Nursing Commons^™

Supporting Nurses To Increase Retention: A Literature Review, Lucy Camarena, Rn, Bsn, Cnl, Cpn, Phn

DNP Qualifying Manuscripts

Background: Nurse retention has become vital to ensure that healthcare settings have a sufficient number of nurses who are confident and knowledgeable in providing safe patient care. Factors that influence nurses to leave their current jobs include self-care, interprofessional communication, knowledge base, leadership team, and professional development.

Objectives: To conduct a comprehensive review of the related literature to examine recent findings related to supporting nurses to increase retention, and to identify methodological challenges and the implications of new evidence for future studies.

Design: A comprehensive search of the recent literature related to supporting nurses to increase retention was undertaken to …

Improving Communication To Reduce Patient Falls In A 48-Bed Medical-Surgical Unit, Christian Gella

Nursing and Health Professions Faculty Research and Publications

Abstract

Problem: Patient falls has been associated with increased morbidity, mortality and decreased quality of life. The increase in total patient falls for 2018 relative to 2017, and a spike of 10 patient falls for the month of June 2018 from a baseline of 5.3 falls per month has gained greater attention to reduce patient harm from falls while hospitalized. Prevention of falls minimizes patient exposure to the possibility of being injured. Despite efforts to curtail patient falls, improvement in communication is essential to address the safety issues surrounding improving quality of care practices, and consequentially reduce un-reimbursable hospital costs …

Improving Pediatric Oral-Systemic Health Through Motivational Interviewing: An Interprofessional Training Intervention, Oksana Prodan

Doctor of Nursing Practice (DNP) Projects

Introduction: In response to the prevalence of early childhood carries (ECC) in the United States, recommendations were established for pediatric primary care providers to routinely incorporate oral-systemic health promotion services into clinical practice. An interprofessional education project was developed between Advanced Practice Registered Nurses (APRNs) and dentistry students in San Francisco to assist trainees in the effective delivery of oral systemic health promotion services. Improving health promotion communication skills was identified as an area of need for both sets of learners. Therefore, the IPE activity was designed to incorporate Motivational Interviewing (MI) into the training along with pediatric oral …

Implementing A Telephone Triage System, Joanyett Mays-Scott

Master's Projects and Capstones

Implementing a Telephone Triage System

Abstract

Introducing a telephone triage system requires conscientious regard to the organizational configuration and culture, staff abilities and experience, observed need and expected outcomes, staffing issues, and the physical location in which the system will be introduced (Murdoch et al., 2015). For this microsystem A SWOT analysis and microsystem assessment were performed. This community health center’s goal was to have standardized, evidence-based triage protocols followed by the nursing staff and the contracted nursing staff. The workflow was introduced in a series of lunch and learns provided by clinical nurse managers. Once workflows were established a …

Care For Inmates With Mental Illness: What Can Nurses Do?, Rebecca K. Sakai

Honors Projects

This paper serves to inform nurses of the medical and psychiatric treatment that inmates with mental illness receive and to offer suggestions for treatment interventions. Current practice includes mental health screens, psychotropic medication administration, psychiatric departments, and administrative segregation. The recommended interventions include providing therapy (including Cognitive Behavioral Therapy and Group Therapy), decreasing administrative segregation, implementing reintegration programs, and training and collaborating with correctional officers.

Reducing Inter-Unit Patient Report Delays And Transfer Times, Natalya Marinov

Master's Projects and Capstones

Inter-unit coordination is essential in preventing a bottleneck in patient flow and its resultant stresses to staff, hindering quality patient care, and wasting time. The Medical-Surgical Unit (MSU) and Post Anesthesia Care Unit (PACU) struggle to establish efficient patient report times and transfers. Preliminary data demonstrated report delays attributed to an arduous workload and overburdened MSU nursing staff. The project’s objective focuses on reducing nurse-related report time delays by 10%, increasing understanding and teamwork, promoting proactive thinking to manage workflow efficiently, improving patient flow, and improving the inter-unit relationship between MSU and PACU. Increasing awareness and reducing transfer times are …

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 …

Sugammadex Protocol, Brenna M. Thomas

Doctor of Nursing Practice Projects

Sugammadex is a new medication used for the reversal of muscle relaxation induced by rocuronium, vecuronium, and pancuronium. Sugammadex is available for use at St. Anthony’s Memorial Hospital in Effingham, IL. However, they did not have a protocol regarding the use of this medication. A sugammadex protocol was written for the operating room (OR) staff after a thorough, evidence based literature review was completed. The OR staff included certified registered nurse anesthetists, anesthesiologists, registered nurses, and pharmacy. The protocol was implemented and evaluated with a pretest, an educational PowerPoint regarding sugammadex, and a posttest. A paired samples t test was …

Self-Care In Bsn Students: Developing A Self-Care Plan, Jamie Davis Brandon

Nursing Theses and Capstone Projects

Stress is an issue of concern in nursing practice and nursing education. Stress leads to burn out and compassion fatigue in the nurse and student nurse. To combat stress, professional organizations advocate for self-care practices. Research indicates self-care practice can reduce stress levels and increase health and wellness. An evidenced-based DNP project was conducted over a seven-week time frame during a mental health nursing course to educate senior BSN students on different dimensions of self-care to reduce stress levels and increase use of self-care practices.

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) …

Job Termination Survey: Faith Community Nursing, Deborah Ziebarth

International Journal of Faith Community Nursing

Research regarding community-based nurse voluntary and involuntary termination rates are limited and outdated. This study explores faith community nursing termination using a survey. Survey questions pertaining to why the termination occurred, supportive resources used during termination, and post termination behaviors are addressed. The first three reasons for termination were due to site leadership change, not a strategic priority of the hospital or faith community leadership, and organization restructuring or elimination of the program. The fourth through seventh reasons for termination were financial in nature. They were: not a financial priority to hospital or health care organization, not a financial priority …

Improving Care For Children With Down Syndrome: Nursing Interventions, Hannah Burt

Honors Projects

Down Syndrome (DS) is a genetic disease that affects thousands of families. Children with DS often require more medical care since there are over 100 anomalies associated with DS (Philips & Boyd, 2015). Without proper knowledge of DS, it is difficult for healthcare workers to provide effective and relevant care. This paper will focus on physical differences of people with DS, emotional coping in families of children with DS, along with interventions for physical and behavioral health that nurses can implement.

Child Care Teachers’ Knowledge Of Fun Physical Activities And Healthy Food Choices For Pre-School Children, Elizabeth Gwyn

Nursing Theses and Capstone Projects

The focus of this project was to explore child-care teachers’ knowledge of fun physical activities and healthy food choice activities for preschool children. A four-week educational session was implemented in a rural child-care center. The intervention provided education in relationship to the implementation of fun physical activities and healthy food choice activities for child-care teachers during preschoolers structured playtime. The Child Care Teachers’ Knowledge Evaluation (CCTKE) tool developed by the doctoral student was used to collect responses from participants before and after the intervention. The participants’ data was analyzed using a t-test. There were no statistically significant differences between the …

Exploring The Lives Of Retired Nurses Using The Lens Of Legacy, Verliss L. Keller-Miller

Theses and Graduate Projects

Legacy can be viewed as a summary of life. Legacy develops over a lifetime and changes and grows as one ages. How do retired nurses view their legacy? This paper looks at a select group of five female retired nurses and how each views her legacy at this time in life. Each was a professional nurse, and each is fully retired. Imogene King’s Goal Attainment Theory discusses the concepts of self and role. Through individual conversations, each retired nurse shares her life story of self and the roles she held during her working years. Literature yields little information about this …

Considering Stress In A Nursing Student Context: Pre-Admission To Pre-Graduation, Daniel M. Regner

Honors Undergraduate Theses

In moderation, stress is a normal response to a perceived challenge which can motivate an individual to perform at their best. Nursing students consistently report a significant amount of stress which has been found to be greater than their non-nursing peers. The purpose of this study is to assess the level of stress reported by second-semester freshman and sophomore students who have declared nursing as a major, compared with the level of stress experienced by junior and senior students who are enrolled in the university's nursing program. Through this comparison, a conclusion can be drawn as to the level of …

Defining The Health Of A Work Environment: An Assessment And Evaluation, Jennifer Thornsberry

DNP Projects

PURPOSE: The purpose of this study was to ascertain nursing leaders and direct care nurses’ perceptions of the health of the work environment in medical-surgical, intermediate care, and progressive care units at an acute care hospital located in central Kentucky. METHODS: This study employed a descriptive, correlational design. Bivariate statistical procedures were utilized to determine the relationship between the perceptions of the health of the work environment and nursing turnover and engagement. RESULTS: Direct care nurses and nurse leaders both scored effective decision making/skilled communication as the healthiest attribute of the work environment, while genuine teamwork was scored as the …

Tobacco Cessation Education For Primary Care Nurses And Advanced Practice Providers, Stephanie Scammell

Walden Dissertations and Doctoral Studies

Tobacco use is the leading cause of premature and preventable death in the United States, yet millions of Americans continue to use tobacco. Nursing professionals comprise the largest health care provider group and can help improve tobacco cessation among their patients. The purpose of this doctoral project was to increase nursing staff and advanced practice providers knowledge, skills, and confidence related to tobacco cessation interventions. The project took place in a family medicine clinic in Central Texas. The nursing staff (which included 1 registered nurse and 3 licensed vocational nurses) and advanced practice providers (which included 3 nurse practitioners and …

Educating Nurse Managers To Create A Culture Of Nurse Retention, Stacey Trotman

Walden Dissertations and Doctoral Studies

Nurse managers are stakeholders in creating a culture of nurse retention. The purpose of this staff education project was to identify evidence-based best practices that promote nurse retention and to educate nurse managers about these strategies. Knowles's theory of adult learning was the theoretical framework for the project. The practice-focused question addressed whether an education program for nurse managers would increase their understanding of evidence-based strategies to create a culture of nurse retention. The education program centered on 4 themes: professional development, communication and relationships, culture and work environment, and organizational structures and support. The concepts of 5 domains-- status, …

A Systematic Review: Factors For Burnout And Compassion Fatigue In U.S. Nurses, Kaitlyn Marcum, Tabitha Rusnak, Mckenzie Koch

Williams Honors College, Honors Research Projects

Many nurses suffer from burnout and compassion fatigue. Compassion fatigue is “fatigue, emotional distress, or apathy resulting from the constant demands of caring for others or from constant appeals from charities” (Compassion Fatigue, n.d.). Burnout develops over a long period of time as a result of cumulative frustrations within a work environment (Sacco, Ciurzynski, Harvey, & Ingersoll, 2015). Burnout and compassion fatigue both result in physical and mental strain on the person experiencing it. Compassion fatigue and burnout in nurses are associated with decreased patient satisfaction and poorer outcomes with care (Potter et al., 2010). The goal of the systematic …

Early Recognition And Treatment Of Acquired Pneumonia, Michael Lamorgese

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening organ dysfunction disease process that costs the healthcare system millions of dollars each year. By using existing assets, the number of patients admitted to the hospital suffering from sepsis secondary to community-acquired pneumonia can be reduced. The purpose of this project was to improve and expand the scope of practice of the registered nurse working in a private medical office to initiate treatment for suspected CAP using evidence-based practice. Data from the last quarter of 2017 and the first quarter of 2018 were compared. The purpose of comparing these data sets was to examine outcomes of …

Impact Of A Leadership Development Program On Perceptions Of Structural Empowerment, Leadership Self-Efficacy, And Staff Nurse Clinical Leadership, Matthew E. Proud

DNP Projects

BACKGROUND: In order to serve as full partners on the interdisciplinary health care team: nurses at all levels must develop essential leadership competencies Organizations need to identify the essential leadership competencies required for bedside nursing staff and develop programs to enhance these competencies. Leadership competencies in areas such as managing change can help bedside nursing staff improve care delivery and quality outcomes.

PURPOSE: The purpose of this project was to evaluate the impact of an established leadership development program on participants’ perceptions of structural empowerment, leadership self-efficacy, and staff nurse clinical leadership in one university health system.

METHODS: The pilot …

Development Of An Australian Nursing Critical Thinking Tool Using A Delphi Process, Elisabeth R. Jacob, Christine M. Duffield, Darren Jacob

Research outputs 2014 to 2021

Aim: To develop a critical thinking assessment tool for Australian undergraduate nurses. Background: Critical thinking is an important skill but difficult to assess in nursing practice. There are often many responses a nurse can make to a clinical problem or situation. Some responses are more correct than others and these decisions have an impact on a patient's care and safety. Differences in a response can relate to the depth of knowledge, experience and critical thinking ability of the individual nurse. Design: This study used a Delphi process to develop five clinical case studies together with the most appropriate clinical responses …

Fall Prevention, Linda Fang

Master's Projects and Capstones

Fall Prevention Abstract

Background: According to the CDC, the medical cost for falls was approximately $30 billion in 2012. When a patient falls, and gets serious injury, these costs could sum up to $14,056 per patient. As a result, hospital stays per patient are observed to increase by approximately 6.3 days longer than those patients who haven’t encountered falls.

This study focused on identifying high fall risk patients, and developing a plan of care to reduce the occurrence of falls in a hospital setting. Nurses using safe fall interventions techniques have been proven to inspire fall preventions.

An assessment of …

Improving Discharge Planning Using The Re-Engineered Discharge (Red) Program, Sterling L. Roberts, Leslie C. Moore, Brian Jack

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

The 12-actionable items of the Re-Engineered Discharge Program (RED) are equipped to address essential areas to prevent hospital re-visits. Evidence supports the use of nurses to complete these essential components of hospital interventions. The aims of this project were to: 1) assess nurses’ readiness to learn prior to receiving education on the RED Program, and 2) measure the utilization of the RED discharge process from patient chart reviews following an educational intervention focused on the RED 12-actionable items. Participants (N = 69) scored high M = 219.8 (SD 23.7) on the Self-Directed Learning Readiness – Adult Scale, indicating the nurses …

Nurse Perspectives On The Work Impacts Of Decentralized Nursing Unit Design, Susan Mcdevitt

Electronic Theses and Dissertations

This study investigated nurse perspectives on the work impacts of a decentralized inpatient unit model. The study involved two rural acute-care hospitals in rural Nebraska that moved from a centralized to a decentralized inpatient unit design. The researcher conducted focus group discussions with staff and nursing management at both facilities with a total of 28 participants. In addition, the participants completed a 12-item questionnaire using a five-point Likert scale for responding. Focus group discussion and questionnaire were designed to investigate the areas of quality of care, communication, documentation, stress and wellbeing, and transition. Data gathered revealed that on all survey …

Job Embeddedess Of Nurses Working In South Central Appalachia’S North Carolina Counties, Susan L. Adams Mrs.

Electronic Theses and Dissertations

Nurses working in the North Carolina counties of South Central Appalachia (NC-SCA) are a unique subset of nursing professionals. A continued nursing shortage is projected in this area while staffing has improved in other areas of SCA. The purpose of this research was to ascertain the level of job embeddedness of nurses working in NC-SCA in order to offer guidance regarding retention of nurses working in this area. Actively working licensed practical nurses, registered nurses, and advanced practice nurses (nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists) from 29 North Carolina counties included in South …