Nursing Commons^™

The Efficacy Of The Role Of Therapeutic Play In Alleviating Pain Or Anxiety In Pediatric Cancer Patients, Savannah B. Duke

Honors Undergraduate Theses

Aim: To evaluate the efficacy of therapeutic play in alleviating pain or anxiety in the pediatric cancer patient.

Background: Therapeutic play is an intervention often incorporated within the care of pediatric cancer patients and children with other disease processes to promote well-being. Even though play therapy is supported by research, nurses have the option to implement nursing care interventions in a play-like manner. Therapeutic play is an individualized technique that provides an intentional opportunity for children to express their emotional responses in a controlled environment.

Method: The databases used in this search included CINAHL, MEDLINE, APA PsycINFO, ERIC, and Education …

Ophthalmic Nursing Education: The Key To Unlocking Patient Access To Retina Services, Jacob P. Mcginnis

Master's Theses and Capstones

Background: Ophthalmology, the medical field dedicated to the human eye and visual system infrequently uses nurses due to a lack of nursing knowledge about ophthalmology.

Local Problem: An ophthalmic microsystem in the Northeastern United States is experiencing increased demand for services and decreased access to their retina section. The microsystem does not utilize nurses in the clinic because of education and training barriers. The specific aim of this quality improvement (QI) project is to increase nursing knowledge about ophthalmology from baseline to an overall passing score of 80%.

Methods: This QI project sought to see if registered nurses could …

Factors Influencing The Development And Implementation Of Nurse Practitioner Candidacy Programs: A Scoping Review, Lisa Whitehead, Diane E. Twigg, Rebecca Carman, Courtney Glass, Helena Halton, Christine M. Duffield

Research outputs 2014 to 2021

Background

To meet the growing needs of a diverse population, it is critical that healthcare service provision is underpinned by innovative, cost-effective, and sustainable services and solutions. The role of the nurse practitioner creates an opportunity to meet the increasing demands of complex care and enables greater access to high quality care. Understanding how best to support nurse practitioner candidates to develop into the nurse practitioner role will create greater opportunities to transform service delivery and improve healthcare outcomes.

Aim

To identify key factors that support and positively impact the implementation of nurse practitioner candidacy programs and candidate experiences.

Methods …

The Effect Of An Educational Intervention On Attitudes Toward Behavioral Health Patients Among Medical Floor Nurses: A Pilot Study, Caroline C. Bowman

DNP Projects

Background: Stigma towards behavioral health patients by healthcare workers can create barriers to quality care for patients. Addressing these negative attitudes towards behavioral health patients can improve health outcomes and reduce healthcare costs. Current evidence-based practice for tackling stigmatizing attitudes include interventions to improve mental health education among healthcare providers to promote improved patient outcomes.

Purpose: The goal of this project was to enhance medical floor nurses' attitudes toward behavioral health patients by delivering a web-based educational intervention on recognition and management of behavioral health disorders. The aims of the project were to: 1.) Assess nurses' stigma toward behavioral health …

The Effect Of A Web-Based Training On Suicide Knowledge, Attitudes, And Health Access Behaviors Of Behavioral Health Nurses Regarding Suicide Prevention, Marc Woods

DNP Projects

Background: Nurses, critical to the health care delivery system, experience a variety of psychological stressors that predispose them to suicide risk. Recent studies have verified elevated suicide risks in nurses when compared to the general population. There is limited understanding regarding the effectiveness of various strategies to reduce risk factors and increase protective factors for suicide among nurses.

Purpose: The purpose of this study was to evaluate if a web-based education module can improve the knowledge, attitudes, and ratings of willingness to access help related to suicide prevention in behavioral health nurses.

Conceptual Framework: Ajzen’s theory of …

Experiences Of Nurses Who Provide Advance Care Planning In The Dialysis Setting, Sheree Mullen

Walden Dissertations and Doctoral Studies

AbstractPatients diagnosed with end-stage renal disease (ESRD) receiving dialysis experience increased symptom burden and multiple hospitalizations as the disease progresses. Dialysis nurses are charged with involving ESRD patients in decisions regarding their care and advance care planning for end-of- life; however, discussions about end-of-life care do not consistently occur. Providing advance care planning is important to involve the patient in their end-of-life care needs. The purpose of this qualitative descriptive study guided by the theory of planned behavior was to explore the experiences of nurses who provide advance care planning to patients receiving dialysis therapy. Eight participants volunteered to participate …

Purposeful Nurse Hourly Rounding: Plan To Decrease Patient Falls During A Pandemic, Robbie Masangkay

Doctor of Nursing Practice (DNP) Projects

Problem: Patient falls remain a critical and persistent safety problem in healthcare today. The prolonged impact of the COVID-19 pandemic raises leadership concerns regarding the safe care of high-risk COVID patients and mitigating the increased stress and potential risks of infection to clinical staff.

Context: This Doctor of Nursing Practice (DNP) scholarly project details implementation of an evidence-based purposeful nurse hourly rounding (PNHR) pilot project designed to decrease the incidence of patient falls on a designated COVID-19 unit.

Measure: A modified PNHR rounding tool was implemented to guide focused elements for key nurse/patient interactions.

Interventions: …

Implementing Staff Education To Reduce Stress And Increase Resilience, Samantha Lambert, Mariana Corpus, Sherry Chesak, Susanne M. Cutshall, Diane M. Forsyth, Habibo A. Haji

Nursing DNP Projects

Purpose: Persistent levels of high stress among nurses impact work activities and job performance, leading to burnout, compassion fatigue, lower job satisfaction, high workplace turnover, and diminished quality of patient care (Lin et al., 2018). Nurses who demonstrate resilience are better able to adapt to unexpected events with a positive attitude, self-esteem, and tolerance (Huang et al., 2020). The purpose of this project was to decrease stress levels and improve resilience among nursing staff, utilizing education on holistic stress management and resilience techniques.

Methods: A four-hour mindfulness-based education course was provided to staff members (N=76). Components included an initial two-hour …

Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner

Master of Science in Nursing Final Projects

Abstract

Percutaneous coronary interventions (PCIs) are considered life-saving techniques in the event of myocardial infarction and remain the standard of care for managing acute heart attack. Given the success of the procedures, decreased complications, and the economic advantage over open-heart surgery, coronary interventions continue to be the preferred treatment choice. However, amidst the growth and success of these procedures, readmissions after percutaneous coronary interventions have been identified and still prevail among hospitals. Hence, the goal was to conduct an integrative review to identify and synthesize literature on the interventions that help reduce readmissions after percutaneous coronary interventions and illuminate nurses' …

Purposeful Nurse Hourly Rounding: A Plan To Decrease Patient Falls During A Pandemic, Robbie Masangkay

Doctor of Nursing Practice (DNP) Projects

Aims: This paper describes the design of a purposeful nurse hourly rounding pilot to decrease the incidence of patient falls on a COVID-19 designated unit in an acute hospital setting.

Background: Falls in acute care hospitals are a persistent patient safety problem. The COVID-19 pandemic has added to concerns to safely care for high-risk COVID patients while mitigating the risk of infection for frontline staff.

Methods: A PNHR pilot project was designed for implementation in a 28-bed COVID-19 designated unit in a not-for-profit acute hospital in California. A modified PNHR rounding tool guides focus points for every nurse/patient interaction. Pre- …

Implementing Mindfulness Meditation To Reduce Nurse Burnout, Jannelle V. Sanchez

Electronic Theses and Dissertations

Abstract

There will be an estimated shortage of 100,000 nurses by the year 2022, with 500,000 seasoned nurses retiring. The nursing profession has recently experienced a devastating pandemic that left no time to combat the detrimental effects of burnout, specifically for intensive care nurses, who are the frontline workers of a physically and psychologically draining working environment conducive to burnout. Nurses experience burnout for a mixture of reasons, but mainly it is due to the lack of interventions to help them combat the disease. Mindfulness meditation represents an interventional tool that has been shown to reduce the negative stressors associated …

Health Promotion Within High-Risk Communities: Become An Agent Of Change To Enhance Vaccination Acceptance In Communities, Natalie A. Fischetti Dr., Susan Mee Dr.

Open Educational Resources

This is a course of six self-paced modules for nursing students to learn about vaccines, vaccine safety and patient education regarding vaccines.

Code Gray Response Team, Charlie A. Brizzee

IPS/BAS 495 Undergraduate Capstone Projects

This video presentation addresses the declining feeling of safety by frontline clinical staff due to the recent escalation of combative patients and workplace violence in the healthcare setting, identified through Emotional intelligence and the approach created to address it. This project was crafted as an innovative and creative approach to addressing the issue in the clinical setting without adding additional staff or additional expense to the organization. Additionally, the approach had to be innovative and creative as the author does not own the current process, and knowing to receive stakeholder acceptance, the ownership had to remain with the current stakeholder. …

Coronavirus Disease 2019 (Covid-19): A Literature Review From A Nursing Perspective, Amir Emami Zeydi, Mohammad Javad Ghazanfari, Farzam Shaikhi Sanandaj, Reza Panahi, Hamed Mortazavi, Keyvan Karimifar, Samad Karkhah, Joseph Osuji

BioMedicine

Introduction: As the COVID-19 pandemic ravages the world, nursing resources, and capacities play an essential role in disease management. This literature review focuses on the central issues related to the nursing care of patients affected by COVID-19.

Material and Methods: This literature review was conducted with an extensive search of databases, including PubMed, Web of Science (WOS), and Scopus, using the keywords "COVID19", "2019-nCoV disease", "2019 novel coronavirus infection", "Nurse", "Nursing Care", and "Nursing management." The span of the literature search was between December 01, 2020, and January 12, 2021. A total of 28 original and English-language articles …

Addressing Critical Care Nurse Burnout, Julie Suarez

Master's Projects and Capstones

Problem: Critical care nurses are at higher risk for developing burnout than nurses from other areas of clinical practice. If not addressed promptly, the problem of burnout can worsen, negatively affecting the healthcare provider, organization, and patient outcomes.

Context: Increased stress and burnout observed in the microsystem with the onset of the COVID-19 pandemic prompted consideration of ways to address the well-being of critical care nursing staff with targeted interventions that could be implemented quickly with readily available resources.

Interventions: The project aim was to reduce critical care nurse burnout scores through implementation of evidence-based strategies addressing participative management, camaraderie …

The Impact Of A Structured Civility Educational Module And Cognitive Rehearsal Training (Crt) On Job Satisfaction And Turnover In Rural Healthcare Employees: A Quality Improvement Pilot Project, Laurel Matthews

Doctor of Nursing Practice (DNP) Manuscripts

Incivility is a top-cited stressor resulting in decreased job satisfaction and turnover. Uncivil behaviors jeopardize patient safety through poor communication and team ineffectiveness. This project aimed to determine if a structured civility educational module with CRT positively impacted job satisfaction and turnover of healthcare employees.

A pretest using the Workplace Civility Index (WCI) and investigator generated questions determined current civility behaviors, notable civility issues, and attitudes surrounding job satisfaction and turnover. The interactive, virtual modules highlighted dilemmas regarding incivility and their consequences to patient care. During CRT, the participants responded to filmed, uncivil conflicts using provided frameworks to curate civil …

The Impact Of Mindfulness-Based Stress Reduction Techniques On Nurse Burnout In An Icu, Heather L. Vincent

Student Scholarly Projects

Practice Problem: Burnout among nurses has been linked to turnover, negative patient safety and quality outcomes, and higher costs for institutions.

PICOT: The PICOT question that guided this project was, in ICU nurses (P), what was the impact of the use of MBSR techniques (I), versus the current state in which no MBSR techniques are practiced (C), on self-reported BO (O), over the course of eight weeks (T).

Evidence: A total of 14 studies were identified in the literature that directly support the implementation of this project. Themes from the literature show that mindfulness-based stress reduction techniques such as meditation, …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

Exploring The Effect Of Language Concordance Between Nurses And Limited English Proficient Patients On Their Health Outcomes., Elizabeth K. Moon, Sarah Miner

The Review: A Journal of Undergraduate Student Research

Communication is essential to the medical field. Approximately 350 different languages are spoken in the USA. The commonality of language discordance between patients and health care providers causes poor communication, limited understanding of their condition, and a decrease in the patient’s satisfaction with their care. This literature review explored the effect that a language concurrent healthcare provider has on the health outcomes of LEP patients. LEP is defined as limited English proficiency. METHODS: CINHAL and Pubmed were used. The key terms used were communication barriers, language barriers, nurse, nurses, nursing, and health outcomes. The search revealed 719 articles. Seven articles …

The Nurse Will See You Now: Improving Nurse-Led Chemotherapy Teaching, Laura Oka

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: According to The International Agency for Research on Cancer (IARC) 2020 World Cancer Report, cancer has contributed to 9.6 million deaths in 2018 and is now globally considered the second most common cause of death (IARC, 2020).

Context: As a cancer patient moves beyond diagnosis, there becomes a need to introduce the plan of care and education related to evidence-based treatments with an intent to cure. As the delivery of these treatments continues to move toward outpatient care, herein lies the challenge of sharing important information with the patient to improve health outcomes.

Intervention: This DNP change of …

Implementing In-Situ Mini Mock Code Trainings For Medical-Surgical Nurses To Improve Nurse Readiness And Self-Confidence During A Code Blue, Allison Haley Jeong

Master's Projects and Capstones

Immediate, high-quality cardiopulmonary resuscitation (CPR) and early defibrillation are important in increasing survival rates during a cardiac arrest. At the Medical Center, which is part of an integrated healthcare system in a metropolitan area of the San Francisco Bay Area, a quality improvement project was implemented to increase readiness and self-confidence of medical-surgical nurses during a code blue situation. Nurse participants completed a pre- and post-intervention survey containing questions about their self-confidence in performing different skills relevant to a code blue, scored on a 5-point Likert scale from Strongly Disagree (1) to Strongly Agree (5). The intervention included an in-service …

Nurses' Perspectives On Pain Management In The Emergency Department, Elizabeth Fitzgerald

Seton Hall University Dissertations and Theses (ETDs)

Over 130 million people seek care in emergency departments (ED) in the United States annually. Most patients who seek treatment in emergency departments are experiencing a painful condition, and as such, ED nurses should have a deep understanding of pain management in the ED. There is limited qualitative research which explores pain management from the nurses’ perspective. The purpose of this study is to describe pain management from the nurse’s perspective. Thorne’s (2005) method of Interpretive Description guided this qualitative inquiry. New knowledge describing the nature of pain management in the ED provides insight into elements which support and impede …

Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee

Evidence-Based Practice Project Reports

Given the global tragedy that this most recent pandemic has caused, more attention has been given to the devastating outcomes that the spread of infectious disease outbreaks can have. Similar to those with comorbid conditions, pregnant women are also extremely vulnerable to infectious diseases, as disease manifestation does not only affect the mother, but the fetus as well. Thus, the prevention of both the influenza virus and pertussis are two major goals when providing care for this population. Preventing both of these disease processes during the intrapartum period helps to ensure optimal wellness for both mother and baby and overall …

Better Together? The Effects Of Shared Medical Appointments On Bmi In Obese Adults, Amanda Larson

Evidence-Based Practice Project Reports

The United States (U.S.) is amidst an obesity epidemic, with Indiana ranking as the 15th worst state (Institute of Medicine, 2012; United Health Foundations, 2020). Despite current management strategies, the obesity rate in both the U.S. and Indiana continues to rise (WHO, 2020). Therefore, obesity management must change. The purpose of this evidence-based practice (EBP) project was to determine if the addition of shared medical appointments (SMAs) consisting of informational group sessions by specialists and brief individualized meetings with the provider will result in greater reduction of weight and body mass index (BMI) compared to standard care alone in those …

Education Combined With Reminder Strategies To Improve Cervical Cancer Screening Rates, Christina E. Mclean

Evidence-Based Practice Project Reports

Cervical cancer is the second most common cancer among women worldwide and a leading cause of death in some countries (Jayasekara, 2020). Approximately 13,800 cases of cervical cancer were diagnosed in the U.S. last year, and about 4,290 women died (American Cancer Society [ACS], 2020). Regular cervical cancer screening (CCS) reduces morbidity and mortality, but screening rates are low in the U.S. and at the project site (ACS. 2020). The purpose of this evidence-based practice (EBP) project was to increase CCS at a Federally Qualified Health Center (FQHC) with six clinic locations in Northwest Indiana; the primary project site was …

Implementation Of A Cost-Effective Treatment Algorithm For The Management Of Acne Vulgaris In College Students, Cristina Borsilli

Evidence-Based Practice Project Reports

Acne is one of the most common skin disorders in the United States, occuring in over 5.1 million Americans. Of those with acne, 53.8% are adults between the ages of 18 and 44 years old (American Academy of Dermatology [AAD], 2017). Acne can lead to multiple issues such as scarring, poor self-esteem, anxiety, and depression (Zaenglein et al., 2016). Acne can also negatively impact quality of life (Cengiz & Gurel, 2020). The purpose of this evidence-based project was to develop a cost-effective treatment algorithm for the management of acne vulgaris in adult college students. A literature search determined the best …

Using Mindfulness To Decrease Stress In College Students, Saska Pavlovic

Evidence-Based Practice Project Reports

The prevalence of stress is increasing in colleges, where students are experiencing anxiety at an alarming rate, with anxiety being the topic most discussed in university counseling centers. The purpose of this evidence-based practice project was to determine the effect of mindfulness exercises on college students’ perceived stress. The Stetler Model guided the project development and implementation. The literature search revealed that best practice included mindfulness exercises through a combination of face-to-face instruction and remote online audio meditation for a duration of eight weeks. For this project, 56 undergraduate students (health care-leadership, health-science, and nursing majors) enrolled in a health …

The Effect Of Implementing A Generalized Anxiety Disorder Protocol For Anxiety And Depression Symptoms In The Primary Care Setting, Bailey J. Hinman

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is very prevalent in the United States with 5.7% of citizens affected (National Institute of Mental Health [NIMH], 2017). This number is expected to be even higher because individuals avoid care due to stigma of mental illness (Andrews et al., 2018). GAD can have significant implications such as decreased ability to function, decreased quality of life and increased risk of suicide (Fong, 2018; Lizarondo, 2018). The purpose of this project was to improve outcomes for adult patients with GAD in the primary care setting by improving treatment to follow best practice recommendations. The Johns Hopkins Evidence …

Developing A Resiliency Bundle For Home Care Nurses, Candace Unger

Nursing DNP Projects

Home care (HC) nurses are experiencing increased stress related to workload, isolation on the job, and COVID-19 restrictions. A literature review found numerous interventions effective in reducing nurse burnout through building resiliency and decreasing moral distress. The purpose of this evidence-based project was to improve resiliency and decrease the risk of burnout in HC nurses through the introduction of a resiliency bundle. Based on the evidence, the following priority interventions for a resiliency bundle were chosen: a) gratitude strategies, b) connecting with co-workers, c) storytelling, and d) resiliency training. Duffy’s Quality-Caring Model and Neal’s Theory of Home Health Nursing Practice …

Don't Be Such A Buzzy®Kill: Reducing Pain During Vaccinations In College-Age Students, Katherine Long

Evidence-Based Practice Project Reports

Immunizations play a fundamental role in reducing the occurrence of preventable diseases in the population. Injections related to immunization are the most frequent pain-producing medical procedure implemented worldwide and account for nearly 12 billion injections annually (CDC, 2019; Taddio et al., 2015). These procedures are often perceived as simple but can have a variety of complications including pain. This evidence-based practice project addressed the following PICOT question: In college-aged students receiving immunizations (P), does the Buzzy® device (I) when compared to non-intervention standard of care (C) effectively reduce injection site pain (O) over a 12-week time period (T)? The Buzzy® …