Frequency And Magnitude Of Obstacles And Helpful Behavior Items In End-Of-Life Care As Perceived By Nurses Working In Critical Access Hospitals, Shalyn C. Larsen

Theses and Dissertations

Background: Twenty percent of Americans live in rural areas where most of their healthcare is provided in Critical Access Hospitals (CAHs). It is unknown how frequently obstacle and helpful behavior items occur in End-of-Life (EOL) care in CAHs. Objectives: To determine the frequency of occurrence scores of obstacle and helpful behavior items in providing EOL care in CAHs. To also determine which obstacles and helpful behaviors have the greatest or least impact on EOL care based on the magnitude scores. Methods: A questionnaire was sent to nurses working in 39 CAHs in the United States. Nurse participants were asked to …

Parental Sleep When Their Child Is Sick: A Phased Principle-Based Concept Analysis, Stephanie Smith, Mary Tallon, James Smith, Charlotte Angelhoff, Evalotte Mörelius

Research outputs 2022 to 2026

Sleep is a common challenge for parents with sick children and can impact parents' health, wellbeing, and caregiving responsibilities. Despite the vast research around parental sleep when their child is sick, the concept is not clearly defined. A phased principle-based concept analysis that includes triangulation of methods and quality criteria assessment was used to explore how the concept is described, used, and measured in the current literature. The aim was to analyse and clarify the conceptual, operational, and theoretical basis of parental sleep when their child is sick to produce an evidence-based definition and to identify knowledge gaps. A systematic …

Central Line Associated Blood Stream Infection (Clabsi) Prevention Through Designated-Nurse Peripherally Inserted Central Catheter (Picc) Line Dressing Change, Belinder Atabongafac

MSN Capstone Projects

The goal of this review is to show ways in which a nurse can have influence in the patient’s life by caring for their PICC line. The rate of hospital-acquired infections is related to the care that patients get while admitted in the hospital. All hospital acquired infections can and should be prevented. This is also true for central line associated blood stream infections (CLABSI). The care provided to a patient with a PICC line, including how their line is taken care of, decides if the line gets infected, and if the patients get an infection. When patients get a …

Comparing The Effectiveness Of Perioperative Ketorolac To Opioids: A Scoping Review, Kruze T. Vanderford Bsn, Ccrn, Srna, Abbie E. Walter Bsn, Ccrn, Srna, Anastasiya V. Woodard Bsn, Ccrn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Abstract Purpose/Background Opioids are commonly administered in the perioperative period to manage surgical pain. However, the ongoing opioid epidemic in the United States makes it necessary to evaluate other modalities of pain management that do not cause respiratory depression, nausea, vomiting and addiction. Ketorolac is a nonsteroidal anti-inflammatory drug that can manage pain safely and effectively. This scoping review examines the available literature on the effectiveness and feasibility of using ketorolac to minimize perioperative opioid use.

Methods A comprehensive literature review was performed between October 2020 and September 2021 utilizing five scholarly databases: GoogleScholar ™, PubMed, Ovid, Cochrane Library, and …

Asthma Education With Asthma Action Plan, Lois K. Sanders

MSN Capstone Projects

MSN capstone project in which pediatric asthma patients were given audio visits for the purpose of formulating asthma action plans.

Effectiveness Of Perioperative Ketamine Vs. Opioid Analgesia On Extubation Time And Total Perioperative Opioid Requirement, Robert H. Gray Srna, Sarah S. Hardesty Srna, Heidi E. Higginbotham Srna, Charles A. Hoyt Ii, Srna, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Purpose/Background Opioid analgesics are a primary source of pain control in the perioperative patient. However, all opioids decrease ventilatory drive secondary to mu2 receptor agonism in the brainstem. Ventilatory depression delays extubation after mechanical ventilation in post-operative patients, thus increasing the risk of complications such as ventilator-associated pneumonia and barotrauma. Non-opioid analgesics such as ketamine have been considered for use in order to reduce this risk. Ketamine is a noncompetitive N-methyl-D-aspartate receptor-antagonizing sedative that bears analgesic properties while preserving respiratory drive. Research suggests that ketamine provides effective perioperative pain control and decreases postoperative extubation time when given alone or with …

Checklist Based Vap Bundle, Molly Van Gorp

ONU Student Research Colloquium

Problem: Ventilator Associated Pneumonia (VAP) is the leading cause of death of all hospital acquired infections. VAP bundles have been researched and utilized throughout hospitals. However, there is a gap that exists between physical practice and knowledge.

Purpose: This proposed study aims to implement a checklist based VAP Bundle into the ICU to increase nurse adherence to bundle and thereby decrease rates of VAP.

Methods: This project is a three phase quasi-experimental research design taking place in an ICU. The first phase is a retrospective data collection over five months. The second phase will take place over two months. This …

Quality Improvement Initiative To Improve Door To Needle Time In Acute Stroke Patients, Lauren N. Trace

ONU Student Research Colloquium

Problem: A stroke is when a blockage occurs in the blood vessels to the brain or when a blood vessel bursts in the brain, creating a lack of oxygen supply to keep the brain functioning effectively. The earlier a stroke patient is treated, the better the outcomes will be. Door to needle time is the time difference between when the patient arrives to the time treatment is given.

Purpose: The purpose of this project is to determine if implementing a one call notification system can decrease door-to-needle (DTN) time.

Methods: A quasi-experimental approach will be used for this study. Five …

Ensuring Safety During Behavioral Health Emergencies In Emergency Rooms, Allison Logue

ONU Student Research Colloquium

Problem: Psychiatric patient emergencies and behavioral outbursts are increasingly present in nonmental health units. With the associated increase in complexity and acuity of mental health emergency room visits, there is an associated increase in risk that they will become agitated, posing a risk to themselves and others. The yelling, manipulating, physical outbursts, and verbal or physical threats that can be associated with this patient population increases the risk of injury for staff and patients.

Purpose: The purpose of this project is to determine if the implementation of a behavioral health/aggressive patient bundle will decrease the number of staff injuries by …

End Of Life Simulation Education For Nurses, Shaun T. Wagner

ONU Student Research Colloquium

Problem: End of Life (EOL) care requires skilled nursing skills. Many nurses report negative experiences and attitudes related to End of life care. This may lead to negative patient and family EOL outcomes. Simulation education may be one method to improve nurses attitudes toward EOL care.

Purpose: The purpose of this project is to determine if simulation based EOL education leads to improved nurse attitudes.

Methods: This quasi-experimental quality improvement project will include registered nurses who receive EOL simulation training. Participant attitudes of EOL care will be measured prior to and following simulation using the Frommelt Attitude Toward Care …

Trauma Related Stress On Nursing Care, Karsen Bresnahan

ONU Student Research Colloquium

Problem: ED nurses are faced with critical unexpected traumas daily. Nurses must be able to cope with traumatic patient events to provide care to other assigned patients. The inability to cope may lead to burnout and medical mistakes. Mindfulness is a coping strategy that can be used to decrease stress.

Purpose: The purpose of this quality improvement study is to determine if educating nurses on the use of mindfulness after experiencing a patient trauma decreases nurses’ physical and mental stress.

Methods: This will be a quantitative, quasi-experimental study comparing the stress levels of nurses who received mindfulness training to nurses …

The Effects Of Oral Care In Reducing The Incidence Of Ventilator-Associated Pneumonia In Mechanically Ventilated Patients In The Icu, Alexandra Ann Waugh

ONU Student Research Colloquium

Problem: Ventilator-Associated Pneumonia (VAP) is a severe complication that occurs within mechanically ventilated patients. Despite initiatives to decrease complications of mechanical ventilation, VAP continues to occur in critically ill patients.

Purpose: The purpose of this study is to evaluate the effectiveness of oral care in reducing the number of patient’s in the ICU who develop VAP.

Methods: This project uses a three part quasi-experimental retrospective study design. The participants include mechanically ventilated patients in the ICU and the nurses taking care of them. The oral care kits used in this study consists of chlorhexidine, suction swabs, suction brushes, and mouth …

Provision Of Maternal Breastmilk In The Neonatal Intensive Care Unit: A Grounded Theory Analysis, Emma West, Samrawit Kelkay

21st Annual Celebration of Undergraduate Research and Creative Activity (2022)

Despite the importance of providing hospitalized extremely preterm (EP, < 32 weeks gestation) very low birth weight (VLBW, < 1500 grams) infants with mother’s own milk (MOM), a low percentage of neonates are discharged receiving MOM. The purpose of this study was to explore the experience of mothers of EP VLBW infants and related breastmilk provision in the neonatal intensive care unit (NICU) to develop a general theory of maternal breastmilk provision. This grounded theory study implemented classical qualitative methods. Transcribed maternal interviews were analyzed using the web-based data management and analysis platform of Dedoose. A total of 30 mothers, recruited within a large Midwestern hospital’s NICU, were included in this study. Ten participants provided longitudinal data, while 20 provided data at one-time point. Participants were primarily 22-25 years old (30%, n=10), Black (61%, n=20), multiparous (55%, n=18), living with the father of the baby (36%, n=12), and gave birth via Cesarean section (70%, n=23). Interview analyses yielded three core constructs: maternal psychosocial experiences, maternal cognitive experiences, and infant health. We hypothesized that these core constructs impact maternal breastmilk provision through the mediating factor of maternal health. The psychosocial construct encompasses relationships, responsibilities, resources, bonding, and control. The construct of cognition was categorized into knowledge level and initial breastfeeding intentions. Individual theme co-occurrence, chronological distribution of thematic influence, and general conclusions are pending, as they will be derived from code co-occurrence findings and a chronological understanding of the themes. Limitations include the use of a single hospital site for data collection and the hospital’s high level of support for lactating mothers. Future research should explore prominent themes that emerge from this study and their chronological impact on MOM provision. Nurses should implement evidence-based interventions related to these themes to support breastfeeding mothers of EP VLBW infants.

Compassion Satisfaction, Burnout, And Secondary Traumatic Stress Among Heart Transplant Nurses In A Hospital Setting, Marissa Potts

DNP Projects

Abstract

Purpose: The purpose of this study was to assess whether or not, and the degree to which compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) are present among inpatient acute-care heart transplant nurses. Perceived presence of other contributing factors that contributed to CS, BO, and STS was also assessed.

Design: A cross-sectional survey-based mixed methods study with an explanatory sequential design was used to assess baseline levels of CS, BO, and STS and identify any other factors at work or home that may impact these constructs.

Methods: A Qualtrics survey was sent to potential participants. A convenience …

Accurate Methods In Pulse Rate Assessment By Palpation: Pilot Study, Emilija Stankute

Honors Projects

A person’s pulse rate, which provides key data about physical and psychological health, must be assessed using a method that is both reliable and valid. Since no manual palpation standard exists, healthcare providers’ assessment methods vary depending on count time (15, 30, or 60 seconds) and start points (zero or one). Some researchers have shown more accuracy when starting the count with “zero,” but the common practice continues to be starting the count with “one.” The purpose of this study is to be a pilot for pulse count method validation, specifically examining the effect of counting interval (15, 30, or …

Nur 621: Clinical Pathophysiology Oer Curation, Chealsye Bowley

Curated OER Collections

This OER curation is an annotated bibliography of prospective OER for the GVSU course NUR 621: Clinical Pathophysiology, assembled by request from the instructor.

Nur 265: Introduction To Nursing Research And Evidence-Based Practice Oer Curation, Chealsye Bowley

Curated OER Collections

This OER curation is an annotated bibliography of prospective OER for the GVSU course NUR 265: Introduction to Nursing Research and Evidence-based Practice.

Development Of A Point-Of-Care Ultrasonography Workflow Within A Rural Clinic, Lauren Myers

Masters Projects

Abstract

Background and Objectives: Healthcare has revolutionized with advancements in ultrasound technology. Among these advancements and the increasing availability of imaging modalities is point-of-care ultrasonography (POCUS) technology.

Problem: While POCUS has gained considerable ground in primary care, infrastructure to support its utility is deficient. The purpose of this project was to design, pilot, and evaluate a POCUS workflow to facilitate technology utilization and increase access to care.

Methods: Program development and evaluation involves the design, implementation, and evaluation of an evidence-based workflow for POCUS technology. The project was intended to address the needs of individuals in a rural setting. Participants …

Improving Patient Portal Enrollment Through Education And Technology At Rural Family Practice, Kelsey Crampton

Doctoral Dissertations & Projects

Background: Patient portals are available through many healthcare offices. They offer the opportunity to improve patient engagement and quality of patient care, but few patients enroll. At a small rural primary care office, less than 20% of the patients were enrolled in the patient portal.

Objective: The purpose of this quality improvement project was to address the barriers reported by patients at this clinic and determine whether changes in portal enrollment volume occurred. Reported barriers included a lack of knowledge about the portal and difficulties with the sign-up process.

Methods: Over three months, strategies included the development of a …

Alternating Pressure Overlay Systems, Maris Rathgeb

MSN Capstone Projects

Although preventable, pressure injuries are an overwhelming problem in the healthcare system and can lead to poor quality of life, increased length of hospitalization, and unsatisfactory patient outcomes. Many cardiac surgeries take anywhere from six to twelve hours, and patients are completely immobilized for the entire length of time. Alternating pressure overlays placed on the operating room table provide tissue offloading with inflating and deflating nodes, leading to micro-movements on high pressure bony prominences. The intervention PICO question to be answered in this paper is: In intraoperative patients (P), how does the use of an alternating pressure surface (I) compared …

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

Moving On After Critical Incidents In Health Care: A Qualitative Study Of The Perspectives And Experiences Of Second Victims, Melanie Buhlmann, Beverley Ewens, Amineh Rashidi

Research outputs 2022 to 2026

Aims: To gain a deeper understanding of nurses and midwives' experiences following involvement in a critical incident in a non-critical care area and to explore how they have 'moved-on' from the event.

Design: An interpretive descriptive design guided inductive inquiry to interpret the meaning of moving-on.

Methods: Purposive sampling recruited 10 nurses and midwives. Data collection comprised semi-structured interviews, memos and field notes. Data were concurrently collected and analysed during 2016–2017 with NVivo 11. The thematic analysis enabled a coherent analytical framework evolving emerging themes and transformation of the data into credible interpretive description findings, adhering to the COREQ reporting …

The Effect Of Contingency Management On The Recovery Of Patients With Substance Use Disorder: A Systematic Review Of The Literature, Emily A. Gilman, Alexis Mccrossin, John R. Massey

Thinking Matters Symposium

Substance use disorder (SUD) is traditionally managed with behavioral therapy and medication. Contingency management (CM), a therapeutic method that reinforces positive behaviors with incentives, may be a useful adjuvant to enhance treatment engagement and efficacy for those who struggle with SUD. This systematic review of literature was conducted using databases CINAHL, Cochrane, and PubMed from January 2010 to July 2021. The search yielded 132 initial records. Studies were included if they were written in English, peer reviewed, and randomized control trials. Six final studies rendered results for 650 patients with varying substance use disorders including cannabis, tobacco, and opioids. Studies …

Evaluation Of Current Post-Graduate Family Nurse Practitioner Training Programs: A Qualitative Analysis, John R. Massey

Thinking Matters Symposium

Introduction: Family nurse practitioners (FNPs) are master or doctoral-level trained registered nurses that manage the care of patients in the primary care setting. FNP post-graduate training programs further prepare FNPs and ease the transition from education to practice. While FNP post-graduate training programs are emerging and remain relatively new, they are becoming more commonplace as graduates and employers alike seek further preparation to practice in the primary care setting.

Methods: Interview questions were developed using Consolidated Framework for Implementation Research (CFIR) guidelines. Participants were selected using convenience sampling. 14 semi-structured interviews with 19 key informants were conducted between …

Intimate Partner Violence Education For Pregnant And Postpartum Adolescents And Young Adults, Tatiana Filajdic

Dissertations

Abstract

Problem The commencement of intimate partner violence (IPV) often begins with relationships during adolescence and young adulthood; hence, young age is a risk factor. Young adult females, pregnant and post-partum adolescents are at high risk of experiencing intimate partner violence (IPV).

Methods A prospective, descriptive design evaluating the impact of three IPV education sessions offered over a three-month period at a non-profit shelter specific for young adult, pregnant and post-partum adolescents.

Results Twelve participants attended the sessions (N=12), and seven (n=7, 61.5%) of shelter residents attended at least one IPV education session. A two-proportion z …

Reducing 30 Day Chf Readmission Rates: Evaluating Medication Efficacy, Jesse Bebout Msn, Rn, Ccrn, Brandon May Bsn, Rn, Tiara Richmond Bsn, Rn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background Heart failure (HF) is a leading cause of hospital readmissions and lost revenue under the Hospital Readmission Reduction Program (HRRP). Medication management plays a crucial role in controlling HF symptoms leading to hospitalization. This scoping review examines the benefits of angiotensin receptor-neprilysin inhibitors versus beta-blockers in reducing hospital readmissions within 30 days of discharge related to heart failure with reduced ejection fraction (HFrEF) in the United States.

Methods We conducted a literature search from August 2020 to November 2021 on the Google Scholar, PubMed, and CINAHL databases using the key phrases heart failure with reduced ejection, beta-blockers, angiotensin receptor-neprilysin …

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 …

Adverse Childhood Experiences Screening In Adulthood: Knowledge, Attitudes, And Self-Efficacy Among Tennessee Nurse Practitioners, Megan M. Wanca

DNP Projects

Despite the prevalence of adverse childhood events (ACEs) and the relationship with negative health outcomes in adults, research shows clinical use of ACE screening is low among healthcare providers including nurse practitioners (NPs). The scholarly project’s purpose was to examine how Tennessee NP knowledge, attitudes, and self-efficacy influence intentions to screen for ACEs related to childhood trauma or abuse in adult patients. Using the Information-Motivation-Behavioral Skills Model as the theoretical framework, a cross-sectional and exploratory design assessed the association of NPs’ ACE screening knowledge, attitudes, and self-efficacy on the NPs’ intention to screen for ACEs in adult patients. A reliable …

A Quality Improvement Project To Examine The Impact Of The Use Of Structured Diabetes Educational Materials For Medical Personnel, Alina Jaffer

DNP Projects

With the immigrant population increasing in the United States, the demand for healthcare providers who can provide culturally appropriate care and intracultural communication has increased. Compared to individuals born in the United States, immigrants with diabetes are less likely to meet the standardized targets for diabetes management, resulting in disparities in diabetes-related complications. The problem is the lack of evidence-based patient education for all people, including immigrants who do not speak English as a first language. The purpose of this project was to assess whether or not language-specific structured diabetes educational material for healthcare personnel use would increase the efficacy …

When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores

Dissertations

In healthcare, workgroup mistreatment is a pervasive problem that begins during medical education (medical and nursing school) and becomes embedded in the “hidden curriculum of professionalism,” which dissuades and even punishes learners for talking about abuse they witness. Furthermore, the mistreatment of healthcare providers (HCPs) pervades all disciplines in the healthcare delivery chain due to a combination of cultural factors, systemic pressures, dysfunctional hierarchies, and leadership’s tolerance of intimidating and disruptive behaviors. Not surprisingly, 18% of U.S. HCPs have left the medical field since the start of the COVID-19 pandemic, and burnout, stress, anxiety, and increased workloads have been identified …