this study was to examine pediatric bullying education in Arkansas baccalaureate nursing programs. Through the use of a mixed-method approach, the newly created survey was to be completed by one faculty member from each of the 12 BSN programs in Arkansas (12 participants; 6 respondents). The paper describes the quantitative and qualitative data analysis from this non-experimental descriptive pilot study. Results …

Generational Differences In Faculty And Student Comfort With Technology Use, Amanda Culp-Roche, Debra Hampton, Angie Hensley, Jessica L. Wilson, Amanda Thaxton-Wiggins, Jo Ann Otts, Sharon Fruh, Debra K. Moser

Nursing Faculty Publications

Background: Navigating through online education courses continues to be a struggle for some nursing students. At the same time, integrating technology into online courses can be difficult for nursing faculty.

Purpose: The purpose of this study was to assess faculty technology integration practices, student attitudes about technology use, and generational differences related to faculty and student technology use.

Methods: A descriptive cross-sectional survey design was used to obtain data for this study.

Results: Integration of technology into online courses and student attitudes about technology use were not significantly different by generation. Faculty and students from the Baby Boomer and Generation …

A Strategic Plan To Thread Genomics Competencies Into Undergraduate Curriculum, Holly Mathis

Dissertations

Problem: Genomics in undergraduate nursing education has experienced slow adoption in the United States. Various approaches have been proposed but do not address barriers to successful implementation.

Methods: A strategic plan was developed to increase the amount of genetics and genomic content in the curriculum of an undergraduate nursing program. A gap analysis was performed on the curriculum revealing a paucity of content. A SWOT analysis informed the strategic plan, which included a faculty education program using the ANA/ISONG’s Essentials of Genetic and Genomic Nursing: Competencies, Curricula Guidelines and Outcome Indicators (2^nd ed.) (2009) as a foundation.

Results: Faculty …

Improving Palliative And Hospice Knowledge Among Nurses In A Long-Term Care Facility., Kelly Rae Smith

Doctor of Nursing Practice Papers

Background: Early referral and implementation of palliative best-practices in patients with chronic diseases and at the end-of-life (EOL) significantly decreases patient symptom burden, increases quality-of-life, contributes to patient and family satisfaction with care, and reduces healthcare costs. Nurses in long-term care (LTC) are poised to help identify patients appropriate for referral, to provide quality palliative and EOL care, but lack adequate knowledge. Objectives: To determine if a short one-on-one or two-on-one palliative and hospice educational offering can improve (a) knowledge of best-practice palliative and hospice care symptom management techniques (b) the ability of nurses to identify patients appropriate for hospice …

Hepatitis A Educational Program In Food Service Workers., Katherine Barker

Doctor of Nursing Practice Papers

Louisville, KY was affected by a significant outbreak of Hepatitis A in 2017-2018. Kentucky consisted of one-third of the national deaths. The outbreak influenced not only human mortality but had an economic impact on the food service industry. Many restaurants were affected, and some were forced to close due to Hepatitis A outbreaks. To address this issues, a two-step educational process was designed for management to gain understanding of hepatitis A content. The first step was to survey staff (kitchen staff, waiters/waitress, busier, etc.) to determine the compliance rate and variables that influence the compliance rate for vaccination of Hepatitis …

Pediatric Asthma, Monica Stricklin

Nursing Student Class Projects (Formerly MSN)

Effective management of asthma will improve pediatric patient quality of life. This may be achieved through the prevention of asthma exacerbations by continuous pediatric and guardian/parent education to proper inhaler technique, appropriate medication management and the avoidance of environmental triggers. These modalities may prevent trips to the emergency department, hospital admissions and the pediatric patient can avoid missing days from school.

Preoperative Opioid Education: Total Knee And Total Hip Arthroplasty., Brittany Durbin

Doctor of Nursing Practice Papers

Opioids are commonly prescribed for the treatment of acute pain symptoms such as surgical pain. The United States is struggling to deal with abuse, misuse, and accidental death associated with prescription opioids. Lack of knowledge regarding safe opioid use is partly to blame for this crisis. The purpose of this evidence-based quality improvement project is to implement a dual-modality (written and spoken) opioid educational intervention to both health care providers and patients. Intended outcomes include increased opioid knowledge for providers yielding more effective opioid education to patients. A pre- and post-test design was used to evaluate provider knowledge and intent …

Education Module For Serotonin Syndrome With 24-Hour Dose Monitoring Intervention., Jonathon Blake Hicks

Doctor of Nursing Practice Papers

Background: Serotonin Syndrome (SS) is recognized by a combination of mental status changes, neuromuscular hyperactivity, and autonomic hyperactivity (Volpi-Abadie, Kaye, & Kaye, 2013). Despite the severity and commonality of SS, it is an under reported and an under treated condition (Boyer, 2018). The purpose of this project was to 1) implement an education module on SS using a pretest and posttest design to increase LTC staff knowledge, and 2) evaluate the effectiveness (e.g., confidence level, satisfaction) of the intervention among nursing staff. Method: An education module was implemented focusing on recognizing and treating SS in aging adults. A pretest-posttest design …

Breastfeeding Education In The Postpartum Period., Kiersten Proctor

Doctor of Nursing Practice Papers

Breastmilk is the best source of nutrients for an infant, yet many mother-infant dyads do not sustain breastfeeding past initiation. Breastfeeding education and support offered to the motherinfant dyad in the postpartum period have the potential to increase maternal breastfeeding selfefficacy, and attribute to a longer duration of breastfeeding. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement breastfeeding education and support in the postpartum period to mothers who have initiated and maintained breastfeeding by the time of the newborn well-child check, occurring at two to eight days postpartum. This project aimed to increase …

Sepsis Screening Education, Brittany R. Horn

Doctor of Nursing Practice Scholarly Project

Sepsis is a significant burden to the healthcare field with 1.7 million Americans annually diagnosed with this condition. Earlier diagnosis and treatment are the most effective ways of reducing morbidity and mortality related to sepsis. The current sepsis screening tool in place at Stormont-Vail Hospital, in Topeka, Kansas, is the systemic inflammatory response (SIRS) criteria; however, this screening tool has proven to be less effective than other screening tools available. The screening tools proven more effective than the SIRS criteria, are the quick sequential organ failure assessment (qSOFA) and the sequential organ failure assessment (SOFA). For this project, nursing staff …

Improving Hypoglycemia Protocol Compliance Through Nursing Education, Concepta Onyatta

Doctor of Nursing Practice Projects

Nurses hold a vital role in glucose management in order to ensure safety and quality outcome for hospitalized patients.

Background: Assessing serum and point of care glucose results and bringing abnormal results to the attention of the healthcare team can help maintain optimal management. Despite challenges to hypoglycemic protocol compliance, informed nurses can advocate effectively for their patients. Understanding insulin action and the effective use of evidence-based guidelines/protocols can help nurses promote optimal patient outcomes. Common barriers to glucose control and education of current best practices in the acute care setting were reviewed.

Purpose: To improve hypoglycemic protocol compliance …

Effects Of Standardized Self-Care Behavior Education On Self-Efficacy Outcomes In Type Ii Diabetes Mellitus, Nishita Patolia Bsn, Rn, Dnp Student

Doctor of Nursing Practice Final Manuscripts

An evidence-based practice (EBP) project was implemented in a primary care setting to decrease Hemoglobin A1c (HgbA1c) levels and increase self-efficacy in Type II Diabetes Mellitus (T2DM) diagnosed individuals. According to the Centers for Disease Control (CDC), 30.3 million adults have diabetes in the United States, and one in four do not know they have it (CDC, 2017). It is a disease that can be managed and reversed with standardized self-management education. Self-management interventions can improve diabetes knowledge and encourage patient participation in caring for their health (Flode, Iversen, Aarflot, & Haltbakk, 2017).

The purpose of this evidence-based project was …

Insulin Injection Re-Education For Improved Glycemic Control, Daniela Shon

Doctor of Nursing Practice Final Manuscripts

Title: Insulin Injection Re-education for Improved Glycemic Control

Background: Patients on insulin therapy often continue to show suboptimal glycemic control. Data from adult patients with T2DM have demonstrated that 56.1% had poor control, despite adherence to treatment, oral and injectable. Poor glycemic control stems from many sources, including poor self-efficacy regarding insulin dosage adjustment, inaccurate insulin dosing, expired insulin, lipohypertrophy of the injection site and technique, and equipment issues.

Purpose: This project aimed to implement and assess the efficacy of re-education in the insulin injection technique for improved glycemic control.

Methods: This project was conducted based on …

Peer-Led Education Expedites De-Prescribing Proton Pump Inhibitors For Appropriate Veterans, Mary H. Bowman

Doctor of Nursing Practice Final Manuscripts

Costly proton pump inhibitors (PPIs) have been widely prescribed since the 1990’s for prevention and treatment of ulcers and gastroesophageal reflux disease (GERD). Evidence published since 2012 demonstrates risks associated with taking PPIs longer than eight weeks. Primary care providers (PCPs) mostly de-prescribe PPIs for persons not meeting criteria for long term use. Many patients resist discontinuation.

A three-month evidenced based practice (EBP) education project was conducted by a nurse practitioner to improve PCP peer de-prescribing successes with appropriate patients in an outpatient California based veteran Primary Care Clinic. Fifteen PCPs were pretested about usual care practices between two comparable …

A Follow-Up Phone Call To Post-Operative Patients Using The Five A’S, Brittney Ochs

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: The 2016 National Survey on Drug Use and Health reported that 53 percent of people that misused pain relievers in the past year received them from a friend or relative. The NIDA describes that from 2002 to 2008 that drug abuse in service members went from 2% to 11%. Often patients are initially prescribed and introduced to opioid medication for acute pain. One such circumstance is in the perioperative period that could provide an opportunity to promote opioid-sparing techniques to reduce the exposure to opioids.

Purpose of Project: To assess discharge medication characteristics and reinforce discharge medication instructions …

Fall Prevention Assessment In The Intermediate Care Patient Population, Dawn Rose

Doctor of Nursing Practice Final Manuscripts

Fall Prevention Assessment in the Intermediate Care Patient Population

Falls cause greater than 600,000 deaths per year and are the most common injury in people over 65 years of age. Fall prevention in the acute care setting has been identified as key goal in the most recent JCAHO review process. Falls on an intermediary care unit lead to an increased rate of morbidity, delayed discharge, and excess cost expenditure.

Even with appropriate evidence-based tools in place, Hospital A’s intermediate care unit, recorded an increased rate of falls; the highest rate in its health care system. An investigation identified factors contributing …

Increased Knowledge Of Autism Spectrum Disorders Reduces Stress Levels In Staff Caring Directly For Patients With Autism Spectrum Disorder., Katelyn E. Triplett

Doctor of Nursing Practice Scholarly Project

Autism Spectrum Disorders (ASD) is a group of disorders that affects approximately 1 in 59 children (Autism Spectrum Disorder, 2019). This group of disorders can cause deficits in communication, social relationships, and those with the diagnosis may exhibit undesirable behaviors as well as restrictive and repetitive behaviors (RRBs). There is limited education given to healthcare providers on this group of disorders, making it difficult to care for these patients. This study was conducted to determine if the stress level of staff that directly care for patients with ASD, at a pediatric behavioral health hospital, decreased following an educational presentation over …

Unaddressed Challenges For The “Most Honest And Ethical Profession:” A Pilot Study Of Web-Based Learning Strategies To Prevent Moral Distress, Kelly Straight

Doctor of Nursing Practice (DNP) Projects

Background: Nurses and nurse practitioners (NPs) face greater responsibility to address the ethical challenges that present during the course of patient care, due to advances in medical technology and pharmaceutical innovation, and because of widening disparities within the U.S. healthcare system. These ethical questions, which arise during the course of routine patient care, are increasing in both number and complexity in nearly every patient care setting. Even with codified ethical standards, unresolved and/or ongoing ethical questions and dilemmas pose further issues such as the development of moral distress. This pilot project was designed to help NPs and other healthcare workers …