Nursing Commons^™

Reducing Hospital-Acquired Clostridium Difficile, Tracy Esposo

Master's Projects and Capstones

Background: This project focused on implementation of clostridium difficile (C. diff) education sessions at Hospital A, a not-for-profit, short-term, acute care hospital serving the Greater Sacramento community. It comprises of 241 staffed beds in the medical-surgical, telemetry, and intensive care units.

Problem: My Clinical Nurse Leader project focused on preventing hospital-acquired C. diff. At Hospital A, there were 19 hospital-acquired C. diff cases for the 2022 performance year. Of the 19 clostridium difficile cases, 12 were related to C. diff testing criteria fall-outs.

Despite huddling with staff on opportunities and providing education through health stream modules, Hospital A continues to …

Implementing Trauma-Informed Care Curriculum In A Doctoral Nursing Program, Mary D. Brown

Dissertations

Purpose: Trauma is highly prevalent with 70% of individuals encountering at least one traumatic event during their lifetime and approximately 30% experiencing four or more events (Wheeler & Phillips, 2021). Despite the dramatic impact of trauma, there is minimal literature to assist nurses in caring for patients with a trauma history. The purpose of this project was to evaluate the implementation of a virtual, asynchronous trauma-informed care (TIC) educational program for Doctor of Nursing Practice (DNP) students at a midsized, Midwestern public university using knowledge, attitudes, and competency scores as outcome measures.

Methods: This program evaluation (PE) project was an …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

Implicit Bias In Nursing: Raising Awareness, Fostering Change, Jeanette C. Sandoval

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Extensive research evidence demonstrates that implicit bias can lead to differential treatment of patients based on race, gender, weight, age, income, language, and insurance status. Evidence-based interventions that couple implicit bias mitigation with therapeutic communication skills can contribute to the delivery of equitable care.

Local Problem: Implicit bias in healthcare occurs when unconscious behavior that is not favorable to the patient population served perpetuates unequal treatment and contributes to poor healthcare outcomes.

Methods: Knowledge of implicit bias in the nursing staff was assessed through a validated and reliable survey tool before and after participation in an online LMS …

Educating Nursing Staff On Evidence-Based Maternal Positioning To Promote Fetal Descent During The First And Second Stages Of Labor, Maryellen Barillas, Maryellen Barillas

Master's Projects and Capstones

This project aims to increase the confidence of nurses using birthing positions to aid with mobility to assist with fetal descent and decrease the duration of labor in the first and second stages of labor. Lack of mobility and increased duration of labor are associated with the use of cesarean sections, which is an invasive surgery with potential complications. A knowledge gap in a South Bay Area hospital exists in current evidence-based birthing positions. Recent evidence shows that flexible sacrum positions, which are any upright positions that take the weight off the sacrum, promote vaginal deliveries, and improve birthing outcomes. …

Hyperoxemia Education To Nurses To Increase The Adherence To Oxygen Weaning Goals In Inpatient Copd Patients., Katherine Ellingson

Doctor of Nursing Practice Projects

Hyperoxemia in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at risk for increased hospital stay, mechanical ventilation, and increased risk of death. Literature supports that establishing increased education to nursing staff on the risks of hypoxemia to increase adherence to oxygen weaning protocols has the potential to improve future practice. Oxygen weaning protocols are often not followed for concern of patient care. Nurses may believe to be helping patients when increasing oxygen, when they could actually be potentially harming them. Increased education on hypoxemia in COPD patients for the nursing staff will assist them to feeling …

Enhancing The Education Of Paediatric Nurses: A Positive Step Towards Achieving Sustainable Development Goals, Aimable Nkurunziza, Godfrey Katende, Philomene Uwimana, Patricia J. Moreland

School of Nursing & Midwifery, East Africa

Aim: The aim of this discursive paper was to describe and expound on how paediatric nurses will be able to address the needs of children and adolescents through the lens of selected Sustainable Development Goals (SDGs) in Rwanda.

Design: A discursive analysis of SDGs relating to the roles of paediatric nurses in the context of Rwanda.

Methods: A discursive method using SDGs as a guiding framework is used in this paper. We drew on our own experiences and supported them with the available literature.

Results: A collection of contextually relevant examples of how paediatric nurses will …

Effects Of Guided Journaling On Nursing Clinical Judgment During An Externship, Jaclyn Parrill

Undergraduate Theses

Background: There is longstanding discussion concerning the competency of novice nurses who passed the National Council Licensure Exam (NCLEX) and their ability to practice safely. Nursing clinical judgment (CJ), also known as critical thinking or clinical decision-making, accounts for more than 46% of daily tasks nurses perform in their first year (Hensel, 2020, p. 128). Guided reflective journaling is one active learning strategy that encourages students to reflect on what they have learned, anticipate future needs, and enhance clinical judgment skills (Meijer, 2021, p. 9, 11). This qualitative pilot study follows one nursing student throughout a student nurse extern program …

Improving Pediatric Medical Nurses’ Confidence In Caring For Pediatric Mental Health Patients: A Pilot Project Large Academic Pediatric Health System In The Pacific Northwest, Lauren Kalember

Doctor of Nursing Practice Projects

Problem Description

Pediatric mental and behavioral health care needs continue to increase across the nation. Approximately ten percent of pediatric hospitalizations are for a primary mental or behavioral health condition (Canvara & Johnson, 2020). With the increase in hospitalizations for mental health (MH) needs, pediatric psychiatric units are at capacity, and MH patients are admitted to pediatric general medical/surgical units for care. Most of the nurses that work on these units have not received pediatric mental health education outside of nursing school curricula and report a lack of confidence in their ability to care for pediatric MH patients. With the …

Nursing Faculty Perceptions Of Stress, Coping, And Intent To Leave The Profession In The Ongoing Covid-19 Pandemic: A Quantitative Study, Lynlee Morgan

Dissertations

The COVID-19 pandemic impacted all of society to varying degrees; this impact was especially true in higher education due to an overnight transition to distance learning and incessant pivots to meet new guidelines and overcome obstacles. Nursing faculty were significantly impacted due to the responsibility of producing safe, qualified, competent practitioners to provide care in the clinical setting. The limitations in or exclusions from clinical experiences combined with the fact that faculty were managing personal concerns and had never encountered these unprecedented conditions exacerbated the challenge of preparing new nurses. This study was critical due to the faculty role and …

Implementation Of Collaborative Care Intervention Within A Fqhc To Achieve Uniform Data System (Uds) Measure Of Depression Remission, Rasha A. Kafi Msn, Rn, Fnp-C

Doctor of Nursing Practice Projects

Background: Depression is one of the most common and treatable mental health conditions. Untreated depression causes emotional suffering, reduced productivity, lost wages, increased comorbidity risks, and increased healthcare costs.

Purpose: The purpose of this project was to implement Collaborative Care Interventions (CCI) to achieve the Uniform Data System (UDS) Measure of Depression Remission.

Aims: The AIMS of this project were: (a) Increases the percentage of nursing staff compliance and completion of the educational training; (b) increases nursing staff knowledge of recognition of depression signs and symptoms, early identification of depression, and administration to all adult patients; (c) Increase the percentage …

Faculty Readiness And Learning Needs For Incorporating Virtual Healthcare Into The Curriculum, Kelley Connor, Jason Blomquist, Darci Mccall, Cara Gallegos, Janet Reis

Nursing Faculty Publications and Presentations

Objective: Virtual healthcare technologies are becoming increasingly acceptable and available to patients and providers to deliver care. Although common in practice settings, many nursing schools have not integrated virtual care concepts into the curriculum. One reason may be because faculty are not prepared to teach these concepts. The purpose of this study was to assess the virtual healthcare learning needs of faculty.

Methods: An exploratory, descriptive study design was used to evaluate faculty receptiveness and readiness to teach virtual nursing care concepts. Thirty-seven full time faculty members were asked to complete an anonymous survey consisting of demographic, open-ended, and Likert …

The Impact Of Student-Led Lactation Education On Self-Efficacy In Clinical Simulation: An Integrative Literature Review, Kaitlyn Flores Yu

Honors Undergraduate Theses

Simulation is a critical component of nursing education. It provides a safe environment to practice and evaluate skills, supplements clinical hours, and removes barriers to a well-rounded education. Nurses are expected to be educators as part of our scope of practice, and simulation can facilitate this. One topic of nursing importance is lactation education, as breastfeeding has been shown to have multiple benefits for both mother and baby. National rates of exclusive breastfeeding for the first 6 months do not currently meet CDC recommendations. The pedagogy known as the Protégé Effect suggests that learning can be improved through teaching. Breastfeeding …

The Long-Term Impact Of Covid-19 On Nursing: An E-Panel Discussion From The International Network For Child And Family Centred Care, Mandie Jane Foster, Julie Blamires, Sarah Neill, Imelda Coyne, Guðrún Kristjánsdóttir, Veronica D. Feeg, Ann Marie Paraszczuk, Mohammad Al-Motlaq

Research outputs 2022 to 2026

Aim: To explore the International Network for Child and Family Centred Care (INCFCC) members' experiences and views on the long-term impact of COVID-19 on the nursing workforce. Background: On the 11 March 2020, the World Health Organization declared COVID-19 a global pandemic. While some countries adopted a herd immunity approach, others imposed stricter measures to reduce the transmission of the virus. Hospitals in some countries faced an avalanche of extremely sick admissions, whereas others experienced an early surge in cases or were able to control the spread. Design: Discursive paper. Methods: A web-based survey was e-mailed to 63 INCFCC members …

The Relationship Between Perceived Stress And Academic Self-Efficacy To The Academic Performance Of Undergraduate Nursing Students, Ashley J. Pierre

Nursing Theses and Dissertations

When nursing students fail and are required to repeat a course in a pre-licensure nursing program, they are at risk for attrition. While nursing student attrition is a problem with recognized consequences to the student, school, and profession, the incidence of students who fail a required course and need to repeat it has had little attention. Despite research addressing students' experiences with course failure, little describes strategies and interventions to support the retention and success of these students. The first manuscript, Student Repeaters in Baccalaureate Nursing Programs: A Concept Analysis, provided a foundation that enhanced the conceptual understanding of nursing …

Creating A Primary Care Track In Prelicensure Nursing Education, Janice E. Hawkins, Lynn L. Wiles, Jamela Martin, Beth Tremblay, Karen Higgins, Ingrid Mahoney

Ellmer School of Nursing Faculty Publications

BACKGROUND: RNs practicing in primary care (PC) increase access to health care and contribute to better patient outcomes and cost savings, yet undergraduate nursing education traditionally focuses on disease-oriented care. This article describes a curricular track for infusing PC prelicensure programs.

METHOD: PC content is threaded across four semesters with targeted assignments and clinical experiences. Providing clinical immersion experiences with practicing RNs as preceptors in community and PC settings is a key component of this initiative.

RESULTS: Student feedback has been favorable. Students stated they gained insight to the role of RNs in PC through class assignments and clinical rotations. …

Hepatitis B Immunity Among Undergraduate Nursing Students: A Brief Report, Robin M. Dawson Phd, Rn, Cpnp-Pc, Courtney Catledge, Ann Scott Dnp, Rn, Ccrn-K, Cne, Leigh Blackmon Pate Dnp, Msn, Aprn, Fnp-Bc, Gail Vereen

Publications

Background: Health sciences students who report low/equivocal hepatitis B titers may be required to repeat the immunization series, even though the result may not indicate non-immunity. Method: To describe hepatitis B immunity patterns, this retrospective, descriptive study utilized de-identified vaccination records and anti-HBs titers of three cohorts of sophomore nursing students entering clinical rotations in 2018–2019. Results: Only 33% of students had initial anti-HBs quantitative serum titer ≥10 mIU/ml, demonstrating immunity. After students with low/equivocal titers (n = 191, 64%) were re-immunized per institution protocol, only 2% (n = 7) were identified as non-responders. Cumulative costs incurred by students for …

Climate And Health: Impact Of Climate Education On Nursing Student Knowledge, Confidence, And Intent To Act, Beth Tremblay, Janice Hawkins

Ellmer School of Nursing Faculty Publications

Background: Because climate change negatively impacts human health, nurses need skills to mitigate climate change and nurse educators need effective educational strategies to teach climate change content in undergraduate nursing programs. To address this need, we embedded an energy efficiency treasure hunt and Climate for Health Ambassador Training into our prelicensure nursing curricula.

Purpose: To evaluate the impact of these educational activities on self-reported knowledge, confidence, and intent to engage in climate action.

Methods: A quasi-experimental one-group posttest design examined the effectiveness of 2 educational interventions on increasing knowledge, confidence, and intent to engage in climate action. A convenience sample …

Immersive Virtual Reality As An Effective Alternative To Traditional Clinical Nursing Education: An Integrative Review, Alisha Gelder, Myrtha Labastille-Normil

Master of Science in Nursing Final Projects

Immersive Virtual Reality as an Effective Alternative to Traditional Clinical Nursing Education: An Integrative Review 

Abstract 

Aim: To assess the usefulness of immersive virtual reality as an effective alternative to traditional face-to-face clinical education for undergraduate nursing students. 

Background:  The Covid-19 pandemic impacted nursing education to a point where change is needed in traditional curricula to meet program outcomes. Virtual Reality (VR) based simulations introduce students to clinical situations in a safe environment and therefore became an effective solution during the pandemic to enhance student learning. Due to the lack of research, regulatory bodies are hesitant to accept VR clinical …

Closing The Experience Complexity Gap Using Peripheral Iv Education, Taylor N. Daughtery Msn, Rn, Cv-Bc, Cphq, Melinda M. Webb Bsn, Rn, Va-Bc, Stephani Schultz Bsn, Rn, Cmsrn

Nursing Publications, Posters, & Presentations

Poster Presented at the Nursing Research Symposium, 2022

Introduction

At Parkview Health System, a gap in peripheral IV (PIV) insertion education was identified. • PIV insertion is not a curriculum priority in nursing school. • In practice, IV insertion needs to be completed in a timely manner to avoid care delays. • An aversion to starting PIVs, by new and seasoned nurses, create unique barriers to PIV insertion. • Experienced nurses may not be well versed in placing IVs due to the availability of a hospital IV team. To close the experience complexity gap and incorporate all learning styles, the …

Perceptions And Utilization Of A Multimedia Teaching Strategy To Prevent Student Nurse Attrition, Lorretta Krautscheid, Pamela Fifer, Rebecca Hernandez, Taryn Blum

Faculty Publications - College of Nursing

Untethered Lecture Capture (ULC) is a teaching method facilitating student classroom engagement while simultaneously creating audiovisual lecture capture (LC) resources. This single-site, convergent parallel mixed-methods study qualitatively described how nursing students with attrition risk factors perceived ULC influenced learning and quantified how such students utilized LC. Study participants (N = 28) reported watching most LC resources (57.1%) and 42.9% watched entire LC videos from start to finish. Qualitative findings produced new evidence about untethered faculty proximity in the classroom and ULC techniques supporting in-class focus and post-class self-paced learning efficiencies. Findings help nurse educators prioritize instructional methods among students with …

Defining Foundational Competence For Prelicensure And Graduate Nursing Students: A Concept Analysis And Conceptual Model, Katie L. Mcdermott, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Aim

To define the concept of foundational competence as it pertains to prelicensure and graduate nursing students during their educational program, thereby informing pedagogical and assessment practices.

Background

Competence has many definitions and uses, however a lack of consensus of a clear and useful definition in nursing persists. Without shared language, competence remains open for interpretation across and among groups and impedes the ability to teach and assess it in a competency-based education framework.

Method

Using the Walker & Avant method of concept analysis, literature was reviewed and synthesized to define and explain the concept of foundational competence in nursing …

Assessing Nursing Student Engagement In Clinical And Simulation Experiences, Karrie Osborne

Dissertations

clinical education, nursing education, student engagement

Bispectral Index (Bis) Monitor: Applying The Evidence For Appropriate Application And Use, Mandy Christensen-Geraci, Becky Templin

Nursing DNP Projects

Abstract

Background: Accurate monitoring of sedation and proper utilization of the BIS Monitor in intensive care unit (ICU) patients can result in decreased use of sedative medications, which can lead to decreased time to extubation, thereby reducing costs and even perhaps the length of hospital stay. The purpose of this project was to provide education to medical intensive care unit (MICU) nurses to increase their knowledge and confidence using the BIS monitor.

Methods: A middle range theory, specifically the Synergy Model for Patient Care was used as a conceptual framework for designing the intervention and The Johns Hopkins Evidence-Based (JHNEBP) …

Self-Compassion And Perceived Readiness For Practice Among Baccalaureate Nursing Students: A Mixed-Methods Study, Laurie A. Walter

Dissertations

There is increasing concern about how nursing students’ psychological health will impact their future nursing practice. The COVID-19 pandemic has enhanced these concerns. Nurse educators are being challenged with preparing nursing students to provide compassionate, patient-centered care despite the stress and psychological challenges of today’s healthcare environment. Self-compassion is a practice of mindfulness, self-kindness, and common humanity which positively influences and predicts psychological health. The purpose of this study was to explore the relationship between self-compassion and perceived readiness for professional practice among undergraduate nursing students.

A convergent mixed-method design utilizing correlational and directed content analyses explored this relationship. The …

Debriefing For Meaningful Learning: Implementing A Train-The-Trainer Program For Debriefers, Aimee A. Woda, Jamie Hansen, Kristina Dreifuerst, Brandon Kyle Johnson, Anne Loomis, Nolan Cox, Cynthia Sherraden Bradley

College of Nursing Faculty Research and Publications

Debriefing for Meaningful Learning (DML) is a method of debriefing grounded in the theory of reflection used following a simulation or clinical learning experience to engage participants in an interactive dialogue aimed at examining and evaluating their thinking and decision-making processes. With increasing adoption of DML worldwide, a sustainable training program for nurse educators is needed. Attending conferences and workshops that provide training is challenging for many nurse educators because of time and cost constraints. One promising solution is the train-the-trainer (TTT) model. In this article, the development and implementation of a TTT model of DML debriefer training, adaptable to …

A Cross-Sectional Study Of Self-Perceived Educational Needs Of Emergency Nurses In Two Tertiary Hospitals In Nairobi, Kenya, Anthony Ndung’U, Eunice Ndirangu, Ahmed Sarki, Lilian Isiaho

School of Nursing & Midwifery, East Africa

Background: Many low- and middle-income countries lack resources for well-functioning emergency care systems. Emer- gency nurses interact with injured and critically ill patients as the first contact in many health care settings. However, insuffi- cient training limits nurses from providing ideal emergency care. The purpose of this research was to highlight educational needs specific to nurses working in 2 emergency departments in Nairobi, Kenya.

Methods: A descriptive cross-sectional study involving emer- gency units of 2 of the largest referral and teaching hospitals (Aga Khan University Hospital, Nairobi, and Kenyatta National Hospital) in Nairobi, Kenya, was conducted. Data were …

Implementation And Evaluation Of An End-Of-Life Standardized Participant Simulation Into An Adult/Gerontology Acute Care Nurse Practitioner Program, Shannon Daly

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

Palliative care interventions are in high demand due to patients living longer with chronic, life-limiting conditions. Nursing professionals are instrumental in the care of patients across their lifespan, and it is imperative that they receive end-of-life care training in their respective curriculums. The aims of this project were to 1) implement end-of-life content into an AGACNP program using the ELNEC curriculum and 2) to determine if the simulated environment affects the AGACNP students’ self-confidence and anxiety levels when making clinical decisions for end-of-life patients. As a result of the standardized participant (SP) end-of-life simulation, AGACNP students experienced an increase in …

Infant Car Seat Safety Education And Confidence Measure For Maternal-Child Nursing Students, Mariah A. Arnett

Honors College Theses

Studies have shown that nursing students experience a greater-than-normal amount of anxiety and decreased clinical confidence when in settings involving infants and children, which is said to have a negative impact on the learning experience (Lassche, 2013; Moscaritolo, 2009). Patient education is a vital aspect of nursing, but one that the student nurse may not feel comfortable taking part in, either because of their lack of nursing experience or because of a lack of experience with infants and infant safety (Potter, 2020; Lassche, 2013). This project attempts to assess for a change in clinical confidence after providing a subject specific …

The Impact Of An Innovative Simulation On Prelicensure Nursing Student Empathy Levels, Annie Harrison

Articles, Abstracts, and Reports

Empathy is the ability to see oneself in the situation of another and to take actions on behalf of that individual based on that perception. However, empathy has been shown to decrease in nursing education and continues to do so in nursing practice. Importantly, aspects of empathy have been shown to be teachable. This scholarly practice project examined whether an innovative simulation would increase empathy in prelicensure nursing students. This study, guided by self-determination theory (SDT) and designed according to the Plan-Do-Study-Act (PDSA) change model, used a mixed-methods design. The instrument for quantitative data collection was the Toronto Empathy Questionnaire …