Nursing Commons^™

Reflection Of Distinct Nursing Leadership In Argentina, Indonesia And Jamaica., Emely Baez

Senior Honors Projects

Nurses provide more than 80% of patient care worldwide. Unfortunately, this percentage does not correlate with the number of nurses involved in leadership roles. It’s discouraging to think that the decisions on health care, community, patient care and policy are not being made by those who provide these services and often are the patients’ most passionate advocates. This discrepancy in leadership led me to investigate what factors are at play. Through my observations of nursing practice and leadership in the countries of Jamaica, Argentina and Indonesia, I have specified some of the obstacles or lack of resources in place that …

Attitudes Of New Graduate Rns Regarding Their Readiness For Practice Before And After Hospital Orientation, Diane Young

Dissertations

The acuity level of patients continues to increase making it more vital than ever that new graduate Registered Nurses (RNs) be prepared to give safe, quality care when leaving their hospital’s orientation program (Spector et al., 2015). Today, new graduate RNs need orientation programs that will ensure a smooth transition into nursing practice. This involves the ability to apply higher-level knowledge and skills in everyday practice situations, thereby, maintaining quality care (Henderson, Ossenberg, & Tyler, 2015).

The purpose of this study was to identify differences between new graduate RNs’ opinions on readiness for practice, as measured by the Casey-Fink Readiness …

Simulation As Replacement For Traditional Clinical In Pre-Licensure Nursing Education: Outcomes Of Different Ratios Of Replacement Time For Traditional Clinical With Simulation, Tiffany Zyniewicz

Dissertations

The use of simulation in nursing education has grown over the last 30 years. The National Council of State Boards of Nursing National Simulation Study indicated that up to 50% of traditional clinical hours can be replaced with simulation at a 1:1 replacement ratio and produce the same outcomes. A review of the literature indicated that there is no standard replacement ratio for simulation time to traditional clinical time being used in pre-licensure nursing education in the United States. The purpose of this study was to explore the outcomes of utilizing a 1:1 simulation-to-traditional clinical time replacement ratio and a …

Nursing Interventions That Address Barriers In The United States That Impact Neonatal Mortality, Victoria D. Sullivan, Ashton J. White

Anna Vaughn School of Nursing Undergraduate Work

In 2016, four out of every 1000 babies born in the US died within one month of age. This systematic research review explored nursing interventions that addressed barriers that impact neonatal mortality. The most significant barriers nurses faced in reducing and preventing NM were maternal access to healthcare and education during pregnancy, which can be influenced by maternal age, low socioeconomic status, lack of familial support, poor health literacy, and geographic location. The articles examined included nursing interventions that were evidence-based and addressed barriers relating to NM. Interventions promoting the reduction of NM included education of women’s health and prenatal …

The Use Of Clinical Decision Support To Improve Nursing Practice, Kathleen Klimpel

Dissertations

Healthcare information technology is solidly entrenched in most acute care hospitals but the need to demonstrate its positive impact on patient outcomes persists. Clinical decision support (CDS) is an informatics tool that is highly customizable to promote patient improvement activities. Despite its high potential, studies have had mixed results regarding the impact of CDS and it has not been widely studied in the realm of nursing practice. One aim of this dissertation was to analyze the concept of CDS in order to inform the examination of the relationships between CDS implementation and nursing interventions. The determining factors of nurses use …

Older Adults’ Implementation Of Discharge Instructions Following An Acute Care Hospital Stay, Brenda Miller

Dissertations

Discharge instructions are a self-care guide for patients after discharge from an acute care hospitalization. The discharge process starts on admission to the hospital and continues until discharged. Many patients rely on informal caregivers to provide support after a discharge. However, it is often unclear whether the patients or caregivers completely understand instructions provided during the discharge process. Key concepts related to how discharge instructions were implemented following discharge to home have been understudied from the patient’s and informal caregivers’ perspectives. Developing effective discharge instructions based on study findings may assist in reducing 30-day hospital readmission rates.
This study was …

Postpartum Depression Interventions, Maggie Brown, Corie Vanarsdale Msn

Anna Vaughn School of Nursing Undergraduate Work

PPD affects up to 19% of women worldwide. Possible behavioral changes include poor child outcomes, altered mother-infant bond, and even abuse of the child by the mother. The purpose of this systematic review is to synthesize current research to answer the question, what nursing interventions best treat postpartum depression affecting mothers of low SES in developed countries. The methodology included 10 articles in research of interventions related to sleep, exercise, and social support. Of these interventions in the discussion, exercise is the most effective. Peer support increases maternal mood and likelihood of seeking professional help. Volunteer support is effective if …

Developing A Business Case For The Care Coordination And Transition Management Model: Need, Metrics, And Measures, Sheila Haas, Phd, Rn, Faan, Regina Conway-Phillips, Phd, Rn, Beth Ann Swan, Phd, Crnp, Faan, Laura De La Pena, Msn, Rnc, C-Efm, Rachel Start, Msn, Rn, Ne-Bc, Diane Storer Brown, Phd, Rn, Cphq, Fnahq, Faan

College of Nursing Faculty Papers & Presentations

In this descriptive qualitative study, nurse and healthcare leaders' experiences, perceptions of care coordination and transition management (CCTM®), and insights as to how to foster adoption of the CCTM RN role in nursing education, practice across the continuum, and policy were explored. Twenty-five barriers to recognition and adoption of CCTM RN practice across the continuum were identified and categorized. Implications of these findings, recommendations for adoption of CCTM RN practice across the care continuum, and strategies for reimbursement policies are discussed.

Development And Psychometric Analysis Of The Roy Adaptation Modes Scale (Rams) To Measure Coping And Adaptation, Sandra A. Russo

Dissertations, Theses, and Capstone Projects

Peoples’ lives are often interrupted or changed by experiencing a serious illness. It is important to study and understand the various coping processes that people have in adapting to illness. The purpose of this study was to develop an instrument to measure a person’s coping response to illness-related stimuli using the Roy Adaptation Model (RAM) as its structure and framework. This study is quantitative descriptive design to develop the validity and reliability of a new instrument the Roy Adaptation Modes Scale (RAMS). A review of RAM based measurement instruments found no instrument that measured all four adaptive modes that is …

Associate And Baccalaureate Degree Nursing Students’ Knowledge Of And Attitudes Toward Medication Errors And Reporting Medication Errors: Implications For Curriculum Development, Tabatha Diann Teal

Graduate Theses and Dissertations

This paper evaluates senior nursing students’ knowledge and attitudes of medication errors and reporting errors. This study was conducted to evaluate a need for improvements to nursing education on these two concepts. This mixed method study was conducted using a modified version of the Medication Administration Error Reporting Survey by Wakefield, Uden-Holman, and Wakefield (2005) and focus group sessions at four nursing programs in the Southern United States. Medication errors continue to be a threat to patient safety and underreporting exists due to the stigma surrounding admitting a mistake. Evaluating nursing students’ knowledge and attitudes on these concepts is a …

A Comparison Of The Curricula Of The Top-Ranked Prelicensure Baccalaureate Nursing Programs In The United States, Silvia Imanda

Graduate Theses and Dissertations

What constitutes an ideal prelicensure nursing curriculum is not well understood. Specifically, what are the strategic curricular sequencing and curricular themes or focus might be included to contribute to producing high quality graduates? The purpose of this qualitative multiple case study investigation was to look at successful programs and identify effective curricular sequencing and curricular themes or focus that might be inferred to have contributed to producing high quality graduates. Seven top-ranked prelicensure baccalaureate nursing programs were selected based on three national college rankings services. Based on data from interviews and publicly accessible documents, seven case studies were compared and …

Implementing A Heart Failure Education Program For Bedside Nurses In The Acute Care Setting, David L. Morrow

UNLV Theses, Dissertations, Professional Papers, and Capstones

Heart failure is a chronic disease in which a weakened heart is no longer able to deliver adequate blood flow to supply the body with needed oxygen and nutrients. Heart failure is the most common reason for hospitalization in the United States for patients age 65 and over, accounting for over 1,000,000 hospital admissions annually. Due to the chronic nature of this debilitating condition and associated symptoms, patients discharged from the hospital with a diagnosis of heart failure are at high risk for readmission. Effective self-care behaviors have been shown to reduce readmissions and improve quality of life for these …

Problem Based Learning With Teamstepps®, Dana Clairmont

Nursing Capstones

No abstract provided.

Poster: Creating Voice In School Nurses Through Increasing Self-Efficacy, Kate King

Doctor of Nursing Practice Scholarly Projects

Creating voice in school nurses is essential to implement and promote health care in schools. Increasing self-efficacy, the knowledge, practice and internal belief of the nurse that he or she is an expert, creates voice and thus, the ability to assist students and families navigate various concerns and health issues. Therefore, the purpose of this project was to increase self-efficacy by providing school nurses with an interactive educational module that focused on social modeling and persuasion, responses to stress reaction experiences and attainment and application of evidence based practice, all skills of self-efficacy. The interactive educational model was presented to …

Creating Voice In School Nurses Through Increasing Self-Efficacy, Kate King

Doctor of Nursing Practice Scholarly Projects

Creating voice in school nurses is essential to implement and promote health care in schools. Increasing self-efficacy, the knowledge, practice and internal belief of the nurse that he or she is an expert, creates voice and thus, the ability to assist students and families navigate various concerns and health issues. Therefore, the purpose of this project was to increase selfefficacy by providing school nurses with an interactive educational module that focused on social modeling and persuasion, responses to stress reaction experiences and attainment and application of evidence based practice, all skills of self-efficacy. The interactive educational model was presented to …

Pain Management For Intrauterine Device Insertion And Endometrial Biopsy, Michelle Lipton-Carroll

Evidence-Based Practice Project Reports

Intrauterine device (IUD) insertions and endometrial biopsies (EMB) can be painful in office gynecological procedures. In the clinical setting used for this evidence-based project (EBP) it was noted there was no consistent pain management being used for these procedures. For this EBP project a protocol for pain management during IUD insertions and EMBs was developed and implemented into this clinical setting. The protocol was created from an exhaustive literature search, which yielded six pieces of high-level evidence of good quality. The evidence supported the use of a 1% lidocaine paracervical block prior to IUD insertion and a 2% lidocaine intrauterine …

The Effects Of Implementing A Smartphone Application To Improve Asthma Self-Management In Adults, Lindsay J. Humpfer

Evidence-Based Practice Project Reports

Asthma is one of the most common chronic diseases, affecting 20.4 million adults in the United States (CDC, 2018). While asthma can generally be controlled, patients having an exacerbation may experience missed days of work and school, limitations in daily activities, decreased enjoyment of life, and decreased productivity at home, work, and school (MarcanoBelisario et al., 2013). Therefore, the purpose of this project was to improve patients’ overall asthma control and asthma-related quality of life by encouraging self-management through patient education and the implementation of a mobile smartphone application. A total of 26 adult primary care patients with asthma participated …

Prevention Of Oral Mucositis In Cancer Patients, Patricia E. Biel

Evidence-Based Practice Project Reports

Oral mucositis [OM] is one of the most severe non-hematological problems related to cancer treatments and can impact quality of life. It is linked to poorer outcomes due to the associated weight loss, pain, dehydration, and risk of developing life-threatening infections. The purpose of this evidence-based practice project was to determine if OM is preventable with the use of an oral care protocol and zinc supplementation when compared to use of oral care protocols alone. The Johns Hopkins Nursing Evidence-Based Practice Model was used to guide project implementation in an outpatient oncology office. Recommendations were developed from an exhaustive review …

Effects Of Therapeutic Music On Improving Depressive Symptoms Among Long-Term Care Facility Residents, Yi Jin

Evidence-Based Practice Project Reports

Depression is a common mental disorder that can contribute to both physical and psychological suffering (Skinner, 2014). The prevalence rate of depression is especially high among long-term care facility residents (CounsultGeri, 2018; Lolk & Andersen, 2015). The purpose of this EBP project was to establish a protocol incorporating therapeutic music as an adjunct therapy for managing depressive symptoms among residents of a long-term care facility in the Midwest. Roy adaptation model (Roy, 2009) was utilized as the theoretical framework, and the model for evidence-based practice change (Rosswurm & Larrabee, 2009) guided the project implementation. A total of 13 subjects were …

Anxiety Is Something To Worry About: The Effects Of A Cognitive Behavioral Therapy And Selective Serotonin Reuptake Inhibitor Intervention Protocol On Generalized Anxiety Disorder, Alesha E. Mcclanahan

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is highly prevalent in the United States with at least 12% of the population affected (Edmund & Sheppard, 2018). GAD can pose significant distress and debilitation throughout the lifespan (Bystritsky, Khalsa, Cameron, & Schiffman, 2013; Edmund & Sheppard, 2018). Barriers to treatment include adverse effects, inaccessibility, and expense. The purpose of this project was to implement an evidence-based protocol involving combination therapy with self-administered cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication in order to improve patient outcomes through more accessible, affordable, and standardized treatment of GAD. The Neuman Systems Model and Stetler …

Effects Of An Obstructive Sleep Apnea Screening Program On Providers' Adherence, Kelsie A. Tokarczyk

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) is a widely prevalent chronic disease estimated to affect 22 million Americans, with 80 percent of moderate to severe cases undiagnosed (American Sleep Apnea Association [ASAA], 2017). Unmanaged OSA has been associated with numerous detrimental health outcomes including hypertension, chronic heart failure, atrial fibrillation, stroke, and other cardiovascular conditions (ASAA, 2017). The purpose of this evidence-based practice project was to determine if the implementation of a screening protocol would affect providers’ adherence to screening for OSA. The Theory of Planned Change was used as a guide to optimize providers’ adherence to the protocol at a family …

Meditation As An Intervention To Help College Students Cope With Stress, Marissa Bottos

Evidence-Based Practice Project Reports

According to the American College Health Association (ACHA) (2017), in a survey of 31,463 students, 31.7% stated that stress negatively impacts their academic performance (lower grades, dropped course, etc.). Additionally, 45.1% of the students stated they have more than average stress levels. The purpose of this evidence-based practice (EBP) project was to determine if mindfulness meditation was effective in helping college students cope with stress. Based on current evidence, Jon Kabat-Zinn’s online application for mindfulness meditation is supported as an effective way to help college students cope with stress (Regehr et al. 2013; Yusufov et al. 2018; Cavanagh et al. …

Rn To Apn Role Transition, Bethney Hernandez

Honors Theses

Role Transition can be difficult whether the transition is planned or unplanned. The transition from student to practitioner for nurses who follow the traditional path to licensure is challenging. Practitioners who change specialties, roles or scope of practice experience some of these same challenges, as well as unique challenges. The consequences of an unsuccessful role transition include unresolved stress, reduced job satisfaction, increased risk of errors, and changing roles again, without settling into the current role. This literature review will explore these challenges from the perspective of Meleis’s Transition Theory. Successful transitions occur when the practitioner finds employment, feels pride …

Application Of Beers Criteria And A Brown Bag Event To Increase Prescribing Safety In Older Adults, Kristen Garza

Evidence-Based Practice Project Reports

With older adults making up about 14.5% of the U.S. population, polypharmacy may be an unintended consequence of adhering to clinical practice guidelines (Kim & Luck Parish, 2017). Effective polypharmacy interventions are needed in the primary care setting to increase prescribing safety and lower the risk of adverse drug events among older adults. The application of the Beers criteria, in conjunction with a brown bag medication reconciliation event, was initiated as focused interventions for a private primary practice without electronic health records. Outcomes included medication reduction, identification of possible inappropriate medication, decrease of medication dosages, and identification of duplicate medication. …

Traditional And Innovative Approaches To Faculty Practice: Income Generating Contracts At Non-University Clinics, Kelly Gonzales

Posters and Presentations: College of Nursing

No abstract provided.

Nursing Students’ Knowledge And Understanding Of Acute Cystitis, Kayla Weber

Undergraduate Honors Theses

Acute cystitis (AC) is characterized by a sudden inflammation of the bladder caused by bacteria. The severity of AC ranges from mild to severe and may be recurrent, especially in at-risk populations. Bacteria in the bladder may travel further into the urinary system, causes urinary tract infections (UTI’s) resulting in urosepsis. Hygienic procedures play a large role in decreasing the bacteria that causes AC, so it is important for nursing students to understand and correctly apply the knowledge learned throughout the curriculum. This study focused on the knowledge and understanding nursing students have about AC. To determine this information, a …

Evaluation Of Safety Related To Current Patient Mobility Practices, Karissa Bright, Logan Callahan, Sarah Saunders

Spring Showcase for Research and Creative Inquiry

A major practice that may be overlooked in the nursing field is how to move patients. Since nurses care for a diverse patient group, some patients may have limited to no mobility. In these cases, the nursing team must decide how to move the patient to provide care while still maintaining a safe environment. The purpose of this project is to evaluate current evidence on the safest ways to move and ambulate patients, while still maintaining the effectiveness that must be present in the medical environment. Hopefully, through this research, effective and safe ambulating practices can be determined.

A Multi-Faceted Intervention To Improve Diagnosis And Treatment Rates Of Overweight And Obesity By Nurse Practitioners In Primary Care, Susan Disser

Evidence-Based Practice Project Reports

The United States is amid an obesity epidemic (Institute of Medicine, 2012). Indiana ranks as the tenth most overweight state. (America’s Health Rankings, 2018). Despite guidelines outlining the treatment of obesity, primary care providers seldom use these guidelines (Hayes et al., 2017). In a 2010 study, only 28.9% of obese patients received a diagnosis of obesity and less than 25% of these patients received counseling on diet, exercise, or weight loss (Bleich, Pickett-Blackely, & Cooper, 2011). The purpose of this evidence-based practice (EBP) project is to determine if a multi-faceted intervention consisting of academic detailing, reminders, audit with feedback, and …

Optimizing Strategies For Care Coordination And Transition Management: Recommendations For Nursing Education, Beth Ann Swan, Regina Conway-Phillips, Sheila Haas, Laura De La Pena

College of Nursing Faculty Papers & Presentations

The purpose of this descriptive qualitative study was to explore nurse and healthcare leaders' experiences and perceptions of care coordination and transition management (CCTM®). Four barriers emerged that added insight into the lack of adopting and integrating CCTM knowledge, skills, and attitudes in nursing education in the following categories: curriculum redesign, silos of care settings and care providers, knowledge gap, and faculty development/resistance. Recommendations and implications for education, for both nursing students and practicing nurses, are described.

Clarifying Model For Continuity Of Care: A Concept Analysis, Sarah J. Bahr, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Aim

The aim is to clarify the use of the term continuity in the specific context of acute care hospitalization and discharge.

Background

The meaning of “continuity” is often co‐mingled with other concepts, specifically coordination and communication. To increase usefulness for contemporary concerns with the hospitalization‐postdischarge continuum, continuity of care is examined from the specific context of acute hospitalization and discharge.

Design

Concept analysis.

Data Sources

Medline via Ovid, Cochrane Library, Cinahl, and Google Scholar. Search years encompassed 2001–2016.

Review Methods

Rodgers evolutionary concept analysis method.

Results

A total of 50 papers were included in this concept analysis. Synthesis of …