Nursing Commons^™

Utilizing Simulation For Family Member Caregivers Of Nicu Infants: A Pilot Project, Brenda M. Seegmiller

Doctor of Nursing Practice Projects

According to the World Health Organization (WHO), there are approximately 15 million babies born prematurely every year. Family members of premature infants in the Neonatal Intensive Care Units (NICU) are overwhelmed and lack confidence with basic skills to care for their newborn. Simulation is an education modality used for adult learners that utilizes a hands-on method for education and allows application of knowledge and skill development in a safe environment. Although clinicians are frequently trained utilizing simulation, there is limited information on its use among family members and caregivers. The purpose of this DNP Project was to explore use of …

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena White Jones

Walden Dissertations and Doctoral Studies

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …

Multidisciplinary Simulation Training To Improve Nursing Knowledge Of Intraoperative Malignant Hyperthermia, Heather Burrell

Walden Dissertations and Doctoral Studies

Malignant hyperthermia (MH) is a rare but severe reaction that can occur in the operating room. Due to the low volume of these reactions, nurses are often unprepared to handle the event; however, not recognizing the event and intervening can lead to the death of the patient. This is a practice problem that can be addressed through a nursing staff education simulation training program. The purpose for this doctoral project was to develop a multidisciplinary MH simulation program that could improve nursing knowledge when caring for patients experiencing an MH crisis in the operating room. The practice-focused question for this …

Effects Of High-Fidelity Simulation On The Critical Thinking Skills Of Baccalaureate Nursing Students, Janine Roth Blakeslee

Walden Dissertations and Doctoral Studies

This project study addressed the decline in successful passing rates for the National Licensure Exam for Registered Nurses (NCLEX-RN) in a nursing program at a private university in the Midwestern United States. There is support from the literature for a connection between critical thinking skills of nursing students and successful passing of the NCLEX-RN. The purpose of this quantitative study was to examine whether significant differences existed in mean critical thinking skill scores across time within groups (pretest to posttest) and between groups (simulation versus written case studies), as measured by the Health Science Reasoning Test. Cognitive learning theory as …

Development And Evaluation Of A Long-Term Care Skills Simulation Program, Tina Marie Gerovac

Walden Dissertations and Doctoral Studies

New graduate nurses often lack clinical skill competency. In a single year, a long-term care facility located in the midwestern region of the United States reported 25 clinical errors, each costing the facility approximately $10,000. Root-cause analysis revealed 85% of those errors were made by nurses in their 1st year of practice. The increase in clinical errors were attributed to insufficient clinical preparation prior to independent practice. A review of the current scholarly literature suggested simulation had demonstrated efficacy in the development and maintenance of clinical nursing skills and answered the practice-focused question: Development of a skills simulation program for …

Simulation As A Remediation Tool For Clinically At-Risk Associate Degree Nursing Students, Janna G. Lock

Walden Dissertations and Doctoral Studies

Evidence-based remediation options are limited for nursing students who fail their clinical competency evaluations. Scholarly literature provides a paucity of studies related to the use of simulation-based technology to remediate nursing students. The research question focused on the difference in the initial competency demonstration evaluation scores of associate degree nursing students compared to the reevaluation scores after remediation with simulation-based technology. Benner's novice to expert and Kolb's experiential learning theories were used to explain how nurses acquire and develop skills. The researcher used a quantitative one-group pretest posttest design to examine archival data from 149 nursing students from a South-Central …

Validation Of Communication Simulation Scenarios For Nurse Preceptors, Karie Thurston

Walden Dissertations and Doctoral Studies

An expectation of the nurse preceptor role includes the ability to evaluate, deliver feedback, and coach new graduate nurses. A gap in nurse preceptors' communication skills can affect the safety-related behaviors and quality of care provided by new graduate nurses, thus affecting patient outcomes. To bridge this gap, robust training on delivering feedback and coaching is needed for preceptors. The purpose of this staff education project was to develop and validate 5 communication simulation scenarios for preceptor training. Mezirow's transformative learning theory and the National League for Nurses-Jeffries simulation theory were used to guide the project. A panel of nurse …

The Effect Of A Simulation-Based Education Program On Nihss Accuracy And Inter-Rater Reliability Among Nursing Staff In The Neurological/Neurosurgical Intensive Care Unit, Amanda Novak

DNP Projects

PURPOSE: The purpose of this Quasi-experimental study was to examine the effect of a simulation-based educational NIHSS workshop on nursing accuracy and inter-rater reliability upon use of the National Institutes of Health Stroke Scale (NIHSS).

METHODS: This study was conducted in the Neurological/Neurosurgical Intensive Care Unit (ICU) at Baptist Health, a comprehensive stroke center located in Lexington, KY. The sample included 26 eligible nurses employed in the aforesaid unit. Nurses completed the NIHSS on a patient actor in a simulated scenario (this session was videotaped), a one-on-one debriefing with review of the videotape was conducted afterward, and then the nurse …

Nursing Partnership With Patients, Parents And Families For Safety Through Simulation, Courtnay Caufield

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The importance of communication between nurses, patients, and their family members with respect to treating each other as partners in safety cannot be overstated. It is imperative that families and patients feel empowered to speak up and report clinical errors at any time and be able to communicate effectively to prevent harm and encourage communication.

Context: This is especially important in the acute care setting, where patients may be in contact with multiple people and processes daily. Attention to this safety partnership can be established through improvements in patient satisfaction scores, which are usually collected from patients and …

The Incorporation Of Evidence-Based Simulated Activities In An Existing Nurse Residency Program, Wendy Partin Thompson

Doctoral Dissertations and Projects

As new graduate nurses are challenged with caring for patients with complex disease processes, nurse residency programs are designed to ease the transition into practice. A community based hospital, in the southern United States has recently implemented such a program. However, the organization continues to have problems with nursing turnover. This problem is especially evident in nurses with less than one year of clinical experience. Research has shown that nurse residency programs without simulative activities eliminate vital critical thinking activities which prepare novice nurses for clinical practice. The purpose of this project was to design evidence-based simulative activities to increase …

Cognitive Load Measurement, Worked-Out Modeling, And Simulation, Jayne Josephsen

Nursing Faculty Publications and Presentations

Using a cognitive load theory framework, this study investigated implementation of a worked-out modeling (WOM) prebriefing intervention on postsimulation knowledge acquisition and cognitive load experienced. A quasi-experimental quantitative design was used with a convenience sample of 61 senior-level nursing students who had previously participated in a simulation. The treatment group received the WOM intervention before simulation participation, and the control group received the usual presimulation interventions. A presimulation and postsimulation knowledge survey and a cognitive load measurement tool were administered after the simulation. Data indicated increased knowledge related to falls and situation, background, assessment, and recommendation in the treatment group …

A Malignant Hyperthermia Competency Training For Nurse Anesthesia Trainees: Development, Implementation, And Evaluation, Andrew M. Christ

College of Science and Health Theses and Dissertations

Background: Video simulation is an alternative method of teaching that can play an important role in nurse anesthesia education. Using video simulation for uncommon crisis could prove beneficial.

Objectives: The purpose of this study is to analyze the effects of an educational video simulation regarding malignant hyperthermia (MH) recognition and management on knowledge of nurse anesthesia trainees (NATs).

Methods: A single group pretest-posttest design was used to compare knowledge on recognition and management of malignant hyperthermia. The study included a voluntary convenience sample of junior and senior nurse anesthesia trainees at NorthShore University HealthSystem School of Nurse Anesthesia. Pretest scores …

Simulation Course Redesign, Hsuan Ho

Master's Projects and Capstones

The purpose of this project is to enhance the clinical nurse leader (CNL) nursing students’ learning experiences through simulation education, ensure that their learning outcomes meet course objectives, and increase students’ recognition of educational best practices in simulation.

This summer semester, the number of students in the obstetric course doubled and the course was changed from four scenarios held over two simulation days for four pre-licensure students each class to five simulation days with eight to ten students in attendance each class period. While the old student-to-instructor ratio was three to four to one, the new ratio is nine to …

Implementing A Caps Simulation To Increase Nursing Education Practice Students’ Self-Awareness Of Attitudes And Beliefs About Poverty, Melissa Ehmke

Dissertations

Problem. The purpose of this project is to determine if college students who are currently in nursing school, will benefit from the addition of a poverty simulation to positively influence their self-awareness and individual-level beliefs and attitudes towards poverty, therefore being able to serve those in poverty fully and guide them to appropriate resources.

Methods. Bachelor of Science in Nursing (BSN) and Doctoral Nursing Practice (DNP) students participated in a three-hour Community Action Poverty Simulation (CAPS). A twenty-one item Attitude Toward Poverty Scale short form (ATPS) survey was completed pre and post-simulation participation.

Results. Significant improvements resulted in three of …

Implementation Of A Scripted Debriefing Tool In Simulation-Based Nursing, Mary Kidd

Doctor of Nursing Practice Scholarly Projects

In nursing education, simulation represents real patient scenarios that are designed to enable students to practice combining theoretical knowledge with clinical skills within a controlled environment (Bland, Topping, & Wood, 2011). Debriefing is a facilitated reflection of the simulation experience and is performed to uncover relationships among the events, actions, thought processes and outcomes with the intention of improving future practice (Cheng et al., 2014; Kolbe, Grande, & Spahn, 2015). Without proper debriefing, erroneous critical thinking, decision-making, and clinical judgement may go uncorrected, potentially negatively impacting patient care. There is an abundance of literature on debriefing methods; yet, empirical evidence …

Decreasing Simulation Anxiety In Nursing Education, Kimberly Byler

Doctor of Nursing Practice Scholarly Project

The purpose of this quantitative research project was to examine the efficacy of pre-simulation progressive muscle relaxation in decreasing the level of anxiety experienced by nursing students during simulation exercises. Simulation is an important teaching strategy in nursing education; it provides an arena in which to practice skills and decision-making without putting real patients in danger of any mistakes. Student anxiety is a challenge of the simulation teaching strategy, because it can make students feel unsuccessful. Decreasing student anxiety will be important as simulation is used more frequently in nursing education. Our study assessed students’ anxiety before simulation and the …

Local Anesthetic Systemic Toxicity Management: An Assessment Of Simulation-Based Staff Education, Kevin L. Kanallakan

Doctor of Nursing Practice Projects

When local anesthetics are administered at toxic doses or when certain local anesthetics are directly injected into the patient’s circulation, excessive plasma concentrations of the drug will produce a systemic cascade of events known as local anesthetic systemic toxicity (LAST). LAST is a rare, potentially life-threatening complication, which affects both the central nervous and cardiovascular systems. Anesthesia providers and perioperative healthcare professionals must remain current on best practice LAST management in order to reduce morbidity and mortality.

This quality improvement project utilized high fidelity simulation paired with LAST education to improve stakeholder knowledge and management of a LAST scenario. With …

Nurse Confidence Levels In Malignant Hyperthermia, Paige Wilson

Nursing Theses and Capstone Projects

Malignant hyperthermia is a life threatening medical emergency. When individuals with a certain genetic predisposition are exposed to certain pharmaceutical triggering agents, a malignant hyperthermia crisis can occur. If the crisis is not recognized early and symptoms are not treated, the ending result will be patient death. The ability to recognize and intervene in a malignant hyperthermia crisis demonstrates knowledge and confidence by the nurse. Simulation training is an educational tool that nurses can use to increase confidence levels in recognizing and intervening in this type of medical emergency in a safe environment. The findings from this research indicate a …

Using End Of Life Care In A Simulation Scenario In An Effort To Help Increase Student Confidence, Amy P. Davis

Nursing Theses and Capstone Projects

This evidence-based project examined how using the end of life care in a simulation scenario would help in an effort to increase student confidence. A sample size of 28 Practical Nursing Students participated in the simulation scenario. The Confidence Scale (C-scale) developed by Susan Grundy, was administered to the students as a pre-test prior to the simulation and a post-test after the simulation. The C-scale measured student confidence and consisted of five questions asking the students to rate themselves on a scale of one to five in performing a task. The goal was to see if the student’s confidence level …

An Education Intervention To Increase Rounding And Toileting And Reduce Falls In A Hospital Acute Care Of The Elderly (Ace) Unit, Amelia Grayson

Doctoral Projects

Introduction: Falls are the most common accident reported in acute care hospitals and patients who are 65 and older are the most vulnerable. Falls can lead to physical and emotional injury, reduced mobility and functioning, increased length of hospital stay, increased healthcare costs, and admission to long-term care facilities. In 2008, the Center for Medicare & Medicaid Services (CMS) has eliminated reimbursement to hospitals for treatment of injuries resulting from a fall during hospitalization. Research on fall prevention in adult acute care found multifactorial interventions that address multiple risk factors for falls are the most successful at prevention. This …

Try To See It My Way: Patient Perspective Video Capture Debriefing In Simulation, Terri Hendry

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

Video capture of simulation provides observation from a wide-angle view. This study introduced a new technique, “patient-perspective” video capture, using a camera mounted into eyeglasses allowing learners to view their nonverbal and verbal communication through the patient’s eyes and to compare this to the wide-angle view. The participants (n = 29) were Nurse Practitioner students. The majority were female (93.2%), with a mean age of 36.8, SD = 12.31. The sample consisted of Millennials (65.6%), Generation Xers (13.8%), and Baby Boomers (20.7%). The average number of years of nursing practice was 9.89. Instruments measured demographics, five domains of patient-centered care …

Patient Deterioration Simulation Education And New Graduate Nurses' Self-Confidence And Competence, Heather B. Norris

Doctor of Nursing Practice Projects

Inconsistent identification and intervention for patient deteriorations has been identified as a global healthcare issue that has a profound effect on patient outcomes. Failure to rescue (FTR) rates are influenced by the quality of care a hospital provides in the event of patient deterioration. Rapid Response Teams (RRTs) are summoned to the bedside in the event of a patient deterioration to assess the patient and intervene quickly. Efficient use of RRTs prevents cardiopulmonary arrests and decreases hospital mortality, thirty-day morality, and length of stay. Patient deterioration simulation education can improve the use of RRTs and positively influence patient outcomes. New …

The Impact Of Simulation Learning On Community Opioid Overdose Prevention In Nursing Education, Lara Sheppa

Nursing Theses and Capstone Projects

Drug overdose, especially from opioids, is a global problem which has stretched across all racial, generational, and socio-economical groups. Millions of people have been affected on a personal or professional basis by the emotional, physical, and financial impacts of this crisis. There is a critical need to provide support for public health awareness and education on opioid overdose prevention. Worldwide, federal, state and grassroot initiatives have been implemented to help reduce harm from opioid use. The goal of this scholarly project was to prepare Associate Degree nursing students with the requisite knowledge, skills, and attitudes to manage opioid overdose within …

Developing Clinical Judgment Through The Implementation Of Information And Communication Technology, Such As The Electronic Healthcare Record (Ehr), Sherri Carter

Nursing Theses and Capstone Projects

Graduate nurses are expected to enter a technology-rich workforce with an understanding of the electronic health record (EHR) and how it is used to guide patient care. Limited access to EHRs in clinical settings may result in students entering professional practice with limited ability to understand the full potential of the EHR. Over a seven-week term, students enrolled in the Patient-Centered Care I course, during the 2018 Spring I term, participated in high-fidelity simulation and seminar activities that included an educational electronic healthcare record (EEHR). These activities were integrated into the course to guide students when making clinical decisions regarding …

Simulation Outside The Silo: Allied Health Interprofessional Education Day To Improve Patient Outcomes, Eva Huneycutt Whitley

Nursing Theses and Capstone Projects

Since 2003, the World Health Organization (WHO) has identified working in interdisciplinary teams as a critical factor in providing patient-centered care. Simulationenhanced interprofessional education (Sim-IPE) has shown improved knowledge, skills, attitudes, and behaviors of teamwork required to improve patient outcomes. The purpose of this project was to determine whether a simulation-based interprofessional education day would improve these factors in senior allied health students in a small community college. The NLN Jeffries Simulation Theory was used as a theoretical framework for this project. The project administrator used the Interprofessional Socialization and Valuing Scale (ISVS) 9A pre-test to examine beliefs, behaviors, and …

Evaluation Of Self-Efficacy And Confidence Levels Among Newly Graduated Nurses Exposed To An End-Of-Life Simulation: A Comparison Study, Catherine Edwards

DNP Projects

Purpose: The purpose of this project is to compare self-efficacy and confidence levels among a cohort of newly graduated nurses (defined as nurses who have had no nursing experience and are participating in a new graduate nursing residency) who will participate in an EOL simulation with another cohort of nurses who have been practicing for a year or more, but have not participated in an end-of-life simulation.

Methods: The study included two parts. The first portion included a pre and post-test evaluation of an end-of-life (EOL) simulation intervention with newly graduated nurses (Group One, n= 22), as part of their …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Applying Lean Methodology To Improve The Response And Management Of Postpartum Hemorrhage, Caroline Siefken

DNP Scholarly Projects

Postpartum Hemorrhage is an obstetric emergency that can lead to substantial maternal morbidity and mortality. Lean methodology is an improvement framework that addresses processes and identifies opportunities to eliminate waste and introduce efficiencies. The North Shore Medical Center uses an improvement framework modeled after the Toyota Production System that uses lean methodology to assess processes. This framework is called the North Shore Production System. This quality improvement project used the lean methodology tools from the North Shore Production System and applied them to interdisciplinary, simulated drills at the North Shore Medical Center Birthplace. After analysis of the tools, a postpartum …

Graduate Nurse's Perspective Of Simulation To Address The Theory-Practice Gap In Nursing, Joset Elaine Brown

Walden Dissertations and Doctoral Studies

Graduate nurses are being employed to provide care in high acuity care areas, and this becomes a problem of significance as the literature suggests that graduate nurse's experience a deficit in integrating theoretical concepts in the clinical environment, described as the theory-practice gap; which can result in a risk to patient safety and the potential for negative outcomes. Cognitive constructivism was the conceptual framework that guided this study. A qualitative phenomenological design was used to explore the lived experiences of 13 graduate nurses employed at a community hospital in northern New Jersey. After recruiting the participants through purposive sampling, semi-structured …