Nursing Commons^™

Patient Satisfaction With Nurse Versus Non-Nurse Post-Discharge Outreach, Iyore Adonri

West Chester University Doctoral Projects

In today’s current healthcare environment, there has been an extensive focus on patient satisfaction, and healthcare leaders struggle with the options of utilizing a registered nurse or a non-nurse when making outreach follow-up calls to recently discharged patients. Healthcare leaders find that designing, implementing and managing an efficient telephone outreach program can be challenging, however, this has become a necessary aspect of the patient continuum of care plan. Studies demonstrate that patient follow-up post-discharge increases patient satisfaction and their compliance with post-discharge instructions, thereby reducing readmission rates and emergency room visits (Meek, Williams, & Unterschuetz (2018). This quality improvement project …

Professional Development For Nurse Educators, Samdaye Ramdial

Walden Dissertations and Doctoral Studies

At a large university on the outskirts of Toronto, Canada, there was an influx of students entering the nursing program. Therefore, the need arose for an updated, restructured, and professional development training guideline with current knowledge for nurse educators to achieve high quality learning and critical thinking. The purpose of this study was to explore professional development leaders’ perceptions of quality training guidelines for nurse educators. The conceptual framework of this study was Knowles’s adult learning theory. The research questions were centered on what professional leaders perceive to be quality professional development. A qualitative case study design was used in …

Increasing Compliance With Sequential Compression Devices To Reduce Venous Thromboembolism, Randy Mcclain

Walden Dissertations and Doctoral Studies

Venous Thromboembolism (VTE) is a life-threatening complication. Approximately 900,000 people in the United States are affected by VTE with a mortality of 300,000 cases per year. Although potentially preventable, VTE remains the leading cause of hospital deaths in the U.S. The practice problem addressed in the Doctor of Nursing Practice (DNP) project was evidence of an increased incident of VTE events on a trauma surgical unit. The practice-focused question evaluated the extent to which a nurse-driven protocol for VTE prophylaxis could improve adherence to mechanical prophylaxis with sequential compression devices and compliance with nursing documentation. The purpose for the doctoral …

Associate Degree Nursing Graduates’ Experiences Of The Transition From Student To Nurse, Katherine Margaret Slusser

Walden Dissertations and Doctoral Studies

Attrition among newly graduated nurses remains a top concern among nursing leaders in the United States. Many published studies about new graduate nurses focus on bachelors-prepared nurses or on mixed populations of nurses that include both associate and baccalaureate degree graduates. No published studies were located that focused specifically on the Associate Degree Nursing (ADN) graduate. The purpose of this qualitative, interpretive phenomenological study was to understand the experiences of transition after graduation and into professional nursing of newly employed nurses who graduated from an ADN program. The theoretical basis for this study was Meleis’s transition theory. The research question …

Newly Licensed Registered Nurse Generation Cohorts And Retention In First Registered Nurse Positions, Elizabeth S. Gizenski

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to evaluate the association between newly licensed registered nurses (NLRN) generational cohorts and NLRN who plan to leave or have left their first nursing position. The research problem focused on the generational cohorts of NLRN and retention. The research questions addressed different generations of NLRN, their intent to stay in their first job, and whether poor orientation was a factor for those who already left their first nursing position. The theoretical foundation was Strauss–Howe’s generational theory explaining how each generation views the world based on what they experienced in their lifetime. Data retrieved …

Nurse Perception Of Pain And Innovative Approaches To Pain Management, Tracey-Ann Nichole Knight

Walden Dissertations and Doctoral Studies

AbstractInsufficient assessment and management of pain among the patient population during their hospital stay may result in ineffective delivery of care, increased length of stay, poor clinical outcomes, and decreased patient satisfaction. The quality report at a local facility showed compliance scores of 78% for administration of pain medication and 79% for reassessment of pain. These scores and the weekly patients’ satisfaction survey results suggested a substandard adherence to the facility’s pain management guidelines. One identified barrier to properly managing patients’ pain was nurses’ lack of knowledge and understanding of the theoretical foundation of pain management. The purpose of this …

The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early

Theses and Dissertations

Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level …

Compounding Effects Of Reducing Nurse Burnout And How It Can Produce An Increase In Patient Safety And Satisfaction, Alexander Mua

Master's Projects and Capstones

The reduction of nurse burnout has shown to have an increase in patient satisfaction and quality of care. It also has shown a decrease in patient-related or sentinel events. Accordingly, with the reduction of nurse burnout, there has also been a reduction of compassion fatigue. This project has illuminated the benefits of acuity-based caseload at the micro-level, including the cost-effective nature of overtime pay, including HCHAPS benefit score. The method of obtaining, planning, and implementing was based on the Plan, Do, Study, Act (PDSA), which required collaboration amongst multiple disciplines, groups, departments, and executives. The process and goals concluded to …

Caring Science Education: The Essence Of Professional Practice For The Registered Nurse, Linda C. Ackerman

Doctor of Nursing Practice (DNP) Projects

Problem: Hospitals have moved from caring, healing environments to business or economic models of caring institutions that focus on census instead of on patients and on technology instead of on touch or human connection (Watson, 2006).

Context: As nurse leaders, we have an obligation to create an environment of authentic, professional, human caring practices within our organizations. Caring science empowers nurses to balance the art and science of clinical judgment by engaging and collaborating with the patient and their family, focusing on the needs of the whole person, honoring the unique perception of health and healing, and engaging them to …

Implementation Of A Mentor Program To Support Nurse Retention: A Pilot Project, Lucy Camarena

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Primary factors affecting nurses’ decisions to stay at an organization include nurse self-concept, job satisfaction, and professional growth. A high turnover rate of nurses poses a risk to patients’ safety and healthcare outcomes. The implementation of mentor programs in institutions that employ new nurses has been shown to reduce turnover rates, increase the quality of patient care, and empower nurses in professional development. The existing literature supports the use of mentor programs and encourages their implementation in healthcare institutions.

Interventions: The DNP project’s goal was to identify effective methods of promoting positive nurse self-concept and increasing job satisfaction …

"Rise And Shine" Early Ambulation In Surgical Patients, Bhapinder Thiara

Master's Projects and Capstones

Abstract

An assessment done in a hospital unit established low rates of early ambulation for patients in postoperative care. At the same time, early ambulation after surgery has been shown to improve clinical outcomes and patient satisfaction. Some of the factors for the low rates of early ambulation include inadequate nurse staffing, poor teamwork, and the inability to utilize technology effectively. Consequently, a project was designed to empower nursing staff, promote interprofessional collaboration, and obtain technologies for ambulation. It is expected that the project will improve rates of early ambulation and lower hospital length of stay.

Medication Management In A Primary Care Practice, Melissa Fowler

Doctor of Nursing Practice

Improving medication management has become the 3rd National Patient Safety Goal. Medication errors cost $42 billion annually. A 5-month quality improvement project was conducted in a primary care clinic located in a south Texas metropolitan city to address medication reconciliation problems. The project improved medication management by implementing 7 tools to decrease preventable medication errors: One Source Medication List, staff knowledge pre- and post-tests, visual signs and staff badges, staff templates, Beers Criteria pocket guide, patient brochure, and a quality improvement tracking form. There were two objectives: 1. Staff would improve medication reconciliation documentation by 50%. 2. For patients 65 …

Understanding Multigenerational Nurse-Faculty-Collaboration Strategies-A Delphi Study, Heather M. Fowler

Nursing Theses and Dissertations

Four distinct generations have come together to work cooperatively, producing higher quality nursing students who are engaged and satisfied in their learning experience from nursing faculty. The multigenerational nursing faculty workforce must learn to work together through positive collaboration, using teamwork strategies, and decreasing conflict and negative influences in the workplace. Strauss and Howe’s (1991) generational-cycle model depicted four archetypes that recur throughout history every 22 years; the life stages of generations provided the foundation for this study. Generations can come together if they understand what various generational cohorts perceive as positive collaboration factors, teamwork strategies, and negative influences. A …

Treating Substance Use Disorders: Enhancing Attendance At The Weekly Inpatient Medication Assisted Treatment Group, Devon Gillis, Jayne Weisberg, Dena Whitesell, Amy Mcauliffe, Amy Sparks, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Operations Transformation

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline.

A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%.

A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to …

The Validity And Utility Of Violence Risk Assessment Tools To Predict Patient Violence In Acute Care Settings: An Integrative Literature Review, Manonita Ghosh, Di Twigg, Yvonne Kutzer, Amanda Towell-Barnard, Gideon De Jong, Mary Dodds

Research outputs 2014 to 2021

To examine risk assessment tools to predict patient violence in acute care settings. An integrative review of the literature. Five electronic databases – CINAHL Plus, MEDLINE, OVID, PsycINFO, and Web of Science were searched between 2000 and 2018. The reference list of articles was also inspected manually. The PICOS framework was used to refine the inclusion and exclusion of the literature, and the PRISMA statement guided the search strategy to systematically present findings. Forty-one studies were retained for review. Three studies developed or tested tools to measure patient violence in general acute care settings, and two described the primary and …

The Ward-Based Nurse Clinical Educator: Impact On Student Learning Outcomes And Student And Preceptor Experiences, Karen Ann Mccarthy

Theses: Doctorates and Masters

Aim

This study aimed to determine the impact of the implementation of a ward based Nurse Clinical Educator (NCE) role on students and staff at one health service whilst students were on clinical practicum at a Western Australian regional health care facility.

Question

The research question was: “What impact does the NCE support intervention have on students and clinical staff during clinical practicum?” Background Clinical experience for undergraduate student nurses (students) undertaking their bachelor’s degree is of utmost importance for gaining both competence and registration. Students encounter difficulties in obtaining opportunities to practice their skills and develop competence when on …

Nurse Family Member Perceptions Of Patient Death And Nursing Care After Withdrawal Of Life-Sustaining Treatment, Deena Drake

Dissertations

Purpose/Aims: This pilot study explored nurse family member perceptions of nursing care and patient quality of death and dying during and after withdrawal of life-sustaining treatment within Intensive Care Units (ICU).

Rationale: Past research that examined physician, nurse, and family member experiences of End-of-Life (EOL) care within the ICU found significant differences between the three groups.

Background: Approximately 500,000 people die within an ICU each year in the United States. End-of-Life and Palliative Care programs focused primarily on physician interventions to improve quality of EOL care have had little impact on family member perceptions of quality of care or patient …

The Effects Of A Mobile Fitness Application On Weight Management And Physical Acticity Amongst University Students, Erica Deenihan

Evidence-Based Practice Project Reports

The prevalence of obesity, and obesity related diseases throughout America, specifically in regard to the college student population has steadily climbed over the course of the last forty years, due largely in part to the increase in sedentary lifestyle behaviors, amongst other factors (Swanson, 2016). Physical activity has been widely recognized as a valid means of combatting obesity and weight gain while promoting health related quality of life (Swanson, 2016). Therefore, implementing strategies aimed at increasing physical fitness in attempt to control weight management is imperative to promoting improved health outcomes. The purpose of this evidence-based project was to examine …

The Effect Of Home Blood Pressure Monitoring And Self-Titration On Achieving Blood Pressure Targets, Katina A. Varner

Evidence-Based Practice Project Reports

One-third of U.S. adults over the age of 20 are hypertensive, with an estimated cost of $47.5 billion in direct medical expenses and increased individual CVD risk (CDC, 2018). Routine office visits afford primary care providers a means of managing hypertension; however, time constraints limit the ability to accurately assess and track BP in most patients (Jung, 2015). The purpose of this project was to determine if implementation of HBPM and an algorithm for selftitration of antihypertensive medications increased the number of participants at guideline recommended BP goal over a 90-day period. The Health Promotion Model provided the theoretical framework …

Clinical Practice Guideline Adherence: Primary Prevention Of Cardiovascular Disease In At-Risk Adults, Sharnita L. Rice

Evidence-Based Practice Project Reports

The American College of Cardiology (ACC) and the American Heart Association (AHA) (2013; 2016), as well as the American Diabetes Association (ADA) joined forces to create clinical practice guidelines (CPGs) recommendations for healthcare providers (HCPs) to follow with the aim of preventing cardiovascular disease (CVD). Cardiovascular disease is the leading cause of morbidity and mortality in the United States. The Centers for Disease Control (2017a) estimates CVD costs 325 billion dollars annually. Although CVD has an astronomical cost associated with it, CPG adherence continues to be an issue among HCPs and improvement is warranted. The purpose of this EBP project …

The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava

Evidence-Based Practice Project Reports

The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient outcomes, …

Incorporating Oral Health Care In Pediatric Primary Care Practice, Salamatu Yusif

Evidence-Based Practice Project Reports

The most common chronic disease in childhood is dental caries and is more prevalent than asthma and hay fever (HHS, 2000). Data show that in the United States from 2011-2014, 24% of children aged 2-5 years had experienced dental caries in their primary teeth, with 11% having untreated caries (Dye et al., 2017). Primary care clinicians have an important role to play in promoting children’s oral health as much as dentists because they have more contact with children. The purpose of this evidence-based practice project was to integrate an evidence-based oral health program for children in a pediatric primary care …

Implementation Of An Advance Care Planning Protocol To Increase Advance Directive Completion Rates, Christine Engle

Evidence-Based Practice Project Reports

Advanced directives (AD) allow an individual to retain autonomy in end-of-life decisions and can prevent unnecessary costs and treatments associated with aggressive life-prolonging measures. As of 2017, only an estimated 36.7% of the United States adult population had a form of advance directive documented (Yadav et al., 2017). The purpose of this evidence-based project was to determine if implementation of an advanced care planning (ACP) protocol would increase ACP discussions, AD completion, and result in a modification in stage of change or behavior. The Transtheoretical Model (TTM) and Stetler Model of evidence-based practice were used as the framework to guide …

Nurses' Attitudes And Understanding Of The Suicidal Patient, Cheryl Lemmon

Doctor of Nursing Practice Scholarly Project

Motivation / Problem statement: While not all suicides are predictable, there are reasonable guidelines for identifying those individuals at risk and reducing risk for high-risk individuals. There is, however, an apparent gap in best practice as there is a continual climb in suicide statistics. The aim of this project is to survey emergency department nurses to discover their attitudes and understanding of suicide. The purpose is to better understand the phenomenon, and guide education initiatives, as nurse professionals are in a key position of prevention when working with these patients.

Methods / Procedure / Approach: A non-probability, purposive and voluntary …

A Multifaceted Approach To Antibiotic Stewardship In The Outpatient Clinical Setting For Bronchitis, Elizabeth A. Weaver

Evidence-Based Practice Project Reports

Antimicrobial resistance is a world-wide health crisis (Infectious Disease Society of America [IDSA], 2016; World Health Organization [WHO], 2017) expedited by the overuse/inappropriate use of antibiotics. In the outpatient setting it has been determined that approximately 60% of antibiotic therapies are prescribed (Centers for Disease Control and Prevention [CDC], 2016). Antibiotic stewardship is the coordinated effort to improve the use of antibiotic therapies, minimize misdiagnosis and delayed diagnosis and select appropriate antibiotic drug regimens (IDSA, 2016). The purpose of this evidence-based practice project was to evaluate the effects of an antibiotic stewardship program (presentation, survey collection, bimonthly e-mail reminders, patient …

Use Of Smartphone Application To Facilitate Weight Loss And Promote Accountability In Obese And Overweight Patients, Angela M. Turner

Evidence-Based Practice Project Reports

In 2015, the U.S. Department of Health and Human Services published a National Health and Nutrition Survey (NHANES) on obesity from 2011 through 2014. From the survey, it was determined that the prevalence of obesity in the U.S. was 36% in adults and 17% in young adults/children (Ogden et al., 2015). Lifestyle modifications including moderation of caloric intake and increased exercise have been shown to be effective for both prevention and treatment of obesity. The purpose of this evidence-based practice (EBP) project involved the design, administration, and evaluation of a technology-assisted weight loss intervention to address the health problem of …

Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean

Evidence-Based Practice Project Reports

Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …

Moral Distress In Critical Care And Emergency Department Nurses, Morgan Timberlake, Nicole Phillips

Senior Honors Projects, 2010-2019

Moral distress is a phenomenon that occurs when a person is unable to carry out what they believe is the ethically appropriate action due to various external constraints. This literature review seeks to explore the interventions that are most effective in reducing moral distress in critical care and emergency department nurses who have experienced moral distress in practice.

A Lifestyle Modification Program For Adult Patients With Coronary Artery Disease, Amanda M. Yarbrough

Evidence-Based Practice Project Reports

As a leading cause of death worldwide, coronary artery disease affects people of all races and ethnicities. The foundation for the prevention of secondary fatal cardiac events, such as stroke or myocardial infarction, is lifestyle modification to effectively lower cholesterol levels. Lifestyle change impacts diet, physical activity, smoking habits, vital sign measures, and stress management. The purpose of this evidence-based practice project was to reduce implement a lifestyle intervention to lower LDL-C levels and promote healthier lifestyles. This practice change was developed utilizing Stetler’s Research Utilization model to promote evidence-based practice changes in the clinical setting. Nola Pender’s Health Promotion …

Male Nurses’ Experience Of Gender Stereotyping Over The Past Five Decades: A Narrative Approach, Michael W. Finnegan

Theses & Dissertations

Negative stereotyping of men in nursing has been a chronic problem that has a direct effect on males and detracts from efforts to recruit and retain them. At this time in American history (2018), traditionally male-dominated professions are making significant progress toward the goal of a gender-balanced workplace. However, the opposite is not true. Traditionally female-dominated professions are not attracting or appealing to men. In the nursing profession, the number of male nurses is relatively small and has remained relatively fixed over time. Estimates vary between 6-15 percent, with the current average being approximately 11 percent (American Nurses Association, 2014). …