Nursing Commons^™

The Effect Of Shared Medical Appointments And Education On Hemoglobin A1c Levels, Gina L. Moore

Evidence-Based Practice Project Reports

Type II diabetes affects millions of people worldwide. Approximately 25.8 million or 8.3 percent of the United States (U.S.) population has type II diabetes. The number of adults in the United States developing diabetes has been projected to double by the year 2030 (World Health Organization, 2013). Diabetes is the leading cause of kidney failure and blindness, as well as the major cause of heart disease and stroke which is the 7th leading cause of death in the U.S. The purpose of this evidence-based project was to determine the effects of education during shared medical appointments with type II diabetic …

Influence Of A Palliative Care Protocol On Nurses' Perceived Barriers To Palliative Care And Moral Distress, Christina Cavinder

Evidence-Based Practice Project Reports

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported …

The Effect Of Patient Education On Anxiety Levels In Patients Receiving Chemotherapy For The First Time, Sarah Garcia

Evidence-Based Practice Project Reports

Cancer affects approximately 1.5 million people every year throughout the United States.Comprehensive care that includes psychosocial aspects is important to help patients effectively adapt to their diagnosis and treatment plan. Improper prevention and management of anxiety can lead to poor psychosocial outcomes, dissatisfaction with care, and decreased adherence to treatment. Current evidence suggests that education is effective at helping reduce anxiety in patients receiving chemotherapy for the first time. The purpose of this evidenced based practice project was to determine if nurse-led patient education regarding chemotherapy side effects, side-effect management, and orientation to the infusion center was effective at decreasing …

Effects Of An Osteoporosis Educational Intervention: Knowledge And Self-Efficacy Of Prevention In Young Adult Collegiate Females, Valerie A. Bollenbacher

Evidence-Based Practice Project Reports

Osteoporosis is a silent and potentially debilitating chronic illness. In 2012, the CDC reported that 4.5 million women over the age of 50 were diagnosed with osteoporosis in the United States. Within the next 20 years, 41 million women worldwide are projected to have osteoporosis. The annual financial burden of osteoporosis is estimated to be 19 billion dollars. The objective of this evidence-based practice project was to answer the clinical question: In young adult collegiate females, how does an osteoporosis educational intervention compared to current education effect osteoporosis knowledge and self-efficacy of osteoporosis prevention over a one-month time period? The …

The Use Of Stress Reduction Techniques In Nursing Education, Jennifer S. Bauer

Evidence-Based Practice Project Reports

Stress is a complex phenomenon that has significant effects on students which may disturb their physiological, psychological, and spiritual health and well-being. Nursing students have been identified to be at high risk for stress during their education. Stress can arise from new clinical experiences, academic load, and personal stressors (Jones & Johnston, 2006). This increase in stress can lead to the student’s inability to assimilate and learn within the classroom and clinical settings. A review of the literature provided evidence that reported a positive relationship between guided imagery and a decrease in stress and anxiety. This evidence-based practice (EBP) project …

The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

Effects Of A Parish Based Heart Healthy Education Program, Kristin A. Kilinski

Evidence-Based Practice Project Reports

Cardiovascular disease is the leading cause of mortality and morbidity in the United States. Some risk factors for cardiovascular disease can be modified which include: diet; physical activity; smoking; hypertension; diabetes; and weight. Various national programs, such as “Go Red for Women” and “Let’s Move,” have been implemented to address this growing epidemic. Community programs are needed as an adjunct to these national initiatives. Thus, a parish based cardiovascular disease educational program would provide for a unique socially and spiritually supportive environment for education at the community level. Research findings indicate that parish based educational programs are effective in increasing …

The Effects Of Education On Cardiovascular Disease Knowledge, Lauren A. Ostrowski-Winkler

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for adults in the United States. The three main risk factors for the development of CVD include hypertension, high cholesterol, and tobacco use; these factors are largely prevented or reduced through lifestyle modifications. Researchers indicate that knowledge of CVD mortality has been linked with individual action to reduce one’s CVD risk. Researchers have also indicated that segments of our underserved society, particularly those with the highest CVD mortality rates, are also the least knowledgeable about CVD and their own personal risk. These risk factors were a concern within the …

Screening Asymptomatic Women For Cardiovascular Risk, Kathryn Nelson-Murphy

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) has long been recognized as a significant health problem in the U.S., and is the leading cause of preventable death in women, collectively causing about one death per minute (Caboral, 2013). A myriad of modifiable risk factors including dyslipidemia, hypertension, smoking, obesity, and type II diabetes are associated with 80-90% of CVD morbidity and mortality. Despite sobering statistics, valid risk prediction screening tools, and national preventive guidelines, adequate screening in clinical practice settings is sadly deficient. An evidence-based practice project was designed and implemented at a large OB/GYN practice in southern Ohio to address this identified gap …

Prevention Of Unplanned Extubations, Melissa Fradette, Donna Kamps

Nursing Posters

Background: The trend of unplanned extubations is rising. Unplanned extubations are a safety concern for patients. A ventilator bundle is in place to guide nurses and respiratory therapists for weaning and extubating patients who meet criteria; it is not always being used. This concern has been discussed at the ICU safety team, ICU NP, ICU ROE, and ICU leadership meetings.

Nursing Skin Integrity Guidelines: A New Approach To Skin Care, Kim Schuster, Amy Gorecki, Jennifer Burris

Nursing Posters

What is nursing skin integrity guidelines: a nursing driven order to provide evidence based skin integrity interventions; provides a streamlined process for immediate application of best practice interventions for identified skin impairments; the interventions can be implemented based on assessment findings and clinical judgment; and provides a guideline for consulting the WOC Nurse, including when wounds are not healing, all pressure ulcers, and ostomy needs.

Impact Of Tranexamic Acid (Txa) On Hemoglobin Levels In Elective Total Knee Arthroplasty Patients, Gina Anderson-Malum

Nursing Posters

Over the last 2 years, the Bone and Joint Center has focused on blood utilization for total knee and total hip arthroplasty. With the use of a blood transfusion protocol, we significantly reduced blood transfusion rates and standardized the approach to care. As an expansion of this work, other ideas to further decrease blood utilization were considered. The purpose of the data collection of preoperative and postoperative Hemoglobin (HGB) levels was to evaluate the effect of Tranexamic Acid (TXA) on the average change in Hgb levels compared to Hgb levels of patients that did not receive the medication. In addition, …

Creating Opportunities For Personal Empowerment For Adolescent Students In A Rural High School, Sharon A. Edwards

Doctor of Nursing Practice Projects

BACKGROUND: With the incidence of 3% of children and 6% of adolescents diagnosed with depression, treatment appropriate for this population is needed. Provision of mental health care is limited due to barriers of access such as transportation, parental consent, and availability of services in the adolescent’s environment such as the school setting. OBJECTIVES: To decrease the depressive symptoms and increase the self-confidence perceptions of adolescents in a high school setting utilizing a cognitive-behavioral skills enhancing, seven-session intervention called COPE (Creating Opportunities for Personal Empowerment).

STUDY DESIGN: The project was an evidence-based nurse practitioner project utilizing pre- and …

The Innovation Of Simulation Laboratories And The Novice Nurses In The Clinical Setting, Brenda Washington Moore

Walden Dissertations and Doctoral Studies

The push to generate professional nurses has raised questions about the competency level of the novice nurses that are entering the workforce. Utilization of simulation laboratories is being viewed as an option for bridging the gap for the shortage of nurses, nurse educators, and clinical sites. The theory of goal attainment was used to guide this project, which aimed to develop and validate an ER simulation scenario that mimics a clinical setting as a tool for measuring nursing skills. An additional purpose, to be accomplished after graduation, will be to implement a pilot project to determine the impact of the …

Assessing Certified Registered Nurse Anesthetists’ Attitudes Toward And Barriers To The Use Of Evidence-Based Anesthesia Practice, Laurie E. Parkman

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Evidence-based practice is the integration and synthesis of the best research evidence with clinical expertise and patient values. Use of evidence-based practice decreases variability in care and improves patient outcomes. This research project assessed variables that inhibit the adoption of evidence-based practice into individual CRNAs’ practice. Ninety-two CRNAs in Georgia participated in an email survey to assess attitudes and perceived barriers to evidence-based practice. Attitudes toward evidence-based practice were assessed with the Evidence-Based Practice Questionnaire (EBPQ), and perceived barriers to the use of evidence-based practice were assessed with the BARRIERS scale. A Pearson product-moment correlation coefficient was computed to assess …

Teaching Information Literacy Skills To Undergraduate Nursing Students: A Collaborative Approach, Suzanne E. Zentz, Kimberly J. Whalen

Nursing and Health Professions Faculty Presentations

Background An expectation of baccalaureate nursing education is to prepare nurses to implement evidenced-based practice (EBP). This expectation extends far beyond a basic understanding of the research process. BSN prepared nurses must be able to effectively and efficiently identify, analyze, and synthesize evidence (AACN, 2008). The acquisition of information literacy skills is foundational to the development of EBP. Implementation The study took place at a College of Nursing within a mid-sized, faith-based university located in the Midwest. Historically, students enrolled in their senior level undergraduate nursing research/EBP course underwent one library instruction session with the nursing librarian to reinforce search …

Global Health And Nursing, Heather Trane, Dr. Lynn Clark Callister

Journal of Undergraduate Research

A key component of the nursing profession is a lifelong commitment to learning with an emphasis on evidence-based practice. Research finds new data everyday as the world is constantly changing. For nurses to provide the best possible care to patients, they need to be up to date on the latest research findings.

An Educational Approach: Increasing College Freshmen's Knowledge Regarding Sexually Transmitted Infections, Jennie Mcclain

Evidence-Based Practice Project Reports

According to the Centers for Disease Control (2009), young adults account for only 25% o fsexually active persons in the United States, but account for 50% of the newly diagnosed cases of sexually transmitted infections (STIs). Some young adults may not have received appropriate or credible information on sexual health by which to make knowledgeable decisions that may influence the rest of their lives. High schools are not required to offer comprehensive sex education. Therefore, some students may have received abstinence-only sex education. Risk reduction and disease prevention are important in college health. This evidenced-based practice project included the creation, …

The Effect Of Heart Failure Education On Reducing Readmissions, Mayola Lara Villarruel

Evidence-Based Practice Project Reports

Management of heart failure is a significant financial challenge for the health care industry, costing approximately $33.2 billion annually. Common reasons for preventable heart failure readmissions include inadequate discharge education and lack of self-care and health management activities. Education at discharge is a vital component of improving heart failure outcomes. Following a review of the literature, high quality evidence supports that heart failure education should focus on medication adherence, sodium and fluid restriction, daily weights, activity tolerance, identification of deteriorating signs and symptoms of heart failure, and smoking cessation. The purpose of this EBP project was to reduce heart failure …

Using A Research Log And Reflective Writing To Improve Ebp And Information Literacy Skills Of Bsn Students, Suzanne E. Zentz, Kimberly J. Whalen

Library Faculty Presentations

Background Baccalaureate nursing educators must prepare nurses to implement evidence-based practice (EBP). BSN nurses must be able to effectively identify, analyze, and synthesize evidence (AACN, 2008). In a nursing research course, students conducted group projects which required searching for the best evidence. Project evaluations revealed that students were not searching systematically. To facilitate EBP and information literacy skill development, a collaboration between the College of Nursing and Library Services emerged.

Targeted Learning Outcomes 1. Formulate a strategic search using databases and Internet resources 2. Evaluate and select the ‘best available’ evidence 3. Document systematic search (keywords, subject headings, limiters, and …

Using A Research Log And Reflective Writing To Improve Ebp And Information Literacy Skills Of Bsn Students, Suzanne Zentz, Kimberly Whalen

Library Faculty Publications

Baccalaureate nursing educators must prepare nurses to implement evidence-based practice (EBP). BSN nurses must be able to effectively identify, analyze, and synthesize evidence (AACN, 2008). In a nursing research course, students conducted group projects which required searching for the best evidence. Project evaluations revealed that students were not searching systematically. To facilitate EBP and information literacy skill development, a collaboration between the College of Nursing and Library Services emerged.

Targeted Learning Outcomes

1. Formulate a strategic search using databases and Internet resources

2. Evaluate and select the ‘best available’ evidence

3. Document systematic search (keywords, subject headings, limiters, and results) …

Reducing Heart Failure In An Era Of Reform, Sandra M. Kurpela

Evidence-Based Practice Project Reports

Heart failure (HF) affects an estimated 5 million Americans, with 550,000 new patients diagnosed yearly (American Heart Association, 2004). Despite advancements, readmissions for HF remain high. Management is especially important due to recent legislation that penalizes hospitals with excessive readmissions. The purpose of this evidence-based project (EBP) was to determine if a chronic disease HF management program with advance practice nurse, home care, and telehealth would affect hospital readmission 4 weeks post-discharge. Orem’s Self-Care Deficit Nursing Theory and the Iowa Model guided this system change. The project used a longitudinal experimental pre- and post-test design with convenience sample from two …

Effects Of A School-Based Education Intervention On Bmi And Physical Activity, Lauren M. Panner

Evidence-Based Practice Project Reports

In 2011, the CDC reported that there are 12.5 million obese children and adolescents living in the United States (U.S.). The financial burden of childhood obesity in the U.S. is estimated to be 14 billion dollars. The objective of this evidence-based practice (EBP) project was to answer the question: In school-aged children, how does school-based, structured, family-oriented physical activity education affect body mass index (BMI) compared to usual education over an eight week time period? The Stetler Model of EBP and the health belief model were used to guide this project in a rural, Northwest Indiana elementary school. For eight …

The Effectiveness Of A Parental Education Intervention About A Child-Oriented Approach To Tolieting For Healthy Thai Toddlersthe Effectiveness Of A Parental Education Intervention About A Child-Oriented Approach To Tolieting For Healthy Thai Toddlers, On-Anong Thammajinda

Evidence-Based Practice Project Reports

Toilet training (TT) is a necessary developmental task that all healthy children must ultimately achieve. The Centers for Disease Control and Prevention (CDC, 2001) noticed that E. coli can be spread to playmates by toddlers who are not toilet trained. Studies showed parental participation in the TT process is crucial and parental readiness to pledge to TT is an important step for training. In Thailand, very few studies were conducted about TT a toddler, and all of the studies were descriptive. The purpose of this evidence-based practice project was to determine the effectiveness of a parental education intervention about TT, …

The Effects Of A Violence Assessment Checklist On The Incidence Of Violence For Emergency Department Nurses, Sarah Knapp

Evidence-Based Practice Project Reports

Workplace violence (WV) is commonplace in American culture, and nurses working in emergency departments (ED) are not immune to its effects. Violence against emergency department nurses is prominent in current nursing literature, and a cause for major concern. Regrettably there is no consistent tool being used to assess for potential patient violence specific to the emergency department. Current assessment tools have been developed and are commonly used in the mental health arena. This evidence-based practice project concentrated on answering the clinical question of whether or not a violence risk assessment checklist reduced the incidence of violence and increased perception of …

Healthy Skin Is In: Effects Of A Multifaceted Sun Safety Program For Adolescents, Lindsay A. Munden

Evidence-Based Practice Project Reports

Skin cancer is a common, potentially life threatening disease notably on the rise among young Americans. A substantial portion of lifetime exposure to ultraviolet (UV) radiation, the greatest modifiable risk factor for skin cancer development, occurs during childhood and adolescence. Schools infrequently integrate sun safety education into the classroom and many lack essential sun safety policies. The purpose of this EBP project was to implement a multifaceted educational intervention providing middle school students with the knowledge behavioral skills needed to minimize the risk of developing skin cancer. The Health Belief Model and ACE Star Model of evidence-based practice guided this …

Sitter Observation, Lisa Kilgard, Elizabeth Schuler

Nursing Posters

To implement a practice change at St. Cloud Hospital which reduces one to one observation in medical and behavioral patients as compared to current routine practice of one to one sitter use as a common intervention used.

The Influence Of Emergency Rns' Characteristics And Readiness For Change On Their Intention To Implement Evidence-Based Practice, Mary Kathryn Naccarato

MUSC Theses and Dissertations

Emergency departments are a major source of hospital admissions with patients at risk for pressure ulcer development. Yet, there is a paucity of literature in two key areas: emergency RNs' role in PU prevention and their knowledge, skills, attitudes and intentions toward implementation of PU prevention guidelines. Manuscript 1 was an integrative review that found multiple factors--knowledge, attitudes, and environmental--that affect nurses' use of PU prevention. Manuscript 2 was an integrative review that found the readiness for change construct as a precursor to implementing an organizational or individual change. Some nurse researchers suggest a readiness assessment as the first step …

Patient Safety Competencies In Rural Asn Students: An Evidence-Based Curricular Innovation, Janeen Berndt

Evidence-Based Practice Project Reports

Hospital clinical experiences are important events in prelicensure nursing education. Benefits include the opportunity for students to experience actual nursing responsibilities, immersion into environment, and professional socialization. However, challenges in finding appropriate clinical experiences include competition over clinical sites, decreasing patient acuity, and high student-faculty ratios. Rural schools of nursing have these challenges and those inherent in rural environments such as limited health care access, restricted critical access hospitals, and limited resources. The purpose of this evidence-based practice project was to plan, implement, and evaluate the use of a series of patient care simulations as an educational intervention to improve …

A Multi-Component Intervention To Reduce Alcohol Consumption In College Freshmen, Kimberley L. Jelinek

Evidence-Based Practice Project Reports

Alcohol consumption is a health concern on all college campuses in the United States. College students’ alcohol consumption is a highly prevalent behavior, with 44% reporting that they are consuming alcohol at the binge level or greater (Wechsler & Nelson, 2008). The purpose of this evidence-based practice (EBP) project was to answer the clinical question: In college freshmen, how does a multi-component intervention influence alcohol consumption over a four-month period? The Transtheoretical Model of Behavioral Change (TTM) and Diffusion of Innovations (DoI) were used to guide the project. Evidence demonstrates that implementing brief intervention, promoting substance-free events, and increasing campus …