Nursing Commons^™

Exploring Moral Permissibility Of Nurse Participation In Limited Resuscitation, Felicia Stokes

Electronic Theses and Dissertations

This dissertation offers a novel approach to support nurses when they face conflict between clinicians and families or alternate decision-makers over potentially inappropriate end-of-life goals of care. This dissertation will provide a normative analysis of the moral permissibility of limited resuscitation, with arguments supported by analyses of families’ and nurses’ perspectives and actions in the EoL decision-making process. Limited resuscitation is a cardiopulmonary resuscitation effort where full pharmacologic and mechanical intervention is not used, or the length of the resuscitative effort is shortened. It is typically associated with deception because it is performed without the knowledge of patients and families. …

Long-Term Health Outcomes For Adult Women Who Experienced Sexual Assault, Jodie Flynn

Electronic Theses and Dissertations

The purpose of this study is to understand the impact of sexual assault pre- and post-sexual assault on health, health care experience, and health-related quality of life in adult women. Research identifying quality of life as a health outcome post-sexual assault is limited. No long-term studies to evaluate differences in health-related quality of life pre-and post-sexual assault have been conducted. In addition, only a few studies have investigated mental health changes over time. An exploration into self-perceived general health pre-and post-sexual assault and overall current quality of life needs to be conducted to determine improvements in health care services for …

Cultural Beliefs About Healthy And Unhealthy Weight In Children 2 To 11 Years Of Age Among Parents Of Mexican Heritage, Nathalie Confiac

Electronic Theses and Dissertations

Introduction: Despite multisectoral preventive interventions, the obesity prevalence among children of Mexican heritage remains the highest of all ethnic groups in the US. Methodology: Guided by Leininger’s Culture Care Diversity and Universality Theory, this study explored the culture care beliefs and practices of Mexican heritage parents about healthy and unhealthy weight in children 2-11 years of age using the ethnonursing research method. Eight key and 17 general informants were interviewed, and the four phases of ethnonursing data analysis guided analysis. Results: Twenty-six categories were identified which led to seven culture care patterns revealing four themes. Informants shared the …

Factors Influencing Vaccination Rates In Children Under Two In Southeast Kansas, Danielle Bennett

Doctor of Nursing Practice Scholarly Project

Introduction

A large Federally Qualified Health Center (FQHC) in Southeast Kansas has a 37% compliance of children completing the recommended combo 10 primary vaccination series before their second birthday. An additional 20% of children would be compliant if the flu vaccine was excluded, raising the compliance rate to 57%. This is still below the national average of 68-75%, leaving many children in Southeast Kansas and northeast Oklahoma unprotected from preventable childhood diseases.

Purpose

The purpose of this scholarly project was to identify barriers to vaccination, including vaccine hesitancy and socioeconomic barriers affecting completion of the primary vaccine series, or combo …

Genetics And Genomics In Nursing Practice: Assessing Barriers, Facilitators, And Tailoring Implementation Strategies, Jaanna Guillory

Doctor of Nursing Practice Scholarly Project

The Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics were published in 2006. These guidelines define the minimal competency in genetics expected of all nurses regardless of role, specialty, or level of education. However, research indicates that nurses lack knowledge and confidence in their role in genetics/genomics.

This quality improvement project aimed to assess barriers and facilitators of genetics/genomics integration into nursing. This study followed a cross-sectional design emphasizing a representative subset of the nursing practicing community at the Veterans Healthcare System of the Ozarks. Participants were invited to complete the Genetics and Genomics in Nursing Practice Survey …

Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug

Doctor of Nursing Practice Scholarly Project

As the geriatric population grows rapidly, the importance of utilizing and understanding palliative services continues to rise. Although palliative and hospice care are included in different healthcare courses, misconceptions and lack of knowledge continue to serve as barriers to the utilization of palliative care. The purpose was to assess knowledge, improve palliative care education, and increase understanding of the perspectives of the interdisciplinary team involved in acute patient care. The setting was the telemetry unit in a 300-bed acute care Kansas hospital. A mixed design was utilized with a goal of quality improvement in the use of palliative care. The …

Provider Education On Physical Activity For Older Adults, Joseph Morris

Doctor of Nursing Practice Scholarly Project

PROVIDER EDUCATION ON PHYSICAL ACTIVITY FOR OLDER ADULTS

An Abstract of the Scholarly Project by

Joseph Morris

The purpose of this study was to educate nursing staff and providers on the importance of physical activity for older adults to prevent functional decline and maintain quality of life. The project was conducted online using Qualtrics survey software. Data was collected from October 25, 2021 to November 25, 2021. Nursing staff and healthcare providers (physicians, nurse practitioners and physician assistants) that are actively practicing medicine and have experience interacting with older adults participated by completing a two-part survey. The survey consisted of …

Reducing The Stigma Associated With Maternal Substance Use Disorder In A Rural Midwest Hospital And Clinic, Jami Vineyard

Doctor of Nursing Practice Scholarly Project

The purpose of this study was to determine if an educational resource provided to maternal healthcare providers, more specifically, providers in a Midwest regional hospital and clinic, would reduce the stigma associated with maternal substance use disorder (SUD). This project also aimed at increasing provider knowledge on the disease process of maternal SUD and current treatment guidelines.

A quantitative research design was used for this study. There was no control group; therefore, it is a quasi-experimental study. Qualtrics were utilized to design a pre-test and post-test. An email including a brief description of the study, an invitation to participate, and …

Improving Venous Thromboembolism Prophylaxis Knowledge Among Registered Nurses On A Medical-Surgical Inpatient Unit In The Midwest, Theresa Umscheid

Doctor of Nursing Practice Scholarly Project

Venous thromboembolism (VTE) is the third most common vascular disease and includes approximately 900,000 cases annually in the United States. The purpose of this quality improvement project was to enhance education regarding VTE prophylaxis for registered nurses on a medical-surgical inpatient unit at a hospital in the Midwest. This study was initiated due to one nurse’s perception that staff on this unit lacked confidence and expertise on the importance of VTE prophylaxis interventions. Participants completed a VTE knowledge pretest, followed by an educational intervention on VTE prophylaxis utilizing Health Stream. After the intervention, participants completed a VTE knowledge post-test. The …

Evaluation Of An Educational Presentation On Improving Nursing Students’ Knowledge About Medication Reconciliation, My Trinh

Doctor of Nursing Practice Scholarly Project

Medication reconciliation is the process of comparing a patient’s medications that they are currently taking and comparing it with newly ordered medications or comparing the list to another source of information. It is completed to avoid and reduce the risk for potential adverse drug events, medication discrepancies, and improve communication between transition of care settings. Although people acknowledge and perceive the value of medication reconciliation as an important process in reducing medication errors and patient harm, healthcare team members including nurses may receive little formal training and education in school. The purpose of the Doctor of Nursing Practice (DNP) scholarly …

Pregnancy Education In Rural Areas, Kayla Tinsley

Doctor of Nursing Practice Scholarly Project

Educating of the pregnancy population before, during and after pregnancy can help to ensure a healthy pregnancy and in turn reduce maternal mortality. The purpose of this research project was to understand education provided in the clinic and hospital setting in a rural area by those who take care of and talk to pregnant women and their support persons. A descriptive research design was utilized to discover the important education topics that are discussed, and the routine tests that are done throughout the pregnancy, during labor and at delivery, and even ask how prepared they feel they are equipped to …

Does Nurses Confidence Improve After Attending A Training For Teaching Home Infusion Patients?, Carol Menorah Young Dnp

Doctor of Nursing Practice Scholarly Projects

Discharge can be a difficult step for patients and their families and a challenging task for nurses. Poor instructions have a negative impact on the patient population. In addition, improper and incomplete discharge information negatively affects the posthospital recovery period and may cause the patient to return to the hospital for the same episode of care. Returning to the hospital emergency room or readmission for the same episode of care will increase the dangers to the patient’s health and recovery plan and increase the cost of individual healthcare. The patient population ranks the quality of discharge information via their responses …

The Lived Experience Of Second Victim Crnas, Michael Neft

Electronic Theses and Dissertations

A second victim is a health care provider who has been involved in a critical event. A

critical event is a clinical situation in which an unforeseen clinical outcome occurs, or

the clinical deterioration of the patient takes place for many different reasons. The

patient and his/her family are the first victims. The health care provider(s) involved in

the event are second victims. After such an event, the healthcare provider may

experience a constellation of negative emotions, such as guilt, sadness, depression,

somatic symptoms, hypervigilance, and fear. Most second victims require support to

cope with the adverse clinical situation. Second …

Knowledge, Attitudes, And Beliefs Of Cardiovascular Disease Prevention In Young Georgian Adults, Kimberley Crawford

Electronic Theses and Dissertations

Introduction: Cardiovascular disease (CVD) accounts for 46% of all mortality in the country of Georgia (former Soviet Union). Young adults in that country have not been studied regarding CVD and a need exists to understand lifestyle modifications to promote cardiovascular health.

Design: An interpretive description qualitative design was used to explore Georgian young adults’ knowledge, attitudes, and beliefs of CVD preventative practices and life experiences.

Methods: A convenience sample of 19 ethnic Georgian participants (18 to 40 years old) who were fluent in either English, Georgian, or Russian from a local private university was used. Semi-structured interviews were conducted …

Improving Patient Satisfaction And Preventative Health Service Utilization For Limited English Proficiency Immigrants At Pearl Medical Centr, Chioma Holland

Graduate Theses, Dissertations, and Capstones

Background: Despite research efforts to address health disparities within immigrant communities, immigrant health continues to lack the attention from healthcare stakeholders it needs. Many immigrants already face dire health threats like extreme poverty, political unrest, and mental health concerns in their countries of origin, making them even more vulnerable to poor physical, mental, and social health outcomes upon arrival to the United States (U.S.). The purpose of this project was to improve patient satisfaction and increase immigrant use of preventative care by utilizing appropriate interpreter services. Method: The Quality improvement (QI) project involved surveying limited English proficiency (LEP) immigrants older …

Perceptions Of Perinatal Nurses Caring For Perceived Stigmatized Patients During The Covid-19 Pandemic In Perinatal Settings: A Qualitative Study, Deborah Tucker

Dissertations

Perinatal nursing consists of caring for women before, during, and shortly after the birth experience, providing a unique opportunity for nurses to care for women and families in a fundamental moment of life (Simpson et al., 2020). This qualitative descriptive study design allows for straight descriptions of phenomena to evaluate perceptions of nurses caring for perceived stigmatized patients in the perinatal setting during the SARS-CoV-2 (COVID-19) pandemic. As research gaps were identified, the following research questions were developed and used to guide this study:

1. What are the perceptions of caring in perinatal nurses who deliver care to perceived stigmatized …

Improve Primary Care Advanced Practice Nurse's Knowledge Of Depression By Educational Interventions And Treatment Recommendations, Dorothy Adams

Doctoral Projects

Poor medication adherence is one of the significant barriers to treatment for depression, often due to fears about side effects and insufficient knowledge among nurses. Educating primary care advanced practice nurses can help to improve understanding about symptoms of depression and the treatment recommendations. Education can help engage the primary care advanced practice nurses to improve patient understanding and thereby support better adherence measured as improved refill rates and follow-up reports. The refill rates will show if the patients under the primary care advanced practice nurses ‘care have been following the medications prescribed in the right frequency and dosage. The …

Decreasing Hospital Readmission With Post-Hospital Discharge Primary Care Clinic Appointments, David Snodgrass

Doctoral Projects

ABSTRACT

The Centers for Medicare and Medicaid Services (CMS) continue to apply costly financial penalties for hospital readmission. Hospital readmission can stem from multiple causes which can lead to poor health outcomes or increased healthcare financial costs. However, with the use of an implemented 14-day post-hospital follow-up appointment with a primary care provider, hospital readmission could be reduced, and patient care improved. The multiple factors that can lead to hospital readmission include non-adherence to medication, socioeconomic factors, patient-related factors, condition-related factors, or health system-related factors. Through the implementation of post-hospital discharge follow-up visits within 14 days of discharge, hospital readmissions …

A Quality Improvement Project: Streamlining The Post-Surgical Process In Total Knee And Hip Replacements With An Evidence-Based Guidance And Practice Protocol, Bianca Bullie

Doctoral Projects

ABSTRACT

The rates of total joint replacements, such as total knee arthroplasty (TKA) and total hip arthroplasty (THA), are on the rise in the United States and are expected to rise further in the next 20 years (Singh et al., 2019). Implementing an ERAS protocol coupled with current orthopedic practices will decrease a vast number of postoperative issues such as length of hospital stays, the financial burden on the facility, and overall patient satisfaction. The DNP project proposed a multidisciplinary protocol to standardize the care of patients undergoing THA or TKA and identified if this surgical process would be adopted …

Improving Compliance With Treatments For End-Stage Renal Disease Patients On Hemodialysis, Susan Blakeney

Doctoral Projects

According to Blumrosen et al. (2020), the dialysis population cost expenditure is greater than “seven percent of the Medicare budget at nearly $40 billion a year” even though this population is “less than one percent of the Medicare population” (p. 1436). Additionally, the renal disease population is growing in the United States and internationally which contributes to rising healthcare costs around the globe (Levin, 2018).

The purpose of this Doctor of Nursing Practice (DNP) project was to identify the factors or reasons hemodialysis patients miss treatments or only stay for partial treatment. Hemodialysis patients are required to have treatments three …

Improving Readiness For Nursing Practice Via Simulation In Workplace Violence Mitigation, Paul J. Weingartner

Doctoral Projects

Workplace Violence (WPV), a significant problem in health care in the United States and worldwide, causes emotional and physical harm to nurses, negatively affects quality care delivery, and contributes to burn out, job dissatisfaction, and attrition. Clinical simulation was used to educate registered nursing students about WPV and train them in mitigation techniques in an effort to improve their awareness and readiness for professional nursing practice. Data from 37 students in their final semester of nursing school were collected anonymously prior to and after reviewing online materials about WPV and attending a 3-hour simulation experience in which two scenarios were …

Increasing School Personnel Knowledge And Self-Efficacy Of Allergy Management, Sabrina Monzione

Doctor of Nursing Practice Scholarly Projects

Introduction: School-aged children with allergies is a growing population. Allergies are a leading cause of chronic illnesses, are costly to the healthcare system, and can result in death. Allergic reactions in schools negatively impact student outcomes. The sites for this improvement project were four urban, public schools in Suffolk County, Massachusetts that did not have standardized school personnel allergy education.

Methods: The project took place in four, urban public schools in Suffolk County, Massachusetts. The four schools are comprised of three middle schools and one high school serving over 1,400 students. Over 240 teachers and supporting staff members provide instruction …

Implementing Universal Depression Screening In A College Health Clinic, Marilyn J. Grabau

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: College students are at high risk for depression, and this carries a considerable burden. The American College Health Association supports depression screening on college campuses recognizing that early identification leads to better outcomes.

LOCAL PROBLEM: The project site is a public university located in New England. The college campus health center incorporates medical and counseling services. From August 2019 to December of 2019, 67% of students seen in the counseling center described depressed mood as the presenting concern. Currently there is no routine depression screening in place.

METHODS: This QI project implemented universal depression screening at the student health …

The Outcome Of A Multidimensional Intervention Strategy For The Management Of Generalized Anxiety Disorder In An Internal Medicine Setting, Nicholas Davidson

Evidence-Based Practice Project Reports

Anxiety disorders are very prevalent in the United States. The most common type, Generalized Anxiety Disorder (GAD), affects 6.8 million adults every year. GAD can cause significant deficits in a person’s ability to function, decrease their quality of life and increases a person’s risk of attempting suicide. The purpose of this evidence-based practice (EBP) project was to improve the outcomes of adults diagnosed with GAD in an internal medicine setting by implementing a protocol composed of a combination of interventions. A thorough literature search was conducted to find the best available evidence to support the project. A total of 11 …

The School Nurse's Experience Of Secondary Exposure To Trauma, Catherine A. Grano

Seton Hall University Dissertations and Theses (ETDs)

The school nurse (SN) is often the sole health care expert in the school setting, providing for the physical and socio-emotional needs of others. SN may be exposed to reports of trauma, a widespread and costly public health issue. This study sought to explore the experience of the SN when exposed to reports of trauma from those in their care. Seven N.J. certified school nurses participated in two online interviews via Microsoft Teams, spaced one to two weeks apart between June 2021 and September 2021. Interviews were recorded & transcribed verbatim and thematic analysis applied. This study found that SN …

Moral Distress And Ethical Climate In Pediatric Nurses In The Time Of Covid, Katherine Bliss Soriano

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

Moral Distress in an increasing problem in nurses and other healthcare professionals due to the many challenges nurses face in proving care to their patients and families. These challenges can be magnified when the nurse is conflicted and unable to successfully navigate the moral and ethical responsibilities of the profession leading to moral distress. The COVID-19 pandemic has had profound and global widespread consequences including the impact on pediatric nurses. This descriptive correlational study examined the relationship between moral distress and ethical climate among pediatric nurses who cared for patients during the COVID-19 pandemic. This study used Corely’s Theory …

Contextual Factors Associated With Organizational Learning In Hospitals: An Instrument Development Study, Bret Lyman, Kylie C. Thorum

Faculty Publications

Aim: Develop a valid, reliable research instrument to measure contextual factors associated with organizational learning in hospitals.

Background: A valid, reliable instrument for measuring contextual factors associated with organizational learning is needed so nurse leaders and researchers can improve healthcare by facilitating and studying organizational learning.

Methods: The Organizational Learning in Hospitals model guided development of the Organizational Learning Instrument-Context. Content validity was refined and evaluated through cognitive interviews and expert reviews. The instrument was distributed to direct care nurses in Magnet® hospitals in the United States. Intraclass correlation coefficients validated the use of multilevel analyses. Construct validity was assessed …

The Use Of Appreciative Inquiry In Identifying Pueblo Core Values, Kristyn N. Yepa

Doctor of Nursing Practice Scholarly Projects

This study used appreciative inquiry to identify core values or concepts essential to the Jemez Pueblo community to inform an evaluation framework used by community strength-based programs in Jemez Pueblo. Key informant interviews and a focus group were conducted in Jemez Pueblo with key program staff and tribal leaders. The audio recordings were transcribed and analyzed using inductive reasoning to identify core values. In addition, grounded theory was used to develop a conceptual model from the themes generated from the analysis. The PICOT question was, "Can the Appreciative Inquiry method help uncover core values of a Pueblo community?"

Nurse Driven Antibiotic Stewardship, Dr. Judy Liesveld R. White

Doctor of Nursing Practice Scholarly Projects

Abstract

Antibiotic use has increased tremendously and has led to antimicrobial resistance. Because it is a growing problem across healthcare systems around the world, healthcare systems and organizations must combat the detrimental effects of inappropriate use of antibiotics. The development of antibiotic stewardship programs is crucial to providing high quality, safe patient care. The work ofthis project intends to form a basic understanding ofa nurses' role as a member of the antibiotic team. Most healthcare systems have operated by a pharmacy driven antibiotic team concept and have just recently included nurses as a missing component to a full functioning team. …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …