Nursing Commons^™

Evaluation Of Educating Registered Nurses Prior To Implementing New Evidence-Based Protocol: Enhanced Recovery After Surgery (Eras), Lisa Brooks

Dissertations

Evidence-based protocols promote standardization of care and patient safety. The inclusion of major stakeholders is imperative to the success of implementation of a new protocol. The “Enhanced Recovery After Surgery” (ERAS) protocol was implemented at the Veterans Administration Medical Center – St. Louis prior to formal education of direct-care registered nurses (RNs), a major stakeholder group. Due to the lack of knowledge, the RNs who were expected to implement and adhere to the ERAS protocol were not prepared and displayed a lack of confidence. Subsequently, an educational training intervention was designed and executed with thirty-five RN participants. Prior to this …

Screening Amblyopic Risk Factors In A Pediatric Population Using An Automated Vision Screener, Rebecca Dawn Slominski

Evidence-Based Practice Project Reports

Amblyopia is the most common visual disorder in children and is potentially curable if detected early and treated properly in the first few years of life. Amblyopia is the leading cause of monocular vision loss in children (Bradfield, 2013). It is a developmental neuroplasticity which derives from birth causing structural and functional changes in the eye and brain. With this structural and functional disruption, visual blur occurs due to refractive amblyopia, strabismic amblyopia, cataracts (form-deprivation amblyopia), or a combination of any of these (Solebo, Cumberland, & Rahi, 2015). Refractive errors related to amblyopia can also occur. The purpose of this …

The Effect Of Algorithm Implementation In The Family Practice Setting On The Pain And Recovery Of Acute Low Back Pain Patients, Joan Caito

Evidence-Based Practice Project Reports

Nearly $86 billion is spent annually in healthcare costs for Americans with low back pain (Lee, McAuley, Hübscher, Allen, Kamper, Moseley, 2016). Additionally, the burden on the economy due to loss in productivity incurs approximately $114 billion dollars of lost revenue annually (Lee et. al., 2016). Patients with an acute low back injury inadequately treated may become a chronic issue. Only 50% of patients who experience back pain symptoms for 12 months will return to work (Petit, Fouquet, & Roquelaure, 2015). The purpose of this project will be to implement an evidence-based algorithm to standardize acute low back pain care …

When Disaster Strikes: A Training Intervention To Improve Nurses' Confidence And Preparedness For The Surge, Nichole M. Weber

Evidence-Based Practice Project Reports

There has been an exponential rise in mass casualty incidents (MCI) internationally. These human induced and naturally occurring events have affected over 4.6 billion people, and are not discriminatory to region or community (World Health Organization, 2011). Governing bodies require training and education, but nurses continue to report suboptimal competence and self-reported readiness, and a need for standardized, evidence-based training remains. The purpose if this evidence-based practice project is to authenticate current research supporting implementation of competency-based education, to improve nurses’ self- perceived preparedness and confidence in their ability to respond to MCI. The project results can be utilized for …

Sun Prevention Fun (Spf): A Multicomponent Sun Prevention Program For Children In Kindergarten And First Grade, Sarah Gouker

Evidence-Based Practice Project Reports

Skin cancer is an important topic in the United States due to the recent increase in cost and mortality. The purpose of this evidence-based practice (EBP) project was to determine if the early implementation of a multicomponent sun prevention program positively impacted kindergarten and first grade students’ knowledge and behavioral intentions to practice safe sun techniques after a one week period. Kotter’s Model of Change and the ACE Star model were utilized to guide this EBP project. An exhaustive review of the literature yielded 12 articles which were used to develop best practices for education on sun safety. The quality …

Health Professions Faculty Beliefs, Confidence, Use, And Perceptions Of Organizational Culture And Readiness For Ebp: A Cross-Sectional, Descriptive Survey, Kerry A. Milner, Holly B. Bradley, Tammy M. Lampley

Nursing Faculty Publications

Background: Evidence-based practice (EBP) is an essential skill and ethical obligation for all practicing health professions clinicians because of its strong association with improved health outcomes. Emerging evidence suggests that faculty who prepare these clinicians lack proficiency to teach EBP.

A Multi-Faceted Intervention To Improve Naloxone Co-Prescription Rates Among Primary Care Providers, Jolane S. Conklin

Evidence-Based Practice Project Reports

It is estimated that 91 Americans die every day due to opioid overdoses, with at least half of those overdoses involving an opioid prescription (CDC, 2016d). To address this issue, the U.S. Department of Health and Human Services (USDHHS) has initiated an opioid initiative, and the Centers for Disease Control and Prevention (CDC) has released a clinical guideline, both of which include a focus on increasing use of naloxone. Despite these recommendations, providers often fail to co-prescribe naloxone to patients at increased risk of opioid overdose. The purpose of this evidence-based practice (EBP) project was to evaluate the effect of …

Effects Of Incorporating Patient Acuity Into The Rn Assignment Process, Melissa L. Forton

Evidence-Based Practice Project Reports

As the largest sector of healthcare, nurses are the primary providers of patient care. By 2025, it is estimated that there will be a shortage of over 250,000 registered nurses (RNs) (American Association of Colleges of Nursing, 2011). Factors contributing to the nursing shortage include increased complexity of patients and decreased staffing that leads to decreased job satisfaction (Fox & Abrahamson, 2009). Over half of neonatal intensive care nurses reported missing at least one nursing task per shift when staffing was inadequate or patient acuity was high (TubbsCooley, Pickler, Younger, & Mark, 2015). The purpose of this evidence-based practice (EBP) …

What’S In A Name: Performance Improvement, Evidence-Based Practice, And Research?, Andrea Prentiss, Eve Butler

Nursing & Health Sciences Research Journal

No abstract provided.

Assessment Of Self-Efficacy And Outcome Expectations In Evidence-Based Activities For Nurses In A Newly Opened Hospital, Julie Lamoureux, Andrea Lavallee, Tanya Cohn, Brittany Pichette

Nursing & Health Sciences Research Journal

Background: There may be a lack of self-efficacy or confidence in some nurses in the use of evidence-based practice (EBP) especially in a new hospital with nurses who are early in their careers. The aim of this study was to measure self-efficacy and outcomes expectations of nurses in the area of EBP in a new non-replacement hospital on the Magnet® designation journey.

Methods: The study design was a cross-sectional survey using a 28-item questionnaire measuring the total level of self-efficacy in undertaking the 5 steps of EBP of direct patient care nurses.

Results: 66 surveys were returned with 6(9%) men …

An Evidence-Based Practice Assessment And Quality Improvement Initiative In Idaho's Critical Access Hospitals, Deena R. Rauch

Doctor of Nursing Practice Projects

Background: Health care providers and systems have been challenged to discard tradition-based care and outdated practices in lieu of evidence-based practice (EBP). Yet, little is known about the state of EBP, barriers and facilitators to EBP, and organizational readiness for EBP in Idaho’s Critical Access Hospitals (CAH). To affect positive change, it was necessary to understand whether providers in Idaho’s CAHs were using evidence as a foundation for practice—and, if not, what challenges existed in implementing EBP. Mitigating barriers and providing EBP education by way of webinar-based online technology has been proven to be practical and feasible. Providing EBP education, …

Nurses And Evidence-Based Practice, Alyson Leann Toney

Nursing Theses and Capstone Projects

Evidence-based practice is a necessary part of providing quality patient care in nursing, and has been linked to lowering costs and bettering patient outcomes. However, evidence-based practice is commonly misunderstood or thrown aside by nurses due to time constraints in the nursing profession. The purpose of the MSN thesis was to explore nurses’ current knowledge and appreciation of evidence-based practice based on previous research, as well as identifying gaps in the knowledge of the concept. A descriptive research design was utilized. Results indicated nurses do have an open mind and appreciation for evidence-based practice, but consider it time consuming and …

Journey To The Bedside: A Quality Improvement Project To Implement Bedside Report Utilizing Watson's Theory Of Human Caring, Rhonda Jones

Nursing Theses and Capstone Projects

A 134 bed hospital in a rural community had a continuous struggle to meet defined goals on the hospital consumer assessment of healthcare providers and systems survey (HCAHPS). The hospital’s medical unit consistently performed lower in the communication with nurses HCAHPS domain than other nursing departments in the organizations. Between 2015 and 2017 the overall communication with nurse’s score in the HCAHPS domain of the medical unit ranged between 74-79%. Nursing staff were task oriented, focusing on the next task to be done instead of the current moment and interaction with the patient. A literature review revealed that consistent themes …

Unpacking Action Research And Implementation Science: Implications For Nursing, Mary Casey, Denise O'Leary, David Coghlan

Articles

Aim

The aim of this study was to unpack the key concepts of action research and implementation science thereby enabling appropriate use of these methods in nursing.

Background

A key issue in action research is not so much the methodology employed to gather data/evidence but who decides the research agenda and who benefits from it. Implementation science is a way to ensure that evidence is translated into practice. The question arises as to how action research and implementation may be understood in relation to one another in nursing.

Design

Discussion Paper

Data sources

This discussion paper is based on our …

Improving Evidence-Based Practice Skills Of Practicing Registered Nurses, Lora K. Moore

Doctor of Nursing Practice Technical Reports

This study evaluated the effect of an educational intervention on improving evidence-based nursing practice (EBP) skills of practicing nurses. In addition, the effects of educational preparation and years of nursing experienced were examined. Using a quasi-experimental pretest-posttest design, the Evidence Based Practice Questionnaire (EBPQ) was administered to a convenience sample of registered nurses from a large regional hospital. The experimental group completed an online EBP educational intervention, the first control group completed an alternate unrelated educational intervention, and the second control group was not provided any type of educational intervention. No significant differences were noted in EBPQ subscale scores of …

Evidence-Based Practice For Influenza And Pneumococcal Nurse-Driven Protocol, Melissa Tunc

Walden Dissertations and Doctoral Studies

At the project site in New Jersey, eligible patients were leaving the hospital without receiving the influenza or pneumococcal vaccine. The field site has an established, evidence-based, nurse-driven protocol. The purpose of this project was to increase adherence to the current influenza and pneumococcal nurse-driven protocol on one medical-surgical unit. This unit had experienced low adherence rates to the nurse-driven protocol for vaccines, not reaching the New Jersey state target of 96% administration prior to discharge. The practice-focused question was: Will increasing awareness of evidence-based practice increase adherence to the influenza and pneumococcal vaccine protocol? A quality improvement plan was …

Development Of A Quality Improvement Program To Support Evidence-Based Nursing Practice, Heather Richards

Walden Dissertations and Doctoral Studies

Nurses are expected to perform evidence-based practice (EBP) at the point of care (POC) to promote positive outcomes through the quality and safety of patient care. The struggle for nurses on the surgical digestive unit in a hospital to adopt EBP is the lack of access and knowledge to evidence-based research at the POC. The utilization of information technology is an innovated approach to providing access and knowledge for EBP at the POC to improve patient outcomes. The project was to develop a quality improvement program to improve nursing access and knowledge of EBP resources. The program was to identify …

Innovative Lesson Plans For Active Learning: Teaching Nursing Research And Evidence-Based Practice, Susan M. Strouse Phd, Rn, Genevieve B. Elrod Phd, Rn, Ocn, Karyn Butler Phd, Rn, Fpmhnp-Bc, Cnm, Chibwe Caroline Powell Bsn, Rn, Afokoghene Odhu Bsn, Rn

Open Textbooks

Innovative Lessons Plans for Active Learning: Teaching Research and Evidence-Based Practice is a resource in research and evidence-based practice for active learning in the undergraduate nursing classroom. It is meant to supplement any nursing research text. Designed to provide educators with creative teaching ideas, this text includes a variety of lessons on nursing research topics. Topics include bias, measurement, sampling, theory and more. Lessons provide active learning for in-class, hybrid, and online formats. Each lesson includes objectives, overview, and detailed steps. As an open access resource, the text is continuously in-process. Designed to be independent of any published text, the …

Assessment Of Fall Protocol Use On A Medical-Telemetry Unit, Ashia Mar

Master's Projects and Capstones

Purpose: This quality improvement project serves to implement a fall prevention plan to decrease patient falls on the medical-telemetry unit of a large metropolitan hospital.

Background: Patient falls are a persistent nationwide problem in the acute care setting. Between 700,000 and 1,000,000 falls occur in hospital every year and approximately 30-35% of these falls result in injury and 11,000 falls result in death (Health Research & Educational Trust, 2016). Falls always cause harm to the patient, whether it is emotional or physical; but, falls can also cause harm to the providers, family, and organization. Patient injury, additional hospital expenses, and …

Critical Appraisal Tools And Reporting Guidelines For Evidence-Based Practice, Robin Buccheri, Claire Olivia Sharifi

Gleeson Library Faculty and Staff Research and Scholarship

Background: Nurses engaged in evidence-based practice (EBP) have two important sets of tools: Critical appraisal tools and reporting guidelines. Critical appraisal tools facilitate the appraisal process and guide a consumer of evidence through an objective, analytical, evaluation process. Reporting guidelines, checklists of items that should be included in a publication or report, ensure that the project or guidelines are reported on with clarity, completeness, and transparency. Purpose The primary purpose of this paper is to help nurses understand the difference between critical appraisal tools and reporting guidelines. A secondary purpose is to help nurses locate the appropriate tool for the …

Implementation Of An Evidenced-Based Practice Curriculum To Improve Nursing Practice For Epidural Administration And Monitoring, Chatty O'Keeffe

Master's Projects and Capstones

Abstract

Epidural analgesia (EA) is one inpatient pain management option prescribed by Acute Pain Services (APS) at VA Puget Sound Health Care Services (VAPSHCS). Historically, EA nursing care at VAPSHCS has been managed by surgical units. However, in the last two years, facility restructuring and budget constraints have led to reorganization and consolidation of units. The reduction in units providing nursing EA care has resulted in an overflow of EA patients to the medical intensive care unit (MICU). A previous gap analysis of the compliance in nursing performance of EA nursing care on the surgical acute care unit demonstrated poor …

Healing Touch: Enhancing Quality Of Life, Julia Mccann-Khludenev

Evidence-Based Practice Project Reports

Healing touch (HT) is a non-invasive energy therapy used in the management of symptoms of various health conditions. HT utilization has demonstrated enhanced comfort and relief of symptoms such as chronic pain, post-traumatic-stress, depression, and anxiety. The purpose of this evidence-based practice (EBP) project was to promote awareness and appointment compliance rate of HT amongst veterans, and also to determine effectiveness of HT intervention on symptom relief and well-being. The PICO question was: “For Veterans, what is the effect of HT education material and mail notification on appointment compliance rate, and HT delivery on symptom relief and well-being as compared …

Nursing Assignments Based On Patient Acuity: The Road To Nursing Job Satisfaction, Kristina Tomic

Evidence-Based Practice Project Reports

Challenges in the healthcare industry, including nursing shortages and low nursing retention, have resulted in nurses’ job dissatisfaction. Improving work environment and workload can lead to improved and equitable nursing shift assignments, which may improve nursing job satisfaction. The purpose of this EBP project was to (a) implement a patient acuity tool in the hospital unit, (b) assess its effectiveness in appropriating nursing shift assignments, and (c) evaluate its effect on nursing job satisfaction. The Evidence Based Medicine (EBM) Model was used as a guide to facilitate the transition of the best evidence into practice. As suggested within the evidence, …

The Effect Of Bundled Interventions On Prevention Of Hospital Acquired Clostridium Difficile Infection, Kaitlin Kendys

Evidence-Based Practice Project Reports

Clostridium difficile infection (CDI) rates have steadily increased in hospitalized patients due to the change in epidemiology. Approximately 13 of every 1,000 inpatients are either infected or colonized with C. difficile (CDC, 2013). CDI rates continue to rise due to the hyper-virulent strain of C. difficile and length of therapy needed to treat CDI. The average cost for a single inpatient CDI is more than $35,000, and the estimated annual cost burden for the healthcare system exceeds $3 billion (Walsh, 2012). The purpose of this evidence-based project (EBP) was to reduce hospital-acquired CDI rates over a 3-month period-oftime from November …

Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano

Evidence-Based Practice Project Reports

Patient/visitor violence against healthcare (HC) employees is a type of workplace violence (WPV) and considered a dangerous hazard within HC occupations (Bureau of Labor Statistics, 2015). Lack of recognition of the true incidence and underreporting of WPV may contribute to a false sense of security within a HC facility (HCF). Therefore, fully addressing the problem may be met with administrative resistance, resulting in poor employee perceptions of support and commitment for a zero-violence environment. A retrospective analysis was conducted on the HCF’s online incident reports, security request calls, and data from a previously deployed WPV employee survey. The emergency department …

Implementation Of A Multifactorial Fall Prevention Protocol, Laura Wilkerson

Evidence-Based Practice Project Reports

According to the Joint Commission Center for Transforming Healthcare (2016), moderate to severe injuries from falls on average add 6.3 days to a hospital stay and cost approximately $14,056 per patient hospitalization. The purpose of this evidence-based practice (EBP) project was to implement a multifactorial approach to identify patients at risk for falls on admission to the orthopedic/neurosurgical unit and provide individualized interventions necessary to prevent falls. The Iowa Model of Evidence-Based Practice and Orlando’s Nursing Process Discipline facilitated the implementation of this project. A total of 45 staff members on the unit were educated on the multifactorial fall protocol …

Implementation Of A Standardized Handoff During Transition Of Care From The Emergency Department To The Intensive Care Unit, Melinda Abbring

Evidence-Based Practice Project Reports

Patient safety and nursing communication are crucial to the nursing handoff during transition of care from the emergency department (ED) to the intensive care unit (ICU). The Institute of Medicine published To Err is Human: Building a Safer Health System (1999) and Crossing the Quality Chasm (2001) highlighting ED handoffs as a safety measure. In 2006, the Joint Commission recognized handoffs with the National Patient Safety Goal 2E. The purpose of this evidence-based practice project was to determine if implementation of a standardized handoff would improve nursing communication and patient safety during transition of care from the ED to the …

Pediatric Hematology/Oncology Outpatient Care: The Effect Of A Standardized Collaborative Medication Reconciliation Process, Traci R. Pulliam

Evidence-Based Practice Project Reports

Pediatric patients are at an increased risk for medication errors and can benefit from processes that facilitate and promote medication safety (Stone et al., 2010). Medication reconciliation (Med Rec) is a valuable tool in improving patients’ medication safety and reducing adverse drug events (The Joint Commission, 2015). The purpose of this evidence-based practice (EBP) project was to improve the accuracy of the Med Rec process in a Midwestern pediatric hematology/oncology outpatient clinic by developing, promoting, and evaluating a standardized, collaborative Med Rec process. The Stetler EBP model guided the implementation of the intervention, with the goal of integrating current evidence …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

The Effect Of Routine Adult Phq-2 Depression Screen And Scheduled Follow-Up Protocol In The Primary Care Setting, Alex F. Bikowski

Evidence-Based Practice Project Reports

Healthy People has projected depression to be the primary cause of disability by 2020; therefore routine depression screening has been prioritized as a national healthcare initiative. The purpose of this Evidence-Based Practice (EBP) project is to demonstrate that routine implementation of the 2-item Patient Health Questionnaire (PHQ-2) depression screener, along with a scheduled follow-up protocol for adults in the primary care setting, can improve current mental health practices regarding the identification of depression by clinicians. The evidence supports use of the PHQ-2 for routine adult depression screening, as long as a scheduled follow-up protocol is available for positive screens. This …