Nursing Commons^™

Improving Suicide Risk Management In Military Primary Care, John A. Hoyos

Doctor of Nursing Practice Final Manuscripts

Background: In the military, completed suicides and attempt rates have risen across the services since 2001 by 82% per 100,000 in spite of various intervention programs. The literature suggests that absent and inadequate suicide assessments may be part of the problem. Primary care providers are often not prepared for risk assessment and management of suicidal patients.

Aim/Purpose of Project: The project sought to improve the consistency of providers in conducting adequate risk assessments and providing crisis hotline information to patients who were cleared to return home after an encounter, as required by NPSG 15.01.01.

Project Plan Process: This evidenced-based project …

Utilizing Tiger Competencies To Improve Informatics Practice, Kwun Ying M. Fung

Doctor of Nursing Practice (DNP) Projects

Nursing Informatics (NI) is quickly becoming an essential part of nursing. From the classroom, to the bedside, and to the boardroom, nurses across the nursing continuum are expected to use NI in their practice with the hopes of delivering better quality care to their patients. However, the training and education of NI provided to all levels of nurses is unable to keep up with the pace of technology. This project seeks to improve the NI competency of the nursing workforce at a pediatric hospital through an educational course using NI competencies identified by the Technology Informatics Guiding Educational Reform (TIGER) …

Barriers To Preoperative Teaching In A Culturally Diverse Healthcare Environment, Rancelle Ablan

Doctoral Projects

The role of the professional nurse is integral in educating and ensuring that patients understand essential components of their plan of care. This is especially true for patients who are to undergo surgical interventions; evidence has demonstrated that preoperative education provided to patients is linked with positive patient outcomes and a decrease in post-operative complications (Blackstone, Garrett, & Hasselkus, 2011). This qualitative study investigated the barriers that nurses experience in providing preoperative education to diverse patients in a multicultural healthcare environment. Ten registered nurses at a private community hospital in the San Francisco Bay Area participated in an hour long …

Delirium Education Program For Critical Care Nurses: A Mixed Methods Study, Meredith Padilla Padilla

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 10-30% of hospital admissions develop delirium where nearly 30-40% of the delirium cases are preventable. Non-detection rates by acute care healthcare workers were reported at 72-75%. Hence, it is crucial for hospitals to develop delirium education programs focused on early recognition and prevention. Thus, the purpose of this mixed method study was to develop and evaluate the effect of a delirium education program (DEP) on improving critical care nurses’ knowledge and self-confidence in identifying delirium and the associated risk factors. In the quantitative strand (Phase I) of the study, both the intervention and control groups completed the online pre-tests …

Developing Registered Nurse Competency In Diabetes Care, Elizabeth Ortiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: As the cost of health care continues to climb in the United States, hospitals are seeing longer lengths of stay and associated costs resulting from the complications of diabetes mellitus (DM). Registered nurses (RNs) play a critical role in caring for patients with DM. Rapid changes in the care of DM require continuing education on the current trends and the use of evidence-based practices to prevent hypoglycemia as a serious complication of lowering blood glucose levels. This doctoral project assessed the knowledge levels of RNs caring for patients with DM in the hospital setting.

Methods: Eighty-five RNs …

Breastfeeding Education For Fathers: An Intervention To Increase Breastfeeding Rates, Jill Marie Frisz

Evidence-Based Practice Project Reports

If every infant were breastfed within an hour of birth, exclusively breastfed until six months, and given breastmilk up to two years, almost 800,000 lives would be saved annually (who, 2014). Nationally, breastfeeding rates drop significantly from three to six months. A search of literature yielded significant evidence as fathers for facilitators to increase breastfeeding rates. The purpose of this evidence based practice (EBP) project was to determine the effects of best practice measures to educate fathers about breastfeeding to increase anytime breastfeeding rates. The social support theory and ACE Star model guided the literature search and implementation of this …

Emphasizing Learning How To Learn In A Nursing Course, Belinda Deal, Zhaomin He, Katy Zagurski

Faculty Posters

This poster was presented during The Lyceum: A Student Research Showcase, and event hosted by the UT Tyler Center for Teaching Excellence and Innovation and UT Tyler Honors Program.

The Effect Of Reduced Carbohydrate Diet Education On Hemoglobin A1c In Patients With Type 2 Diabetes, Lauren Parker

Evidence-Based Practice Project Reports

Type 2 diabetes (T2D) is characteristically the result of modifiable risk factors, impacting the health and well being of all ethnic backgrounds across the lifespan. Research has indicated that despite the many risk factors associated with T2D, alterations in dietary macronutrient composition can lead to improvements in disease management and resultant complications. Therefore, the purpose of this evidence-based practice (EBP) project was to provide individuals with reduced carbohydrate (carb) diet education to promote greater glycemic control and reduce associated risk factors through macronutrient modification, specifically carb intake. An integration of the most current evidence obtained from the critically appraised literature …

Breastfeeding Intention Within A Rural Postpartum Population: Does Education Matter?, Brooke Hawkins

DNP Projects

Purpose: The purpose of this scholarly project was to determine breastfeeding intention in a rural population after receiving education from a certified lactation consultant.

Review of the Literature: The benefits of breastfeeding for both mother and child are clearly stated in the literature. Despite the known benefits, rates of breastfeeding are decreased within rural populations. Previous research suggests education about breastfeeding benefits is beneficial in increasing these rates. In particular, previous studies focused on the contributing factors affecting a mother’s decision to breast or formula feed. However, few studies were found strictly evaluating breastfeeding intention after receiving formal …

A Standardized Palliative Care Referral Workflow And Educational In-Service At An Outpatient Congestive Heart Failure Clinic, Rachel E. Cardosa

Doctoral Projects

Cardiovascular disease is a significant health issue in the US as it is the leading cause of death and most cited reason of hospitalizations in Medicare enrollees (Centers for Disease Control, 2014; Unroe et al., 2011). The American Colleges of Cardiology and the American Heart Association Guidelines recommend palliative care for all patients with heart failure (Yancy et al., 2013). The purpose of the scholarly project was to address the gaps in current practice by creating a standardized palliative care referral process and education for clinicians in an outpatient Advanced Congestive Heart Failure (ACHF) Clinic. A referral tracking process was …

Conceptual Understanding: A Concept Analysis, Susan Mills

The Qualitative Report

The term conceptual understanding was analyzed to determine how educators can help students attain understanding in a concept based curriculum. The investigator sought to establish what salient dimensions and conditions supported conceptual understanding. A dimensional analysis of the term conceptual understanding was employed through a review of the literature in mathematics, science, psychology, and nursing education. The salient dimensions of conceptual understanding were identified as: factual and procedural knowledge, connections, transfer, and metacognition. The supporting properties included: meaningful learning activities, memorization, and misconceptions. The results substantiate conceptual understanding as a process. When this process is utilized by nurse educators, students …

Teaching Strategies To Prepare Prelicensure Nursing Students To Teach-Back, Mariann Kerr

Student Theses, Dissertations and Capstones

Background: Prelicensure nursing programs prepare generalists with essential knowledge, skills, and attitudes to practice in complex health care environments. Nurse educators determine which teaching strategies will best prepare the nurse generalist. Purpose: The purpose of this study was to determine the effectiveness of a teaching plan that combined the strategies of pretest/posttest, classroom activities, and a problem-based learning activity: a clinical immersion experience. The skill of "teach-back" was taught and evaluated. Theoretical framework: Two theories guided the teaching plan for this research. Adult learning theory (Knowles, 1975, 1980, 2012) addressed how and why adults learn, and social cognitive theory (Bandura, …

Qualitative Descriptive Study Of The Experiences Of Nurse Educators In Developing And Implementing Concurrent Enrollment Adn-Bsn Programs, Janice Evans Hawkins

Student Theses, Dissertations and Capstones

Nursing leaders have called for more bachelor-of-science-in-nursing-(BSN)-prepared nurses to meet workforce demands. There is limited capacity in BSN programs to meet the projected demand. Currently, associate degree in nursing (ADN) programs produce the majority of registered nurses. To increase the number of BSN graduates, nurse educators recommend innovative educational models for seamless progression from the ADN to the BSN. Concurrent enrollment ADN-BSN programs offer one potential model to produce more BSN graduates. The purpose of this study was to describe the process of developing and implementing concurrent enrollment ADN-BSN programs. The research question was as follows: What is the experience …

Emotional Intelligence And Empathy Of Nursing Students In An Immersive Capstone Clinical Course, Michelle L. Finch

Student Theses, Dissertations and Capstones

Background. Today’s baccalaureate nursing students need to be prepared to care for patients in an ever-changing, high acuity environment. Many programs offer a capstone immersive clinical experience. However, the benefits of this experience have not been fully explored, and the effect on patient care is unknown. Purpose. The purpose of the study was to determine if there was a change in levels of Emotional Intelligence (EI) and empathy in senior students who completed a capstone immersive clinical experience in the final semester of a baccalaureate nursing program. Theoretical Framework. The theoretical framework for this study was the Mayer and Salovey’s …

Investigating The Efficacy Of Pre-Licensure Clinical Interprofessional Education, Brenda Kay Wheeler

Student Theses, Dissertations and Capstones

Nurses are expected to work collaboratively with other health professionals after graduation; however, most have not been taught to work in teams and are ill-prepared to work in collaborative relationships. Interprofessional Education (IPE) may better prepare nursing students for teamwork. The purpose of this study was to investigate the efficacy of pre-licensure clinical IPE for nursing students. It was hypothesized that nursing students who participate in clinical IPE have more positive attitudes toward health care teams than nursing students who do not participate in clinical IPE as evidenced by higher scores on the Attitudes Toward Health Care Teams Scale (ATHCTS), …

The Development And Implementation Of Hospital-Based Clinical Guidelines To Enhance Nursing Staff Efficacy In Glycemic Management At A Large Psychiatric Teaching Hospital, Cherno Bah

Doctor of Nursing Practice Projects

Background: This quality improvement project was conducted at the Colorado Mental Health Institute at Pueblo (CMHIP) in order to improve glycemic management. In psychiatric inpatient settings, proper glycemic management is inadequate which increases metabolic risk and poor patient outcomes. One way to address this problem is by using practice guidelines and education, which enhances nurses’ efficacy.

Purpose: The purpose of this project was to develop and implement a glycemic management guideline to enhance clinical nursing staff knowledge and confidence.

Method: Fifty-five clinical nursing staff attended an in-service and were asked to fill out a survey before and after the in-service …

Educating Nurses About Spirituality's Effects On Quality Of Life With Chronic Illness, April Gant

Walden Dissertations and Doctoral Studies

Spirituality has been associated with wholeness, inner peace, and key elements of well-being or quality of life. Spirituality support is particularly important for patients with chronic illness and patients who view spirituality as a way of coping with suffering. Evidence-based education is lacking in schools of nursing and in places of nursing employment on spirituality interventions that nurses can use to improve patient quality of life. The purpose of this project was to determine whether an educational intervention would increase knowledge of spiritual care in a small sample of clinic nurses (n = 37). This project used Watson's caring theory, …

Improving Nurses' Knowledge Of Stroke, James Trone Mcdaniel

Walden Dissertations and Doctoral Studies

Stroke is a devastating disease. Stroke care has advanced greatly in the past 20 years with innovations in radiologic imaging, development of tissue plasminogen activator (tPA), organized systems of care, telestroke, and best practice guidelines via Get with the Guidelines Stroke (GWTGS). However, stroke remains the 5th leading cause of death in the United States. To provide current and quality care for stroke patients, nurses need ongoing stroke education. Additionally, stroke centers must provide a sustainable stoke education program to their nurses to keep their knowledge current. Guided by Rosswurm and Larrabee's model, this quality improvement project addressed whether an …

Impact Of Simulation Training On Novice Nurses, Sheila Marjean Moore

Walden Dissertations and Doctoral Studies

In 1999, the Institute of Medicine released its report on building a safer health system. Since then, safety in patient care has become a paramount interest. Given the growing support for increasing patient safety, simulation training has become a common part of novice nurses' orientation program. This simulation training is designed to mimic situations in the acute care setting where novice nurses can practice in a patient safe environment. In this DNP project, a stroke simulation scenario and supporting patient chart was developed as an addition to a novice nurses' orientation program. The National League for Nursing simulation template was …

An Exploration Of The Effectiveness Of Problem-Based Learning In Nursing Education, Yvette Marie Jackson

Walden Dissertations and Doctoral Studies

Critical-thinking is an essential skill that graduate nurses need to make sound clinical decisions. While traditional lecturing is the method most commonly used in nursing education, incorporating problem-based learning (PBL) into nursing curricula has been suggested as a better option for students' learning of theory and practice. The purpose of this study was to explore the difference in critical-thinking and problem-solving skills between nursing students taught using PBL versus those taught with traditional classroom lectures. A quasi-experimental approach, with cognitive learning theory as the foundation, was used to compare the results of an Assessment Technologies Institute (ATI) Comprehensive Predictor posttest …

Evaluation Of Educational Intervention And Management Of Patients With Type Ii Diabetes Mellitus, Elissa Johnson

DNP Projects

Background: Diabetes is a costly disease with devastating consequences. Patients with poor glucose control whether due to inadequate medical care or limited self-care are most at risk for complications. Evidence supports the efficacy of multifaceted interventions in the treatment of type II diabetes mellitus (T2DM). Patient education, assessing behavioral and psychosocial elements, and focusing on lifestyle change (e.g. diet and exercise) are interventions shown to enhance self-efficacy and promote patient empowerment (Knight, Dornan, & Bundy, 2005).

Study Design: A retrospective chart review of 104 patients with established T2DM was conducted along with a qualitative interview with providers focused on management …

Beers Medication: Empowering The Elderly Through Education, Amanda J. Parker

DNP Projects

The elderly population (those aged 65 years and older) has an increased risk of experiencing adverse effects from their prescribed medications. These adverse effects are due to many reasons, one being changes that naturally occur in the aging body, such as diminished kidney function or decreased gastrointestinal motility. This project explores the prescribing practices of one primary care practice setting. Specifically, this project sought to determine the number of patients in a primary care practice who were prescribed medications on the Beers list and whether or not the patients received education on adverse effects. The results concluded the most frequently …

An Educational Initiative To Prevent Unnecessary Hospitalization For Hospice Patients, Alkeisha Hill Mims

Walden Dissertations and Doctoral Studies

Avoidable hospitalizations of hospice patients cost Medicare $3 billion a year. When hospice nurses are able to identify early signs and symptoms of acute illness and provide appropriate interventions to prevent such admissions, 20-60% of the hospitalizations are preventable. The practice problem addressed in this quality improvement doctor of nursing project was the 30% hospital admission rate of hospice patients as evidenced by chart review, admission data, and revocation data. The first purpose of the project was to identify evidence-based nursing care paths in the literature for the top 5 medical diagnoses related to avoidable hospital admissions. The second purpose …

Effects Of Education On Pressure Ulcer Prevention In Developmentally Disabled Individuals, Jasneth M. James

Walden Dissertations and Doctoral Studies

Pressure ulcers were a continuing concern among the nonverbal developmentally disabled population of a state institution. The lengthy use of wheelchairs, the inability to body shift, and physical and mental impairment were attributes of the target population that have been cited in the literature as contributing to pressure ulcer. The purpose of this quasi-experimental pretest/posttest project was to evaluate the effectiveness of an education intervention for direct care staff on the prevention treatment, and eradication of pressure ulcers among patients with developmental disabilities. Orem's self-care deficit theory, particularly the emphasis on the need for nursing staff to perform self-care activities …

Advanced Practitioner Provided Pre-Hospital Discharge Asthma Education, Lyndsay E. Gardner

Walden Dissertations and Doctoral Studies

Asthma is a leading cause of pediatric hospital admissions. Parents of children under the age of 18 with asthma require education to recognize and manage the signs and symptoms of the disease. Parent education has shown to decrease their children's hospital admission and readmission rates. The purpose of this pilot project was to develop an asthma educational module for the parents of children with asthma and obtain parent feedback on the content. Families with children under the age of 18 who had been admitted to the hospital with a diagnosis of asthma, an asthma exacerbation, or status asthmaticus were invited …

Bedside Nurse Recognition Of Delirium In The Medical-Surgical Setting, Bridget Ann Denzik

Walden Dissertations and Doctoral Studies

Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was …

Improving The Charge Nurse's Leadership Role: A Collaborative Learning Forum, Felicia Katherine Pryby

Walden Dissertations and Doctoral Studies

Staff nurses are frequently placed in charge nurse positions without the necessary formal training. The long-term goal of this project was to develop a curriculum for a formal institutional leadership workshop for the charge nurses at the practicum site. The Johns Hopkins Nursing Evidence-Based Practice model and Lewin's change theory were used to guide the development and implementation of the workshop. Data were collected using a focus group approach with 4 novice and 5 expert medical-surgical charge nurses. The short-term goal of the project was to understand the charge nurses' perceptions of leadership and the challenges as a front-line leader. …

Improving Pain Management For Hospitalized Patients, Ronda Sweet

Walden Dissertations and Doctoral Studies

Uncontrolled pain has proven effects on both physiological and psychological responses of hospitalized patients. These incapacitating sequelae most often negatively impact patient outcomes resulting in unnecessary suffering and prolong hospitalizations. First line nurses often have preconceived notions about a patient's pain without developing an individualized patient context that considers appropriate pain management knowledge translated from best practice standards. Guided by Bandura's social learning theory and Lippitt's change theory, the purpose of this quality improvement project was to determine if use of the Curriculum Outline on Pain for Nursing from the International Association for the Study of Pain (IASP) improved nursing …

Simulation Learning And Transfer To The Clinical Environment In Undergraduate Nursing Students, David A. Miles

Dissertations

Simulation learning is an integral component of many undergraduate nursing programs throughout the country. Experiential learning through simulation allows students to improve their cognitive, affective, and psychomotor skills. Some clinical experiences lack significant practice of clinical skills for students; including the inability to assume the role of the nurse. A recent literature review revealed a need to advance the understanding of simulation learning and transfer; with many questions still remaining unanswered. The aim of this study was to conceptualize the process by which simulation learning transfers to the clinical environment in undergraduate nursing students. Twenty-five, fourth-year traditional nursing students, who …

An Evidence Based Approach To Sepsis: Educational Program, Dolores Perez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Evidence-based guidelines for recognizing and treating sepsis have been available for decades, yet healthcare providers do not adhere to the recommendations. Sepsis can progress rapidly if not recognized early. Literature reports reveal that sepsis is the leading cause of death in non-cardiac intensive care units (ICUs), and it is one of the most expensive conditions to treat. A hospital in the Las Vegas, Nevada area had previously introduced sepsis management prescriptions in 2011 with no formal education of sepsis guidelines to nurses. The original hospital’s sepsis management prescription sets followed guidelines dated 2008. The purpose of this project was to …