Nursing Commons^™

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Educating Nurses On Failure To Rescue Due To Treatment Delay, Ganiyu Olasheni Adewale

Walden Dissertations and Doctoral Studies

Studies have found a shortfall in nurses' skills in caring for patients with a significant risk of failure to rescue in an acute care setting. The practice gap the healthcare facility was experiencing today was a gap in relation to failure to rescue with an increased rate of sentinel cases. There was a knowledge deficit among critical care nurses. The importance of educating nursing staff is to increase their knowledge and help decrease the occurrence of failure to rescue in an acute care setting. The practice-focused question for this education project asked if educating nursing staff with a medical-surgical competency …

Comparison Of Rural Associate Degree Nursing Students’ Clinical Judgment After Curriculum Change, Karen Bowen

Walden Dissertations and Doctoral Studies

New graduate nurses often lack adequate clinical judgment skills to practice competent nursing care, which may result in increased risk of committing practice errors that threaten patient safety. To mitigate errors in patient safety, industry leaders have called for nursing program improvements in preparation of nursing students’ clinical judgement as they transition to professional practice. Guided by Tanner’s clinical judgment theory, the rural state nursing programs in this study implemented a concept-based curriculum to promote clinical judgment which includes thinking skills, priority setting, and management of care. The purpose of this three-part, quantitative, nonexperimental study was to compare the development …

Educator Preparedness In The Use Of Simulation In Nursing Education, Marcelene E. Hart

Walden Dissertations and Doctoral Studies

AbstractNurse educators lack preparation when using simulation as a teaching modality in educating nurses and nursing students within their clinical environment. The purpose of this basic qualitative study was to understand nurse educators’ perceptions of the challenges in preparing for simulation-based training experiences for nurses and nursing students. Vygotsky’s constructivist theory was used as the conceptual framework for the study to emphasize students’ innate ability to learn using active and hands-on processes through simulation experiences. Questions were developed to explore the challenges nurse educators encounter when preparing for simulation activities. Survey questionnaire invitations were sent through email to hundreds of …

Comparison Of The Effects Of Telehealth Versus N95 On Nurse-Patient Communication, Tony Christopher Bloomfield

Walden Dissertations and Doctoral Studies

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the …

Nursing Knowledge And Breastfeeding Education, Mary Aguirre

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, the Healthy People 2020 breastfeeding goal immediately after birth of 81.9% was surpassed in 2016, with approximately 83.8% of babies breastfed shortly after delivery. However, by seven days post birth, this number decreased to 82.9%, reduced even more for infants who were exclusively breastfed to 64.7%. Local research has shown that breastfeeding decreases at one week after discharge, which may be due, in part, to the lack of nurses' knowledge related to breastfeeding. This lack of knowledge related to breastfeeding by the nurses, in turn, may negatively impact the support staff …

The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik

Walden Dissertations and Doctoral Studies

The intention to stay in nursing staff working with adult patients in a hospital setting is a major concern for healthcare organizations because of its effect on patient health outcomes. Grounded in the social cognitive career theory, the purpose of this quantitative correlational study was to investigate resilience as a moderating factor in the relationship between burnout and intention to stay for licensed registered nurses with BSN degrees working with adults in a hospital setting. The participants were 80 licensed registered nurses with BSN degrees working with adults in a hospital setting in the United States of America. The results …

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …

Quality Improvement Initiatives And Interventions For Decreasing Falls In The Hospital Setting, Fredlyn Lolange

Walden Dissertations and Doctoral Studies

Patient falls in health care settings are a widespread and severe problem, and they often happen as a result of a complex set of causes. In the United States, between 3.3 and 11.5 falls occur per 1,000 patient days. Reducing the incidence of falls in a health care setting would bring significant positive change and decrease the incidence of harm to patients in the hospital setting. This staff education project’s purpose is based on addressing falls, a safety concern and a health issue that continues to put patients at an increased risk. Theories used to inform the project include the …

Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger

Walden Dissertations and Doctoral Studies

To provide holistic care and ensure positive patient health outcomes, the social determinants of health (SDOH) must be addressed. Research demonstrates that while medical care is a contributor to wellness, the SDOH serve an influential role in patient health outcomes. There is limited literature describing how to best educate practicing nurses about SDOH concepts. The purpose of this DNP project was to provide an educational intervention to increase inpatient staff nursing knowledge of the SDOH. Sources of evidence used to create the education module included scholarly literature describing the SDOH concepts and their application to patient, community, and population health. …

A Global Perspective Of Advanced Practice Nursing Research: A Review Of Systematic Reviews Protocol, Kelley Kilpatrick, Isabelle Savard, Li-Anne Audet, Abby Kra-Friedman, Reneé Atallah, Mira Jabbour, Wentao Zhou, Kathy Wheeler, Elissa Ladd, Deborah C. Gray, Colette Henderson, Lori A. Spies, Heather Mcgrath, Melanie Rogers

Ellmer School of Nursing Faculty Publications

Introduction

In 2020, the World Health Organization called for the expansion and greater recognition of all nursing roles, including advanced practice nurses (APNs), to better meet patient care needs. As defined by the International Council of Nurses (ICN), the two most common APN roles include nurse practitioners (NPs) and clinical nurse specialists (CNSs). They help ensure care to communities as well as patients and families with acute, chronic or complex conditions. Moreover, APNs support providers to deliver high quality care and improve access to services. Currently, there is much variability in the use of advanced practice nursing roles globally. A …

Conservative Anabaptists Descriptions Of Delay, Comfort In Connectedness, And Ease In Cultural Tension When Seeking And Responding To Healthcare, Matthew Donald Hottle

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Conservative Anabaptists description of delay in health seeking behaviors, comfort in connectedness, and ease in cultural tension when seeking and responding to healthcare

Background: Conservative Anabaptists are a large ethnic religious population that continues to grow in the United States. This includes groups of Amish, Mennonites, Hutterites, and Brethren populations residing in rural areas. These groups are known to experience adverse health related outcomes such as community acquired infections, advanced cancer diagnosis, and undiagnosed chronic conditions such as hypertension, diabetes, and heart disease. Therefore, the concept transcending health values has been developed to better understand how conservative anabaptists describe …

A Bibliometric Analysis Of Missed Nursing Care Research: Current Themes And Way Forward, Afia A. Sarpong, Diana Arabiat, Lucy Gent, Amanda Towell-Barnard

Research outputs 2022 to 2026

Background. Missed nursing care adversely affects nurse and patient outcomes in healthcare settings. Comprehensive bibliometric overview of research output in this field is limited, which restricts knowledge of this complex phenomenon in terms of research trends, author’s productivity, and thematic focus of scientific publications. This study aims to examine publications on missed nursing care by conducting a comprehensive bibliometric analysis. Methods. A search was performed in the Scopus database to identify 276 published studies on missed nursing care from inception to 20th February 2022. A bibliometric approach was used to comprehensively analyse retrieved publications based on trend, thematic …

Integrative Review: Factors Impacting Effective Delegation Practices By Registered Nurses To Assistants In Nursing, Carol Crevacore, Elisabeth R. Jacob, Linda L. Coventry, Christine Duffield

Research outputs 2022 to 2026

Aim

To identify the evidence on factors that impact delegation practices by Registered Nurses to Assistants in Nursing in acute care hospitals.

Design

An integrative review.

Data Sources

Database searches were conducted between July 2011 and July 2021.

Review Methods

We used the 12-step approach by Kable and colleagues to document the search strategy. The (Whittemore & Knafl. 2005. Journal of Advanced Nursing, 52(5), 546–553) integrative review framework method was adopted and the methodological quality of the studies was assessed using Joanna Briggs critical appraisal instruments.

Results

Nine studies were included. Delegation between the Registered Nurse and the …

Clinical Deterioration As A Nurse Sensitive Indicator In The Out-Of-Hospital Context: A Scoping Review, Kylie Mccullough, Melanie Baker, Dianne Bloxsome, Carol Crevacore, Hugh Davies, Gemma Doleman, Michelle Gray, Nilufeur Mckay, Peter Palamara, Gina Richards, Rosemary Saunders, Amanda Towell-Barnard, Linda L. Coventry

Research outputs 2022 to 2026

Aims: To explore and summarise the literature on the concept of ‘clinical deterioration’ as a nurse-sensitive indicator of quality of care in the out-of-hospital context. Design: The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews. Methods: Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out-of-hospital context were included regardless of methodology. Text and opinion papers were also …

Increasing Colorectal Cancer Screening Rates In The Psychiatric Inpatient Unit, Diane R. Ventura

Master's Projects and Capstones

Increasing Colorectal Cancer Screening Rates in the Psychiatric Inpatient Unit

Abstract

Problem: Colorectal cancer is one of the leading cancer deaths in the United States. The Psychiatric Inpatient Unit has a colorectal cancer screening compliance rate of 40% compared to the statewide average of 80%.

Context: The Psychiatric Inpatient Unit is a 58-bed inpatient intermediate care facility mental health program in Northern California. Upon review of the EMR, most PIU nurses give verbal instructions and patient education on colorectal cancer screenings when due. Still, no printed handout was provided to the patients upon review of the EMR.

Intervention: Review of …

Usp<800> Hazardous Drug Safe-Handling In The Medical-Surgical Microsystem: A Cnl Quality Improvement Project, Ananda T. Le

Master's Projects and Capstones

Problem: The USP General Chapter <800> guidelines protect healthcare workers from hazardous drugs (HD) and are enforceable by hospital regulatory organizations. Hospitals should increase their safe handling and administration of these drugs to be compliant and protect their workers. This quality improvement project aimed to improve nurse compliance with the safe handling of USP <800> drugs on the medical-surgical microsystem within 16 weeks.

Context: This clinical nurse leader (CNL) quality improvement project was implemented on two medical-surgical microsystems in a San Francisco Bay Area hospital system.

Interventions: The team conducted passive observational data collection and active observation in the form of a …

Esp In Nursing: Building Communicative Competence For Internationally-Educated Nurses, Sami Vuong

Master's Projects and Capstones

The nursing shortage in the United States has been an ongoing issue due to nursing burnout and retirement. Together with the COVID-19 pandemic, it has further exhausted the healthcare system’s resources and healthcare providers. In order to sustain the healthcare system in society, a large number of internationally educated nurses (IENs) have been transferred to work in the United States. As a result of different nursing practices, cultures, and communication styles, many IENs experience language and cultural barriers at work. Difficulty in communication influences the quality of patient care provided, which can lead to negative health outcomes for patients and …

Effects Of Resilience Coaching On Behavioral Health Nurse Burnout, Dalila Franklin

Dissertations

Abstract

Background: Inpatient, staff nurse burnout negatively impacts nurses’ mental and physical health, hospital nurse retention and turnover, and patient care. The Stress First Aid for Health Workers program attempts to bolster resilience and subsequently reduce burnout among mental health nurses in this project.

Method: This quality improvement (QI) project was an observational pre-post survey design and was conducted on a cohort sample of inpatient, behavioral health nurses at an urban, mid-sized, Midwestern hospital psychiatric unit to assess personal, work-related, client-related, and overall burnout utilizing the Copenhagen Burnout Inventory (CBI) tool to quantitatively measure burnout pre- and three months post-implementation …

Nurse Efficiency & Ultrasound Guided Intravenous Access: Evidence Based Intervention Benchmark, Jacob D. Frost

MSN Capstone Projects

Gaining IV access is this first step into accurate, timely diagnosis and interventions of patients. Nurses are typically the first medical professional a patient sees. If the nurse can establish IV access as early as possible this will lead to faster interventions faster diagnostic results and better management for patients and ultimately better patient outcomes. Ultrasound guided IV can increase first attempt success rates leading to decreased painful IV insertions by multiple nurses. This would increase patient satisfactions scores leading to higher re-imbursement.

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Factors Impacting Organ Transplant Outcomes, Katelyn Grubich

Nursing | Senior Theses

Organ transplants are crucial to the survival of those on the receiving end. With medicine advancing, so has transplantation. Health care providers are becoming more aware of the strategies necessary to prolong the transplanted organ and how to obtain better outcomes. Heart, lungs, kidney, liver, pancreas, and some where more than one organ are involved, are the types of organ transplants performed.

Providing patients information will allow them to be a part of their treatment and can help to ease their anxiety knowing what is being performed and what can be expected. Health care providers must ensure that patients and …

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore …

Impact Of Intergenerational Trauma Among Immigrant And Refugee Families: Effects On The Mental Health And Acquisition Of Care, Loralee Chea

Nursing | Senior Theses

Intergenerational trauma is described as a discrete form of trauma that occurs when traumatic effects are passed across generations without the descendants of trauma survivors having exposure to the original event (Isobel et al., 2021). It is a silent suffering experienced among immigrant families from all across the world who have survived war, genocide, displacements, loss, and other psychological trauma. An exploration of literature has also shown that the healthcare crisis from this form of trauma can be identified and intervened with preventative or treatment measures in clinical practice. The purpose of this research paper is to explore the mental …

The Effects Of A Low Fodmap Diet On People With Irritable Bowel Syndrome: A Literature Review, Emily Stalder

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Irritable Bowel Syndrome (IBS) is a very common gastrointestinal disorder around the world. There is no known etiology or cure for the disorder, which leaves researchers to develop coping mechanisms for this prevalent issue. A high percentage (10%-15%) of the general population, mostly in Western, industrialized areas, suffer from IBS. A low FODMAP diet (LFD) is something that has been gaining a following over the past 20 years, which has led to research on its ability to minimize symptoms of IBS. The purpose of this literature review is to see what current research has to offer on the LFD’s ability …

Nurses' Experiences Implementing Eped: An Ipad Application To Guide Quality Discharge Teaching, Carol Klingbeil, Cori A. Gibson, Norah L. Johnson, Michele Polfuss, Karen Gralton, Stacee M. Lerret

College of Nursing Faculty Research and Publications

Quality discharge teaching prepares patients and families to transition safely from hospital to home. Technology can enhance and support quality discharge teaching by promoting patient family engagement during the transition. The purpose of this mixed methods study was to explore clinical nurses' experience with using Engaging Parents in Education for Discharge, an iPad application to guide quality discharge teaching. Twelve nurses at a large Midwestern Children's Hospital participated in small focus groups after use of the Engaging Parents in Education for Discharge application and completed a questionnaire on their perception of the acceptability and feasibility of the app. Findings revealed …

Nurses’ Perceptions Of The Universal Newborn Hearing Screening Program, Aaron Michael Roman, Michelle O'Connor Kensey

Journal of Early Hearing Detection and Intervention

This study explores the knowledge and perceptions of the newborn hearing screening (NBHS) program from the perspective of nurses and nursing support staff. Registered nurses and nursing support staff (n = 84) completed a digitally administered survey that queried their understanding of JCIH guidelines, perceptions around NBHS administration, and parental anxiety. The results demonstrated that while most respondents felt comfortable and confident about NBHS administration, there was a significant difference in their understanding of appropriate screening milestones compared to JCIH recommendations. Participants further demonstrated an interest in additional learning opportunities related to the NBHS.

Pick Your Plate: A Nutrition Education Study, Emmalyn Tucker

Honors College Theses

Childhood obesity has become a cause for concern among many nutrition experts. Childhood obesity can contribute to several health problems such as type 2 diabetes, asthma, high blood pressure. The large percentage of children affected with childhood obesity suggests a lack of essential nutrition education in our country. Junk food consumption and inadequate intake of the USDA’s MyPlate food groups have become essential areas for intervention. Multiple school-based nutrition education interventions have been explored to improve both children’s nutrition knowledge and improve healthy eating behaviors. “Pick Your Plate” is a nutrition education study designed to improve nutrition knowledge regarding junk …

A Clinical Dashboard To Reduce Missed Opportunities To Measure Dialysis Adequacy, Kassandra J. Goodman, Cora L. Wilson, Ann R. Loth

Nursing DNP Projects

In the local department, pre-pilot dialysis adequacy data was housed in a spreadsheet with manually entered, month-old data, inaccessible to clinic staff. The inoperability of the local QAPI workbook and EHR as well as data inaccessibility to staff resulted in missed opportunities to measure Kt/V. Based on the synthesis of evidence, dashboards have been utilized in a variety of interdisciplinary clinical settings with positive outcomes in addressing patient care gaps. The purpose of this pilot was to implement the Epic Dashboard that displays automated, real-time quality metric data to reduce missed opportunities to measure Kt/V in the outpatient HD setting. …

Early And Progressive Mobility: A Program Implementation Strategy For High Acuity Patient Care Locations, Stefani Poland

Student Scholarly Projects

Despite an increase in the promotion of early progressive mobility, its decrease in hospital-acquired complications and improvement of patient outcomes, there remains a reluctance in staff commitment to daily evaluation and implementation. This is largely due to the fact nurses or other interprofessional staff are the primary individuals responsible for this change in process. A lack of confidence in staff to correctly identify patients that meet criteria and anxiety regarding the safe transfer or mobilization of patients, particularly in high acuity settings have been identified as major barriers. The PICOT question that guided this program development of a CBO toolkit …