Nursing Commons^™

Non-Cognitive Factors Influencing The Development Of Clinical Judgment In Undergraduate Nursing Students, Kathryn Robinson

Graduate Theses, Dissertations, and Capstones

A nurse’s ability to form sound clinical judgments is directly related to safe patient outcomes. Pre-licensure nursing programs are focused on developing students’ clinical judgment ability; however, an academic-practice gap continues to exist. The Implicit Theory of Intelligence and Achievement Goal Theory provide insight into how mindset beliefs and goal orientation impact the teaching and learning environment. The performance goal orientation, ineffective learning strategies, and avoidance of challenging tasks associated with a fixed mindset may negatively impact the development of clinical judgment. This exploratory study sought to determine if there is a relationship between the non-cognitive factors, mindset beliefs and …

The Impact Of Prone Ventilation Among Patients Diagnosed With Acute Respiratory Distress Syndrome, Mary Steward, Kimberly Loomis

Nurse Residency

Background Mechanical ventilation is a commonICU intervention for patients in respiratory distress. Proning is a form of mechanical ventilation that has been recently studied which improves gas exchange and lung perfusion among patients specifically diagnosed with ARDS.

Help Programs Impact On Delirium, Abigail Holt

Nurse Residency

Background: Delirium is a condition that affects 1/3 of patients in the hospital. It is a condition that is preventable and reversible.

The Comparison Between Chlorhexidine And Povidone-Iodine Antiseptics In The Operating Room To Prevent Surgical Site Infections, Eleanor Decarolis

Nurse Residency

Background: Surgical site infections (SSI's) are one of the most common and costly complications from surgery. Chlorhexidine gluconate (CHG) and Povidione-Iodine (PVI) are the most common antiseptics used in surgery. The efficacy and uses of these surgical preps have been studied to determine the most effective in preventing surgical site infections.

How Environment Of Care Standards Impact Patient Satisfaction, Taylor Tantingco, Raeven Bilugan

Nurse Residency

Background: Environment of Care (EOC) are standards of care that revolve around the safety and well-being of both the staff and the patient.

EOC takes into account variables such as a clean environment, basic standards of care (ADLs), and access to resources/materials.

Evidence-Based Diabetes Exercise Intervention, Laura Smith

Nurse Residency

Type 2 diabetes mellitus is a chronic, noninfectious disease that affects a large population of adults in the world. Typically, it is associated with obesity, a sedentary lifestyle, and the consumption of undesirable meals (Nakrani et al., 2020/2023). Even with various treatments available for type 2 diabetes, most patients find it challenging to maintain a steady blood glucose level.

The Benefits Of Simulation-Based Training, Brooke Taylor

Nurse Residency

Background: Due to COVID-19, many hospitals shut down their in-person classes and simulated trainings. This has had a negative impact on the education of our new graduate nurses.

Purewick Versus Foley Catheters, Ashleigh Lunt, Grace Tibbetts, Tia Hufstader

Nurse Residency

Background: A Foley catheter is an indwelling urinary drainage device that is placed in a patient's urethra and remains in their bladder, continuously draining urine into a bag. In hospital settings, there are many indications for indwelling catheters such as strict I&O monitoring, incontinence, retention, end of life comfort, surgery, and immobility.

Fall Rates In Patient Populations With Remote Video Monitoring Compared To Companions, Alexandra Volpe, Catherine Close

Nurse Residency

Background: Healthcare facilities are constantly searching for new and improved interventions to minimize injury and fall rates within their units. 1:1 companions, or ‘sitters’, have been used to provide the patient with close monitoring in order to accomplish these goals. However, companions are not always a liable option for facilities due to poor staffing and increased expense in order to staff a ratio of 1 companion to 1 patient. Research has started to develop on the benefits of remote video monitoring, or ‘telesitting’, as an intervention to minimize fall risk and injury.

Lean Implementation Difference Between Lean Maturity, Psychological Well-Being, And Employee Engagement Of Nurses In A Hospital Setting, Kevin E. Smith

Doctoral Dissertations and Projects

This quantitative study examined the differences of Lean implementation in three settings; (a hospital in a health system where Lean is implemented throughout the system, a hospital that has implemented Lean in a health system that has not implemented Lean, a hospital that has not implemented Lean in a health system that has not implemented Lean) between LM, PWB, and EE among nurses in a hospital setting. The theoretical construct of the job demands-resources model is used to base the study. Three survey instruments (Psychological Well-Being Scale, Utrecht Work Engagement Scale, Lean Healthcare Implementation Self-Assessment Instrument) were self-administered by registered …

Improving Student Perceptions Of Collaboration By Using Interprofessional Education, Valerie L. Beshears

Doctor of Nursing Practice Projects

Educators must include interprofessional education (IPE) in the healthcare provider curriculum. Including IPE is the first step in changing the healthcare culture toward interprofessional practice. The project aims to increase nursing students' perceived ability to collaborate with patients, nurses, and other healthcare professionals by introducing IPE to first-semester nursing students. The students will participate in an IPE activity and score a pre-test/post-test survey to assess their perceived ability to collaborate before and after the IPE activity. The data collected from this activity answered the quality improvement question: Among first-semester nursing students in a BSN program, how does incorporating an IPE …

Understanding Research Capacity And Culture Of Nurses And Midwives In Two Health Services In Western Australia, Carrie Janerka, Gavin D. Leslie, Olivia Gallagher, Melissa Mellan, Marguerite Lane, Fenella J. Gill

Research outputs 2022 to 2026

Background: Health services with a strong research culture report better patient outcomes and organisational performance. Measuring research capacity and culture (RCC) is important for understanding baseline research capabilities of a health service and assessing the effectiveness of capacity-building and culture-improving interventions. Aim: To describe the RCC of nurses and midwives in two health services in Western Australia. Methods: A cross-sectional survey of nurses and midwives was undertaken using a previously validated RCC tool to measure RCC in individual, professional group, and organisational domains, and identify barriers, enablers, and research activity. Staff at each health service were recruited via email during …

A Follow-Up Study On The Clinical Impact Of Pre-Registration Extended Immersive Ward-Based Simulation, Hugh Davies, Sue Robertson, Deb Sundin, Elisabeth Jacob

Research outputs 2022 to 2026

Aim: To explore how extended immersive ward-based simulation influenced graduate nurses’ experiences six-months post-registration. Background: Graduates of nursing training programs are expected to enter the workforce meeting the role of a registered nurse. Extended immersive ward-based simulation has been adopted by nurse educators as a means of easing the transition to professional practice. To what degree transfer of learning occurs from these experiences is yet to be determined. Design: A qualitative descriptive design was used to conduct a series of face-to-face focus groups. Methods: Participants were nine former students who had participated in a series of ward-based simulation workshops before …

Nailing The Diagnosis: Using Screen-Based Simulation To Improve Factors Of Diagnostic Reasoning In Family Nurse Practitioner Education, Sarah L. Beebe, Angela M. Mcnelis, Majeda El-Banna, Kristina T. Dreifuerst, Quiping Pearl Zhou

College of Nursing Faculty Research and Publications

Background

Providers’ diagnostic skills and reasoning are essential to the health and safety of patients and the healthcare system. Simulation is a promising modality for improving diagnostic reasoning, with the ability to practice, receive feedback, and reflect in a safe learning environment.

Methods

This study used a quasi-experimental, pretest/posttest one group design to investigate the effect of a 5-week intervention screen-based simulation intervention on metacognitive awareness, knowledge, and diagnostic reasoning factors in family nurse practitioner students in their final semester of clinical coursework. Univariate descriptive statistics were used to describe demographic data and study variables. Paired sample t-tests were used …

Nursing Students’ Attitudes Regarding Technical Standards For Entrance Into A Bachelor Of Science In Nursing Program, Jordyn Leigh Cook

Institute for Disability Studies

Admission into a Bachelor of Science in Nursing program requires students to meet specific criteria including a non-negotiable set of technical standards. Technical standards encompass physical abilities including twisting, bending, and handling objects of varying weights (Good Samaritan College of Nursing and Health Science, n.d.). While physical capabilities may hold significance in bedside nursing, the American Nurses Association does not establish specific physical qualifications (American Nurses Association, 2010). Due to admission criteria and technical standards, individuals with disabilities are rarely found among career nurses and nursing students (Leslie & Miller, 2020). This study aims to determine nursing students’ attitudes towards …

Reducing Inpatient Falls Utilizing Multimodal Standardized Patient Education: An Evidence-Based Practice Project, Sheryl Almandrez

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: This project aims to utilize multimodal standardized patient education as an evidence-based practice intervention to reduce inpatient falls.

Background: In 2022, Kaiser Foundation Hospital (KFH) San Diego had 116 falls. Inpatient falls with injury account for the second-highest Joint Commission (TJC) sentinel event and California Department of Public Health (CDPH) adverse events. These injuries include lacerations, subdural hematoma, subdural hemorrhage, hip fractures, and wrist fractures. The Centers for Medicare and Medicaid Services (CMS) have also stopped reimbursing hospitals for the care provided after patients have sustained a fall with injury.

The project was implemented at KFH-San Diego …

Implementation Of Controlled Substance Agreements In An Adult Outpatient Psychiatric Clinic, Bryana Weimer

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project was to evaluate the clinical applicability of Controlled Substance Agreements (CSAs) in the adult outpatient psychiatric clinical setting. The first goal was to determine the frequency of Controlled Substance Agreement (CSA) utilization. The second goal was to identify potential outcomes associated with the implementation of CSAs, such as improved monitoring practices. Finally, this project aimed to evaluate provider perception of the efficacy of CSAs.
Background: The misuse and diversion of prescribed controlled substances contribute significantly to addiction and fatalities nationwide. Prescription psychotropics are the second most …

School Stock Albuterol, Trish Reyes

Doctor of Nursing Practice Final Manuscripts

SCHOOL STOCK BRONCHODILATOR INHALER POLICY FOR IMMMEDITE ACCESS IN SCHOOLS

Introduction: The purpose of this evidence- based practice DNP project was to do a systematic review, examine stock inhaler policies in school districts, and provide policy recommendations for school districts to implement the Stock Albuterol Access law. The Stock Albuterol law enacted in January 2024 would allow schools to provide an Albuterol inhaler on hand for a student experiencing respiratory distress. Albuterol inhalers provided by school personnel can be lifesaving, control asthma symptoms, have better health outcomes, increase the quality of life, and decrease Emergency and Urgent Care visits, and …

Improving The Utilization Of Lunch Breaks For Nursing Staff, Norma Dawson, Kelsey Robinson, Bridget Miller, Deborah Monck, Beth Kessler

Operations Transformation

The Med-Surg Unit at LincolnHealth has a high number of nursing staff missing lunch breaks, despite encouragement and existing efforts to promote taking breaks. In addition, there are many instances where staff are not accounting for the breaks they have taken on their time sheets.

Approach To Pivie In Pediatrics: Standardization For Early Detection, Jamie Green, Jill Gregory, Elizabeth Murphy, Jessica Miller, Nicole Manchester, Frank Harris, Meaghan Wildes, Cecilia Inman, Jenn Paradis, Faye Weir

Operations Transformation

PIVIE (Peripheral Intravenous Infiltration & Extravasation) can have devastating effects, especially in the pediatric population. The condition may disrupt vasculature severe enough for permanent skin and tissue loss that can lead to impaired limb function due to severe scarring. Problem: No standardized process existed either to prevent or review these events at Barbara Bush Children’s Hospital at Maine Medical Center prior to the study. PIVIEs were measured through the event reporting platform and only severe PIVIEs were being documented in this report. All infiltrations (1-4 on the infiltration scale) should be measured for accurate benchmarking. Occurrences in the electronic medical …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

The Experiences Of Alaska Native Students' Decision To Enter Nursing School: A Transcendental Phenomenological Study, Denise Michelle Gilliland

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenology study was to examine the lived experiences of Alaska Native students’ decisions to enter nursing school, thus choosing nursing as a career. The increased recruitment of Alaska Natives into nursing is imperative. According to the research, a direct association exists between increasing the number of minority nurses and decreasing health inequities. Despite the demand, only a small number of Alaska Native students continue to enroll in nursing programs in Alaska. The theories guiding this study were Ryan and Deci’s self-determination theory and Lowe and Struthers’s theory of nursing in Native American culture. They provided …

Improving Access To Mainehealth Care At Home, Amanda Kunkel, Mhcah Intake Department, Mhcah Scheduling Department, Mhcah Clinical Leadership Team

Operations Transformation

It is known that there are capacity limitations at MaineHealth Care at Home caused by a decrease in staffing. This leads to limited availability of home health services to patients in the community and can also contribute to increased length of stay for patients in acute care hospitals. MaineHealth Care at Home needs a way to measure current capacity to accept referrals and improved systems for communicating with referral sources.

Evaluating Nurse Comfort Levels Assessing For Depression In An Urban Hospital Setting, Jonathan Shafer, Riley R. Clubb

Doctor of Nursing Practice Projects

Evidence shows that a fraction of nurses are uncomfortable assessing patients for depression. When depression assessments are uncomfortable for the clinician, there may be inconsistencies in practice which can negatively affect patient outcomes. An evidence-based survey was developed and distributed to nurses at an urban hospital in Missouri. The survey assessed nurse's confidence, frequency of assessment, and understanding in evaluating patients for depression. Seventy-three nurses took part in the confidential survey. Thirty percent of the participants reported that they sometimes ask about mood and twenty-one percent reported that they rarely ask about mood. Although results showed that nurses were not …

Dnp Final Report: Balancing Self-Care And Patient Care: An Intervention To Enhance Well-Being For Acute Care Nurses, Robert V. Rose Jr.

DNP Final Reports

This project delves into the profound impact of the COVID-19 pandemic on healthcare and nursing, focusing on the well-being of nurses within the context of acute care settings. Poor well-being leads to increased levels of burnout and the evidence-based practice project aimed to increase the perception of well-being.

The formulated PICOT question driving this project was: In acute care nurses (P), how does the use of Acceptance and Commitment Therapy (ACT) program (I) compared to no Acceptance and Commitment Therapy (ACT) (C) impact nurses’ perception of well-being (O). The evidence substantiates that ACT interventions effectively elevate perceptions of well-being, as …

Improving Quality Of Life In Menopausal Women Through A Best Practice Protocol: The Use Of Hormone Therapy, Mindfulness-Based Module And Exercise, Claire Czerwonka

Evidence-Based Practice Project Reports

Menopause is a normal process of aging, but many of the symptoms negatively impact women’s day-to-day quality of life (QOL), as well as activities of daily living, physical and mental health (ACOG, 2014). Generally, systemic estrogen hormone therapy is indicated for menopause-related vasomotor symptoms, but there is no research further addressing QOL issues or lifestyle management in addition to hormone therapy. The purpose of this evidence-base practice (EBP) project was to implement a menopause protocol to address QOL issues in menopausal women with the use of hormone replacement therapy, education through an online mindfulness module, and the use of exercise. …

Nursing Students’ Perceptions Of The Impact Of Teamwork And Collaboration On Patient Care, Riana Square

Honors College Theses

Teamwork and communication are two topics that a vast majority of nursing students are introduced to in their first semester of nursing school. Many nursing students have a desire to improve their communication skills and have a better understanding of the inner workings of interdisciplinary collaboration. A study across multiple cohorts of Georgia Southern Nursing students was conducted to explore their perceptions of the correlation between teamwork and patient care outcomes. This study also explores nursing students’ readiness to communicate with other healthcare professionals and the effectiveness of the means to practice these communication skills while in nursing school. It …

Improving Early Identification And Management Of Depression Symptomology Through Implementation Of Universal Depression Screening In A University Student Health Center, Jessica M. Monjaras

Evidence-Based Practice Project Reports

Depression is the leading cause of disability in the United States for individuals aged 15 to 44 (Anxiety and Depression Association of America, 2023). The purpose of this evidence-based practice (EBP) project was to increase early identification of depression through implementation of universal depression screening, and to implement management strategies to decrease symptoms of depression. A two-tiered approach to universal depression screening was utilized through use of the PHQ-2 and PHQ-9 screening tools. Ten young adult patients, between the ages of 18 to 25, from a university student health center clinic in Northwest Indiana participated in this project. Participants underwent …

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

Healthier Together: A Holistic Office Protocol Addressing The Chronic Nature Of Children And Adolescents With Adhd, Kimberly Olmos

Evidence-Based Practice Project Reports

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent, chronic condition with symptoms that include inattention, hyperactivity, and impulsivity. ADHD affects six million children in the United States (Tran et al., 2021). The purpose of this evidence-based practice project was to implement a holistic office protocol that addressed the chronicity and future health outcomes of children and adolescents, ages 2-17 years with ADHD through stimulant or non-stimulant medication prescriptions, behavioral therapy referrals, and education surrounding diet, and exercise. A comprehensive, systematic literature search yielded 16 articles to determine best practice when treating children and adolescents with ADHD in primary or …